lOMoARcPSD|25985347 Chn211finals LEC Community Health Nursing (Our Lady of Fatima University) Studocu is not sponsored or endorsed by any college or university Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC Mental Health Global Action Program (mhGAP) In 2008, WHO launched the mental health gap action program (mhGAP) in response to the wide gap between the resources available and the resources urgently needed to address the large burden of mental, neurological, and substance use disorders globally. Through mhGAP, WHO aims to provide health planners, policymakers, and donors with a set of clear and coherent activities and programs for scaling up care for mental, neurological and substance use disorders. WHO recognizes the need for action to reduce the burden, and to enhance the capacity of Member States to respond to this growing challenge. mhGAP is WHO’s action plan to scale up services for mental, neurological and substance use disorders for countries especially with low and lower middle incomes. The priority conditions addressed by mhGAP are depression, schizophrenia and other psychotic disorders, suicide, epilepsy, dementia, disorders due to use of alcohol, disorders due to use of illicit drugs, and mental disorders in children. The mhGAP package consists of interventions for prevention and management for each of these priority conditions. Successful scaling up is the joint responsibility of governments, health professionals, civil society, communities, and families, with support from the international community. The essence of mhGAP is building partnerships for collective action. A commitment is needed from all partners to respond to this urgent public health need and the time to act is now! THE TREATMENT GAP Mental, neurological, and substance use disorders are highly prevalent in all regions of the world, and they are major contributors to disease, premature death, and disability worldwide. They are also frequently associated with high levels of stigma and human rights violations, particularly in lowand middle-income countries. Objectives of mhGAP The development of the mental health action program (mhGAP) re昀氀ects WHO’s commitment to closing this gap by scaling up care for mental health and substance use disorders. The key objectives of the action program are: to reinforce the commitment of governments, international organizations, and other stakeholders to increase the allocation of 昀椀nancial and human resources for care of mental health and substance use disorders. to achieve much higher coverage with key interventions in the countries with low and lower middle incomes that have a large proportion of the global burden of mental health and substance use disorders. Through these objectives, mhGAP provides evidence-based guidance and tools to advance toward achieving the targets of the mental health action plan 2013-2020. [REPUBLIC ACT NO. 11036] AN ACT ESTABLISHING A NATIONAL MENTAL HEALTH POLICY FOR THE PURPOSE OF ENHANCING THE DELIVERY OF INTEGRATED MENTAL HEALTH SERVICES, PROMOTING AND PROTECTING THE RIGHTS OF PERSONS UTILIZING PSYCHIATRIC, NEUROLOGIC AND PSYCHOSOCIAL HEALTH SERVICES, APPROPRIATING FUNDS THEREFOR, AND FOR OTHER PURPOSES CHAPTER I GENRAL PROVISIONS Section 1. Short Title – This Act shall be known as the “Mental Health Act” Section 2. Declaration of Policy – The state a昀케rms the basic right of all Filipinos to mental health as well as the fundamental rights of people who require metal health services. The state commits itself to promoting the well-being of people by ensuring that; mental health is valued, promoted and projected; mental health conditions are treated and prevented; timely, a昀昀ordable high quality, and culturally-appropriate mental health case is made available to the public; mental health service are free from coercion and accountable to the service users; and persons a昀昀ected by mental health conditions are able to exercise the full range of human rights, and participate fully in society and at work free from stigmatism and discrimination. The State shall comply strictly with its obligations under the United Nations Declaration of Human Rights, the Convention on the rights of Persons with Disabilities, and all other relevant international and regional human rights conventions and declarations. The applicability of Republic act No. 7277, as amended, otherwise known as the "Magna Carta for Disabled Persons", to person with mental health conditions, as de昀椀ned herein, is expressly recognized. Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC Section 3. Objectives – The objectives of this Act are as follows: a. Strengthen e昀昀ective leadership and governance for mental health by, among others, formulating, developing, and implementing national policies, strategies, programs, and regulations relating to mental health. b. Develop and establish a comprehensive, integrated e昀昀ective and e昀케cient national mental health care system responsive to the psychiatric, neurologic, and psychosocial needs of the Filipino people. c. Protect the rights and freedoms of persons with psychiatric, neurologic, and psychosocial needs, Filipino people. d. Strengthen information systems, evidence, and research for mental health. e. Integrated mental health care in the basic health services; and f. Integrate strategies promoting mental health in educational institutions, the workplace, and in communities. Section 4. De昀椀nitions – As used in this Act, the following terms are de昀椀ned as follows: a. Addiction refers to a primary chronic relapsing disease of brain reward, motivation, memory, and related circuitry. Dysfunctions in the circuitry lead to characteristic biological, psychological, social, and spiritual manifestations. It is characterized by the inability to consistently abstain impairment and behavioral control, craving, diminished recognition of signi昀椀cant problems with one's behavior and interpersonal relationships and a dysfunctional emotional response. b. Carer refers to the person, who may or may not be patient's next-of-kin or relative, who maintains a close personal, relationship, and manifests concern for the welfare of the patient. c. Con昀椀dentiality refers to ensuring that all relevant information related to persons with psychiatric, neurologic, and psychological health needs is kept safe from access or use by, or disclosure to, persons or entities who are not authorizes to access, use, or possess such information. d. Deinstitutionalization refers to the process of transitioning service users, including persons with mental health conditions and psychosocial disabilities, from institutional and other segregated settings to community-based settings that enable social participation, recovery-based approaches to mental health, and individualized care in accordance with the service user's will and preference. e. Discrimination refers to any distinction, exclusion or restriction which has the purpose or e昀昀ect of nullifying the recognition, enjoyment, or exercise, on an equal basis with others, of all human rights and fundamental freedoms in the political, economic, social cultural, civil or any other 昀椀eld. It includes all forms of discrimination, including denial of reasonable accommodation. Special measure solely to protect the rights or secure the advancement of persons with decision-making impairment capacity shall not be deemed to be discriminatory. f. Drug Rehabilitation refers to the processes of medical or psychotherapeutic treatment of dependency on psychoactive substances such as alcohol, prescription drugs, and other dangerous drugs pursuant to Republic Act, 9165, otherwise known as the "Comprehensive Dangerous Drugs Act of 2002". Rehabilitation process may also be applicable to diagnosed behavioral addictions such as gambling, internet, and sexual addictions. The general intent is to enable the patient to confront the psychological, legal, 昀椀nancial, social, and physical consequences. Treatment includes medication for co-morbid psychiatric or other medical disorders, counseling by experts and sharing of experience with other