NCM 213 FINALS

● The characteristics of environmental

conditions that affect quality of health. It
COMMUNITY HEALTH NURSING
is the aspect of public health that is
concerned with those forms of life,
Finals Topic Outline: substances, forces and conditions in the
➔ surroundings or person that may exert
I. Environmental Health influence on human health and well being
A. Definition (DOH,1998)
B. Solid Waste Management ● Comprises aspects of human health
II. Water Sanitation including quality of life that are
A. Additional Notes from other section determined by physical, chemical,
III. Food safety biological, social and psychosocial factors
IV. Sanitation in the environment. It also refers to the
V. Vermin and Control theory and practice of assessing,
VI. Built Environment: National Code of the correcting, controlling and preventing
Philippines those factors in the environment that can
VII. Monitoring and Evaluation, Information potentially affect adversely the health of
Technology and core Competencies in present and future generations (WHO,
Nursing 1993)
VIII. INFORMATION AND COMMUNICATION
TECHNOLOGY (ICT) The philippine government takes
IX. Competency Standards of CHN action/responsibility through
X. HEALTH RELATED ENTREPRENEURIAL ➔ EO 489: INTER-AGENCY COMMITTEE ON
ACTIVITIES ENVIRONMENTAL HEALTH (IACEH)
—------------------------------------------------------------------------- ● Institutionalizing the Inter-agency
“No amount of medical knowledge will lessen the Committee on Environmental
accountability for nurses to do what nurses do; to Health (IACEH) with DOH secretary
manage the environment to promote a positive as chairperson and DENR as vice
life process.” - Sister Calista Roy, Commentary on chairperson
Notes on Nursing 1992 VISION: Healthy settings for all Filipinos
MISSION: Provide leadership in ensuring healthy
ENVIRONMENTAL HEALTH settings
GOAL: Reduction of environmental and
● Is the science and practice of preventing
occupational related diseases, disabilities and
human injury and illness and promoting
deaths through health promotion and mitigation
well being by:
of hazards and risks in the environment and
○ Identifying and evaluating
workplaces
environmental sources of
hazardous agent and Roles of IACEH specified by law includes the
○ Limiting exposure to hazardous task of:
physical, chemical and biological - Coordinating
agents in air, water, soil, food and - Monitoring
other environmental media or - Evaluating Health Programs
settings that may adversely affect Note: To perform above role National
human health Environmental Health Action Plan (NEHAP) had
been created
NCM 213 FINALS

NEHAP identified the 7 components of or have access to any of the three levels of
Environmental Health assigner to the members safe water resources that conforms to
of IACEH namely: national standards for drinking water
● Solid waste
● Water ➔ Level 1 (POINT SOURCE) - refers
● Air to protected well, improved drug
● Toxic and hazardous waste well, developed spring , or
● Occupational Health rainwater cistern with an outlet but
● Food Safety without a distribution system
● Sanitation - adaptable for rural areas
● Climate Change where the houses are thinly
Note: In July 2010, this was expanded to include scattered
CLIMATE CHANGE - Normally served 15-25
ENVIRONMENTAL HEALTH RECORDS households
MANAGEMENT - Outreach must not be more
- maintenance of environmental health than 250 meters from the
records (EHR) is one of the responsibilities farthest user
given to a city, municipality, and provincial - Yield or discharge is
health nurses generally from 40-140
- Field Health Service Information System liters/minute
(FHIS) is the current data management ➔ Level 2 or II - refers to a system
used by the DOH composed of a source, a reservoir, a
- Data collection begins the midwife and piped distribution network, and a
BHW, 2008 version of FHSIS, a midwife is communal faucet located not more
tasked to maintain a monthly record of the than 25 meters from the farthest
environmental health programs house
Note: City health nurse/provincial health nurse is - delivers 40-50 liters per
tasked to maintain EHR capita per dag to an average
EIGHT ENVIRONMENTAL HEALTH INDICATORS of 100 household with one
THAT NEED TO BE MONITORED: faucet per 4-6 households
1. Household with access to improved or safe - Note: piped distribution
water - stratified to levels I,II, and III takes the point of
2. household with sanitary toilets consumption away from the
3. Household with satisfactory disposal solid reservoir thus decreasing
waste risk of pollution;
4. Household with complete basic sanitation contamination of water
facilities more likely take place
5. food establishments during its transport and
6. food establishments with sanitary permits storage in the individual
7. food handlers households
8. food handlers with health certificates
➔ Level 3 (WATERWORKS SYSTEM) -
THE 2008 VERSION OF THE FHSIS PRESENTS refers to a system with a source,
THE FOLLOWING DEFINITION: transmission pipes, a reservoir, and
➔ Household with access to improved or safe a piped distribution network for
water supply - refers to those covered by household taps
NCM 213 FINALS

- requires a minimum ● Food Handlers

treatment of disinfection - refer to the person who handle,
- NOTE: A level III may also store, prepare, or serve any food
include a level I system with item, drink, or ice, or who come in
piped distribution for contact with any eating or cooking
household taps, serving a utensils or food vending machine
group of house dwellings NOTE: The interest of public health nurse as
such as apartments and collators and consumers of FHSIS data is to
condominiums compare the number of food handlers of those
➔ Household with sanitary toilets which have active health certificates. Thus, these
- refers to the households with their people needs health certificate that they are
own flush toilets connected to a qualified physically and medically fit to serve
septic tank and or sewerage system food
or any other approved treatment
system, sanitary pit latrine, or Health Certificate
ventilated improved pit latrine - a written certification using the prescribed
- The national target for this form, issued by the municipal or city health
component is 91% (96% for urban officer ro a person after passing the
and 86% for rural areas) required physical and medical
➔ Households with complete basic examinations and immunizations
sanitation facilities
1. access to safe water THE CODE OF SANITATION OF THE
2. availability of sanitary toilet PHILIPPINES (PD 856) CHAPTER II WATER
3. satisfactory system of garbage SUPPLY
disposal Provisions in the Implementing Rules and
Regulations (IRR):
SANITATION REQUIREMENTS - washing and bathing within a radius of 25
-in accordance with PD 552, 856 and other local meters from any well or other source of
ordinances drinking water is prohibited
● Food Establishment - no artesans, deep or shallow well s be
- refer to those where food or drinks constructed within 25 meters from any
are manufactured, processed, source of pollution (including septic tanks
stored, sold, or served, including and sewerage system) Drilling a well within
those that are located in vessels. a 50 meters distance from a cemetery is
● Sanitary Permit also prohibited
- the written certification of the city - no radioactive source or material shall be
or municipal health officer or stored within a radius of 25 meters from a
sanitary engineer that the y well or source of drinking water unless
establishment complies with the the radioactive source is adequately and
existing minimum sanitation safely enclosed by proper shielding
requirement upon inspection - no dwelling shall be constructed within
conducted in accordance with PD the catchment area of protected spring
552 and 856 and local ordinances water resource, and it shall be off limits to
people and animals
NCM 213 FINALS

