sample cdpr
Transcript of sample cdpr
University of the CordillerasCorner Governor Pack Road, Baguio City
COLLEGE OF NURSING
Central Bayabas, Sablan, Benguet
(July 3 – October 4, 2004)
COMMUNITY DIAGNOSIS PROGRESS REPORT
In Partial Fulfillment of the Requirements for
The Course
Nursing Care Management 101
Presented by:
BSN III
Section 3
Groups A, B, C and D
NCM 101
Ms. Maribeth Esteban, RNClinical Instructor
Central Bayabas, Sablan, Benguet
ACKNOWLEDGEMENT
To our Almighty God, thank you for imparting wisdom,
strength and guidance. Thank you for the wonderful
creations you have shared and given to us that we may enjoy,
learn and care for it.
To our parents; for the years of sending us to school,
for believing in us, for the support, and for the
understanding despite the skepticism and doubt, thank you
very much.
To our clinical instructor, Ms. Esteban, thank you for
imparting your knowledge and opinions to us, for
accompanying us in every journey of our community life, for
lightening our burdens, thank you very much.
To the people of Central Bayabas, Sablan, thank you for
giving us a warm welcome, for letting us feel home, for
letting us experience your life, for letting us understand
your culture and tradition, for teaching us do the “raep
raep thing”, for sharing to us your bountiful fruits, for
letting us experience the spirit of the bugnay wine… once
again our gratitude.
To Mr. Oyam and the teachers, thank you for the
understanding, the support and for letting us stay in your
lovely school.
To the students of Central Bayabas Elementary School ,
thank you for cooperating with us, thank you for the games,
thank you for letting us play with you…
Thank you very much.
SECTION 3
I. Introduction
Community Health Nursing has long been in the forefront
in educating the people on basic health care and in
providing access to health services for vulnerable groups
and communities. Community Health Nursing is a synthesis of
nursing practice, public health practice, health promotion
and primary health care. The practice of community health
nursing expands into the areas of disease prevention, health
enhancement, empowerment, advocacy, community development
and research. The nature of community health nursing is
comprehensive and directed towards the individual, families
and the community at large. As community health nurses, we
fulfill a unique role in the community, promoting and
protecting the health of the community, while using a
framework of sustainability. We promote optimum health of
individuals and the community by promoting the right to
informed choice, advocacy and self-determination. We also
identify and challenge barriers to wellness and empower
people to change the agents that affect their health
adversely.
Pasdong is a rich land where farming is the primary
source of livelihood. As has been described previously by
observers, this place is only remote but not considered as a
depressed area. This means that majority of the constituents
of this are average in terms of economic well-being. This
now calls for further development towards socio-economic
progression. The land is well-cultivated for different crops
that are even exported for commercial consumption. Some of
these are the Pasdong sayote, camote and peanuts being
commercialized and popularized to the public consumers.
Also, the creation of the “Bugnay wine factory” owned by the
Cooperative give way to further commercialization agenda.
However, the locals needed more teaching on how to maximize
these for it to be globally competitive Furthermore; it is
inevitable that this approach would affirm to the idea of
linking wage growth with productivity. Equally important to
this is to provide the locals open doors for selling of
these products in a wider scope. This concern is rooted in
the view that the core of the poverty problem is
joblessness, thus highlighting the need to create new
employment opportunities in the area. At the same time, many
people who have jobs are under-employed and on low wages.
Associated with this is the need to improve the quality of
the workforce in terms of skills for productivity, as well
as the quality of employment, with respect to working
conditions, remuneration and welfare. Thus the employment
challenge calls for the formulation of coordinated
strategies to promote “full, decent and productive
employment” in both the formal and informal economy as a
means of alleviating poverty. To achieve this, the
Government appears to recognize that ultimately its role in
employment promotion is to provide a suitable policy
framework that enables the private sector to perform its
role as the primary source of employment generation.
