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Community Health Nursing (CHN)

Comprehensive Study Notes for the Philippine Nursing Board Exam (PNLE)

1. Primary Health Care (PHC)

Adopted during the First International Conference on PHC in Alma Ata, USSR (Sept 6-12, 1978). Legal basis in the Philippines: LOI 949.

4 Pillars of PHC

Active Community Participation
Intra and Inter-sectoral Linkages
Use of Appropriate Technology
Support System Made Available

8 Elements (ELEMENTS)

Education for Health
Locally Endemic Disease Control
Expanded Program on Immunization
Maternal and Child Health
Essential Drugs
Nutrition (Food Supply)
Treatment of Common Diseases
Sanitation (Water and Waste)

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Beshy Tip!

Ang core strategy ng PHC ay Partnership with the People. Hindi lang tayo nagbibigay ng gamot, tinuturuan natin ang community na maging self-reliant!

2. Immunization Schedule (EPI)

Vaccine	Minimum Age	Dose/Route	Protection
BCG	At birth	0.05ml / ID	Tuberculosis (Miliary/Meningitis)
Hepatitis B	At birth	0.5ml / IM	Hepatitis B infection
Pentavalent	6, 10, 14 wks	0.5ml / IM	DPT, Hep B, HiB
OPV / IPV	6, 10, 14 wks	2 drops / Oral	Poliomyelitis
PCV	6, 10, 14 wks	0.5ml / IM	Pneumonia and Meningitis
MMR	9, 12 months	0.5ml / SC	Measles, Mumps, Rubella

3. Major DOH Health Programs

National TB Program (DOTS)

Strategy: Directly Observed Treatment Short-course. Smear microscopy (DSSM) remains the primary diagnostic tool. Treatment categories follow specific regimen (HRZE).

Maternal and Child Health (MCH)

Focuses on the "Continuum of Care". Integrated Management of Childhood Illness (IMCI) provides a holistic approach to child health, emphasizing assessment of general danger signs.

Family Planning (RA 10354)

Rights-based approach. Methods include Natural (BBT, Billings, SDM) and Artificial (OCP, Condoms, IUD, Injectables, Sterilization).

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Beshy Tip!

Sa IMCI, kapag may "General Danger Sign" (Vomits everything, Convulsions, Lethargic, Unable to drink/breastfeed), URGENT REFERRAL agad! No time to waste!

4. Epidemiology Basics

The Chain of Infection

Agent → Reservoir → Portal of Exit → Mode of Transmission → Portal of Entry → Susceptible Host

Endemic: Constant presence of disease in a localized area (e.g., Malaria in Palawan).

Epidemic: Sudden increase in cases above normal expectations.

Pandemic: Worldwide spread of a new disease.

5. Environmental Health

Water Supply Types:

Level I (Point Source): Well or spring (15-25 HH).
Level II (Communal Faucet): Standposts (100 HH).
Level III (Individual Connections): Piped water into homes.

Waste Disposal (Toilets):

Level I: Non-water carriage (Pit latrine) or Pour flush.
Level II: On-site with water sealed/septic tank.
Level III: Sewage system treatment.

6. Community Organizing (COPAR)

1. PRE-ENTRY

Site selection, profiling, and choosing the target community.

2. ENTRY

Sensitization, integration (living with the people), identifying leaders.

3. ORG-BUILDING

Formation of Community Health Organization (CHO) and training.

4. SUSTENANCE

Mobilization, phase-out, and community self-management.

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Beshy Tip!

Pinaka-importante sa COPAR: "Integration". Hindi ka pumunta dun para maging boss, pumunta ka para maging ka-level nila. "Go to the people, live with them!"

7. Disaster Management (RA 10121)

Focus on the PDRRM cycle: Mitigation → Preparedness → Response → Recovery.

RED
Immediate

YELLOW
Delayed

GREEN
Ambulatory

BLACK
Deceased

8. Key Laws in Public Health

RA 7160: Local Government Code (Devolution of Health Services).

RA 7305: Magna Carta for Public Health Workers (Benefits and Hazard pay).

RA 7875: National Health Insurance Act (PhilHealth).

RA 9173: Philippine Nursing Act of 2002.

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Beshy Tip!

Don't confuse RA 9173 (Nursing Law) with RA 7305 (Magna Carta). Ang Nursing Law ay tungkol sa practice natin, ang Magna Carta ay tungkol sa sahod at benepisyo ng gov't health workers!

9. FHSIS (Reporting)

Field Health Service Information System is the DOH's official reporting tool.

ITR (Individual Treatment Record): Building block/Source document.
Tally Sheet: Monthly summary from ITR.
Output Report: Quarterly/Annual summary for regional offices.