Nurse Advocate

Public Health Programs

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FAMILY HEALTH

Maternal Health Program

Antenatal registration
Tetanus Toxoid immunization
Micronutrient supplementation
Treatment of Diseases and Other conditions
Clean and Safe delivery

The Family Planning Program: Family Planning Methods

Female sterilization
Male sterilization
Pills
Male condom
Injectables

Non-Communicable and Communicable Disease Prevention and Control

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Non-Communicable Disease Prevention and Control

Integrated Community Based Non-Communicable Disease Prevention and Control Program
Causes and Risk Factors of Major Non-Communicable Diseases

Diseases of the Heart and Blood Vessels

Hypertension
Coronary Artery Disease
Cerebrovascular Disease or Stroke

Cancer
Diabetes Mellitus
Chronic Obstructive Pulmonary Disease
Bronchial Asthma

Community Organizing

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Studies have underscored some key elements of the community which may be reactivated to bring social and behavioral change
These include social organizations (relationships. structure and resources), ideology (knowledge, beliefs and attitudes) and change agents
This process of change is often termed as "empowerment" or building the capability of people for future community action

Five Stages of Organizing: A Community Health Promotion Model

Stage 1: Community Analysis

The process of assessing and defining needs, opportunities and resources involved in initiating community health action program
this process may be referred to as "community diagnosis", "community needs assessment", "health education planning", and "mapping
this analysis has five components:

Community-Based Nursing Services

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Assessment of Community Health Needs

Community Diagnosis aims to obtain a general information about the community.
The following are elements of a comprehensive community diagnosis:

Demographic variables
Socio-economic and cultural variables
Health and Illness patterns
Health resources
Political/Leadership patterns

Steps in Conducting Community Diagnosis

Determining the objectives
Defining the study population
Determining the data to be collected
Collecting the data
Developing the instrument

Family Based Nursing Services (Family Health Nursing Process)

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Nursing Assessment of Family:

First Level Assessment:

Family structure, characteristics and dynamics
Socio-economic and cultural characteristics
Home and environment
Health status of each member
Values and practices on health promotion/maintenance and disease prevention

Second Level Assessment:

data include those that specify or describe the family's realities, perceptions about and attitudes related to the assumption or performance of family health tasks on each health condition or problem identified during the first level assessment

Mandatory Continuing Professional Education (CPE) Bills in Congress

2011-12-16T00:03:00.003+08:00

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Continuing Professional Education (CPE) may soon become mandatory once the pending bills on mandatory CPE filed are approved by Congress. This development Congressman Rufus B. Rodriguez disclosed during a seminar on amendments of the various professional regulatory laws held at the Occupational Safety and Health Center in Quezon City on November 23, 2011. In said seminar, he also cited the need for an action plan to fast track the passage of amendatory bills of several professional regulatory laws filed in Congress.

Primary Health Care

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WHO defines as essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development
Primary Health Care was declared during the First International Conference on Primary Health Care held in Alma Ata, USSR on September 6-12, 1978 by WHO. The goal was "Health for All by year 2000". This was adopted in the Philippines through Letter of Instruction 949 signed by President Marcos on October 19, 1979 and has an underlying theme of "Health in the Hand of the People by 2020".

Health Care Delivery System

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The Philippine Health Care Delivery System is composed of two sectors:

public sector - largely financed through a tax-based budgeting system at both national and local levels and where health care is given free at the point of service
private sector (for profit and non-profit providers) - largely market-oriented and where health care is paid through user fees at the point of service

The public sector consists of the national and local government agencies, providing health services. At the national level, the Department of Health (DOH), is mandated as the lead agency in health. It has a regional field office in every region and maintains specialty hospitals, regional hospitals and medical centers. It also maintains provincial health team made up of DOH representatives to the local health boards and personnel involved in communicable disease control, specifically for malaria and schistosomiasis. other national government agencies providing health care services such as the Philippine General Hospital are also part of this sector

Types of Clientele

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Individual

Basic approaches in looking at the individual:

Atomistic
Holistic

Perspectives in Understanding the Individual:

Biological

Unified whole
Holon
Dimorphism

Anthropological

Essentialism
Social constructionism
Culture

Principles and Standards of CHN with Levels of Care

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Basic Principles of Community Health Nursing (CHN)

The community is the patient in CHN, the family is the unit of care and there are four levels of clientele: individual, family, population group (those who share common characteristics, developmental stages and common exposure to health problems - e.g. children, elderly) and the community
In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of care
CHN practice is affected by developments in health technology, in particular, changes in society, in general
The goal of CHN is achieved through multi-sectoral efforts
CHN is part of health care system and the larger human service system