In terms of health resources, there is only one doctor
provided for the entire place of Sablan. This state is a
reflection of the national-wide health issue governing the
unequal distribution of health facilities and health workers
in the local area. This goes back to the issue of those
missing doctors, nurses and teachers which are part of the
vast legions of overseas Filipino Workers (OFWs) - something
that leads former senator and vice-presidential candidate
Loren Legarda to cry over the international image of
Filipinos as "the groveling nomads of the world". In
relation to this, up to 8 million Filipinos are OFWs. Of
those, about 2.5 million are permanent foreign residents;
but the majorities are registered (42%) or illegal (58%)
overseas workers, at least 50% of them women. Without OFWs,
the Philippines would already have hit rock bottom: they are
sending about $8 billion back home per year, and counting.
Unofficially, the total amount of remittances may be 50%
higher, or more. On the other hand, there is a rest back of
this such as lacking health workers to cater to the needs of
the Filipino including those in the countryside and other
more remote places like Sablan.
Overall, there should be expanded employment for
everyone utilizing the resources in the community. Further,
national issues should be addressed through
institutionalized processes as to give solutions to the
local issues as well surrounding the provincial areas such
as Sablan. Through these institutions and processes, the
social partners participate with government in policy-making
and implementation and thereby play a major role in
addressing the social and labor market issues arising from
globalization.
Our exposures to Central Bayabas gave us the
opportunity to experience and understand how people in the
community deal with their daily lives particularly those
concerning health. We were able to extend health services,
health teachings and health monitoring in keeping up with
the Department of Health’s programs. We adhere to their main
purpose of improving and sustaining the health situation of
the most vulnerable individuals and communities eventually
making them self-sufficient in health care through
cooperation with LGUs and community members themselves.
OBJECTIVES:
GENERAL OBJECTIVES:
A) Deliver efficient health care services
B) Apply COPAR and primary health care principles
C) Appreciate community health nursing practice
SPECIFIC OBJECTIVES:
A) Promote health through health education and follow-up
care to identify their needs and formulate a plan of action
to attain these needs by focusing on their immediate and
long-term needs and problems.
B) Help the community health workers in generating community
participation in health development activities.
COMMUNITY DATABASE
Barangay Profile-Barangay Bayabas, Sablan, Benguet
I. GEOGRAPHICAL LOCATION AND ACCESS
Barangay Bayabas is located on the southern portion of
the Municipality of Sablan , Province of Benguet . It is
eight (8) and four (4) kilometers away from the Poblacion
and Naguilian Road , respectively. The center of the
Barangay is Bayabas proper which is 24 kilometers away
from the City of Baguio and 34 kilometers away from the
provincial capitol which is located in the Municipality
of La Trinidad .
II. POLITICAL
Barangay Bayabas is composed of twenty-five (25) sitios
- Monglo, Sedong, Abuloy, Amocao, Balococ, Kipa, Payda,
Bacbacan, Central Bayabas , Calamay, Colat, Teytey,
Beckes, Tongsul, Sacnib, Coplo, Mangi, Batwel, Kinakawan,
Kabaong, Talete, Pagalan, Pidawan, Bulala and Bagto.
III. LAND AREA
Barangay Bayabas is the biggest among the eight
(8)barangays of the Municipality of Sablan in terms of
land area. The Barangay has an area of 2,142 hectares and
it accounts to 26.67% of the total land area of the
municipality.
IV. POPULATION AND HOUSEHOLDS
The Barangay has a total population of 1,972 with 362
households based on the minimum basic needs survey
conducted in 1998.
V. LANGUAGE AND DIALECT SPOKEN
The most common dialect is Ibaloi followed by Ilocano,
Kankanaey, Ifugao, Bontoc and Pangasinense.
VI. HOUSING
Many of the housing structures in the Barangay are made
of timber and galvanized iron.
Houses belonging to above average income earners are
made to concrete structures.