SOLID WASTE MANAGEMENT manner that is in accordance

with the best principles of
DEFINITIONS public health, economics,
Refuse engineering, conservation,
● is a general term applied to solid and semi aesthetics, and other
solid waste materials other than human environmental
excreta. Waste material in refuse may be considerations, and that is
divided into: also responsive to public
attitudes
➔ Garbage ➢ refers to activities that
● refers to leftover vegetable, animal, reduce, and possibly
and fish material from kitchen and eliminate, the potentially
food establishments. recyclable materials in the
● These materials have the tendency waste stream before they
to decay, thus giving off foul odors. end up as added undesirable
matter on the land known as
➔ Rubbish land pollution.
● refers to waste materials such as
bottles, broken glass, porcelain, fin NOTE: Philippine Development Plan (PDP) for
cans, waste paper, discarded textile 2011-2016 aspires to get a 50% increase in the
materials, pieces of metal and other solid waste diversion (SWD) rate from the 33% in
wrapping materials the year 2010. Nurses has a lot of work
inspection everywhere: example are in the street
➔ Ashes foods or turo turo - NO double dipping and
● are the leftovers from the burning advise vendor to provide a longer stick
of wood and coal. Ashes may
become a nuisance because of the ➔ This act to reduce the contamination of
dust associated with them land, supports the work of PHN in enabling
the community to increase its level of
➔ Stable Manure wellness, as it necessarily protects some of
● is animal manure collected from the health supporting functions of land
stables such as:

1. Platform of human activities

➔ Dead Animals Polluted soil may be contaminated
● include dead dogs, cats, rats, pigs with disease causing parasites and
and chickens that are killed by microbes
vehicles on streets and public 2. Agricultural production
highways. Also included are small Alteration of soil composition can
and large animals that die of make the land unsuitable for
disease growing crops and threatens food
➢ discipline associated with security
the control of generation, 3. Habitat of members of the food
storage, collection and chain
transport, processing, and
disposal of solid waste in a
NCM 213 FINALS

Bioaccumulation - Laboratory cultures,

● hazardous materials contaminated waste from
accumulate in the soil and clients, dressings, swab,
affects the lower life forms instruments that are in
Biomagnification contact w/ infected person
● hazardous chemicals - pathologic waste
increase in concentration as - Tissues, organs, body parts,
the creatures in the bottom blood , and body fluids
of the food chain are - pharmaceutical waste
consumed by more superior - Drugs, sera, vaccines, items
creatures used in handling
pharmaceuticals like gloves,
4. Filter for surface water - Soil mask, tubings, drug vials,
saturated with pollution not only boxes /bottles with residues
acts as poor filter but may also - chemical waste
contaminate seeping water - Varied states of chemical
RA 9003 matter from clinical or
● defines SWM as the discipline associated laboratory activities,
with the control of generation , storage, environmental work ,
collection and transport, processing, and housekeeping, and
disposal of solid waste in a manner that is disinfecting procedures
in accordance with the best principles of - sharps
public health, economics, engineering, - Needles, broken glass
conservation, aesthetics, and other scalpel and blades
environmental considerations, and that is - radioactive waste
also responsive to public attitudes - Radiation sources used in
cancer treatments)
RA 9003 ECOLOGICAL SOLID WASTE Another classifications:
MANAGEMENT ACT OF 2000 and the DOH 3. Industrial waste
Manual on Healthcare Waste Management of - refers to the refuse that arise from
2011 classifies solid waste as production and from agricultural,
Classification of solid waste: and mining industries
1. Municipal waste 4. Hazardous waste
- refers to all nonhazardous ● Substances that pose either an
household commercial institutional immediate or long term substantial
waste, street sweeping and danger to human because
construction debris. possessing any of the following
2. Healthcare waste or biomedical waste properties:
- refuse that us generated in the ○ Toxic
diagnosis, treatment, or ○ Corrosive such as acids of
immunization of human beings or Ph<2, and bases of Ph> 12
animals together with those related ○ Flammable
to the production or research ○ Reactive such as those that
This can be classified as follows: can cause explosions
- infectious waste ○ Genotoxic such as
cytostatic/cytotoxic drugs
NCM 213 FINALS

3rd Edition of Manual on Healthcare Waste Level 2: Chemical and physical quality
Management published by DOH in December tested through the parameters of pH
2011 chemical specific levels, color, odor,
color coding of hospital waste bins turbidity, hardness, and total dissolved
- black or colorless solids
- green (biodegradable waste; Level 3: Radiological quality tested
nonhazardous) through the parameters of the gross alpha
- yellow with biohazard symbol activity, gross beta and radon.
(pathological, anatomical waste) 3 KEY COMPONENTS OF WATER SAFETY PLANS
- yellow with black band - pharmaceuticals, DOH AO 2007-0012 – directs all drinking water
cytotonic, or chemical waste (labeled processor from a large water system to water
separately) refilling
- yellow bag that can be autoclaved - station to create a water safety plan.
infectious waste 1. SYSTEM ASSESSMENT - determine if the
- orange with radioactive symbol - drinking water supply chain as a whole can
radioactive waste deliver water of quality that meets
health-based targets
Implementing Rules and Regulation of RA 9003 2. OPERATIONAL MONITORING - identify
has declared the following as some of the control measures in a drinking water
prohibited acts: system that will collectively control
- open burning of solid waste identified risks and ensure that the health
- open dumping based targets are met, and to rapidly
- burning in flood prone areas detect any deviation from the required
- squatting in landfills performance. After the installation of the
- operation on any landfills on any aquifer, water system, it will undergo monthly or
ground water, reservoir, or watershed frequent operational monitoring.
- construction of any establishment within 3. MANAGEMENT'S PLANS - to describe
200 meters from a dump or landfill actions to be taken during normal
operations or incident conditions. Para
may intervene in cases of incidents or
WATER SANITATION
conditions or abnormal operations with
regards to the water system.
- DOH Administrative Order No. 2007-0012
otherwise known as the PHILIPPINE ENVIRONMENTAL HEALTH PD-856- code of
STANDARDS FOR DRINKING WATER of sanitation in the philippines - Water - chapter 2
2007 identifies the three levels of access to DOH 2007-0012 or Philippine Standard for
water supply and set standards of the drinking water of 2007
quality drinking water
Provisions in the Implementing Rules and
General Requirements of Safe Drinking Water Regulations (IRR):
covers the following: - washing and bathing within a radius of 25
meters from any well or other source of
Level 1: Microbial quality tested through drinking water is prohibited
the parameters of total coliform, fecal - no artesans, deep or shallow well s be
coliform, and heterotrophic plate count constructed within 25 meters from any
source of pollution (including septic tanks
NCM 213 FINALS

