PAMANTASAN NG CABUYAO

COLLEGE OF NURSING

Course Learning Packet – NCM 104 Community Health Nursing I

VISION
A premier educational institution of higher learning, developing globally competitive and value-laden professionals and
leaders instrumental to community development and nation building.
MISSION
As an institution of higher learning, PnC is committed to equip individuals with knowledge, skills and values that will
enable them to achieve their professional goals and provide leadership and service for national development.

COURSE TITLE: Community Health Nursing II Individual & Family as Clients

COURSE CODE: NCM104
PRE-REQUISITE: NCM101, NCM102, NCM103
COURSE OBJECTIVES:
At the end of this course, the students should be able to:
1. Apply knowledge regarding awareness of the health situation in our country and the factors affecting
health of Philippine health care delivery system.
2. Provide safe, appropriate and holistic care to individuals and families in the community utilizing the
family nursing process.
3. Describe detailed understanding of the different services under Department of Health Programs.
4. Adopt the nursing core values in the delivery of care to individuals and families.
5. Conduct research of the new technologies and entrepreneurial skills in the delivery of nursing care to
individuals and families in the community setting.
COURSE CONTENTS:
Module 1: Overview of Public Health Nursing in the Philippines
Module 2: The Health Care Delivery System
Module 3: The Family
Module 4: The Family Nursing Process
Module 5: Records in Family Health Nursing Practice
Module 6: DOH Programs Related to Family Health
Module 7: Ethical Considerations in Community Health Nursing
Module 8: Filipino Culture, Values, and Practices in Relation to Health Care of Individual and Family
Module 9: New Technologies Related to Public Health Electronic Information
Module 10: Nursing Core Values as a Community Health Nurse
Module 11: Health-Related Entrepreneurial Activities in the Community Setting

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MODULE 1
Module Title: Overview of Public Health Nursing in the Philippines

Overview:
 Public Health Nursing in the Philippines evolved alongside the institutional development of the
Department of Health, the government agency mandated to protect and promote people’s health and the
biggest employer of health workers including public health nurses. Considering the changing national and
global health situation and the acknowledgement that nursing is significant contributor to health.

Module Objectives:
At the end of module 1, the student should be able to:
1. Integrate relevant principles of social, physical, natural and health sciences and humanities in a given
health and nursing situation.
2. Discuss appropriate community health nursing concepts and actions holistically and
comprehensively.
3. Assume responsibility for lifelong learning, own personal development and maintenance of
competence.

Module Coverage
A. Topic: Global and National Situations
B. Topic: Definition and Focus

TOPIC A
Topic Title: Global and National Situations
Introduction:
Public Health Nursing practice been influenced by the changing global and local health trends. These
global and country health imperatives brought public health nursing into new frontiers and have strategically
positioned public health nurses to emerge as leaders in health promotion and advocacy, to make a difference
in the health outcomes of individuals, families, and communities cared for.

Topic Objectives:
At the end of the topic, the student should be able to:
1. Analyze the impact of global and national situations on the public health systems.
2. Relate about the trends and issues the public health nurses facing today.
3. Fully understand the situations of the public health system.

Topic Contents:

GLOBAL AND NATIONAL SITUATIONS

Public health systems are operating within the framework of ongoing changes, which exert pressures on the
public health system such as:
1. Shifts in demographic and epidemiological trends in diseases, including the emergence and re-
emergence of new diseases and in the prevalence of risk and protective factors.
2. New technologies for health care, communication, and information.
3. Existing and emerging environmental hazards some associated with globalization.
4. Health Reforms.
Global Health Issues for 2020
1. Infectious diseases & potential pandemics
In 2018, Bill Gates told Business Insider that a coming disease maybe one like the 1918 flu could
kill 30 million people within six months, and that countries should prepare for it like they would
for war.
Coronavirus—now officially known as COVID-19—likely won’t be as disastrous as that particular
prediction, but there have been millions of confirmed cases globally many people have died. Last
January 31, 2020, the World Health Organization declared the outbreak a Public Health
Emergency of International Concern.