VII. EDUCATION
Barangay Bayabas has two Public Elementary School-
Talete Elementary School and Bayabas Central Elementary
School . It has also two Day Care Centers- Monglo Day
Care Center and Bayabas Day Care Center.
VIII. LAND USE AND SOURCE OF INCOME
Eighty-five percent (85%) of the total area is
considered an agricultural land hence, the principal
source of income is diversified farming.
IX. MANAGEMENT
The Barangay Government of Bayabas is managed by the
following:
1 Punong Barangay
7 Barangay Kagawads
1 Barangay Secretary
1 Barangay Treasurer
1 Sangguniang Kabataan Chairman
12 Members of the Lupong Tagapamayapa
9 Action Members of the Barangay Tanods
10 Action Members of the BHW
2 NGO members of the Barangay Development Council
Barangay Bayabas is being developed with the future
generation’s welfare in mind. Sustainable developments
particularly in economic, social, and cultural sectors
are being pursued. The programs, projects, and activities of
the Barangay are geared towards empowering the people and
improving the quality of life of its constituent.
II. Community Problems According to Priority
Health Problems and Needs
The following are seen as health problems and needs of the community people:
With regards to health problems, there are a
significant number of populations that are hypertensive
especially the elderly. With this problem, the community
needs information dissemination on the diet and lifestyle
modification. Information about lifestyle is very vital to
be imparted to affected population like proper exercise,
limiting alcohol consumption and vices.
Another health problem that was observed in the
Barangay is that children don’t have proper hygiene and
grooming which may affect their health. These problems are
easy to manage, simple measures on explaining the importance
of proper hygiene and grooming to their health. Cooperation
between teachers and parents are very important that the
children will continually practice it.
One more problem is the unsanitary environment
involving the community’s toilet system and pig pens.
Some modifications with regards to the school is needed
so it may serve as a medium of effective and conducive
learning.
III. Community Diagnosis Action Plan
Health Problems and Needs
Objectives Strategies Expected Outcomes
1. Hypertension among elderly
After the health teachings to the adult community, they will be able to understand the importance of proper nutrition, and lessen, if not totally eradicate, the factors that can contribute to hypertension
Health Teachings/Home visits
The community people will be able to apply what we have taught them regarding proper management of the condition.
2. Personal Hygiene of the pupils of Bayabas Elementary School
After the physical assessment rendered to the pupils as well as the health teachings taught to them, they would be able to maintain proper
Physical Assessment and Health Teachings
The pupils will be able to understand and apply what are being taught to them.
personal hygiene. Furthermore, pupils that need referrals to health medications will comply with the said recommendations.
Pupils who need further medical medications will be given appropriate attention.
3. Unsanitary Environment
After teaching, people in the community would be able to provide solutions to their unsanitary toilets and foul smell emanating from the pig pen
Home visit The community people will result ways of doing proper sanitation that greatly affects their health.
4. a. Beautification of the School (School yard, H.E. room and School Library)
b. Cultivation of the herbarium, setting up of the compost pit
After the exposure in the community, we will be able to finish the beautification of the school
After the exposure in
Labor
Labor
The people will admire and appreciate the contribution of the group to the school
the community, we will be able to maintain and improve the herbarium as well as fix the compost pit.
The people will admire and appreciate the contribution of the group to the school.
Preserve the plants.
Use the herbal plants.
Use the compost pit.
IV. Implementation phase
Health Problems and Needs
Strategies Actual Evaluation
Hypertension among The groups The family
adults in the community
monitored the blood pressure of the community folks. Through health teachings, they were reminded about the factors which affect blood pressure, such as, foods to be avoided, proper diet, exercise, and the use of garlic to control hypertension.
listened attentively and asked questions about their present condition.
Personal hygiene of the pupils
Physical assessment, cephalocaudal assessment, to all the pupils of Bayabas Elementary School was done. Letters to parents/guardians of pupils who need further medical attention were given thru Sir Oyam, the head of the school.