and sewerage system) Drilling a well within about proper washing techniques is of high
a 50 meters distance from a cemetery is importance.
also prohibited
- no radioactive source or material shall be
stored within a radius of 25 meters from a
y well or source of drinking water unless
the radioactive source is adequately and
safely enclosed by proper shielding
- no dwelling shall be constructed within
the catchment area of protected spring
water resource, and it shall be off limits to
people and animals

● [Link] - Escherichia coli - most common Level 1(Point source) - protected well, w/outlet
coliform- strong indication that there is an but w/o distribution system
animal / sewage waste contamination i.e. parang spring pero walang tubo na
● Positive biohazard if there are gaa, gb, and papunta sa mga bahay bahay; deep well- point
r. source; hand pump

WATER SUPPLY AND SANITATION PROGRAM Level 2 (Communal faucet / Standpoint) - may
- EOHO - environmental and organizational source na papunta sa reservoir/tank -> distribute
health office- under DOH to 100 max households
- They set policies and programs
Programs are: Level 3 (water work system) - sources such as
1. Approved types of water facility dam; lawa/lake from the dam
2. Access to safe and potable water
3. Unapproved types of water supply R.A. 9275: Philippine Clean Water Act of 2004
4. Water quality and monitoring Lead Agencies:
5. Disinfection of water supply - DENR : implementation and enforcement
- Annual monitoring and disinfection is of the law
needed - DOH: responsible for the promulgation,
6. Waterworks/ water system and revision, and enforcement of drinking
construction of wells. water quality standards.

APPROVED WATER SUPPLIES IN DAVAO CITY EMERGENCY WATER TREATMENT (WEDC)

- DCWD - In 2007 WHO, through the Water
- Approved deep wells engineering and development center
(WEDC), came up with technical notes for
emergency water treatment.
WATER STORAGE AND CONSUMPTION 1. Pretreatment Process:
- Wide-necked containers with tight fitting - Aeration: rapidly shake half filled
lids are best for water storage as they are bottle. to remove volatile
easy to clean between use. substances, reduce carbon dioxide
- Hands and utensils may come in contact content, and oxidized dissolved
with water, therefore educating people minerals. A method for aeration is
to rapidly shake a container that is
NCM 213 FINALS

partially full of water for about 5 araw, in conducting the SODIS, you
minutes. need to expose the water in two
- Settlement: stand undisturbed in days. Uncommon CHN na ginagawa.
the dark for 24 hrs. done by Maybe itong SODIS not intented for
allowing water to stand the water to be potable but
undisturbed in the dark for a day. maavoid lang ang mga skin allergies
This process causes death to more brought about the use of water
than 50% of most harmful bacteria
and settling of suspended solids. POLICIES
- Filtration: using clean cloth/ sand/
ceramic to filter. - done by utilizing 1. Food establishments are subject to
filters to block particles while inspection (approval of all food sources,
allowing water to pass through. containers, and transport vehicles) all
Filters include clean cloth, sand and establishments before they can operate,
ceramics. Nakikita sa water refilling they need to get certification and place be
station, in between sa filtration kay checked for sanitation
parang bato and sand yun ang 2. Food establishments should comply with
nagafilter. But it will undergo a the sanitary permit requirement for all
process na ready sya and potable na food establishments
ang wateR. 3. Food establishments should comply with
2. Disinfection Processes: updated, health certificates for food
- Boiling- the water should be handlers, helpers, cook.
brought to a "rolling boil and kept 4. Food establishments should destroy or ban
in that state for at least 1 minute. food that is unfit for human consumptions
At higher altitudes, the water 5. Food handlers and operators of food
should be kept in a rolling boil state establishments should be trained on food
for at least 3 minutes. Even sa sanitation
potable na mga water, pediatrician 6. Food establishments shall be rated and
would still advise mother na in classified as:
preparing for the milk of our babies, • Class A - Excellent
ginapaboil ang water atleast 5mins • Class B- Very Satisfactory
before iserve • Class C - Satisfactory
- Chemical Disinfection - can be 7. Ambulant food vendors shall comply with
done using various chemicals but the requirement of acquiring a health
the most widely used remains to be certificate which include monitoring the
chlorine as it can kill the viruses and presence of intestinal parasite and
bacteria. There are other chemicals bacterial infection.
being used to disinfect the water a. Ex. Ambulant food like sa roxas
but the known chemical na market
ginagamit is chlorine 8. Promotions and monitoring of household
- Solar disinfection (SODIS) - This food, sanitation and intensification of food
can be done by filling transparent hygiene education shall be implemented
plastic containers 1 to 2 liters in size through health education and the provision
with clear water, and exposing them of IEC materials
to direct sunlight for about 5 hours.
In cases na di masyado tingkad ang
NCM 213 FINALS

FOUR RIGHTS OF FOOD SAFETY 2. Open Burning - refuse/garbage regularly

piled and later burned in the open air
● Right SOURCE
● Right PREPARATION 3. Animal Feeding - garbage sometimes used
● Right COOKING • as hog feed
● Right STORAGE- involves keeping food
safe to eat. The following should be 4. Composting - grinding and disposal sewer
observed:
○ Cooked food should not be left at Community:
room temp. for more than 2 hours 1. Sanitary landfill - excavation of soil, meter
to prevent multiplication of pits covered with soil, deposition of refuse
microorganisms and located 25 m away from the
○ Store food in tightly sealed compacting with a solid cover of 2 feet
containers o If food is to be stored
in a hot condition, the temperature HOSPITAL WASTE MANAGEMENT
should be > 60 C Goal: To prevent the risk of contracting
○ if food is to be stored in a cold nosocomial infection and other diseases from the
condition, the temperature should disposal of infectious, pathological and other
be <10 C hospital wastes
○ Note that microorganism multiply
best at a temperature range of 10
-60C POLICIES
1. All newly constructed /authorized and
existing government and private hospitals
PROPER EXCRETA AND SEWAGE DISPOSAL shall prepare and implement a hospital
PROGRAM waste management program (HWMP] as a
requirement for registration and renewal
1. Blind Drainage of license.
● Type of wastewater collection and 2. The use of appropriate technology and
disposal facilities shall be indigenous materials for HWMP shall be
emphasized in rural areas until such adopted.
time that sewer facilities and off 3. Training of all hospital personnel involved
site treatment facilities are in waste management shall be an essential
available part of the hospital training program
2. Proper Solid Waste Management 4. Public information campaigns on health
● Refers to satisfactory methods of and environmental hazards arising from
storage, collection and final mismanagement of hospital wastes shall
disposal of solid waste be the responsibility of the hospital
administration.
Two Ways of Excreta Disposal 5. Local ordinances regarding the collection
and disposal techniques, especially
Household: incineration, shall be institutionalized.
1. Burial - deposited in 1 meter x 1 water
supply; no intention to dig feet up later for
use as fertilizer.
NCM 213 FINALS