2. Health workers carry huge responsibility and huge risk.

Health workers like Li Wenliang—who died from coronavirus just two months after he tried to
warn the world about a SARS-like illness in Wuhan, China—and Sheik Umar Khan—a Sierra
Leonean physician who died of Ebola in the same hospital where, just weeks before, he’d been
treating Ebola patients—are on the front lines of any infectious disease outbreak, from measles
to meningitis to polio.
They carry huge responsibility and huge risk. In one Wuhan hospital, a single patient infected at
least ten health workers and four other patients, according to the New York Times.
That’s one reason the Frontline Health Workers Coalition is advocating for more support for
frontline health worker teams, not only as they fight this outbreak but also as a focused
investment in resilient, sustainable, locally led health systems that can respond to infectious
disease outbreaks.

3. Our warming, storming planet

The 2010s were the hottest decade on record. Not just on land, but also at sea, where 90% of
excess heat from greenhouse gases is stored.
Rising temperatures can change everything. Our water quality, our air quality, the quality and
quantity of our food crops around the world. They intensify heatwaves and storms, leading to
floods and wildfires. In fact, UK scientists say that wildfires like the ones Australia is battling—
which have burned 11 million hectares and killed 33 people, tens of thousands of farm animals,
and countless plants and wildlife—will become the norm.
Health workers will see climate consequences in their clinic waiting rooms.
In the coming decade, more and more frontline health workers will see the consequences of our
changing climate in their clinic waiting rooms. They’ll need to be ready to address the effects of
hunger from failing crops, chronic respiratory diseases caused by air pollution, and all the health
challenges that come with human displacement due to catastrophic weather. 

4. Strong supply chains

During the first week of the coronavirus outbreak in China, health workers from eight hospitals in
the Hubei Province, where the city of Wuhan is located, put out an urgent call for medical
supplies—specifically surgical masks, goggles, and gowns, according to a report by the New York
Times. 
“There are no beds, no resources,” a nurse said in an interview with CNN. “Are we supposed to
just fight this battle bare-handed?”
If we’re going to achieve universal health coverage in the coming decade, supply chain
management will be more crucial than ever.
“No health program can succeed if the medicines and health products people need aren’t
available when and where they need them,” write IntraHealth’s Batouo Souare and Melanie
Joiner. Without qualified, well-trained human resources to manage supply chains, we can’t make
sure health products are available, either day-to-day or during emergencies.

5. Digital health
“It’s been ten years since the first truly affordable smartphone was introduced and unleashed a
transformation across the African continent,” says Wayan Vota, IntraHealth’s director of digital
health. “These days, over 40% of all Africans use smartphones, and the technology generates
8.6% of GDP in sub-Saharan Africa. But the tech transformation has not stopped with tele-
communications. The field of digital health has expanded, too.”
In the coming decade, he says, health workers and officials around the world are going to get
more sophisticated in the way they collect, share, and analyze data. From advanced image
processing algorithms that diagnose cancer and eye diseases to chatbots that detect
depression in real time—digital health tech and its users will have to keep up with all-new issues
around data security, machine learning, and using data to solve some of our biggest disease
challenges.

6. A tidal wave of mental health needs

In the US, Time reports, suicide rates are the highest they’ve been since World War II. A study
published in Pediatrics in November 2019 found that the rate of suicide attempts for black youths
in the US rose 73% from 1991 to 2017.
Seventy-three percent.
And according to the World Health Organization, between 76% and 85% of people with mental
disorders in low- and middle-income countries receive no treatment for their disorders, including
depression, bipolar disorder, schizophrenia, dementia, substance abuse, and developmental
disorders. We cannot go on pretending that a tidal wave of need is not going unmet.

7. Heart disease, cancer, & the groundswell of noncommunicable diseases

Today around 70% of all cancer deaths occur in low- and middle-income countries.
As people all over the world live longer than ever, this and other noncommunicable diseases—
including obesity-related illnesses, hypertension, diabetes, heart disease, and mental illness—
have become the leading cause of death and disability worldwide. In the coming decade,
countries will need resilient health systems and strong health workforces to meet this challenge. 

8. The global health workforce

Nurses, midwives, doctors, pharmacists, lab workers, clinical officers—the range of jobs and
responsibilities within the health workforce is vast. And each one is crucial.
The 2020s are starting off with a focus on nurses and midwives. And rightly so—they make up
50% of the health workforce worldwide. As we get closer to our most ambitious global goals—
nothing short of universal health coverage, an AIDS-free generation, and the end of extreme
poverty—the global community has realized that nurses and midwives will be the ones to get us
there. That’s one reason the WHO declared 2020 to be the Year of the Nurse and the Midwife.
But to make real progress, the health workforce needs need more nurses and midwives at the
top.