addicted individuals. g. Impairment or Temporary Loss of Decision-Making Capacity refers to a medicallydetermined inability on the part of a service user or any other person a昀昀ected by a mental health condition, to provide informed consent. A service user has impairment or temporary loss of decision-making capacity when the service user as assessed by a mental health professional is unable to do the following: 1. Understand information concerning the nature of a mental health condition; 2. Understand the consequences of one's decisions and actions on one's life or health, or the life or health of others; 3. Understand information about the nature of the treatment proposed, including methodology, direct e昀昀ects, and possible side e昀昀ects; and Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC h. i. j. k. l. m. n. 4. E昀昀ectively communicate consent voluntarily given by a service user to a plan for treatment or hospitalization, or information regarding one's own condition. Informed Consent refers to consent voluntarily given by a service user to a plan for treatment, after a full disclosure communicated in plain language by the attending mental health service provider, of the nature, consequences, bene昀椀ts, and risks of the proposed treatment, as well as available alternatives; Legal Representatives refers to a person designated by the service user, appointed by a court of competent jurisdiction, or authorized by this Act or any other applicable law, to act on the service user's behalf. The legal representative may also be a person appointed in writing by the service user to act on his or her behalf through an advance directive; Mental Health refers to a state of wellbeing in which the individual realizes one's own abilities and potentials, scopes adequately with the normal stresses of life, displays resilience in the face of extreme life events, works productively and fruitfully, and is able to make a positive contribution to the community; Mental Health Condition refers to a neurologic or psychiatric condition characterized by the existence of a recognizable, clinically signi昀椀cant disturbance in an individual's cognition, emotional regulation, or behavioral that re昀氀ects a genetic or acquired dysfunction in the neurological, psychosocial, or developmental process underlying mental functioning. The determination of neurologic and psychiatric conditions shall be based on scienti昀椀cally accepted medical nomenclature and best available scienti昀椀c and medical evidence; Mental Health Facility refers to any establishment, or any unit of an establishment, which has, as its primary function, the provision of mental health services; Mental Health Professional refers to a medical doctor, psychologist, nurse social worker or any other appropriately trained and quali昀椀ed person with speci昀椀c skills relevant to the provision of mental health services. Mental Health Service Provide refer to an entity or individual providing o. p. q. r. s. t. u. mental health services as de昀椀nes in this Act, whether public or private, including, but not limited to mental health professionals and workers, social worker and counselors, informal community caregivers, mental health advocates and their organizations, personal ombudsmen, and persons or entities o昀昀ering nonmedical alternative therapies; Mental Health Service refer to psychosocial psychiatric or neurologic activities and programs along the whole range of the mental health support services including promotion, prevention, treatment, and aftercare, which are provided by mental health facilities and mental health professionals; Mental Health Worker refers to a trained person, volunteer or advocate engaged in mental health promotion, providing support services under the supervision of a mental health professional; Psychiatric or Neurologic Emergency refers to a condition presenting a serious and immediate threat to the health and wellbeing of a service user, or any other person a昀昀ected by a mental health facilities and mental health condition, or any other person a昀昀ected by a metal condition, or to the health or well-being of others, requiring immediate medical intervention; Psychosocial Problems refers to a condition that indicates the existence of dysfunctions in a person's behavior, thoughts and feelings brought about by sudden extreme, prolonged, or cumulative stressors in the physical or social environment. Recovery-Based Approach refers to an approach to intervention and treatment centered on the strengths of a service user and involving the active participation, as equal partners in care, of persons with lived experiences in mental health. This requires integrating a service user's understanding of his or her condition into any plan for treatment and recovery; Service User refers to a person with lived experience of any mental health condition including persons who require or are undergoing psychiatric, neurologic or psychosocial care; Support refers to the spectrum of informal and formal arrangements or services of varying types and intensities, provided by the State, private entities, or communities, aimed at assisting a service user in the exercise of his or her legal Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC capacity or rights, including; community services; personal assistants and ombudsman; powers of attorney and other legal and personal planning tools; peer support; support for self -advocacy; nonformal community caregiver networks; dialogue systems; alternative , and manual communication; and the use of assistive devices and technology; and v. Supported Decision Making refers to the act of assisting a service user who is not a昀昀ected by an impairment or loss of decision-making capacity, in expressing a mental health-related preference, intention or decision. It includes all the necessary support, safeguards, and measures to ensure protection from undue in昀氀uence, coercion, or abuse. g. h. i. j. k. CHAPTER II RIGHTS OF SERVICE USERS AND OTHER STAKEHOLDER l. Section 5. Rights of Service Users – Service users shall enjoy, on an equal and nondiscriminatory basis, all rights guaranteed by the Constitution as well as those recognizes under the United Nations Universal Declaration of Human Rights and the Convention on the Rights of Persons with Disabilities and all other relevant international and regional human rights conventions and declarations, including the right to: a. Freedom from social economic, and political discrimination and stigmatization, whether committed by public or private actors; b. Exercise all them inherit civil, political, economic, social, religious, educational, and cultural rights respecting individual qualities, abilities, and diversity of background, without discrimination on the basis of physical disability, age, gender, sexual orientation, race, color, language, religion or nationality, ethnic, or social origin; c. Access to evidence-based treatment of the same standard and quality, regardless of age, sex, socioeconomic status, race, ethnicity or sexual orientation; d. Access to a昀昀ordable essential health and social services for the purpose of achieving the highest attainable standard of mental health; e. Access to metal health service at all levels of the national health care system; f. Access to comprehensive and coordinated treatment integrating holistic prevention, promotion, M. rehabilitation, care and support, aimed at addressing mental health care needs through a multidisciplinary, user-driven treatment and recovery plan; Access to psychosocial care and clinical treatment in the least restrictive environment and manner; Humane treatment free from solitary con昀椀nement, torture, and other forms of cruel inhumane, harmful or degrading treatment and invasive procedures not backed by scienti昀椀c evidence; Access to aftercare and rehabilitation, when possible, in the community for the purpose of social reintegration and inclusion; Access to adequate information regarding available multidisciplinary mental health services; Participate in metal health advocacy, policy planning, legislation, service provision, monitoring, research, and evaluation. Con昀椀dentiality of all information, communications, and records, in whatever form or medium stored, regarding the service user, any aspect of the service user’s mental health, or any treatment or care received by the service user, which information, communications, and records shall not be disclosed to third parties without the written consent of the service user concerned or the service user's legal representative, except in the following circumstances: 1. Disclose is required by law or pursuant to an order issued by a court of competent jurisdiction. 