Community Health Nursing

community mobilization

aims at informing and gaining the commitment of community leaders as well as local government agencies, NGOs, women's groups, and cooperatives

availability of resources

Priority goals are set according to ______________________.

Contact person

A _____________ will identify other community members to form a core group who assist the nurse in doing community profiling

situational analysis

* Gather health data * Tabulate, analyze and interpret * Identify health problems *Set priority

Goal and Objective Setting

*Define program goals and objectives *Assign priorities among objectives

Strategy/Activity Setting

*Design CHN programs *Ascertain resources *Analyze constraints and limitations

Evaluation

*Determine outcomes *Specify criteria and standards

outcome

A summative evaluation focuses on the ______________

Evaluation

- Find out if he programs and services achieve the purpose for which they were formulated - Determine whether the program is relevant, effective, efficient and adequate

Priority setting/Situational Analysis

- Involves the process of collecting, synthesizing, analyzing and interpreting information in the community - It brings out the health problems of the community - in this phase, the nurse provides explanation to the problems

Indicator

- It is a specific and objectively verifiable measure of changes or results brought about by an activity - Used as marker of progress towards the attainment of program objectives

observation

- communication and interaction pattern - role perception/task assumption/decision making - conditions in the home and environment

Ongoing Evaluation

- is the analysis during the implementation of the activity, of its continuing relevance, efficiency and effectiveness and present and likely future outputs, effects and impact. - focuses on the appropriateness, adequacy and timeliness of processes or activities

Evaluation

- is the analysis of the effectiveness, quality, scope and timeliness of services given. - Define as the process for determining systematically and objectively the relevance, efficiency and effectiveness and impact of activities in the light of their objectives

external

A summative evaluation is sometimes referred to as ___________.

people oriented, community involvement, group research, big crowds, and political involvement

5 characteristics of participatory action research

futuristic, change oriented, continuous and dynamic, flexible, and systematic

5 concepts of planning

checklist

A ___________ is a good evaluation tool if there are a number of criteria for an objective

goal

A ____________ leads to a desired end which may be a total change, improvement or a maintenance of a situation

process

A formative evaluation focuses on the ______________

internal

A formative evaluation is sometimes referred to as ___________.

Data analysis

A process in community diagnosis that aims to establish trends and patterns in terms of health needs and problems of the community It also allows for comparison of obtained data with standard values

Developing the instrument

A process in community diagnosis where instrument or tools facilitate the nurse's data-gathering activities.

determining the objectives

A process in community diagnosis where the nurse decides on the depth and scope of the data she needs to gather. The nurse must determine the occurrence and distribution of selected environmental, socio-economic and behavioral conditions important to disease control and wellness promotion.

Collecting the data

A process in community diagnosis where the nurse decides on the specific methods depending on the type of data to be generated. The nurse also may interview people about their health beliefs The nurse can also review existing health records in the rural health unit

Defining the Study Population

A process in community diagnosis where the nurse identifies the population group to be included in the study. It may include the entire population in the community or a specific population group such as women in the reproductive age, infants or male populations.

Data collation

A process in community diagnosis where the nurse must develop categories for classification of responses making sure that the categories are mutually exclusive and exhaustive.

Determining data to be collected

A process in community diagnosis where the nurse uses objectives as a guide. The nurse also decides on the sources of data whether these data are available from the records of agencies or from the people themselves.

Community Health Nursing Process

A systematic, scientific, dynamic, ongoing interpersonal process in which the nurse and the clients are viewed as a system with each affecting one another and both being affected` by the factors within the behavior.

collection and analysis, program performance

According to UN, evaluation simply is the _______ and _______ of information to determine _________________.

C.E. Winslow

According to ____________, public health is a science and art of prevention of disease, prolonging life, and promotion of health and efficiency through organized community effort

Comprehensive community diagnosis

Aims to obtain a general information about the community.