TOXIC SUBSTANCES and HAZARDOUS and 3. Toxic, chemical and hazardous waste
NUCLEAR WASTE CONTROL ACT of 1990 or R. A management
No. 6969 4. Red tide control and monitoring
5. Integrated pest management and
➢ Regulates the importation, use, movement, sustainable agriculture
treatment, and disposal of toxic chemicals, 6. Pasig river rehabilitation management
hazardous substances and nuclear waste.

ECOLOGICAL SOLID WASTE MANAGEMENT

FOOD SAFETY
ACT OF 2000 or R.A No. 9003
➔ refers to the assurance that food will not
cause harm to the consumer when it is
➢ Mandates a community-based approach to prepared or eaten according to its
ecological solid waste management through intended use.
composting and recycling Food and Drug Administration
➔ led inter-agency committee formed
LAWS and POLICIES byDepartment of Health to gear toward
the food safety
1. Clean Air Act of 1999 or R.A No.8749 RA 9711 Food and Drug Administration Act
➢ Provides a comprehensive air ➔ enacted in 2009 to strengthen the FDA in
pollution management and control safeguarding the safety and quality of
program. It bans the use of incineration for processed foods, drugs, diagnostic
municipal, biomedical and hazardous reagents, medical devices, cosmetics, and
wastes, but allows traditional small-scale household substances
community burning of waste. It requires all IRR of Chapter III of PD 856: ON SANITATION
vehicles to pass the smoke emission REQUIREMENTS FOR THE OPERATION OF FOOD
standards prior to registration. It also bans ESTABLISHMENTS
smoking in enclosed public places, ➔ Sanitary permit from the city or
including public transport. municipality that has jurisdiction over the
business. Food establishments on board
2. Clean Water Act of 2004 or R.A. No. 9275 sea crafts (application must filed in the
➢ Aims to establish wastewater vessels port of region), must be posted in a
facilities that will clean wastewater before conspicuous place in the establishment
it is released into bodies of water like the ➔ Health certificate on all employed in a food
river or the sea. It also requires LGU's to establishment, must be clipped on the
form water management areas that will upper left portion of the garment while
manage wastewater in their respective working
geographic territories
REQUIREMENTS:
STRATEGIES ON HEALTH RISK MINIMIZATION 1. No person shall be allowed to work of food
DUE TO ENVIRONMENTAL POLLUTION handling if afflicted with communicable
________________________________________ diseases including boils, infected wounds,
1. Anti-smoke belching and air pollutions respiratory infections, diarrhea, and
campaigns gastrointestinal upset
2. Zero solid waste management 2. Food preparation and storage rooms
should never be used or be directly
NCM 213 FINALS

connected to a sleeping apartment or

toilet
3. No animals can be kept in a food area
4. Floors and ceilings must be made of
material that can be cleansed
5. Adequacy of lighting, sufficiency of
ventilation, and minimum space
requirement
6. Hand Washing basins, appropriate toilet
facility, water supply, and refuse
management wastes.
7. Utensils must be scrapped from all food TYPES OF BARRIER TO PREVENT
particles and be washed in warm water (49 TRANSMISSION
degree celsius) with soap 1. Primary barriers
8. If running water is not available the wash ➔ structures and facilities that
water shall be changed frequently. The prevent the fecal contamination of
utensils are subjected to one of the fingers, fluids, flies, and
following bactericidal treatments: fields/floors
➢ immersion for at least 30 seconds in 2. Secondary barriers
clean how water ➔ practices that prevents
➢ immersion for at least 1 minute in contaminated fingers, flies, fluids,
lukewarm water containing 55-100 filed/floors from coming in contact
ppm chlorine solution with food or the new host
➢ exposure to steam for at least 15
minutes to 77 degree celsius or for Four Component of Sanitation Facilities
5 minutes to at least 200 degree 1. Toilet
celsius ➔ could either a receptacle 9bowl)
9. Ambulant food vendors shall sell only where the user sits down or a
bottled drinks and pre-packed food. squatting plate
10. They are prohibited from selling foods that 2. Collection
requires the use of utensils ➔ also known as sewerage systems,
transport the wastewater for
SANITATION treatment of disposal
3. Treatment
➔ The hygienic and proper management,
➔ is the process of reducing liquid and
collection disposal, or reuse of human
solid waste to non polluting matter
excrete (feces and urine) and community
4. Disposal/reuse
liquid waste to safeguard the health of
➔ can mean discharge to water bodies
individuals and communities (Philippine
or release in the atmosphere in the
Sanitation Sourcebook and Decision Aid,
form of gas; ecological sanitation
2005)
moves for the reuse instead of the
Sanitation and Hygiene Promotion Programming
disposal of treated wastewater
Guidelines of 2005 developed the F diagram
➔ The 6 F’s that form part of the means to
transmit microorganisms in fecal materials
to a new host
NCM 213 FINALS