2. The service user has expressed consent to the disclosure; 3. A life-threatening emergency exists, and such disclosure is necessary to prevent harm or injury to the service user or other persons; 4. The service user is a minor and the attending mental health professional reasonably believes that the service user is a victim of child abuse; or 5. Disclosure is required in condition with an administrative, civil, or criminal case against a mental health professional ethics, to the extent necessary to completely adjudicate, settle, or resolve any issue or controversy involved therein; Give informed consent before receiving treatment or care, including the right to withdraw such consent. Such consent shall be recorded in the service user's clinical record; Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC N. Participate in the development and formulation of the psychosocial care or clinical treatment plan to be implemented. O. Designate or appoint a person of legal age to act as his or her legal representative in accordance with this Act, except in cases of impairment or temporary loss of decision-making capacity; P. Send or received uncensored private communication which may include communication by letter, telephone or electronic means, and receive visitors at reasonable times, including the service user's legal representative and representatives from the commission on Human Rights (CHR); Q. Legal services, through competent counsel of the service user's choice. In case the service user cannot a昀昀ord the service, user cannot a昀昀ord the service s of a counsel, the Public Attorney's O昀케ce, or legal; aid institution of the service user or representative's choice, shall assist the service user; R. Access to their clinical records unless, in the opinion of the attending mental health professional, revealing such information would cause harm to the service user's health or put the safety of others at risk. When any such clinical records are withheld, the service user or his or her legal representative may contest such decision with the internal review board created pursuant to this Act authorized to investigate and resolve disputes, or with the CHR; S. Information, within the twenty-four (24) hours of admission to a mental health facility, of the rights enumerated in this section in a form and language understood by the service user; and T. By oneself or through a legal representative, to 昀椀le with the appropriate agency, complaints of improperties, abuses in mental health care, violations of rights of persona with mental health needs, and seek to initiate appropriate investigation and action against those who authorized illegal or unlawful involuntary treatment or con昀椀nement, and other violations. Section 6. Rights of Family Members, Carers and Legal Representatives – Family members, carers and duly designated or appointed legal representative of the service user shall have the right to: A. Receive appropriate psychosocial support from the relevant government agencies. B. With the consent of the concerned service user, participate in the formulation, development and implementation of the service user's individual treatment plan; C. Apply for release and transfer of the service user to an appropriate mental health facility; D. Participate in metal health advocacy, policy planning, legislation, service provision, monitoring, research, and evaluation. Section 7. Rights of Mental Health Professionals. Mental health professional shall have the right to: a. A safe and supportive work environment; b. Participate in a continuous professional development program; c. Participate in the planning, development, and management of mental health services; d. Contribute to the development and regular review of standards for evaluating mental health services provided to service users; e. Participate in the development of mental and health policy and service delivery guidelines; f. Except in emergency situations, manage and control all aspects of his or her practice, including whether or not to accept or decline a service user for treatment; and g. Advocate for the rights of a service user, in cases where the service user's wishes are at odds with those of his or her family or legal representatives Public Health Laws Laws A昀昀ecting Public Health and Practice of CHN R.A. 7160 – or the Local Government Code This involves the devolution of powers, functions, and responsibilities to the local government both rural & urban. The Code aims to transform local government units into, self-reliant communities and active partners in the attainment of national goals thru’ a more responsive and accountable local government structure instituted thru’ a system of decentralization. Hence, each province, city and municipality has a LOCAL HEALTH BOARD (LHB) which is mandate to propose annual budgetary allocations for the operation and maintenance of their own health facilities. Composition of LHB Provincial Level Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC 1. Governor – chair 2. Provincial Health O昀케cer – vice chairman 3. Chairman, Committee on Health of Sangguniang Panlalawigan 4. DOH representative 5. NGO representative City and Municipal Level 1. Mayor – chair 2. MHO – vice chair 3. Chairman, Committee on Health of Sangguniang Bayan 4. DOH representative 5. NGO representative E昀昀ective Local Health System Depends on: 1. The LGU’s 昀椀nancial capability 2. A dynamic and responsive political leadership 3. Community empowerment R.A. 2382 – Philippine Medical Act. This act de昀椀nes the practice of medicine in the country. R.A. 1082 – Rural Health Act. It created the 1st 81 Rural Health Units. Amended by RA 1891; more physicians, dentists, nurses, midwives, and sanitary inspectors will live in the rural areas where they are assigned in order to raise the health conditions of barrio people, hence help decrease the high incidence of preventable diseases. R.A. 6425 – Dangerous Drugs Act It stipulates that the sale, administration, delivery, distribution, and transportation of prohibited drugs is punishable by law. R. A. 9165 – the new Dangerous Drug Act of 2002 This Act repealed Republic Act No. 6425, otherwise known as the Dangerous Drugs Act of 1972, as amended, and providing funds for its implementation. Under this Act, the Dangerous Drugs Board (DDB) remains as the policymaking and strategy-formulating body in planning and formulation of policies and program on drug prevention and control. P.D. No. 651 Requires that all health workers shall identify and encourage the registration of all births within 30 days following delivery. Requires the compulsory immunization of all children below 8yrs of age against the 6 childhood immunizable disease. P.D. No. 825 Provides penalty for improper disposal of garbage. S.A. 8749 – Clean Air Act of 2000 A comprehensive air quality management policy and program which aims to achieve and maintain healthy air for all Filipinos. P.D. No. 856 – Code on Sanitation It provides for the control of all factors in man’s environment that a昀昀ect health including the quality of water, food, milk, insects, animal carriers, transmitters of disease, sanitary and recreation facilities, noise, pollution and control of nuisance. R.A 6758 Standardizes the salary of government employees including the nursing personnel. R.A. 6675 – Generics Act of 1988 Which promotes, requires, and ensures the production of an adequate supply, distribution, use and acceptance of drugs and medicines identi昀椀ed