Research Designs and Research Proposal

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Research Designs

refer to the way in which the investigator plans and structures the research process
the design provides flexible guideposts that keep the research headed in the right direction

Qualitative - one in which the investigator plans to observe, discover, describe, compare and analyze the characteristic attribute, themes and underlying dimensions of a particular unit
Qualitative - concerned with measuring the magnitude, size or extent of a phenomenon
Descriptive-Exploratory - observes, describes, explores and assembles new knowledge

Research

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Research

means delving into a problem
systematic, controlled, empirical and critical investigation of hypothetical propositions about the presumed relations among natural phenomena
general system is followed whose elements are:

identification of the problem
extensive review of literature
formulation of the conceptual framework and hypotheses
designing its design and methodology
data collection
data analysis through the use of statistics and interpretation and drawing conclusions
giving recommendations

Importance of research:

discovers newer trends of dealing with problematic situations effectively
education is modified, enhanced and improved
professionalism is refined
it makes our interventions relevant and effective
sense of accountability is deepened and actualized
ground of nursing science

Roles of Nursing Practice

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Roles

organized set of behaviors that are attributed to a specific office or position
a set of prescription for the expected behavior of an individual in a position or status category
sum total of the behavior expected from a person who occupies a particular position and status in a social pattern

Role Problems

arise from unclear or ambiguous messages

Role Conflict

arise when one receives different directions from several sources

Management

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Management

art of getting things done through people
process of getting activities completed efficiently and effectively with and through people in order to attain goals of the organization

Principles of Management

Division of Labor - specialization leads to efficient work performance
Authority - managers give orders to make things done
Discipline - members of organization respect rules and agreements that govern organization
Unity of Command - a member receives instruction from only one superior
Unity of Direction - common objective(s) for the entire organization
Subordination of the common interest for the common good - organizational interests take precedence over personal interests

Leadership

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Leadership

use of one's skill to influence others to perform to the best of their ability toward goal achievement
an interpersonal process of influencing the activities of an individual or a group toward goal attainment in a given situation (Maloney)
the state where a person, a group of persons, a subsystem or an organization is able to influence others to agree on a goal and work towards it

Influence Tactics

Assertiveness - standing up for one's rights and rights of others without violating the rights of others
Ingratiation - making one feels important and feels good before making a request
Rationality - relying on a detailed plan, reasoning or logic
Sanctions - giving or preventing pay increases or promotions until one gives in to a request

Republic Act 9173 or Philippine Nursing Act of 2002

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AN ACT PROVIDING FOR A MORE RESPONSIVE NURSING PROFESSION, REPEALING FOR THE PURPOSE REPUBLIC ACT NO. 7164, OTHERWISE KNOWN AS "THE PHILIPPINE NURSING ACT OF 1991" AND FOR OTHER PURPOSES

Be it enacted by the Senate and the House of Representatives of the Philippines in Congress assembled:

ARTICLE I: Title

Section 1. Title

This Act shall be known as the "Philippine Nursing Act of 2002."

ARTICLE II: Declaration of Policy

Section 2. Declaration of Policy.

It is hereby declared the policy of the State to assume responsibility for the protection and improvement of the nursing profession by instituting measures that will result in relevant nursing education, humane working conditions, better career prospects and a dignified existence for our nurses.

The State hereby guarantees the delivery of quality basic health services through an adequate nursing personnel system throughout the country.

Board of Nursing Resolution No. 220 (2004)

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PROMULGATION OF THE CODE OF ETHICS FOR REGISTERED NURSES

Whereas, the Board of Nursing has the power to promulgate a Code of Ethics for Registered Nurses in coordination and consultation with the accredited professional organization (Sec. 9, (g), Art. III of RA 9173, known as "Philippine Nursing Act of 2002);
Whereas, in the formulation of the Code of Ethics for Registered Nurses, the Code of Good Governance for the Professions in the Philippines was utilized as the principal basis therefore: All the principles under the said Code were adopted and integrated into the Code of Ethics as they apply to the nursing profession;
Whereas, the promulgation of the said Code as a set of guidelines, regulations or measures shall be subject to approval by the Commission (Sec. 9, Article II of RA 9173); and
Whereas, the Board, after consultation on October 23, 2003 at Iloilo City with the accredited professional organization of registered nurses, the Philippine Nurses Association, Inc. (PNA), and other affiliate organizations of Registered Nurses, decided to adopt a new Code of Ethics under the afore-mentioned new Law;
Now, Therefore, the Board hereby resolved, as it now resolves, to promulgate the hereunder Code of Ethics for Registered Nurses.