Furthermore, health teachings to the pupils were done to emphasize the importance of proper personal hygiene.
All the pupils participated in the physical assessment.
The pupils listened attentively to the health teachings.
Unsanitary environment
Through health teachings, the concerned community folks were informed about the proper
The family listened attentively and asked questions about their
maintenance of clean toilet and pig pens
present condition.
Beautification of the school
The group helped in the beautification of the school specifically the H.E. Room, School Library, Schoolyard and Herbarium.
The school officials appreciated our effort for a job well done.
V. EVALUATION and CONCLUSION
Goals and objectives of the groups were satisfactorily
attained.
Based from the community exposure, the following
conclusions are drawn:
1. Community integration is important in building trust
with the community people.
We had implemented our ocular survey and courtesy call
to meet people.
We built trust by means of home visits and we had
taught the people measures in dealing with their
deficiencies.
2. The community had helped us learn to deal with
different cultures, values and belief of the people.
We were able to manage and gauge proper intervention
needed to cater to different sorts of people possessing
dissimilar qualities.
VI. RECOMMENDATIONS
In line with the conclusions, the following are
recommended:
1. The continuity of care of the pupils of Central
Bayabas Elementary School should be exercised.
This is to remind pupils that improper hygiene would
greatly affect their learning and may pose a greater
risk of emerging diseases.
2. The continuity of the beatification and cleanliness
of Central Bayabas Elementary School .
This is for the maintenance of their school’s
cleanliness to give way to effective and conducive
learning.
3. The continuity of home visits.
This is to facilitate effective health care
intervention for those people who are unable to reach
nearby health care facilities.
APPENDICES
Summary of Activities
Group A:
Dates of Duty: July 3 – 19, 2008
Members:
Binha-on, Claire Marie
Bondad, Kiezel
Calub, JF Nicole
Gayaso, Raqueline
Gumpac, Rizalino
Lachica, Regency Mae
Pingol, Christine
Quilala, Giezle
Sowaken, Mary Lynette
Tamayo, Kimberly
Timaan, Ma. Bernadette
Villar, Danzen Apple
WEEK 1: July 3-5, 2008
Our group departed from UC-BCF at 7am. We arrived at
the Municipal Health Office in Sablan at 8:30am. We had a
brief orientation conducted by Dr. Judith Codamon, Municipal
Health Officer and Ms. Olivia Lambayong, Midwife II-Central
Bayabas. Shortly after, we proceeded to Central Bayabas
Elementary School . We had a courtesy call to the School
Principal in the person of Mr. Nilo Oyam. After which, we
proceeded to the staff house which is the school library
where we reside during our 3 day stay at the community.
After putting things in order, we then went to a nearby
store to give courtesy to Mr. Teofilo Anasioco, Barangay
Captain of Sablan. Along with a Barangay Kagawad, he
oriented us as how many sitios are there in the area.
On the second day, our group went to our destination
which is Sitio Bekkes .We was divided into pairs to perform
ocular survey and home visit to the area.
On the third day, the group went for ocular survey and
home visit to nearby houses in Sitio Central Bayabas. We
went back to Baguio City from Sablan later in the afternoon.
WEEK 2: July 10-12, 2008
Coordination with Mr. Nilo Oyam regarding the following
the beautification of the school clinic was done as well
with Mr. Teofilo Anasioco for the upcoming case presentation
regarding End-Stage Renal Disease.
On the second day, our group went back to do thorough
assessment in selected households in Sitio Bekkes for the
preparation of our FNCP.
On the third day, the group stayed in the school for
the beautification of the School Clinic. We departed from
Sablan to Baguio City in the afternoon.
WEEK 3: July 17-19, 2008
The group stayed in the school for the arrangement and
beautification of the H.E. Room. During the rest of the
afternoon, we cleaned and arranged the herbal garden located
at the back of the school.
On the second day, the group did morning exercises
together with the teachers and students. In the afternoon,
we cleaned the school yard.