by their generic name. R.A. 6713 – Code of Conduct and Ethical Standards of Public O昀케cials and Employees It is the policy of the state to promote high standards of ethics in public o昀케ce. Public o昀케cials and employees shall at all times be accountable to the people and shall discharges their duties with utmost responsibility, integrity, competence and loyalty, act with patriotism and justice, lead modest lives uphold public interest over personal interest. R.A. 7305 - Magna Carta for Public Health Workers This act aims: to promote and improve the social and economic well-being of health workers, their living and working conditions and terms of employment; to develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs; and to encourage those with proper quali昀椀cations and excellent abilities to join and remain in government service. P.D. No. 996 R.A. 8423 Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC Created the Philippine Institute of Traditional and Alternative Health Care. P.D No. 965 Requires applicants for marriage license to receive instructions on family planning and responsible parenthood. P.D. No 79 De昀椀nes, objectives, duties and functions of POPCOM. R.A 4073 Advocates home treatment for leprosy. Letter of Instruction No. 949 Legal basis of PHC dated OCT. 19,1979 promote developmental of health programs on the community level. R.A 3573 Requires reporting of all cases of communicable diseases and administration of prophylaxis. Ministry Circular No. 2 of 1986 Includes AIDS noti昀椀able disease. R.A 7875 – National Health Insurance Act an act instituting a National Health insurance program for all Filipinos and establishing the Philippine Health Insurance Corporation for the purpose. R.A 7432 – senior Citizens Act An act to maximize the contribution of senior citizens to nation building, grant bene昀椀ts and special privileges and for other purposes. R.A 7719 – National Blood Services Act Promotes voluntary blood donation to provide su昀케cient supply o昀昀 safe blood and to regulate blood banks. This act aims to inculcate public awareness that blood donation is a humanitarian act. R.A 8172 – Salt Iodization Act (ASIN LAW) This act requires the addition of iodine to all salt intended for animal and human consumption in order to eliminate micronutrient malnutrition in the country. R.A 7277 – Magna Carta for PWDs Provides their rehabilitation, selfdevelopment and self-reliance and integration into the mainstream of society. A.O. No. 2005-0014 – National Policies on Infant and Young Child Feeding: 1. All newborns be breastfeed within one hour after birth. 2. Infants be exclusively breastfed for six months. 3. Infants be given timely, adequate, and safe complimentary foods. 4. Breastfeeding be continued up to two years and beyond. EO 51 – Phil. Code of Marketing of Breast milk Substitutes Regulates the market of infant milk formula, other milk products, foods and beverages, as well as feeding bottles and treats. R.A – 7600 – Rooming In and Breastfeeding Act of 1992 An act providing incentives to all government and private health institutions with rooming-in and breastfeeding practices and for other purposes. This law is in promotion of the state policy to encourage the practice of breast feeding in the Philippines. R.A 8976 – Food Forti昀椀cation Law Provided the policy on mandatory forti昀椀cation of staple foods and voluntary forti昀椀cation of processed foods or food products. R.A 8980 Promulgates a comprehensive policy in the national system for ECD. A.O. No 2006-0015 De昀椀nes the implementing guidelines on Hepatitis B immunization for infants. R.A 7846 Mandates Compulsory Hepatitis B Immunization among infants and children less than 8 years old. R.A 2029 Mandates Liver Cancer and Hepatitis B Awareness Month Act (February) A.O. No. 2006-0012 Speci昀椀es the revised implementing rules and regulation of E.O. 51 or milk code, relevant international agreements, penalizing violations thereof and for other purposes. TERMINOLOGIES Blood Bank – a place where supplies of blood or plasma for transfusion are stored. Blood Donation – process of collecting, testing, preparing, and storing blood and blood components Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC Con昀椀rmatory Test – An analytical test using a device, tool, or equipment with a di昀昀erent chemical or physical principle that is more speci昀椀c which will validate and con昀椀rm the result of the screening test. Insurance – a thing providing protection against a possible eventuality. Public Health – is the science of protecting and improving the health of people and their communities. Senior Citizen – an elderly person, especially one who is retired and living on a pension. Philippine Culture, Values and Practices in Relation to Healthcare of Individuals and Families VALUES OF FILIPINO NURSES Work Ethic As a group, Filipino nurses are well liked because they are hardworking. They place high value on responsibility and seldom complain. “Many [Filipino nurses] work nights, holidays and/or overtime. So, during this time of nursing shortage, one can rely on a Filipino nurse to volunteer to cover the shift”. It is not unusual to 昀椀nd Filipino nurses who work two jobs. The 昀椀nancial rewards, job security, and personal advancement that U.S. jobs provide to Filipino nurses are valued. Spirituality Filipino nurses are very religious people. There is a deep faith in God that is re昀氀ected in the expression of bahala na “it is up to God” or “leave it to God.” This tends to be incorrectly equated with an expression of fatalism and a passive acceptance of or resignation to fate. Bahala na may also apply to acceptance of illness or malady. Sensitivity Unmarried Filipino nurses’ recoil at the question, “Are you pregnant?” when they go for a medical checkup. Because the Philippine society considers sexual relationships not to occur outside of marriage, it seems odd to them that they would be questioned, although they are aware that this is part of a routine health assessment. Filipinos are generally sensitive and equally sensitive to the feelings of others, so they try to 昀椀nd a way to say things diplomatically. Interpersonal Relationships Filipinos are generally quiet. Very conservative families do not allow their younger members to join the conversation of adults without an invitation. They are sometimes hesitant to articulate their views, especially if it is di昀昀erent from the majority, as it might indicate discordance with the team or group. Engaging in arguments, especially with someone who is older or holds an authority position, is considered uncivilized. Filipinos also have di昀케culty turning down requests from supervisors to whom they feel obligated. Respect and Reverence One’s position in society, professional achievements, and age carry a lot of weight in the Philippine society. Physicians, lawyers, priests, engineers, teachers, and nurses are among the well-respected professionals in the Philippines. Hence, their opinion is generally accepted without question. Filipino values and traditions provide a framework for conduct and mode of communication. Because of a high regard for the elderly and authority, Filipinos tend not to oppose or contradict other views for fear of embarrassing the other party. “Filipinos generally are neither assertive nor aggressive and may often appear guarded or reticent. Nurses often misunderstand this need for passivity and do not appreciate the culturally induced motivation to maintain harmonious balance between man and nature” Modesty Filipino nurses 昀椀nd it uncomfortable to accept even a well-deserved compliment. For example, if someone gives a complement like, “Your dress is beautiful!” the answer might be, “Not really. I bought it cheap.” Or if someone says, “You are so knowledgeable,” the answer might be, “Not really, I just happen to know it.” Yet they are proud of their accomplishments in a sort of quiet way. As a result, many have culture-based barriers to marketing themselves Language Respect is integrated in the Filipino language. Reference to the elderly is the use of the third person. Hence, when