GENERAL CLASSIFICATION OF SANITATION

SYSTEM ACCORDING TO WATER RELIANCE Antipolo toilet
➔ Water-reliant systems ➔ an elevated pit privy that has a covered
- make use of water to flush and latrine. The elevation ensures that the
transport the waste material to the bottom of the pit is at least 1.5 meters
collection system, thus requiring a above the water table
continuous water supply
➔ Non water-reliant systems Septic privy
- make use of dry storage for urine ➔ fecal matter is collected in a built septic
and feces, however, a small amount tank that is not connected in a sewerage
of water may be used to cleanse the system, septic tank contains water but no
parts of the dry system drop pipe from the latrine that is dipped
into the water
IRR of the Sanitation Code of the Philippines
Aqua privy
Component of sanitary privy: ➔ fecal matter is eliminated into a water
1. Earthen pit sealed drop pipe that leads from the
➔ 1 m 2 wide latrine to a small water filled septic tank
2. Floor covering the pit located directly below the squatting plate.
➔ should cover the pit tightly and A ventilation pipe with a fly screen on top
joined to the bowl (watertight and is part of the design.
insect proof joint)
3. Water sealed bowl Overhung latrine
➔ fecal material is directly eliminated into a
body of water such as the flowing river
that is underneath the facility. WHO
SOME SANITATION FACILITIES IN THE recognizes the acceptability of the use of
COMMUNITY THAT A NURSE OR SANITATION such in disaster situations like heavy
OFFICER MAY ENCOUNTER IN THE flooding when the body of water is
COMMUNITY deemed polluted. Body of water must be
large and freely flowing.
Pail System
➔ also known as Box and Can Privy or Bucket Ventilated Improved Pit (VIP) latrine
Latrine ➔ a pit latrine with a screened air vent
➔ Regular removal and disposal of waste in a installed directly over the pit. The ambient
sanitary manner air that enters the pit hole pushes the foul
➔ Burial of contents at least 12 inches from air onto the air vent, screen on top
the ground, to prevent access to flies or prevents entry of insects attracted by the
escape of adult flies smell

Pit latrine or Pit Privy Concrete vault privy

➔ toilet facilities without a bowl, equipped ➔ fecal matter is collected in a pit privy lined
with either a squatting plate or a rise with with concrete in such manner so as to make
a sear, pit reduces the volume of its it water tight
contents as the liquid infiltrated the
surrounding soil
NCM 213 FINALS

Chemical privy
➔ fecal matter is collected in a tank that UNSANITARY FACILITIES
contains caustic chemical solution which in 1. Water sealed toilet connected to a swerve
turn controls and facilitates waste or septic tank shared with other
decomposition households
2. Water sealed toilet connected to other
Compost privy depository type, shared with other
➔ fecal matter is collected into a pit with households
urine and anal cleansing materials with 3. Closed pit, shared with other households
addition of organic garbage such as leaves 4. Open pit
and grass to allow biological 5. Hanging toilet
decomposition 6. Other unsanitary types of practices
7. Open defecation
Pour flush latrine
➔ it has a bowl with a water seal trap similar
to the conventional tank flush except that
VERMIN AND VECTOR CONTROL
it requires only a small volume of water for
flushing ➔ DOH IRR of Chapter XVI Vermin COntrol of
the Sanitation Code of the Philippines (PD
Tank flush toilet 856) defined the following terms:
➔ feces are excreted into a bowl with a water
sealed trap. The water tank that receives a 1. Vermin
limited amount of water empties into a ➔ groups of insects or small animals
bowl for flushing of fecal materials such as flies, mosquitoes,
through the water sealed trap and into the cockroaches, fleas, lice, bedbugs,
sewerage system mice, and rats are vectors of
diseases

Urine Diversion and Dehydration Toilet (UDDT) 2. Insects

➔ waterless toilet system that allows the ➔ flies, mosquitoes, cockroaches,
separate collection (fecal vault and urine bedbugs, fleas, lice, ticks, ants, and
container) an on site storage or treatment other arthropods
of urine and feces. The fecal vault is kept 3. Pest
dry and the feces are left dehydrated for ➔ destructive or unwanted insects or
agricultural waste. small animals (rats, mice, etc.) that
cause annoyance, discomfort,
THREE SANITATION FACILITIES THAT ARE nuisance, or transmission of disease
CONSIDERED SANITARY to humans and damage structures.
1. Water sealed toilet connected to as sewer 4. Rodents
or septic tank used exclusively by the ➔ small mammals such as rats and
household mice characterized by constantly
2. Water sealed toilet connected to other growing incisor teeth used for
depository type used exclusively by the gnawing or nibbling
household 5. Vector
3. Closed pit privy used exclusively by the ➔ any organism that transmits
household infection by inoculation into the
NCM 213 FINALS

skin or mucous membrane by biting ➔ pesticides, environmental

or by deposit of ineffective sanitation measures, and natural, as
materials on skin, food, or other well as mechanical, and biological
objects; or any biological control methods
reproduction within the organism
BUILT ENVIRONMENT:
DOH OUTLINED VARIOUS VERMIN CONTROL
NATIONAL BUILDING CODE OF THE
AND DISINFESTATION METHODS WHICH
PHILIPPINES
INCLUDES THE FOLLOWING:
➔ Environmental sanitation control Built Environments
➔ Naturalistic control ➔ refers to man made structure that provide
➔ Biological and genetic control a setting for human activities
➔ Mechanical and physical control ➔ PD 1096 NATIONAL BUILDING CODE OF
➔ Chemical control THE PHILIPPINES - governs the design of
➔ Integrated control built environments
➔ 2004 - DPWH developed the Revised
VERMIN CONTROL AND DISINFESTATION Implementing Rules Regulations of the
METHODS National Building Code of the Philippines
1. Environmental sanitation control
➔ cleanliness and proper building Some of the provisions enacted to protect public
construction and maintenance. health are as follows:
Clean up drives ● Minimum air space shall be provided as
follows:
2. Naturalistic control 1. School rooms -3.00m° with 1.00m?
➔ pest control method that utilizes of floor area per person
nature and nature’s system without 2. Workshops, factories, and offices -
disturbing the balance of nature 12.00m° of air space per person
3. Biological and genetic control 3. Habitable rooms- 14.00m° of air
➔ utilizes predators, parasites, and space per persons
other natural enemies of the pest ● Minimum sizes of rooms and their least
species to reduce or eliminate the horizontal dimensions shall be as follows :
pest populations. Aimed at killing 1. Rooms for human habitations
the larvae without polluting the -6.00m? with a least horizontal
environment dimensions of 2.00m
2. Kitchen -3.00m? with a least
4. Mechanical and physical control horizontal dimension of 1.50m
➔ utilizes mechanical devices such as 3. Bath and toilet - 1.20m? with at
rodent traps, fl traps, mosquito least a horizontal dimension of 900
traps, and ultraviolet light mm
5. Chemical control
➔ utilizes rodenticides, insecticides, Ceiling height of habitable rooms:
larvicides, and pesticides ___________________________________________
6. Integrated control 1. Rooms provided with artificial ventilation
➔ control pests through the use of shall have a ceiling of heights not less than
different methods and procedures 2.40m(8ft) measures from the floor to the
that are used to complement other ceiling
NCM 213 FINALS

