Post on 01-Jul-2015
Gilbert T. Salacup RN, MSN
TYPES OF PRIMARY HEALTH WORKERS AUXILLARY INTERMEDIATE LEVEL ANCILLARY
CHARACTERISTICS
VILLAGE/GRASSROOTS HEALTH WORKERSTrained community Health worker; health auxiliary volunteer; Traditional birth attendant
General Medical PractitionersPublic Health nursesMidwives
HEALTH PERSONNEL OF 1st LINE HOSPITALSPhysicians with specialty NursesDentists
Initial link, 1st contact of the community
Work in liaison w/ the local health service workers
Provide elementary curative preventive health care measures
1st source of professional Health care Attend to health problems beyond the
competence of village health workers Provide support to the frontline health
workers in terms of supervision, training, referral services & supplies thru linkages with other sectors
Establish close contact with the village & intermediate level health workers to promote the continuity of acre from hospital to community to home.
Provide back-up health services for cases requiring hosp or dx facilities not available in HC
VILLAGE/GRASSROOTS HEALTH WORKERSTrained community Health worker; health auxiliary volunteer; Traditional birth attendant
General Medical PractitionersPublic Health nursesMidwives
HEALTH PERSONNEL OF 1st LINE HOSPITALSPhysicians with specialty NursesDentists
1. WHO ! Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
2.Claude Bernard !Health is the ability to maintain INTERNAL MILIEU. Illness is the result of failure to maintain.
3.Walter Cannon !Ability to maintain HOMEOSTASIS or dynamic equilibrium.
WHO Definition Healtha state of complete physical, mental, & social well-being and not merely the absence of a disease, illness or infirmity WHO: Health is a social phenomenonHealth as a result of interplay of diff. societal factors:-Biological, Physical- heat, temp, Ecological- adaptation to env't.- Political, Economic, Social culturalIt is an outcome of many theories : Multi-Causal Theory of Health, Disease & Death Multi Casual theory- holistic- General systems theory
CONCEPTS OF HEALTH:
1. Nightingale !Health is being well and using one’s power to the fullest extent. Health is maintained through prevention of disease via ENVIRONMENTAL HEALTH FACTORS.
2. Virginia Henderson !Individual’s ability to perform 14 components of nursing unaided.
3. Martha Rogers !Positive health symbolizes WELLNESS.
4. Sis. Callista Roy !State and process of being and becoming an integrated and whole person.
5. Dorothea Orem !State that is characterized by soundness or wholeness human structures and of bodily and mental functioning.
6. Imogene King !Dynamic state in the life cycle. Illness is an interference in the life cycle.
7. Betty Neuman !Wellness is the condition in which all parts and subparts of an individual are in harmony with the whole system.
8. Dorothy Johnson !elusive, dynamic state influenced by BIOLOGIC, PSYCHOLOGIC and SOCIAL FACTORS.
Diseases Vaccine
Minimum Age
Dose No. of Dose
Site Route Interval Reasons
1. Tuber- culosis
BCG At birth / anytime
School entrance
0.05 ml
0.10 ml
1 RDeltioid
L Deltoid
ID Given at earliest possible age protects against the possibility of infection from other family members.
2. Measles Measles
9 mons. 0.5 ml 1 Outer part of the artm
Subcu At least 80% of measles can be prevented by immunization at this age.
3.Diptheria
Pertusis
Tetanus
DPT1
DPT2
DPT3
1 ½ mos.
2 ½ mos.
2 ½ mos.
0.5 ml 3
Upper outer portion of the thigh
IM Z techniq
ue
4 wks. An early start with DPT reduces the chance of severe pertusis.
4.Hepatitis
B
Hepa B1
Hepa B2
Hepa B3
1 ½ mos.
2 ½ mos.
2 ½ mos.
0.5 ml 3 Upper outer portion of the thigh / anterior thigh
Intramus-cular
4 wks. An early start of Hepatitis B reduces the chance of being infected and becoming a carrier.
5. Polio-
Myelitis
OPV1
OPV2
OPV3
1 ½ mos.
2 ½ mos.
2 ½ mos.
2 drps or gtts.
3 Mouth Orally 4 wks. The extent of protection against polio is increased the earlier the OPV is given.
Most sensitive 1
-15to – 25 C OPV LIQUID
2 -15to – 25 C MV FREEZE DRIED
3 2-8 C BCG FREEZE DRIED
4 2-8 C DPT LIQUID
5 2-8 C HBV LIQUID
6 least sensitive 2-8 C TT LIQUID
Disease Vaccine Minimum Age Interval
Dose Route Site Percent Protected
Duration of Protection
Tetanus TT1 At 5th – 6th month of pregnancy
0.5 ml Deep intra – muscular
Deltoid region of the arm
80%
Varies 1 yr
TT2 At least 4 wks after TT1
0.5 ml Deep intra – muscular
Deltoid region of the arm
80% - Infants born will be protected from neonatal tetanus.
- 3 yrs protection for the mother.
TT3 At least 5-6 mons. later of 2nd pregnancy regardless of interval
0.5 ml Deep intra – muscular
Deltoid region of the arm
90% - Infants born will be protected from neonatal tetanus.
- 5 yrs. Protection for the mother.
TT4 At least 5-6 mons. Of 3rd pregnancy. Regardless of interval`
0.5 ml Deep intra – muscular
Deltoid region of the arm
99% - Infants protected from Neonatal Tetanus.
- 10 yrs. Protection for the mother.