On the third day, the group had a general cleaning of
the school library. We departed from Sablan and proceeded to
Baguio City in the afternoon.
Group B:
Dates of Duty: July 24 – August 16, 2008
Members:
Cabfit, Domanay
Camarao, Mildred
Caw-as Naty
Espiritu, Maritess
Kimay, Jeanette
Madarang, Daisy
Manguba, Divina
Nemedez, Bernadette
Olat, Alvin
Osenio, Janice
Torres, Marie Antonette
Wallang Lilibeth
WEEK 1: July 24 - 26, 2008
Our ever first community immersion was full of
excitement, and anticipation of what community can bring
us. For some of us, they are less exposed as compared to
others since they lived all their lives in the comfort of
the city life and taking every task a challenge to win. The
hardships of hiking several mountains and the struggles of
breathing while taking our route up the mountains were much
easier to laugh about after arriving at the site. During
this week we did our ocular survey of our site visiting from
house to house to establish rapport to the people. During
the initial assessment, we took notes on the responses of
different household who took us in and even to some who were
hesitant to let us in to their homes at first. At some
point, when we weren’t able to enter all houses and seemed
welcomed us, we felt frustrated and figure out on ourselves
the possible reasons for this reaction among the locals.
First that we come out is that these people known for being
hardworking people are quite busy tending their own fields
waking up at very early which gives the reason why most of
the houses are closed. Another reason is that the people are
generally shy if not a little bit “hostile” towards
strangers which is manifested b their rigidity of some to
welcome us on their homes. However, we were determined as a
group to take this a test that we need to pass and at the
end of this immersion, things can be better for us all. We
also observed the natural fauna which is preserved by the
locals despite the introduction of roads at the core of the
mountainous terrain.
WEEK 2: July 31 - August 2, 2008
For the second week, we established rapport with the
community people as the initial step we always do in an
immersion. Unfortunately, the news came to us that our
patient suffering of chronic urinary disorder just passed
away so we decided to go to attend the burial. We have seen
how the burial rites go. The villagers were united during
the mourning sessions like this. There were all gathered at
the residential area of the dead. As a traditional way, the
family butchered pigs to cater in to the attendees. The
family was accommodating and the people showed as warmth as
we participate in the burial session. We have shown our
deepest condolence to the family while we also took part in
getting the blood pressure among the folks applying
therapeutic communication as we converse with them. We can
feel gradually that the barrier between us and the people
became lighter felt we gained trust as we respected them for
their tradition and actively and sincerely cooperated with
the events as it happened along the way.
WEEK 3: August 7 – 9, 2008
Third week it is. This was a bit more exciting for the
rest of us. We we’re invited to join the neighborhoods to
plant rice as planting rice is a community event or
traditionally done in “Bayanihan” order in such a way that
every rice field are planted by the members of the community
one after the other. Our group personally called this
activity as the “Let’s do the raep – raep thing”, of which
“raep” is the Benguet term for “plant”. We had fun even if
it was drizzling during that day.
The next event that we did is to organize a program for
the Nutrition Month in addition to feeding program. We
prepared a short skit or short stage play and invited the
children as well as the teachers to participate at the end
of the skit. In line with the Nutrition month, we
distributed the food that we prepared catering to all the
students in the school. The event is rewarding knowing we
were able to put smile on the faces of each child with our
small ways.
We also made a follow-up visits to the area.
Surprisingly, the villagers were more open to us at this
time. We were offered some few sip of coffee and hot
chocolate, in their homes while we lightened the
conversation with a spice of humor. We observed that the
people may be a little bit reserved when they speak but they
can also have a good sense of humor with them. We were also
offered “buko”, santol, guava and rambutan as our
“baon”. During the home visits, we made sure to meet our
objectives though. We assessed every home, took down
family’s health history, observed health practices and
lifestyle and listing all the data we need.