2. Rooms with natural ventilation shall have a - external - independent expert to

ceiling heights of not less than 2.70 m (9ft) evaluate the effectiveness of the
3. Mezzanine floors shall have a clear ceiling project
height not less than 1.80 m above and - internal - person responsible for
below it the project will do the evaluation
- can be done by: process evaluation and
Minimum window sizes: outcome evaluation
___________________________________________ - Purpose - to simple provide results
1. Rooms intended for any use mot provided the impact of the project to check
with artificial ventilation system, shall be the efficiency of interventions
provided with a window or windows with a A good evaluation answers the questions such
total free area of openings equal to at as:
least 10% of the floor area room provided - DId the program work as intended?
that such opening shall be not less than - What results did the program accomplish?
1.00m^2 - what measurable impacts did the program
2. Toilet and bathrooms laundry rooms and achieve?
similar rooms shall be provided with - Is the program cost effective?
window/s with an area not less than 1/20
of the floor area of such rooms, provided Kinds/APPROACHES..
that such opening shall not be less than Structure Evaluation
240mm^2 - involves looking into the manpower and
3. Such windows shall open directly to a physical resources of the agency
court, yard, public street or alley or open Process Evaluation
watercourse. - is examining the manner by which
assessment, diagnosis, planning,
implementation, and evaluation were
MONITORING AND EVALUATION,
undertaken
INFORMATION TECHNOLOGY AND CORE
- assess whether an intervention or model
COMPETENCIES IN NURSING
was implemented as planned, whether the
Monitoring target population.
- ongoing activity during program
implementation to assess the current Outcome Evaluation
status of its implementation in terms of - is determining the degree of goals and
compliance to the design of the program, objectives
timeliness, and attainment of goals. - determine whether and to what extent the
(Kettner et al., 1999) expected changes occurred and whether
- a continuous internal process for making these changes can be attributed to the
sure that the activities under the programme activities
programme/project are on track (WHO)
Evaluation Ongoing evaluation or Monitoring
- process of determining systematically and - done during implementation to provide
objectively the relevance, efficiency and feedback on compliance in the plan to
effectiveness and impact of activities in the improve the process and outcomes of
light of their objectives interventions
- can be internal, external or involving many - Monitoring activities should be done on a
key stakeholders regular basis
NCM 213 FINALS

- Progress of project activities, use of ➔ Accuracy

resources, res - refers to the validity and reliability
of the results of the evaluation. It
Types of Evaluation Planning begins with accurate
formative evaluation documentation while the
- are conducted during program community health process is
development and implementation and are ongoing.
useful if you want direction on how to best - A high degree of validity and
achieve your goals or improve your reliability can be achieve by utilizing
program the appropriate evaluation tool

Summative Evaluations What are the bases for a good evaluation?

- should be completed once the programs
are well established and will tell you to Steps in Program Evaluation
what extent the program is achieving its 1. decide what to evaluate
goals 2. Design the evaluation plan - specifying
data collection
What type of evaluation is conducted during Tools include:
program development and implementation? - - questionnaires or interview
formative eval schedules
- checklists
Standards of Evaluation

➔ Utility
- is the value of the evaluation in
terms of usefulness of results. this
will help provide basis for utilizing
the community health process

➔ Feasibility
- answers the questions of the plan
for evaluation considering the 3. Collect relevant data
resources available for conducting 4. Analyze Data
the evaluation - Evaluators should assess the quality
➔ Propriety of the data before they start their
analysis
- respect for worth and dignity of the 5. Make Decisions
participants upon data collection - If the intervention or program was
should be given consideration effective and efficient, this could be
- The results of the evaluation should continued to another client or
be truthfully recorded to give credit group given similar circumstances
where it is due and to show 6. Report or provide feedback
strength and weakness of the - the result of the program
community evaluation should be submitted
submitted to the local authorities
NCM 213 FINALS

WORKING WITH GROUPS TOWARDS Interventions to Facilitate Group Growth

COMMUNITY DEVELOPMENT
STAGES OF GROUP DEVELOPMENT 1. Orientation, Structure and Direction -
The Stage of Orientation during the stage of orientation and
The task confronting group members during the dependence, the level of anxiety can be
initial stage are: reduced by helping provide the necessary
1. they must determine a way to achieve their orientation, structure and direction to the
primary task - their purpose of which they group.
joined the group. - In instances when the group
2. they must find a place for themselves in members do not know each other,
the group, one that will provide the the preliminaries of introduction
comfort necessary to attain their task, but should be made. There is a big
will also result in additional gratification impact on group members if they
from the pleasure of the group. get introduced by the leader of the
facilitator.
The Stage of Conflict 2. Process, Negotiate and Resolve Conflicts
- This stage is characterized by the group's to Member’s Satisfaction
concern over dominance, control and - their dynamism characteristics of
power. The experience of the conflict is the work group is maintained, if the
between members and leaders. hostility and conflict in the group
- The struggle to control this part of the are permitted to develop. However,
dynamics of every group; it is always stability, in the face of turbulence
present sometimes too tranquil to be cannot be sustained unless group
recognized, at other times suppressed at members have the necessary
some other time may become a full blown attitude onwards conflicts and the
expression to a fire. competencies necessary to handle
The Stage of Cohesiveness or manage them.
- After the previous conflict, the group 3. Awareness of the Effects of Behavior
gradually developed into a cohesive unit. - the nurse or the facilitator of the
- there is an increase of morale and mutual group discussion exerts an
trust as a member feels group influence on the behaviors and
belongingness. experience of the group members.
- the chief concern of the group is with As members look up to the leader
intimacy and closeness for approval of certain behavior;
responses or actions.
Work Group Stage
- the uniqueness of the members and the
INFORMATION TECHNOLOGY AND
leaders are seen and expected.
COMMUNITY HEALTH
- members accept one another’s differences
without associating “good or bad” with the
differences.. ➔ E-health: is the use of information and
- conflict is still present however the communication technologies (ICT) for
conflict is just substantive rather than health
emotional conflict ➔ The eHealth unit works with partners at
the global, regional and country level to
promote and strengthen the use of ICT in
NCM 213 FINALS

health development, from applications in PHIE is composed of six (6)

