CHN 1 Module 3

Don Mariano Marcos Memorial State University
South La Union Campus

COLLEGE OF COMMUNITY HEALTH AND ALLIED MEDICAL SCIENCES
Agoo, La Union
COMMUNITY HEALTH NURSING I

(NUPC 105)
DARIO M. RAGMAC RN
1st Semester SY 2022-2023
COMMUNITY HEALTH NURSING 1 / 2022-2023 BACHELOR OF SCIENCE IN NURSING II

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COURSE INTRODUCTION
 The course consists of four (4) modules. Community Health Nursing 1

(CHN1) deals with concepts, principles, theories and techniques in the
provision of basic care in terms of health promotion, disease
prevention, restoration and maintenance and rehabilitation at the
individual and family level. It includes the study of the Philippine Health Care
Delivery System, national health situation and the global context of public
health. The learners are expected to provide safe, appropriate and holistic
nursing care to individual and family as clients in community setting utilizing
the nursing process.
It is a 2-unit lecture and 6-unit laboratory course offered every 1 st
semester of each school year to second year Nursing students.
CLASS INTRODUCTION
Your instructor for this course NUPC 105 (Community
Health Nursing I) is Mr. Salvador P. Llavore/ Mr. Dario M.
Ragmac for this semester, SY 2022 – 2023.
This module that is crafted for you will be combined with
online asynchronous and synchronous learning activities that
aim to achieve the priority learning outcomes of the course. Asynchronous
Learning activities and lectures will be sent through Facebook Messenger or
Google Classroom. Online meeting will be conducted through Google
Meet/Zoom, links will be provided through Facebook Messenger.
If you have any inquiries/ questions, you may contact me thru my email
address: rdbananjr@dmmmsu.edu.ph / dragmac@dmmmsu.edu.ph. It is
advised that you always use your official DMMMSU email address when
communicating with your instructor.
COURSE LEARNING OUTCOMES
At the end of the course, the students will be able to:

1. Apply knowledge of physical, social, natural, health sciences, and
humanities in the care of individual and family in the community setting.
2. Provide safe, appropriate and holistic care to individuals and families in
the community utilizing the family nursing process.
3. Apply guidelines and principles of evidence-based practice in the
delivery of care to individual and family in the community setting.
4. Practice nursing in the community setting in accordance with law, legal,
ethical and moral principles.
5. Communicate effectively in speaking, writing, and presenting using
culturally appropriate language in the community setting.
6. Document care of individual and family accurately and comprehensively.
7. Work effectively in collaboration with inter-, intra and, multi-
disciplinary and multi-cultural teams in the care of individuals and
family in the community.
8. Practice beginning management and leadership skills using system
approach in the delivery of care to individual and family.
9. Conduct research with an experienced researcher in the care of
individual client and family in the community setting.
10.Engage on lifelong learning with a passion to keep current national and
global development in the care of individual and family in the
community setting.
11.Demonstrate responsible citizenship and pride of being a Filipino.
COMMUNITY HEALTH NURSING 1 / 2021-2022

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12.Apply techno-intelligent care systems and processes to perform safe and

efficient nursing activities for individual and family in the community.
13.Adopt nursing core values in the delivery of care to individuals and
families.
14.Apply entrepreneurial skills in the delivery of nursing care to individuals,
and families in community setting.
COURSE REQUIREMENTS
To pass this course, students must:

1. Read and comprehend the entirety of the modules and attend the
face-to-face/ online meeting when required.
2. Answer all the print-based discussion activities.
3. Take the graded written quizzes.
4. Submit all projects and activities before the finals term.
5. Accomplish the Midterm and Final Evaluation/Exams.
 DIRECTIONS/MODULE ORGANIZER
There are review-lessons in the module. Review each lesson carefully then
answer the recall questions, exercises/activities and assignments to find out how much
you have benefited from your review. Work on these exercises and assignments
carefully and submit your output to me through correspondence.
In case you encounter difficulty, discuss this with me during the face-to-face/
online meeting. If not, contact me at my email address:
rdbananjr@dmmmsu.edu.ph / dragmac@dmmmsu.edu.ph.
This icon introduces some important ideas to remember. Read it carefully and
 store them in your memory. Each lesson will end up of an activity to evaluate
if learning outcomes has been achieved.
You will find this icon in every end of the lesson. It signifies an exercise/s to
determine how well you achieved the objective/s of the module. Read and
answer carefully all the questions in all the exercises.
You will find this icon in every end of the module. It signifies activity/ties to
determine how well you achieved the objective/s of the module. Read and
answer carefully all the questions in all the activities.
You will find this icon in every end of two (2) modules. It signifies a summative
test, Midterm and Final Examinations respectively. Your instructor will announce
when you will take these, and will provide information on how to access an online
exam.