Nurse and Contracts

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Contract

Meeting of minds between two persons whereby one binds himself, with respect to the other, to give something or to render some service
An agreement between two or more competent persons upon sufficient consideration to do or not do some lawful act
Can be written or oral

Kinds of Contract

Formal Contract - refers to an agreement among parties involved and is required to be in writing by some special laws
Informal Contract - one which is concluded as the result of a written document or correspondence where the law does not require the same to be in writing, or as the result of oral and spoken discussion between parties or conduct between the parties, evidence and intention to contract
Express Contract - is one in which the conditions and terms of contract are given orally or in writing by the parties concerned

Nurses and Crimes

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Crime

an act committed or omitted in violation of societal law and punishable by a fine and/or imprisonment or death
Two elements:

Criminal act
Evil/Criminal intent

Conspiracy to Commit Crime

exists when two or more persons agree to commit a felony and decide to do it

Principals - those who take a direct part in the execution of the act; directly for or induce others to commit it
Accomplices - those persons who, not being principals, cooperate in the execution of the offense by previous or simultaneous act
Accessories - those who, having knowledge of the commission of the crime; by profiting themselves or assisting the offender to profit from the effects of the crime by destroying or concealing body of the crime, or the effects or instruments, in order to prevent its discovery or by harboring, concealing or assisting in the escape of the principal of the crime

Legal Aspects and the Nurse

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Professional Negligence

Negligence

refers to the commission or omission of an act, pursuant to a duty , that a reasonably prudent person in the same or similar situation would or would not do, and acting or the non-acting of which is the proximate cause of injury to another person or his property

Elements of a Professional Negligence

Existence of a duty on the part of the person charged to use due care under circumstances
Failure to meet standard of due care
The foreseeability of harm resulting from failure to meet the standard
The fact that the breach of this standard resulted in an injury to the plaintiff

Nursing Jurisprudence

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Nursing Jurisprudence

Department of law which comprises all the legal rules and principles affecting the practice of nursing
Includes the study and interpretation of rules and principles and their application in the regulation of the practice of nursing

Functions of Law of Nursing

provides a framework for establishing what nursing actions in the care of patients are legal
delineates the nurse's responsibilities from those of other professionals
helps to establish the boundaries of independent nursing actions
assists in maintaining a standard of nursing practice by making nurses accountable to the law

LAWS AND REGULATIONS AFFECTING NURSING PRACTICE IN THE PHILIPPINES

Act No. 2493

Regulations of the practice of medicine which covers nursing practice

History of Nursing Law

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Act No. 2493 (115)

An act to amend No. 310 regulating the practice of medicine in the Philippines
Provided for the examination and registration of nurses
Nurses must apply for registration to the Director of Health
Requirements: Good moral character, good health and 21 years old

Act No. 2808 (1919)

An act regulating practice of nursing profession
the first "True Nursing Law"
created the board of examiners composed of 3 members
Examination date on the 2nd Monday of June and December
First board exam: 10920

Act No. 3025 (1922)

Amplification of the definition of the nursing profession
Granting the privilege of registering as nurses without exams the Registered Nurses from the United States
Change the date of exam: 2nd Monday of April and October

Professional Adjustment as a Nurse

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Adjustment

an educational process referring to changes in behavior towards better life, better relationships and better contribution to society

Profession

a calling by which members profess to have acquired special knowledge by training, by experience or both so that they may guide or advice or serve others in that field
an occupation usually involving relatively long and specialized preparation on the level of higher education and governed by its own code of ethics

Professional Adjustment

the growth of the whole individual and development of all his/her capacities, physical, mental, social and spiritual towards efficient and effective performance of his/her profession

Code of Nursing Ethics

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Under the Philippine Nursing Act, the Board of Nursing is vested with authority to study the conditions affecting the practice of nursing in the Philippines and to exercise powers necessary to insure the maintenance of efficient ethical standard in the practice of nursing, taking into consideration the health needs of the nation
By necessary implication from this authority and its power to promulgate such rules and regulations may be necessary to carry out the provisions of the Nursing Act, the board has likewise the power to adopt a code of nursing ethics for the guidance of registered nurses in the Philippines in the observance of ethical principles that should govern their nursing practice, conduct and professional relationships
the professional code of ethics for Filipino nurses provides direction for the nurses to act morally

Philippine Nurses Association

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Vision

The caring and fortifying light giver committed to providing opportunities for the professional growth and development of world class Filipino nurses

Mission

Zealously provide strategic directions and programs that enhance the competencies of nurses to be globally competitive
Passionately sustain the quality work life and collegial interactions with and among nurses
Continuously strengthen the internal capacity and capabilities for quality care and services to the nurses
Enthusiastically explore possibilities of collaboration towards unification of nurses