spoken to assertively in a direct way, Filipinos feel o昀昀ended. There is no gender di昀昀erentiation in the Filipino language. Although they are fully aware of the male and female genders, their native language is what hinders them from precisely using he or she in spoken English. Frequently, this leads to confusion. Close Family Ties Filipino nurses have strong family ties. While in the United States, their close friends become their family members. As a result, they perpetuate the cultural burden (as a Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC downside) thus making it more di昀케cult and taking them longer to assimilate into the mainstream culture of their adopted country. They tend to eat the same food and mingle with individuals of the same ethnic backgrounds. HEALTH BELIEFS, BEHAVIORS, AND PRACTICES Preventive Health Because most of their time is devoted to work, going for preventive health checkups takes a backseat. Yet, one may hear a Filipino extolling the importance of preventive health to her patients or clients. Filipino nurses have a tendency to self-diagnose, self-medicate, and seek alternative therapies. In rural areas in the Philippines, people go for Hilot for relief of pain and aches instead of seeking medical attention. In an alternative context, Hilot may refer to a practitioner or the practice of chiropractic manipulation and massage for the diagnosis and treatment of musculoligamentous and musculoskeletal ailments. Home Remedies Three concepts underlie Filipino American health beliefs and practices: 昀氀ushing, heating, and protection. Each identi昀椀es a basic process used to promote good health. Flushing keeps the body free from debris, heating maintains a balanced internal temperature, and protection guards the body from outside in昀氀uences. Although Western and scienti昀椀c concepts are similar, Filipino theories are founded on di昀昀erent premises. Flushing is based on the notion that the body is a container that collects impurities, heating means that hot and cold qualities must be balanced in the body, and protection involves safeguarding the body’s boundaries from supernatural as well as natural forces. Pain Tolerance Generally speaking, Filipino nurses have a high tolerance to pain. For example, one of the author’s sisters has severe arthritis, yet she continues to do housework regardless of her pain. Filipino nurses normally use home remedies such as liniments and topical ointments and manage pain before seeking medical care or while under medical treatment. Health care providers need to probe more into the cause and degree of pain from Filipino patients to elicit more information. The elderly group, in particular, is unlikely to complain about their pain because they do not want to have extra burdens being imposed on caregivers. Privacy Filipinos are mostly reserved and private people. As patients, they may not readily reveal their personal and health information. Women in particular are sensitive to touching another individual as well as being touched. “Young female service providers should practice discretion with regard to touching older Filipino male patients such as lying one’s hand on the patient’s hand or shoulder to reassure comfort in moments of distress.” HEALTH BELIEFS AND PRACTICES ARE ORIENTED TOWARDS PROTECTION OF THE BODY Flushing The buddy is thought to be a vessel or container that collects and eliminates impurities through physiological process such as sweating, vomiting, expelling gas, or having an appropriate volume of menstrual bleeding. Heating Adopt the concept of balance between “hot” and “cold” to prevent occurrence of illness and disorders. Protection Safeguards the body's boundary from outside in昀氀uences such as supernatural and natural forces. Coping styles Coping styles common among elderly Filipino Americans in times of illness or crisis include: - Patience and Endurance (Tiyaga): the ability to tolerate uncertain situations - Flexibility (Lakas ng Loob): being respectful and honest with oneself - Humor (Tatawanan ang problema): the capacity to laugh at oneself in times of adversity - Fatalistic Resignation (Bahala Na): the view that illness and su昀昀ering are the unavoidable and predestined will of God, in which the patient, family members and even the physician should not interfere - Conceding to the wishes of the collective (Pakikisama) to maintain group harmony Responses to Mental Health Indigenous traits common among elderly Filipino Americans when faced with illness related to mental conditions: Devastating Shame (Hiya) - Sensitivity to criticism (Amor Propio) - Common Perceptions of Filipinos about Mental Illness - Unwillingness to accept having mental illness, which leads to the avoidance Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC - - - - - of needed mental health services due to fear of being ridiculed Involvement of other coping resources such as reliance on family and friends or indigenous healers, and dependence on religion which can diminish the need for mental health services Prioritizing of 昀椀nancial and environmental needs which preclude the need for mental health services Limited awareness of mental health services resulting in limiting access Di昀케culty in utilizing mental health services during usual hours because of the unavailability of working adult family members Mental illness connotes a weak spirit, and may be attributed to divine retribution as a consequence of personal and ancestral transgression Lack of culturally oriented mental health services Health Beliefs and Behaviors: Indigenous Health Beliefs Concept of Balance (Timbang) This concept is central to Filipino self-care practices and is applied to all social relationships and encounters. According to this principle, health is thought to be a result of balance, while illness due to humoral pathology and stress is usually the result of some imbalance. Rapid shifts from “hot” to “cold” cause illness and disorder. Illustrated below are a range of humoral balances that in昀氀uence Filipino health perceptions: - Rapid shifts from “hot” to “cold” lead to illness - “Warm” environment is essential for maintaining optimal health - Cold drinks or cooling foods should be avoided in the morning - An overheated body is vulnerable to disease; a heated body can get “shocked” - When cooled quickly, it can cause illness - A layer of fat maintains warmth, protecting the body’s vital energy - Imbalance from worry and overwork create stress and illness - Emotional restraint is a key element in restoring balance - A sense of balance imparts increased body awareness - Health Beliefs and Behaviors: Theories of Illness Physical and mental health and illness are viewed holistically as an equilibrium model. In contrast, other explanatory models may include mystical, personalistic and naturalistic causes of illness or disease (Anderson, 1983; Tan, 1987; Tompar-Tiu & Sustento-Seneriches, 1995) Mystical Causes Mystical causes are often attributed to experiences or behaviors such as ancestral retribution for un昀椀nished tasks or obligations. Some believe that the soul goes out from the body and wonders, a phenomenon known as Bangungot, or that having nightmares after a heavy meal may result in death. Personalistic Causes Personalistic causes are associated with social punishment or retribution from supernatural forces such as evil spirit, witch, (Manga ga mud) or sorcerer (mangkukulam). The forces cast these spells on people if they are jealous or feel disliked. Which doctors (herbularyo) or priests are asked to counteract and cast out these evil forces through the use of prayers, incantations, medicinal herbs and plants. For protection the healer may recommend using holy oils, or wearing religious objects, amulets, or talismans (anting anting). Naturalistic Causes Naturalistic process includes a host of factors ranging from natural forces (Thunder, lightning, draft, etc.) to excessive stress, food and drug incompatibility, infection, or familial susceptibility. TERMINOLOGIES Behaviors - the way in which one acts or conducts oneself, especially toward