Community Health Nursing (Learning Feedback Diary (LFD #25)

Angelica M. Revil Ms.
Krista Liza Besario RN, MAN

BSN 202 Sept. 11, 2020
COMMUNITY HEALTH NURSING

(LEARNING FEEDBACK DIARY(LFD #25)
Today I learned about the The Expanded Programme on Immunization

(EPI) was established in 1974 to develop and expand immunization
programs throughout the world. In 1977, the goal was set to make
immunization against diphtheria, pertussis, tetanus, poliomyelitis,
measles and tuberculosis available to every child in the world by 1990.
Problems encountered by the Programme have included: lack of public
and governmental awareness of the scope and seriousness of the target
diseases; ineffective programme management; inadequate equipment and
skills for vaccine storage and handling; and insufficient means for
monitoring programme impact as reflected by increasing immunization
coverage levels and decreasing incidence of the target diseases. The
Philippines Expanded Programme on Immunization, begun in 1976,
added polio, measles, and tetanus for pregnant women, and also
estimation of vaccine coverage and monitoring of incidence and mortality
of the 6 target diseases. Oral polio vaccine and tetanus were added in
1980 and measles in 1982. Twice yearly mass campaigns were held from
1977-1983, increased to 4 times yearly in 1984. Clinic-based year-round
delivery has been expanded gradually. Reported coverage rates for 1986
are BCG-51%, DPT3-32%, OPV3-37% and measles-40%. In children
under 5, incidence of all 6 diseases fell, especially polio, which was down
83% compared to 1980. Measles is down 20% since 1982. Under the law,
any “physicians, nurse, midwives, nursing aide, or skilled birth attendant”
present during the delivery of a newborn are required to inform parents or
legal guardians of the “availability, nature, and benefits” of
immunizations against vaccine-preventable diseases at birth. The
mandatory basic immunization is given free at any government hospital
or health center for children up to 5 years old.
Vaccine against Hepatitis-B, meanwhile, should be administered to an
infant without 24 hours after birth. Subsequent doses shall be completed
according to the recommended schedule as provided by the DOH. I
learned that while administering vaccines a nurse must only use one
syringe and needle per client, never mix different vaccines in one syringe
before injection, and need to restart a vaccination series regardless of the
time that has elapse between doses. Injections sites must also should be
2.2-5 cm apart to prevent overlapping of local reactions, the dropper must
not touch the tongue because it will be use again to others, and only
monovalent vaccine must be used for the dose or containing antibodies
specific for one antigen. The antigens are BCG vaccine only be givn at
birth, the dose is 0.05ml, the route is intradermal 15 degrees angle and the
site of administration is in the right deltoid region(arm). Hepatitis B
vaccine must be administered at birth and the dose will be 0.05ml,
intradermal in the anterolateral thigh muscle. The DPT-HepB-
Hib(pentavalent vaccine) must be administered 6 weeks, 10 weeks, and
14 weeks. 0.5ml, intramuscular route(90 degrees) at the anterolateral
thigh muscle. The anti-measles vaccine or AMV 1 must be administered
at the age of 9-11 months before 1 year old with a dose of 0.5 ml,
subcutaneous at the outer part of the upper arm. Oral polio vaccine must
be administered at the ages of 6 weeks, 10 weeks, and 14 weeks, 2 drops
oral route and at the mouth. The AMV2 must be administered ages 12-15
months with the dose of 0.5 ml, subcutaneous at the outer part of the
upper arm. Then the rotavirus vaccine, 6 weeks and 10 weeks, 1.5 ml oral
route and the site of administration is the mouth. I learned about the TT
dose for anti-titanus both can be administered for a mothers and children
with the right interval, percent, and duration of protection of the vaccine.
I learned that inorder to maintain the potency of a vaccine it must be
preserved in the cold chain with specific requirements such as the opv: 15
to -25 degrees celsius in the freezer. Hep b, pentavalent vaccine, rotavirus
vaccine, and TTare not applicable to cold chain because it can damaged
the effectivity and those vaccines by freezing. Diluents must be stored in
the door shelves of the refrigerators. I learned about some side effects or
adverse effects of those vaccines and even contraindications and false
contraindications like malnutrition, low-grade fever, diarrhea, and mild
respiratory infection.The EPI recording and reporting which I learned that
fully immunized children, those that already 1 year old, the completely
immunized children are those with complete vaccination at the age of 2
years old or 12-23 months. And child protected at birth. We also
discussed today about the IMCI, its 3 main components , protocol
guidelines, and IMCI elements which comprises of assessment,
classification, identification, treatment, assess and counselling, and
follow up care for patients. IMCI is an integrated approach to child
health that focuses on the well-being of the whole child. IMCI aims to
reduce death, illness and disability and to promote improved growth and
development among children under five years of age. IMCI include
curative and preventive elements that are implemented by families and
communities and by health facilities. That’all and after that we had our
lecture in pharmacology and I study again.

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Angelica M. Revil Ms.

Krista Liza Besario RN, MAN

COMMUNITY HEALTH NURSING

Today I learned about the The Expanded Programme on Immunization

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