9. Women leaders in health care

Women make up 70% of the total health and social care workforce and an even larger share of
the nursing and midwifery profession, yet they occupy only 25% of health system leadership
roles.
One of the many reasons, according to the 2019 report Investing in the Power of Nurse
Leadership: What Will It Take?, is that women, more so than men, must juggle paid and unpaid
work, managing jobs and home life at the same time. Case in point:
“It’s clear this isn’t about the individual nurse who needs to be developed,” “It’s about the
systems that need to be changed in order to raise the profile and improve the status and
effectiveness of nurse leaders.” In the coming decade, we will be pushing for greater global
progress toward gender equity, in the health workforce and beyond.

10. Our ambitious 2030 goals

We have a lot to do before 2030 if we’re going to get close to achieving the Sustainable
Development Goals.
We want to achieve an AIDS-free generation. Family planning for all who need it. Universal health
coverage. Gender equality in health care. An end to maternal and child deaths. And solutions for
the 70.8 million people who have now been forcibly displaced from their homes due to war and
other disasters.
In the coming decade, we will be monitoring and pushing for progress on all these fronts—
working hard to build the future we want.

Reference:
1. Department of Health, Public Health Nursing in the Philippines, 2009
2. https://www.healthypeople.gov/2020/topics-objectives/topic/global-health
3. https://www.intrahealth.org/vital/10-global-health-issues-watch-2020s

Critical Thinking Exercises 

Activity 1: Discuss in 10-15 sentences.

Name: ______________________________________ Section: _________________________

As a student nurse,
1. What is your insight about the health situation facing our country/world today? (10 pts.) Link or
attachment of one article can be used to support your answer. (10 pts.)
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Link: ________________________________________________________________________

2. During this crisis what do you think is your best contribution to your community? (10 pts.)
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TOPIC B
Topic Title: Definition and Focus
Introduction:
This Module is composed of terminologies and definitions that would enable the students to better
understand what community health nursing and descried the roles of community health nurses.

Topic Objectives:
At the end of the topic, the student should be able to:
1. Discuss concepts of community health.
2. Describe concepts of community health nursing.
 3. Differentiate roles of community health nurse.

Topic Contents:

PUBLIC HEALTH - Dr. C.E. Winslow defines public health as:

the “science and art of preventing disease, prolonging life, promoting health and efficiency through
organized community effort for the sanitation of the environment, control of communicable diseases,
the education of individuals in personal hygiene, the organization of medical and nursing services for the
early diagnosis and preventive treatment of disease, and the development of the social machinery to
ensure everyone a standard of living adequate for the maintenance of health, so organizing these
benefits as to enable every citizen to realize his birthright of health and longevity”.

WHO defines public health as: the “art of applying science in the context of politics so as to reduce
inequalities in health while ensuring the best health for the greatest number”.

COMMUNITY HEALTH - Part of paramedical and medical intervention/approach which is concerned on

the health of the whole population

PUBLIC HEALTH NURSING - This is a “special field of nursing that combines the skills of nursing, public
health and some phases of social assistance and functions as part of the total public health programmed
for the promotion of health, the improvement of the conditions in the social and physical environment,
rehabilitation of illnesses and disability”.

One of the famous definitions of community health nursing comes from Ruth B. Freeman. It refers to “a
service rendered by a professional nurse with communities, groups, families, individuals at home, in
health centers, on clinics, in schools, in places of work for the promotion of health, prevention of
illnesses, care of the sick at home and rehabilitation”.

COMMUNITY HEALTH NURSING (CHN) - “The utilization of the nursing process in the different levels of
clientele-individuals, families, population groups and communities, concerned with the promotion of
health, prevention of disease and disability and rehabilitation.” ( Maglaya, et al)

Goal: “To raise the level of citizenry by helping communities and families to cope with the discontinuities
in and threats to health in such a way as to maximize their potential for high-level wellness” ( Nisce, et
al)

Special field of nursing that combines the skills of nursing, public health and some phases of social
assistance and functions as part of the total public health program for the promotion of health, the
improvement of the conditions in the social and physical environment, rehabilitation of illness and
disability ( WHO Expert Committee of Nursing)