WEEK 4: August 14 - 16, 2008
This is the fourth and the last week of our immersion
with the community people. Starting our day was leading the
morning exercises for the students which they enjoyed since
some of the exercises we taught them were unfamiliar to
them. We were invited to the Bugnay factory owned by the
Coop for the Bugnay wine making. We observed the process and
listened while it was being explained to us every step. We
gained insights and we understood that making wine is not as
easy that what is seems. The process involved is critical
and that every step is crucial for the success of the entire
wine making with the goal of producing a fine or quality
product that can be available commercially. However, it was
also noted that funds can be a primary constraint to this
endeavor and that much work needed to be done in into its
progression.
Further, first aid teaching to the students were also
organized as part of our initial plan. After the teaching,
we allowed the children to demonstrate to us what they have
learned.
Finally, we did our last home visit particularly to the
area we haven’t visited. We performed the needed assessment
and took the BP of the residents while giving health
teachings as well. For some of our findings that needed
immediate attention, we referred them to the nearest local
clinic.
Group C:
Dates of Duty: August 22 – September 13, 2008
Members:
Bencio, Jennelyn
Budong, Rita
Cabote, Joanna Marie
Ebuenga, Therese
Facunla, Current Grace
Fontanilla, Ronnie
Opolento, Lilibeth
Pihoc, Rosemarie
Pletchetero, Dianna
Sagubo, Jovy
Sigabu, Arcel
Unay, Lyzette
WEEK 1: August 22-23, 2008
The group made an ocular survey in Colat and Teytey
WEEK 2: August 29-30, 2008
The group had home visits; also, we had conversations
with the clients.
WEEK 3: September 4-6, 2008
The group had home visits in Calamay. We also cleaned
the surroundings of Bayabas Elementary School .
WEEK 4: September 11-13, 2008
We had our last home visits in Sitio Calamay. We
cleaned the surroundings of the school as well as the school
library. Furthermore, we fixed the school compost pit.
Group D:
Dates of Duty: September 18 – October 4, 2008
Members:
Agasen, Clifton
Agrimor, Raiza Lea
Balingan, Ruthlyn
Carpio, Liza Lorraine
Cunanan, Precy
Dianso, Lucille
Estipular, Jennifer
Fernando, Mary Giselle
Focasan, Amyline
Malag, Marie Ann
Operana, Mariza
WEEK 1: September 18 - 20, 2008
Before heading to the community and since it was our
first exposure to the community, we first have our
orientation given by the municipal nurse on duty at the
municipal health center before we proceed to the barangay
office and have our courtesy call with the barangay captain
together with another group. On our first week of dwelling
within the community at the school library, we journeyed
towards the Sitio of Calamay for home visit with the
following goals: to establish and maintain the started
rapport with the community people, to evaluate and update
the general health status of the folks, to report and attend
initially to any encountered diseases or situations that
need immediate and further medical attention. We all did
these together with the supervision of our clinical
instructor.
WEEK 2: September 25 - 27, 2008
On our second week of stay, we continued our home
visit, this time towards the Sitio of Beckes, having the
above mentioned goals and also rendering our nursing
interventions to the community people who were in need.
Also, to encourage the people to change or improve their
practices affecting and alleviating diseases that brings
great effect to them as a functional citizen.
WEEK 3: October 2 - 4, 2008
During our last week, we carried out the order of our
Dean who visited us the past week and offered us to
accomplish physical assessment to the entire pupils of
Bayabas Elementary School ; this is to serve as their health
record. We assessed them thoroughly and accordingly
considering every aspect and we wrote a letter to the
parents of those students who need referral for medical
interventions. After this activity, we also integrated
health education emphasizing on the needs of the students
basing from our assessment, such as the need of the pupil to
be reminded and encouraged for their good and proper
hygiene. We also carried out our nursing interventions to
the folks who were in need as well as integrating our
termination phase with them. Moreover some activities and
moments of the group speak of through the pictures in the
succeeding pages.