Sensitive

An indicator is _______, if changes in the indicator in fact reflect changes in the situation or phenomenon

Objective

An indicator is _______, if it is not influenced by personal biases or if he answers are the same if measured by different people in similar circumstances

Timely

An indicator is _______, if it is possible to collect data reasonably quickly

Specific

An indicator is _______, if it is sensitive to the given situation or phenomenon only

Reliable

An indicator is _______, if it lends itself to measurement with minimum error

Valid

An indicator is _______, if it measures what is supposed to measure

Cost-effective

An indicator is _______, if the results are worth the time and money it costs to apply them

executive summary

An_________________ should be prepared for them and should contain a brief description of the focus and procedures of the evaluation, summary and interpretation of results, conclusions and recommendations

Evaluation

Are we on track to achieve the goal?

Attainable

Are you attempting to achieve too much?

Specific

Are you being precise about what you want to achieve?

cultural practices and lifestyle

Before entry in the community, know first the ______________ and _________________ of the people

Health Resource Distribution Program

COPAR is a strategy used by the ___________________ in implementing the Primary Health Care delivery in depressed and underserved communities to become self-reliant

Field health services and information system

Composed of recording and reporting tools.

presentation

Data __________ will depend largely on the type of data obtained.

Organizational Phase

Consists of activities leading to the formation of a people's organization

narrative report

Descriptive data are presented in a ________________.

Review

Do we need to re-define the objective?

Relevant

Do you have resources to make the objective happen?

Intersectoral Collaboration

Facilitate and coordinate with institutions, agencies and other key people.

easureable

Have you quantified your objectives?

Time-bound

Have you stated by when the objective should be achieved?

Advocacy

Helps empower the people to make decisions and carry out actions that have the potential to better their lives

Collection place based

Identify the type of record that includes: Collected at institutional (records of hospitals/health centers) Records to be kept with the individual (immunization cards, disease cards)

Subject based

Identify the type of record that includes: Economical (financial structure of family, village) Social (records of social structure) Political Medical and nursing (treatment and medicine records)

Unit based

Identify the type of record that includes: Individual (individual health cards) Related to family (family folders) Related to community (community folders) National (national health programs records)

Periodical

Identify the type of record that includes: Permanent records (cumulative) Temporary records (casual/daily records)

skills

If ________ are the focus of the evaluation, the client can be asked to demonstrate the specific skills that she/he learned or observed for specific health practices or behaviors

present state of affairs.

In general, planning is done in our desire to improve the _________________.

valid, reliable, objective, sensitive, specific, cost-effective and timely

Indicators should be:

Strategy and Activity Setting

It implies identification of resources-manpower, money, materials, technology, time and institutions-needed to implement the program

midwife, nurse

Monthly forms are prepared by the _______ and submitted to the _________.

Priority setting

Prioritize which health problems can be attend to considering the resources available at the moment

table or graphs

Numerical data are presented into ________________.

co-learning, participation, and organizational transformation

Participatory Action Research emphasizes ____________, ____________, and ____________. (Greenwood et al, 1993)

ongoing

Participatory Action Research is an ______________ organizational learning process.

the people

Participatory Action Research is an attribute of action research in which the problem is determined by _________________ who believe and feel that the problem is really a problem in the local setting and the solution to the problem is within the same setting without intention of generalizing its results.

facility based, BHS or RHU

Records are _____________ , that is they are kept at the ________ or at the ________, and contain a day to day account of the activities of health workers. Services delivered to the clients are the basis of the data entered in the records.

Documentation

Serves as a permanent record of client information and care.

political, community, government, corporate, and beneficiary

Social mobilization is concerned with mobilizing human and financial resources through 5 main approaches:

learn more about the conditions of the community, the nurse deepens and strengthens her ties with the people

Social preparation

Reporting

Takes place when two or more person share information about client care, either face to face or by telephone

relevance, progress, effectiveness, impact and efficiency

The WHO suggested five dimensions of program performance that could be then evaluated:

get people to work together

The aim of partnership and collaboration is to _____________________ in order to address problems or concerns that affect them

Community Diagnosis

The bases for developing and implementing community health nursing interventions and strategies. Others may call it community assessment or situational analysis

valuable working relationships

The community health nurse must plan to establish and maintain _______________________ with people such as POs, health organizations, educational institutions, the LGUs, financial institutions, religious groups, socio-civic organizations, NGOs and sectoral groups.

accurate and reliable

The evaluator's primary aim is the generation of __________ and __________ data

CDX

The nurse uses the ____________ report as a basis for the situational analysis

short term or immediate objectives

The objectives are formulated for problem situations which require immediate attention, and results can be observed in a relatively short period of time. Can be accomplished with a few nurse-patient contacts. Relatively require fewer resources.