A learned practice discipline with the ultimate goal of contributing as individuals and in collaboration
with others to the promotion of the client’s optimum level of functioning thru’ teaching and delivery of
care (Jacobson)

A service rendered by a professional nurse to IFCs, population groups in health centers, clinics, schools ,
workplace for the promotion of health, prevention of illness, care of the sick at home and rehabilitation
(DR. Ruth B. Freeman)
HEALTH - “state of complete physical, mental, and social well being, not merely the absence of disease
or infirmity

A. ROLES OF THE COMMUNITY HEALTH NURSE

Clinician or health care provider - utilizes the nursing process in the care of the client in the home
setting through home visits and in public health care facilities; conduct referral of patients to
appropriate level of care when necessary.

Educator – utilizes teaching skills to improve the health knowledge, skills and attitudes of the
individuals, family and the community, and conduct health information campaigns to various groups for
the purpose of health promotion and disease prevention.

Coordinator and Collaborator – establish linkages and collaborative relationships with other health
professionals, government agencies, the private sectors, non- government organizations and people’s
organizations to address health problems.

Leader and change agent – influences people to participate in the overall process of community
development.

Manager – organizes the nursing services component of the local health agency or local government
unit, also responsible for the delivery of the package of services provided by the health program to the
target clientele.

Researcher – participates in the conduct of research and utilizes research findings in practice.

*If the Municipal Health Officer (MHO) is unable to perform his duties/functions or is not available, the
Public Health Nurse will take charge of the MHO’s responsibilities.
Other Specific Responsibilities of a Nurse, spelled by the implementing rules and Regulations of RA 7164
(Philippine Nursing Act of 1991) includes:
 Supervision and care of women during pregnancy, labor, and puerperium
 Performance of internal examination and delivery of babies
 Suturing lacerations in the absence of a physician
 Provision of first aid measures and emergency care
 Recommending herbal and symptomatic meds…etc.

In the care of the families:

 Provision of primary health care services
 Developmental/Utilization of family nursing care plan in the provision of care

In the care of the communities:

 Community organizing mobilization, community development and people empowerment
 Case finding and epidemiological investigation
 Program planning, implementation, and evaluation
 Influencing executive and legislative individuals or bodies concerning health and development
 Responsibilities of CHN
be a part in developing an overall health plan, its implementation and evaluation for communities
 provide quality nursing services to the three levels of clientele
 maintain coordination/linkages with other health team members, NGO/government agencies in
the provision of public health services
 conduct researches relevant to CHN services to improve provision of health care
 provide opportunities for professional growth and continuing education for staff development

Reference:
1. Monina H. Gesmundo, RN RM MAN, (2010). The Basics of Community Health Nursing; A study Guide for
Nursing Students and Local Board Examinees. Philippines
2. Araceli S. Maglaya, (2004). Nursing Practice in the Community (4th ed). Philippines
3. DOH, (2008). Public Health Nursing in the Philippines. Philippines

QUIZ 1: (10 pts.)

Identification. To fully understand the different roles of the community health nurse the following examples
are given. Identify the different roles of the community health nurse. Write the letter of your choice before
each number.
A. Clinician or health care provider
B. Educator
C. Coordinator and Collaborator
D. Leader and change agent
E. Manager
F. Researcher

_________________ 1. Nurse Jane conduct survey in her barangay to collect data about Covid 19 affected.
_________________ 2. Nurse Lea discussed about Covid 19 Prevention and Control in Barangay Masipag
as part of her program in information dissemination.
_________________ 3. Nurse Roy referred patient Norma to the next level of care facility due to lack of
instruments to perform the procedure and to avoid further complication.
_________________ 4. To support the 6 months period of Feeding Program in Brgy. Busilak, Nurse Liza ask
for the assistance and sponsorship of the Lion’s Club and other non-government organization.
_________________ 5. Every Wednesday afternoon is the home visit schedule of Nurse July to his
bedridden patient Leopoldo.
__________________6. Nurse Jose organize Medical and Surgical mission in his Barangay.
__________________7. With Nurse Joan effort in encouraging people in her barangay she noticed the
increase number of participants every immunization day.
__________________8. Nurse Ronald conduct health information campaign about poliomyelitis in her
barangay.
__________________9. Nurse Fe Conducts pre-marital counseling.
___________________10. Motivates changes in health behavior in individuals, families, groups, and communities that
also include lifestyle to promote and maintain health.