others. Beliefs - an acceptance that a statement is true or that something exists Culture - the arts and other manifestations of human intellectual achievement regarded collectively Practices - the actual application or use of an idea, belief, or method, as opposed to theories relating to it. Values - the regard that something is held to deserve; the importance, worth, or usefulness of something. New Technologies Related to Public Health Electronic Information Introduction The Department of Health (DOH) is mandated to be the overall technical authority on health that provides national policy direction and develop national plans, technical standards guidance on health. It is also a regulator of all health services and products, and provider o昀昀 special order tertiary health care services end of technical assistance to other health providers Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC especially to local government units. The implementation of Kalusugan Pangkalahatan or Universal Healthcare is directed towards ensuring the achievement of the health system goals o昀昀 better health outcomes, sustained health 昀椀nancing and responsive health system. The World Health Organization de昀椀nes eHealth as the use of information and communication technologies for health. it supports the delivery of health services and management of health systems to become more e昀케cient and e昀昀ective. eHealth Is described also as a means to ensure that “the right health information is provided to the right person at the right place and time in a secure, electronic form to optimize the quality and e昀케ciency of health care delivery, research, education and knowledge. The application of information and communication technologies in health has rapidly increased for the past years and gained signi昀椀cance not only in the Department of Health but in the entire health sector. The DOH has continuously addressed the challenges and demands to further improve healthcare service deliveries and outcomes. Many countries have recognized the importance of adopting information and communication technology and health, also called as eHealth, to optimize processes and improve data collection, processing, and analysis. The adoption of ICT has provided concrete foundation for health investments and innovations. Countries have formulated their own eHealth agenda to establish direction and plan the necessary steps to achieve their intended vision, mission, and goals. The National Objectives for Health, 20052010 and the 2011-2016 Prioritized the use of ICT in various reforms areas, critical health programs, and speci昀椀c areas in Health Administration. In 2005 and 2013, the Philippines was signatory to the 58th and 66th World Health Assembly Resolution. The 58th World Health assembly advocated the following: Draw up a long-term strategic plan for developing and implementing eHealth services in the various areas of health sectors including Health Administration which includes an appropriate legal framework and infrastructure and encourage public and private partnership. develop the infrastructure for ICTs for health as deemed appropriate to promote equitable, a昀昀ordable and universal access. build on closer collaboration with private and nonpro昀椀t sectors in ICTs. rich communities, including vulnerable groups, with eHealth services appropriate to their needs. Mobilize multi sectoral collaboration for determining evidence-based eHealth standards and norms and share the knowledge of cost-e昀昀ective models, thus ensuring quality, safety and ethical standards and respect for the principles of con昀椀dentiality of information, privacy, equity and equality. Establish national centers and the networks of excellence for eHealth best practice, policy coordination, and Technical Support for health care delivery, service improvement, information to citizens, capacity building, and surveillance. establish and implement national electronic public health information systems and to improve, by means of information, the capacity for surveillance of, and rapid response to, disease and public health emergencies. eHealth in the Philippines developing software for 昀椀eld health services and information system, and has continuously developed or built other application or information systems. The use of ICTs in the DoH has remarkably supported and improved some of the functions of the department. ICTs have been used in the areas of innovative technological charges, networking and infrastructure, o昀케ce automation, development and implementation of computer based systems. from the limited resources in terms of ICT personnel and funds, the DH management has augmented the budget on ICT to fully accomplish and support the ICT strategic goals and direction. Existing information systems and data sources are being integrated or harmonized to eventually address other challenges like establishment o昀昀 the DH data warehouse, quality database and establishment of a more responsive information system and access to and sharing of knowledge products. For remote and underserved areas and vulnerable populations, the DH has implemented telemedicine in selected pilot areas through the national telehealth center, national Institute for Health, university of the Philippines, Manila. The DoH has also developed and implemented mobile technology solutions in reporting cases through the health Emergency Management Sta昀昀’s - surveillance in post extreme emergencies and disasters (SPEED) with support from WHO. there are several mobile technology applications developed and for implementation, e.g. text TB for reporting Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC inventory of tuberculosis drugs, maternal and neonatal death reporting, and routine health data reporting. eHealth Vision By 2020 eHealth will enable widespread access to healthcare services, health information, and securely share and exchange patients’ information in support to a safer, quality health care, more equitable and responsive health system for all the Filipinos people by transforming the way information is used to plan, manage, deliver, and monitor health services. The strategic vision describes the Philippines Health System that has been enabled by eHealth. It shows how eHealth will be used to address health system’s priority goals and challenges to deliver health outcomes. The Aquino Health Agenda on achieving Universal Health Care or Kalusugan Pangkahalatan for all Filipinos is a continuing commitment to health sector reform and achieving the Millennium Development Goals. The National Objectives for Health 2011-2016 has set the health program goals, strategies, performance indicators and targets towards achieving KP. The overall goal is to achieve health system goals of 昀椀nancial risk protection, better health outcomes, and responsive health system for the Filipino people. eHealth has proven to provide improvements in health care delivery and is at the core of responsive health system. eHealth will improve the quality and safety of the health system through empowerment of health consumers to better manage their health records; availability of information like single view of the patients’ information at the point of care, decision support tools and knowledge-based information thereby reducing medical errors, improved treatment and monitoring; and availability of information for e昀케cient and e昀昀ective surveillance and monitoring of diseases and management of health information about the availability, location, expertise and services of health care providers. This will provide health consumers with ready information for reference purpose and health care providers for referral process. Electronic consultations in rural, remote and disadvantaged areas can be made accessible or available. eHealth will provide a more responsive health system because information can be securely shared and exchanged without repeating e昀昀ort and time in providing the same information to di昀昀erent health care providers; use of eHealth solutions to speed up processes like ordering system and results reporting; reduced time and cost of health consumers undergoing unnecessary or duplicated diagnostic tests; improved diagnosis and treatment activities; reduced travel time using telehealth services; and e昀케cient and e昀昀ective disease monitoring and response. Key Strategic Guiding Principles Key strategic guiding principles in the development of Philippines eHealth Strategic Framework and Plan are as follows: 1. eHealth must serve the needs of the client or person. 