TT5 At least 5-6 mons. Of 4th pregnancy. Regardless of interval`
0.5 ml Deep intra – muscular
Deltoid region of the arm
99% -lifetime protection.
- All infants born to that mother will be protected.
Retrospective (Past)
Case Control study
-Show an association bet. the risk factor & disease
Cross- Sectional (Present)
Prevalence study- old & new cases
-Get prevalence of disease (Lung CA)
- Get prevalence of risk factor (smoking)
Prospective Cohort (future)
- Incidence or new cases
10 Leading Causes of Morbidity 10 Leading Causes of Mortality
1.P - neumonia --bacterial2.Di -arrhea3.Bro - nchitis4.In - fluenza -respiratory5.H - ypertension6.Tu - berculosis respiratory7.Di -seases of the heart8.Ma - laria9.Chick -enpox10.Me -asles
1. Di -sease of the heart2. Di -seases of the vascular system3. Ma -lignant neoplasm4. P -neumonia5. A- ccidents6. TB –all forms7. CO -PD8. Con -ditions originating in perinatal period9. DM 10. N - ephritis, nephritic syndrome
Fluids Frequent feeding Fast Referral
Oresol Rehydration
Therapy
Encourage/ensure intake of any fruit juices, “am”, “lugaw”, homemade soup
Continue breastfeeding/SF
With children over 6 mos; cereals/ starchy foods mixed with meat or fish & vegetables
Mashed banana or any fresh fruit
Feed the child at least 6x/day
After diarrhea episode, feed 1 extra meal/day for 2 weeks
If child doesn’t get better in 3 days, or if danger signs develop-refer patient
Danger signs:
FeverSunken fontanelSunken eyeballFrequent watery stoolsRepeated vomitingBlood in stoolPoor intake of mealsWeakness
Breastmilk Formula
CHO Increase decrease
CHON (LACTALBUMIN) (CASEIN)
Fats = =
Linoleic acid content (3x) Decrease
Minerals decrease Increase
SCHISTOSOMIASIS
CONTROL PROGRAM
H-FEVER
(DENGUE)
FILARIASIS
CONTROL PROGRAMSchistosomiasis-
A parasitic infection caused by blood flukes inhabiting the veins of their vertebral victims transmitted thru skin penetration causing diarrhea, ascites, hepatosplenomegaly
Dengue-
Acute febrile infection of sudden onset, caused by Aedes Aegypti, vector mosquito
> A mosquito borne disease caused by a tissue nematode attacking the lymphatic system of humans thereby causing elephantiasis, lymphedema & hydrocele
> Started in 1957 as an operational research of malaria. Eradication Service Three Filaria Control were established & later on integrated with the Regional Health Officers
Activities:
> C -ase Finding
> S - urveillance of the disease
> H - ealth education- encourage use of rubber boots for protection
> E - nvironmental Sanitation-proper disposal of feces
> S - nail Eradication- use of moluscides
Activities:
>Case Finding
Early reporting of any known case or outbreak
D
L
S -Stagnant
U - rban
Activities:
>Case Finding
>Early reporting of any known case of outbreak
H – ealth education
N – et mosquito
Targeted Food Task Force Assistance
Program
Nutrition Rehabilitation Ward
Akbayan sa Kalusugan (ASK Project)
Provision of food rations of bulgur wheat & green peas
Target population:
Pre-schoolers
Pregnant women
Lactating mothers
Every hospital must have a Nurse ward, where an adequately trained nutritionist were assigned (RA 422)
Aimed to provide rice & corn soya blend supplemented with local foods.
Target pop:
6 mos- 2 years
Moderately & severely underweight
Pre-schoolers not served by the DSWD and DA in Regions 2,8,9,10,11,12
Generics Act of 1988
R.A. # 6675
Dangerous Drugs Act
R.A. 6425
“Formally proclaims the state of promoting the use of generic terminology in the importation, manufacture, distribution, marketing, promotion & advertising, labeling, prescribing & dispensing of drugs.”
“Reinforces the NDP with regards to the assurance of the high-quality & rational drug use.”
“ The safe administration & transportation of prohibited drugs is punishable by law.”
2 Types of Drugs:
Prohibited Regulated
LSD Benzodiazepines
Eucaine Barbiturates
Cocaine/ codeine, Opiates
Level 1
Point Source
Level II
Communal Faucet System/ Stand Posts
Level III
Waterworks System/ Individual House
ConnectionsA protected well of a developed sprung with an outlet but w/o a distribution system for rural areas where houses are thinly scattered.
A system composed of a source, a reservoir, a piped distribution network & communal faucets, located at not more than 25 meters from the farthest house in rural areas where houses are clustered densely.
A system with a source, a reservoir, a piped distributor network & household tap that is suited for densely populated urban areas.
Level 1 Level 2 Level 3Non- water carriage
toilet facility:
-P-it Latrines-R-eed Odorless Earth Closet
- Compost-Bored-Hole-Ventilated improved pitToilets requiring small amount of water to wash waste into receiving space
-Pour flush, Aqua Privies
On site toilet facilities of the water carriage type with water sealed & flushed type with septic vault/tank disposal facilities.
Water carriage types of toilet facilities connected to septic tanks & /or to sewerage system to treatment plant.
Household Community
Burial
Deposited in 1m x 1m deep pits covered with soil, located 25m away from water supply
-Grinding and disposal sewer
-Animal feeding
-Composting
-- Open burning
Sanitary Landfill or Controlled Tipping
> Excavation of soil deposition of refuse & compacting with a solid cover of 2 feet
- Incineration