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NOTE: Essays will be graded accordingly using the rubrics below.
Levels of Achievement
Criteria Excellent Good Fair Poor
(8-10 points) (6-7 points) (4-5 points) (0-3 Points)
There is one specific, There is one clear, There is one topic, The topic and
well-focused topic. Main well- focused topic. but main ideas are main ideas are not
Focus and
ideas are clear and are Main ideas are clear but not especially clear. clear
details well supported by are not supported by
detailed and accurate detailed information or
information. facts

The introduction is The introduction states The introduction There is no clear
inviting, states the main the main topic and states the main topic. introduction,
topic, and provides an provides an overview of A conclusion is structure, or
Organization overview of the the paper. A conclusion included, but is not conclusion
argument. Information is is included, but does especially relevant/
relevant and presented in not strengthen the supportive
logical order. The argument/position
conclusion is strong.
The author’s purpose of The author’s purpose of The author’s purpose The author’s
writing is very clear, and writing is somewhat of writing is purpose of writing
there is strong evidence clear, and there is somewhat clear, and is unclear.
of attention to audience. some evidence of there is evidence of
Voice
The author’s knowledge attention to audience. attention to
of and/or experience with The author’s knowledge audience. The
topic is evident of and/or experience author’s knowledge
with the topic is of the topic seems
evident. limited
The author uses vivid The author uses vivid The author uses The writer uses a
word and phrases. The words and phrases. The words that limited
choice and placement of choice and placement communicate clearly, vocabulary.
Word Choice words seems accurate, of words is inaccurate but the writing lacks Jargon or clichés
natural, and appropriate. at times and/ or seems variety and seems are not used
overdone or inappropriate to the properly and
inappropriate for the subject matter. detract from the
subject matter meaning.
All sentences are well- Most sentences are Most sentences are Sentences sound
constructed and have well- constructed and well constructed, but awkward, are
varied structure and have varied structure they have a similar distractingly
length. The author makes and length. The author structure and/or repetitive, or are
Sentence very few errors in makes a few errors in length. The author difficult to
structure,
grammar, mechanics, grammar, mechanics, makes several errors understand. The
Grammar,
Mechanics, and/ or spelling and/ or spelling, but in grammar, author makes
and Spelling these mistakes do not mechanics, and/ or numerous errors
interfere with spelling that interfere in grammar,
understanding. with understanding. mechanics, and/
or spelling that
interfere with
understanding

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COURSE STUDY GUIDE

This module was prepared for you to work on independently and
diligently. It aims for you to be independent confident in honing and
performing your nursing skills. Do it with enthusiasm.
1. Give your best – you have the knowledge and skills to make it
through. You can do it!
2. Be patient – do not miss any important part in the module.
3. Focus your attention and motivate yourself – read other materials or
references for a better understanding of the subject matter. Ask any
member of your family or friends to assist you if you encounter difficulties.
Do not give up.
4. Answer confidently – make sure to answer completely and concisely. Cite
your references. Answers to essays should be direct to the point.
5. Submit on time – before the end of midterms and finals, you will need to
submit your output or accomplished activities thru correspondence or
during our face-to-face meeting.
If you need assistance during the course of your study, you may contact me
thru my email.
Read, Internalize and consider the knowledge you have acquired. Good luck!
GRADING SYSTEM
Module Activities and Assignments - 60%
Quizzes
Project
Midterm/Final Examination - 40%
Total 100%
 COURSE CONTENT
Module I
Lesson 1 Overview of Public Health Nursing in the Philippines
Lesson 2 The Health Care Delivery System
Lesson 3 The Family
Module II
Lesson 1 Family Nursing Process
Lesson 2 Records in Family Health nursing Process
Lesson 3 DOH Programs Related to Family Health
Module III
Lesson 1 Ethical Considerations in Community Health Nursing
Lesson 2 Filipino Culture, Values and Practices in relation to Health
Care of Individual and Family
Module IV
Lesson 1 New Technologies Related to Public Health Electronic
Information
Lesson 2 Nursing Core Values as a Community Health Nurse
Lesson 3 Health-Related Entrepreneurial Activities in the Community
Setting

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 REFERENCES
Books:
Nies, M. A., McEwen, M., (2020) Community and Public Health Nursing,
2nd Edition
eBooks:
Nies, M. A., McEwen, M., (2020) Community and Public Health Nursing:
Promoting the Health of Population, 2nd Edition
Rector, C., (2018) Community and Public Health Nursing: Promoting the
Public’s Health, 9th Edition
Stamler, L. L., et al; (2020) Community Health Nursing
Riegelman, r. Kirkwood, B. (2019) Public Health 101: Improving
Community Health, 3rd Edition
Websites:
https://www.doh.gov.ph/sites/default/files/basicage/Philippine
%20Health%20Agenda_Dec1_1.pdf
https://www.who.int/health-topics/sustainable-development-goals
https://pdfslide.net/documents/family-coping-index
https://www.google.com/search?
q=filipino+family+culture+and+traditions
https://www.nursingpath.in/2019/02/records-and-reports.
ei=BWY7X5zEBIqg0gS935lA&q=bemonc+and+cemonc+program
ei=ethical+considerations+in+public+health+nursing
ei=nursing+core+values+as+a+community+health+nurse
q=What+are+the+common+traditional+beliefs+of+the+Filipino
https://rnspeak.com/nurses-code-of-ethics/