2. Collaboration and partnerships with key health care stakeholders are critical in realizing the country’s eHealth vision. 3. Users’ must be involved at all phases of development and implementation to gain commitment for implementation. 4. A strategic approach in terms of phases enables more focus, and judiciously and e昀케ciently make use of resources to achieve the eHealth vision. 5. eHealth activities must be aligned or harmonized, without controlling health care providers to implement local eHealth solutions. 6. The presence of entities that have already started eHealth must be recognized so as not to constraint their continuing advancement and gain their support. 7. Human resource can be made available by building capability to implement the eHealth agenda in the country and promote transparency and public accountability. 8. Implementation of eHealth must comply to relevant laws and regulations. 9. Investments must be made on areas that deliver the greatest bene昀椀ts to health consumers, health care providers, and healthcare managers; and ensure no duplication in terms of time, e昀昀ort and resources. eHealth Components eHealth will also support a more equitable health system through presence of Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC The components are the building blocks to achieve the stated vision. There were initial identi昀椀ed components to realize the outcomes of eHealth in the Philippines, i.e. enabling structures and resources, missioncritical health application systems, Philippine Health Information System, Knowledge Management for Health, and telemedicine/mHealth services. The groupings are more information or application systems based and were reviewed together with the National eHealth Strategy Toolkit. Updated components are governance, strategy and investment, eHealth solutions (services and applications), standards and interoperability, infrastructure, legislation/policy and compliance, and human resource. 1. 2. Components Governance Legislation, Policy and Compliance Description Directs and coordinates eHealth activities at all levels like hospitals and health care providers. Critical areas of governance are management of the eHealth agenda, stakeholders’ engagement, strategic architecture, clinical safety, management and operation, monitoring and evaluation, and policy oversight. Formulation of the required legislations, policies and compliance to support the attainment of the eHealth vision. Examples of these are the national legislations, policies, and regulations on how health information are stored, accessed and shared across geographical and health sector boundaries; implementation of unique health identi昀椀er; implementation of national health data standards; and software certi昀椀cation or accreditation 3. Standards and Interoperabil ity 4. Strategy and Investment 5. Infrastructur e Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) Promotes and enables exchange of health information across geographical and health sector boundaries through use of common standards on data structure, terminologies, and messaging. One strategy to ensure compliance to health data standards for interoperability is the implementation of software certi昀椀cation or accreditation where eHealth solutions must comply in order to be certi昀椀ed as able to exchange health information. Develops, operates, and sustains the national eHealth vision. These components support the development of a strategy and plans to serve as guide in the implementation of the eHealth agenda. Investment refers to the funding or amount needed for executing the strategies and plans. Establishes and supports health information exchange, i.e. the sharing of health information across geographical and health sector boundaries, and implementation of innovative ways to deliver health services and information. Infrastructure includes physical technology and software platforms, services and applications to support health information lOMoARcPSD|25985347 CHN 211 – Finals LEC 6. Human Resources 7. eHealth Solutions exchange. Examples of these are highspeed data connectivity and computing infrastructure, like computers and mobile devices for the collection, recording and exchange of electronic information, among others. Workforce or manpower to develop, operate or implement the national eHealth environment such as the health workers who will be using eHealth in their line of works, health care providers, information and communication technology workers, and others. Required services and applications to enable widespread access to health care services, health information, health reports, health care activities, and securely share and exchange patient’s information in support to health system goals. These address the needs of the various stakeholders like individuals, health care providers, managers, o昀케cials, and others. Examples of eHealth solutions are electronic health/medical/pers onal records, electronic referrals, medications management, distance learning and electronic resources, telemedicine, mobile health, adverse event monitoring, disease surveillance, among others. HEALTH INFORMATION MANAGEMENT SYSTEMS IN PUBLIC HEALTH SYSTEM/DEVELOPER KEY INFORMATION BizBox A set of web-based for various health care institutions such as hospitals and rural health units. Community Health One of the Information Tracking pioneering EMR System (CHITS) developed in 2004 by the University of the Philippines Manila. The relevant customized forms based on DOH and Philhealth programs in CHITS were organized into modules for easier work昀氀ow integration. eHealth TABLET for Key product Informed Decision features of eHatid: Making of LGU’s EMR software (eHatid) application for mobile android devices, dashboard, and a Mayor-Doctor Communication as a channel for decision making and sharing of health-related information. Event-based An online health Surveillance and event surveillance Response System reporting system. It (ESR) involves reporting all health events (existing or rare) that raise concern, fear, alarm in the community which may have known, suspected or possible impact on human health. As an integrated Integrated Clinic system, it is linked Information System to other DOH home (iClinicSys) grown systems such as the Maternal and Neonatal Death Reporting, Tuberculosis Information System, Injury Reporting and Chronic NonCommunicable Disease Reporting. Integrated Hospital It has modules for Operations and the following areas Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC Management Information System (iHomis) Integrated Tuberculosis Information System (IT IS) Mag-Ina (Maternal and Neonatal Telereferral System (MInTS) National Rabies Information System Philhealth eClaims System Philippine Integrated Disease Surveillance and Response (PIDSR) System Secured Health Information Network Exchange (SHINE) SegWorks Integrated Health Management System (SegIHMS) in the hospital: admitting, outpatient, emergency room, billing and cashier, nursing, pharmacy, dietary, laboratory and radiology. It has a case management module that captures patient’s demographic pro昀椀le, TB examination record and treatment information. A web-based maternal and neonatal telereferral system. It enables lying-in clinics to electronically send referrals requests when pregnant mothers and newborns need to be transferred to a higher care facility. It allows animal bite treatment center to capture bite patient records and generate reports for submission to program managers at all levels of the health system. A web-based facility developed by Philhealth for claim reimbursement transactions Indicator reporting