Medium term or intermediate objectives

The objectives are those which are not immediately achieved and are required to attain the long-term ones

long term or ultimate objectives

The objectives require several encounters, an investment of more resources. Requires time to demonstrate.

deviations or problems

The purpose of monitoring is to identify _____________ or _______________ so that corrective actions or interventions can be instituted immediately. This requires reporting to appropriate persons or offices at regular intervals

disease registries

These are collections of secondary data related to patients with a specific diagnosis, condition, or procedure.

Registry of vital events

These are records of life events kept under governmental authority, including birth certificates, marriage licenses, and death certificates

Effects

These are the outcomes of the use project outputs (intermediate).

Nature of the condition

These problems are classified by the nurse as health status, health resources or health -related problems.

Health related problems

This community health nursing problem may be described in terms of existence of social, economic, environmental and political factors that aggravate the illness-including situations in the community.

Health status problems

This community health nursing problem may be described in terms of increased or decreased morbidity, mortality, fertility or reduced capability for wellness.

Health resources problems

This community health nursing problem may be described in terms of lack of or absence of manpower, money, materials or institutions necessary to solve health problems.

Survey

This data collection method can be used to obtain both qualitative and quantitative data

Interview

This data collection method can yield 1st hand information, including health history, health status, health of family members, etc.

physical examination

This data collection method provides significant data about health status of individual family members which can be obtained through direct IPPA

Community forum

This data collection method's immediate purpose is to get feedback or opinion from the residents in the community about a problem or issue

Participatory Action Research

This is a form of action research in which professional social researchers operate as full collaborators with members of organizations in studying and transforming those organizations.

planning

This is a process that entails formulation of steps to be undertaken in the future in order to achieve a desired end.

Census data

This is a regularly occurring and official count of a particular population.

Impact

This is the output of program effects and is an expression of broader, long-range program objectives.

Health records and reports

This is the principal repository for data and information about the healthcare services provided to an individual patient. It documents the who, what, when, where, why, and how of patient care.

Community Organizing

This is utilized to facilitate the process of forming and sustaining self-reliant and self-determining communities. Is a process whereby the community members develop the capability to assess their health needs and problems, plan and implement actions to solve these problems

preparatory phase

This phase includes area selection, community profiling, entry in the community and integration with the people.

Community Profiling

This provides an overview of demographic characteristics, community related services and activities.

Objectives

This refers to more specific statements of the desired results or outcomes of care and are the milestones to reach the destination

Monthly Consolidation Table

This table is accomplished by the nurse based on the summary table

formative evaluation

This type of evaluation is a method for judging the worth of a program while the program activities are forming (in progress). They can be conducted during any phase of the Analysis Design Development Implementation and Evaluation (ADDIE) process.

summative evaluation

This type of evaluation is a method of judging the worth of a program at the end of the program activities (summation).

ocular survey

Through a(n) _____________________, the nurse is able to determine the physical and topographical characteristics of the community.

Phase-out

Turnover of works to the community organization and develop monitoring and follow-up activities.

monitoring

UN defined _____________ as the "continuous or periodic review and surveillance by management at every level of the hierarchy of the implementation of an activity to ensure that input deliveries, work schedules, targeted outputs and other required actions are proceeding according to plan.

Survey questionnaire Interview guide Observation checklist

What are the 3 most common instruments that the nurse can use in data collection?

Inputs, Process, and Outcome/Result

What are the three Major Foci of Program Evaluation?

How do we know we are there?

What is the question being answered in Evaluation?

Where do we want to go?

What is the question being answered in Goal and Objective Setting?

How do we get there?