the field to global governance 1. Client registry
Main Areas: - manage the unique identification of
✓ The delivery of health information, citizens receiving healthcare
for health professionals and health services
consumers, through the internet 2. provider registry
and telecommunications - manages unique identification of
✓ Using the power of information health care providers
technology and e-commerce to 3. health Facility registry
improve public health services, - manages the unique identification
through the education and training of places where health services are
of health workers administered
✓ The use of e-commerce and ebusiness 4. Standards Terminology Services
practices in health - clinical activities, activities standard
systems management health data sets, terminologies and
Storage formats
➔ An electronic health record is the 5. shared health record
systematized collection of patient and - a repository of client’s records with
population electronically- stored health information and the exchange
information in a digital format. The data 6. interoperability layer
remains in the health facilities where - receives communication from
services were rendered various application systems being
Purposes used by health facilities and
➔ Ease the unification and integration of orchestrates messaging processing
health data and processes across different interoperably.
health facilities employing disparate
electronic medical record systems Point of service applications - i.e. the systems
➔ Promote interoperability by providing used by the health facilities such as hospitals, rural
means for communication and health units, and clinics to access and update the
coordination of electronic health data client records interact with the PHIE
among the various health domains (i.e ➔ DOH Integrated Hospital Operations and
disparate clinic information systems, and Management Information System
applications) without loss of semantics (IHOMIS), and Integrated Clinic Information
➔ increases accountability for the proper System (iCLinicSys) used by government
management of health information hospitals and rural health units,
➔ Harmonize and optimize eHealth processes respectively, for recording and updating a
and workflows client medical record.
➔ Serve as reference in the development of One of the essential end-products of this component
integrated information systems is a unified client - centric electronic medical record
➔ Promote the implementation and use of that can be securely shared among healthcare
interoperability standards
INFORMATION AND COMMUNICATION
TECHNOLOGY (ICT)
● Diverse set of technological tools and
resources used to communicate and to
NCM 213 FINALS

create, disseminate store, and manage health services including the

information budget
4. Target users are unfamiliar with the
POWER OF DATA INFORMATION technology
● Nurses are knowledge managers
● They constantly process raw data of the Using eHealth in the Community
patient into valuable information to deliver - The universal health care and ICT-DOH
evidence base and individualized supported the national draft to improve
interventions health care access quality, efficiency and
patient safety and satisfaction
BENEFITS
1. Data are readily mapped, enabling more DOH
targeted interventions and feedback Electronic Medical Records
2. Data can be easily retrieved and recovered - Comprehensive patient record that are
3. Redundancy of data is minimized stored and accessed from computer or
4. Data for clinical research becomes more server
available. - They utilized standard process nationwide
5. Resources are used effectively
Telemedicine
Good data Qualities - Delivery of health care services, where
1. Accuracy - it should be valid and correct distance is a critical factor, by all health
2. Accessibility - characteristics of data care professionals using information and
availability communications technologies for the
3. Comprehensiveness - should be complete exchange of valid information for
4. Consistency/Reliability - theres no diagnosis, treatment and prevention of
discrepancies in the record disease (WHO)
5. Currency - data must be up to date Notes: Discovered because of a very rare skin
6. Definition - data must be properly labedled disease “Tinea Imbricata” only reported in the
and clearly defined country 3 times since 1789 (now 4th case)-
7. Information and Communication* Telehealth has the capacity to bridge gaps
eLearning
eHealth Situation in the Philippines - Health education which is essential in
- The ubiquity of mobile technologies and health promotion and maintenance
availability of internet services in the - Use of electronic tools to aid in teaching
Philippines create a promising ground for - eLearning can also be used to educate
eHealth access fellow health professionals
Factors affecting eHealth in the country:
1. Limited Health Budget Roles of CHN in eHealth:
2. The emergence of Free and open ● Data and record manager
source ○ Monitor the trends of diseases
3. Decentralized Government through EMR, allowing target
a. Under RA 7160 or the local interventions for health
government code of 1991 promotions, disease prevention,
local government are curative services or rehabilitation
autonomous and therefore
in control of their own basic
NCM 213 FINALS

● Change agent
● Explains the
○ by working closely with the
health status of
community and implementing
the
eHealth with them. They do not
clients/groups
force technology in the community
but inform and guide the 2. Provides sound ● Identifies
community ( do not enforce decision client’s
technology with them) making in the wellness
● Educator care of potential
○ provides health education to individuals and/or health
individual and families through ICT /families/group problem
tools s considering ● Gathers data
● Telepresenter their beliefs related to the
○ in the event that a patient needs to and values health
be referred to a remote medical condition
specialist through telemedicine, ● Analyzes the
nurses may function as a data gathered
telepresenter ● Selects
● Client Advocate appropriate
○ must safeguard patients records action to
ensuring security and support
confidentiality and privacy of all /enhance
patient information wellness
● Researcher response;
○ Using eHaleath tools. patient manage the
records can easily be retrieved and health problem
analyzed by the nurse. Pursue in ● Monitors the
continuing nursing informatics progress of the
education with the goal of action taken
developing a research framework to
be beneficial to the community
3. Promotes ● Performs
COMPETENCY STANDARDS CHN safety and age-specific
1. SAFE AND QUALITY NURSING CARE comfort and safety
privacy of measures in all
clients aspects of
Core Competency Indicators
client care
1. Demonstrates ● Identifies the ● performs
knowledge health needs of age-specific
base on the the clients comfort
health/illness (individuals, measures in all
status of families, aspects of
individual/grou population client care
ps groups and/or ● performs
communities) age-specific
NCM 213 FINALS

measures to team
ensure privacy ● finishes work
in all aspects of assignment on
client care time

2. Utilizes ● Identifies the

4. Sets priorities ● Identifies the financial cost-effectiven
in nursing care priority needs resources to ess in the
based in client’s of clients support client utilization of
needs ● Analyzes the care resources
needs of clients ● Develops
● Determines budget
appropriate considering
nursing care to existing
address priority resources for
needs/problem nursing care
s
3. HEALTH EDUCATION
2. MANAGEMENT OF RESOURCES AND
ENVIRONMENT
Core Competency Indicators