based system of priority diseases or syndromes and conditions such as Acute Viral Hepatitis, Dengue, Cholera, Malaria, Measles and Acute Encephalitis among others. It also has referral features and an SMS reminder facility for scheduled visits/ appointments A suite hospital and community electronic health information system Wireless Access for Health EMR (WAH EMT) The current WAH group expanded the CHITS with new modules such as the Synchronized Patients Alerts via SMS, Mobile Midwife and the statistics aggregator. TERMINOLOGIES Digital Health – also known as the Information and Communication technology (ICT) in health system, is the 昀椀eld of theory and practice associated with any aspect of adopting digital technologies to improve health from its conceptualization to application or operation. eHealth – the cost-e昀昀ective and secure use of information and communications technologies in support of health and healthrelated 昀椀eld, including health care services, health surveillance, health literature, and health education, knowledge and research. Electronic Medical Records (EMR) – automated systems based on document imaging or systems which have been developed within a medical practice or community health center. Nursing Core Values as a Community Health Nurse CORE VALUES Mission The National League for Nursing promotes excellence in nursing education to build a strong and diverse nursing workforce to advance the health of our nation and the global community. CARING – promoting health, healing, and hope in response to the human condition INTEGRITY – respecting the dignity and moral wholeness of every person without conditions or limitation; DIVERSITY – a昀케rming the uniqueness of and di昀昀erences among persons, ideas, values, and ethnicities. EXCELLENCE – co-creating and implementing transformative strategies with daring ingenuity. CARING A culture of caring, as a fundamental part of the nursing profession, characterizes our concern end consideration for the whole person, our commitment to the common good, and our outreach to those who are vulnerable. All organizational activities are Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC managed in a participative and personcentered way, demonstrating an ability to understand the needs of others and their commitment to act always in the best interests of all stakeholders. INTEGRITY A culture of integrity is evident when organizational principles of open communication, ethical decision making, and humility are encouraged, expected, and demonstrated consistently. Not only is doing the right thing simply how we do business, but our action reveal our commitment to truth telling and to how we always see ourselves from the perspective of others in a larger community. DIVERSITY Hey culture of inclusive excellence encompasses many identities, in昀氀uenced by the intersections of race, ethnicity, gender, sexual orientation, socioeconomic status, age, physical abilities, religious and political beliefs, or other ideologies. It also addresses behaviors across academic and health enterprises. Di昀昀erences a昀昀ect innovation so we must work to understand both ourselves and one another period and by acknowledging the legitimacy of us all, we move beyond tolerance to celebrating the richness of fat di昀昀erences bring forth. EXCELLENCE A culture of excellence re昀氀ects a commitment to continuous growth, improvement, and understanding. It is a culture where transformation is embraced, and the status quo and mediocrity are not tolerated. What Is a Nurse Entrepreneur? A nurse entrepreneur has a professional background in nursing. Many nurses have clinical experience, so they understand the delivery of patient care period they apply their nursing knowledge and educational preparation to start a business in the healthcare 昀椀eld. What Can Nurse Entrepreneurs Do? Nurse entrepreneurs have a multitude of options for creating a business within the healthcare industry. Ventures may include: Developing computerized systems, medical devices or health products. Providing home health nursing services or telehealth nursing. Serving as a legal consultant. Working as a medical representative. Selling medical equipment. Serving as a wound care nurse. What Are the Steps to Starting a Business? The creation of a business begins with pinpointing a problem and coming up with a solution that is needed. Here are seven steps you should take prior to launching your business. Research your idea to see if it is feasible. Study from market to consider the demand or any competition. Identify your customers. Check local licensing regulations. From a 昀椀nancial and marketing plan. choose a business structure for task purposes. Examples include Sole Partnership, a Partnership, Corporation or a Limited Liability Company (LLC). Price your service or product. Where Do They Work? Nurse entrepreneurs can work in all kinds of settings. They may provide care in private residence or conduct business from a Home O昀케ce or rental location. Additionally, they can be contractors who visit patients in hospitals or clinics. Government agencies, nonpro昀椀t groups or community centers also may employ the services of nurse entrepreneurs. What Skills Do You Need? Successful nurse entrepreneurs are capable of performing many functions depending on the type of business. Nurses may work alone or employ sta昀昀. They may have to schedule appointments, travel, conduct presentations and handle 昀椀nances. Thus, they may function as a chief executive o昀케cer (CEO), administrative assistant, salesperson, and accountant. Successful nurse entrepreneurs exhibit: Ambition Autonomy and independence Decisiveness Excellent communication skills Problem-solving Self-motivation 5 ESSENTIAL SKILLS FOR DELIVERING COMPASSIONATE CARE IN NURSING: 1. Emotional intelligence – strive for high emotional intelligence to handle interpersonal relationships with coworkers and patients. Awareness and mastery of your emotions and others’ emotions will help you provide compassionate care. 2. Resilience – maintain personal resilience through participation in re昀氀ective activities to explore personal values and others’ perspectives. an article published by the American Journal of Critical Care shows that participating in these types of selfexploration activities can improve a Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com) lOMoARcPSD|25985347 CHN 211 – Finals LEC nurse's resilience which is “associated with increased hope and reduced stress.” with increased resilience and reduced stress, nurses are ready to provide quality and compassionate patient care. 3. Critical thinking – demonstrate the ability to think critically and solve problems quickly to achieve highyielding results in patient satisfaction and care. Nurses who can 昀椀nd solutions deliver compassionate care e昀昀ectively to patients and families. 4. Cultural awareness – maintain cultural awareness as it relates to patient centered care. Culture can in昀氀uence a patient's view of treatment, overall health, and death. Knowing the patient well enough to determine their cultural view can augment the nurse-patient relationship in a positive way. 5. Con昀椀dence – a nurse with the ability to communicate any instances of abatement in quality of patient care is critical to fostering the culture of the caring environment within the healthcare organization. Nurses must be able to discuss issues and indicate a clear vision of how compassionate organizations should function with both peers and leaders. TERMINOLOGIES Core Values – of an organization are those values we hold which form the foundation on which we perform work and conduct ourselves Culture – the arts and other manifestations of human intellectual achievement regarded collectively. Ethical – relating to moral principles or the branch of knowledge dealing with these. Excellence – the quality of being outstanding or extremely good. Principles - a fundamental truth or proposition that serves as the foundation for a system of belief or behavior or for a chain of reasoning. Downloaded by Cirujales, Romer S. (rmr.crjls5@gmail.com)