What is the question being answered in Strategy/Activity Setting?

Where are we now?

What is the question being answered in situational analysis?

depressed, oppressed, poor and exploited

What kind of people should be the focus of community organizing?

Hospital

Where can disease registries be accessed?

Goals and Objectives

___________________ serves as a guide to the nurse's efforts.

attitude

____________________ can be assessed through qualitative, semi-structured or unstructured interviews.

Community Organizing Participatory Action Research

a social development approach that aims to transform the apathetic, individualistic and voiceless poor into dynamic , participatory and politically responsive community.

Problem-oriented community diagnosis

deals with assessment/problems to a particular need that are readily seen and should be acted upon immediately.

Spotting and developing potential leaders

gain the trust and respect of the community members. Provide opportunities and test the commitment to the community's well being. Nurse provide learning experiences that will prepare them as future leaders of the community.

Core group formation

identify potential leaders who will be tasked with laying down the foundation of a strong people's organization

line graph

is primarily intended to portray trends and changes indicating population growth, birth rates, morbidity, and mortality rates.

Social mobilization

is the process of bringing together all societal and personal influences to raise awareness of and demand for health care, assist in the delivery of resources and services, and cultivate sustainable individual and community involvement.

Terminal Evaluation

is undertaken from 6-12 months after the project completion it is a substitute for an Ex post evaluation of projects with short duration

Ex post Evaluation

is undertaken some years after the project completion when full program/project benefits and impact are expected to have been realized

bar graph

is used to portray absolute or relative frequencies, population, races or other numerical measurements across the categories of qualitative variable or discrete quantitative (discontinuous) variables.

Pie chart

is used to show how the whole is divided into its component parts through the use of wedge of slice proportional to the relative contribution of the component to the whole pie.

Collaboration

level of organizational relationship where organizations help each other enhance their capacities in performing their task as well as in the provision of services.

Coalition or Multi-sector Collaboration

level of relationship where organizations and citizens for a partnership. All parties give priority to the community

Audit and Quality assurance

monitor quality of care received by client

group relationship

partnership and collaboration gives people opportunity to learn skills in ___________________

Research

provides health data for research

Statistics

provides statistical information for planning

Records

refers to the forms on which information about an individual or family is recorded

networking

relationship among organizations that consists of exchanging information about each other's goals and objectives, services or facilities.

coordination

relationship where organization modify their activities in order to provide better service to the target beneficiary.

Cooperation

relationship where organization share information and resources and make adjustments in one's own agenda to accommodate the other organization's agenda.

Summary Table

serves as a source for the 10 leading causes of morbidity in the municipality/city.

Communication

sharing of information about the client

Goals

tell where the community is going

Individual Treatment Record (ITR

the building block of the FHSIS

Target Client List

the second building block of the FHSIS

Outputs

the specific products or services which an activity is expected to produce from its inputs to achieve its objectives (short term).

Reports

these are accounts or statement describing in detail an event, situation, or like, usually as the result of observation, inquiry, etc.

Education and Training Phase

this is to strengthen the organization and develop its capability and attend to community's basic health-care needs.

Observation

this method of data collection is done though the use of the sensory capacities

Setting up the community organization

this organization will participate in a wider participation and collective action on community problems.

social concern

this refers to the perception of the population or the community as they are affected by the problem and their readiness to act on the problem.

Preventative potential

this refers to the probability of controlling or reducing the effects posed by the problem.

modifiability of the problem

this refers to the probability of reducing, controlling or eradicating the problem

Magnitude of the problem

this refers to the severity of the problem which can be measured in terms of the proportion of the population affected by the problem

education

tool for students

Legal documentation

use as evidence in court

Barangay health centers

where can health records and reports be found?

nurses

who prepares quarterly forms?

Community Profile

· Is a summary of baseline conditions and trends in a community and study area. It establishes the context for assessing potential impacts and for project decision-making. · Is a data sheet that records information on a broad range of factors (such as environmental/natural features and management, sociodemographic characteristics, political and economic structures, local institutions, economic activities and livelihoods, basic household and community facilities