Core Competency Indicators 1. Develops ● formulated a

health comprehensive
1. Organizes work ● Identifies tasks education plan health
load to or activities based on education plan
facilitated that need to be assessed and with the
client care accomplished anticipated following
● Plans the needs components:
performance of objectives,
tasks or content, time
activities based allotment,
on priorities teching,
● Verifies the learning
competency of resources and
the staff prior evaluation
to delegating parameters
tasks ● Provides for
● Determines feedback to
tasks and finalize the plan
procedures
that can be 2. Develops ● Develops
safely assigned learning information
to other materials for education
members of the health materials
education appropriate to
NCM 213 FINALS

the level of the treatment or

client procedure
● Applies health ● Checks the
education completeness
principles in the of informed
development consent and
of information other legal
education forms
materials
2. Adheres to ● Articulates the
organizational vision, mission
4. LEGAL RESPONSIBILITY policies and of the
procedures, institution
Core Competency Indicators local and where one
national belongs
1. Adheres to ● Fulfills legal ● Acts in
practices in requirements in accordance
accordance nursing with the
with the practice established
nursing law and ● Holds current norms of
other relevant professional conduct of the
legislation license institution/orga
including ● Acts in nization/legal
contracts , accordance and regulatory
informed with the terms requirements
consent of contract of
employment 3. Documents ● Utilizes
and other rules care rendered appropriate
and regulations to clients client care
● Complies with records and
required reports
continuing ● Accomplishes
professional accurate
education documentation
● Confirms in all matters
information concerning
given by the client care in
doctorfor accordance to
informed the standards
consent of nursing
● Secures waiver practice
of
responsibility
for refusal to
undergo
NCM 213 FINALS

5. ETHICO-MORAL RESPONSIBILITY 6. PERSONAL AND PROFESSIONAL

DEVELOPMENT
Core Competency Indicators
Core Competency Indicators
1. Respects the Renders nursing care
rights of consistent with the 1. Identifies own ● Identifies one’s
individual/grou client’s bill of rights learning needs strengths,
ps (i.e) confidentiality of weaknesses/lim
information, privacy itations
etc.) ● Determines
personal and
2. Accepts ● Meets nursing professional
responsibility accountability goals and
and requirements aspirations
accountability as embodied in
for own the job 2. Pursues ● Participants in
decision and description continuing formal and
actions ● Justifies basis education non-formal
for nursing education
actions and ● Applies learned
judgment information for
● Projects a the
positive image improvement
of the of care
profession
3. Gets involved in ● Participates
3. Adheres to the ● Adheres to the professional actively in
national and code of ethics organizations professional,
international for nurses and and civic social, civic and
code of ethics abides by its activities religious
for nurses provision activities
● Reports ● Maintains
unethical and membership to
immoral professional
incidents to organizations
proper ● Support
authorities activities
related to
nursing and
health issues
NCM 213 FINALS

7. QUALITY IMPROVEMENT 8. RESEARCH

Core Competency Indicators Core COmpetency Indicators

1. Identifies and ● Reports to 1. Disseminates ● SHares/present

reports appropriate results of s results of
variances person/s research findings to
significant findings colleagues/clie
variance/chang nts/family and
es/occurrences to others
immediately ● Endeavors to
● Documents and publish
reports research
observed ● Submits
variances research
regarding client findings to own
care agencies and
others as
2. Recommends ● Gives an appropriate
solutions to objective and
identified accurate report 2. Applies ● Utilizes findings
problems on what was research in research in
observed findings in the provision of
rather than an nursing nursing care to
interpretation practice individuals/gro
of the event ups/communiti
● Provides es
appropriate ● Makes use of
suggestions on evidence-based
corrective and nursing to
preventive enhance
measures nursing
● Communicates practice
solutions with
appropriate
9. RECORDS MANAGEMENT
groups

Core Competency Indicators

1. Maintains ● Completes
accurate and updated
updated documentation
documentation of client care
of client care ● Applies
principles of
record
NCM 213 FINALS

management clients’ records

● Monitors and in a designated
improves area
accuracy, ● Follows
completeness protocol in
and reliability releasing
of relevant records and
data other
● Makes record information
readily
accessible to
10. COMMUNICATION
facilitate client
care
Core Competency Indicators
2. Records ● Utilizes a
outcome of records system 1. Establishes ● Creates trust
client care ex. Kardex or rapport with and confidence
hospital client, ● Spends time
information significant with the
System (HIS) others and client/significan
● Uses data in members of the t others and
their decision health team members of the
and policy health team to
making facilitate
activities interaction
● Listen actively
3. Observes legal ● Maintains to client’s
imperatives in integrity, concerns/signifi
record keeping safety, access cant others and
and security of members of the
records health team
● Documents/mo
nitors proper 2. Identifies ● Interprets and
record storage, verbal and validates
retention and non-verbal cues client’s body
disposal language and
● Observes facial
confidentially expressions
and privacy of
3. Utilizes formal ● make use of
the clients’
and informal available visual
records
channels aids
● Maintains
● Utilizes
organized
effective
system of filing
channels of
and keeping
communication
NCM 213 FINALS

relevant to ● Recommends
client care appropriate
management intervention to
improve client
4. Responds to ● Provides care
needs of reassurance ● Respect role of
individuals, through the other
family, group therapeutic members of the
and community touch, warmth health team
and comforting ● Maintains good
words of interpersonal
encouragement relationship
● Provides with clients
therapeutic colleagues and
bio-behavioral other members
interventions of the health
to meet the team
needs of clients
2. Collaborates ● Refers clients
5. Uses ● Utilizes plan of care to allied health
appropriate telephone, with other team partners
information mobile phone, members of the ● Acts as
technology to electronic health team liaison/advocat
facilitate media e if the client
communication ● Utilizes ● Prepares
informatics to accurate
support the documentation
delivery of for efficient
healthcare communication
of services
11. COLLABORATION AND TEAMWORK

HEALTH RELATED ENTREPRENEURIAL

Core Competency Indicators ACTIVITIES
1. Establishes ● Contributes to
collaborative decision ENTREPRENURSE
relationship making ➔ A project indicated by the DOLE, in
with colleagues regarding collaboration with the Board of Nursing in
and other clients’ needs the Philippines, DOH, PNA, and other
members of the and concerns stakeholders.
health team ● Participates
actively in HEALTH RELATED ENTREPRENEURIAL
client care ACTIVITIES
management
including audit ➢ Home Health Care
NCM 213 FINALS

➢ Hospice Home Care

➢ Faith community nursing or Parish nursing

HOME HEALTH CARE

● This practice involves providing nursing
care to individuals and families in their own
places of residence to minimize the effect
of illness and disabilities.
● Allows the patient to remain at home and
still received care instead of staying in the
hospital.

HOSPICE HOME CARE

● Home care specifically rendered to
terminally ill.
● Palliative care is important in hospice care.
● Provide support to the patient and family
as they go through the process of dying
and grieving.

FAITH COMMUNITY NURSING OR PARISH

NURSING
● Is the practice of the art and science of
nursing combined with spiritual care.
● A faith community or parish nurse usually
focuses on health promotion and provision
of holistic care.