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MODULE III
Lesson 1 : Ethical Considerations

in Community Health
Nursing
Lesson 2 Filipino Culture,

Values and Practices
in relation to Health
Care of Individual and
Family

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INTRODUCTION
Cultural awareness is a prerequisite prior to achieving cultural

competency. It is the understanding that a cultural divide exists between the
patient and health professional. Some cultural beliefs are discussed in this
module that would help you understand more about the people in the
community.
This module talks about the ethical considerations in community health

nursing; the Filipino culture, values, and practices in relation to health care of
individual and family.
LEARNING OUTCOMES
After studying the module, you should be able to:

 Adhere to ethico-legal considerations when providing safe, quality and
professional nursing care.
 Adhere to established norms of conduct based on the Philippine Nursing
Law and other legal, regulatory and institutional requirements relevant
to safe nursing practice.
 Protect client rights based on “Patient’s Bill of Rights and Obligations”.
 Implement strategies/policies related to informed consent as it applies
in multiple contexts.
 Exemplify love for country in the service of the Filipinos and family.
 Customize nursing interventions based on Philippine culture and values.
DIRECTIONS/ MODULE ORGANIZER

There are two lessons in the module. Read each lesson carefully then
answer the exercises/activities to find out how much you have benefited from
it. Work on these exercises carefully and submit your output through my email
account sllavore@dmmmsu.edu.ph / ragmac@dmmmsu.edu.ph . Essays will be
graded using the rubrics provided in the preliminaries of this module.
In case you encounter difficulty, we can discuss this during the face-to-
face meeting.
Good luck and happy reading!!!

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Lesson 1

Ethical Considerations
In Community Health
Nursing
Basic concepts of the Code of Ethics
1. Rights – According to the Webster dictionary, a right means “something to

which one has a just claim or the power or privilege.” One example of rights is
often discussed in hospital premises, such as the rights of the patient. Nurses
must be aware of these rights since sometimes patients may refuse the nursing
care that they could give. Remember that it is also the right of the patient to
refuse such as procedure or medication even though that your purpose as a
nurse is to help him or her.
2. Autonomy – Is synonymous to “free, independent, and sovereign. While al

these words mean “not subject to the rule or control of another,” autonomous
stresses independence in matters pertaining to self-government. The concept
of autonomy can be seen during decision-making of undergoing such procedures
whether invasive or not. An informed consent is one example of how a nurse
can practice the concept of autonomy. Nurses must be able to accept the fact
that an individual may have different cultural and religious background that
could influence his or her submission to medical procedures. Using a written
consent during such cases can protect the patient and the hospital in particular
against legal violations of invading the privacy of an individual.
3. Beneficence and nonmaleficence – Beneficence means performing a deed

that benefits someone, while Nonmaleficence means refraining from doing
something that harms or injures someone. These concepts can be seen during
rendering nursing care. It is very important that nursing care must do not harm
(beneficence) but rather be safe for the patient. Likewise, nursing care must
also be sure enough that it cannot lead to intentional harm (nonmaleficence).
Patients nowadays are very sensitive regarding these concepts, so nurses are
challenged to give quality nursing care every day.
4. Fidelity – Faithfulness to a person, cause, or belief, demonstrated by

continuing loyalty and support. Most of the time, this term is correlated to
marital relationship. However, nurses should have fidelity towards four major
parts of her profession: patient, company, community and environment.
Fidelity is being accountable to your actions towards each individual or group
you encounter.
5. Veracity- is defined as being honest and telling the truth and is related to
the principle of autonomy. It is the basis of the trust relationship established
between a patient and a health care provider.
In the Philippines for instance, the Professional Regulatory Board and

Board of Nurses have adopted the Philippine Code of Ethics for Nurses in July

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14, 2004. Each nurse practicing in the Philippines must be aware of such in

order to serve the Filipinos the best nursing care they could have.
The Code of Ethics for Filipino Nurses embodies ethical principles and
guidelines to be observed, stipulated under seven (7) articles. The ethical
principles are stated below.
Article I – Preamble
1. Health is a fundamental right. The Filipino RN, believing in the worth
and dignity of each human being, recognizes the primary
responsibility to preserve health at all cost. This responsibility
encompasses promotion of health, prevention of illness, alleviation of
suffering, and restoration of health. However, when the foregoing
are not possible, assistance towards a peaceful death shall be his/her
obligation.
2. To assume this responsibility, RNs have to gain knowledge and
understanding of man’s cultural, social, spiritual, psychological, and
ecological aspects of illness, utilizing the therapeutic process.
Cultural diversity and political and socio-economic status are
inherent factors to effective nursing care.
3. The desire for the respect and confidence of clientele, colleagues,
co-workers, and the members of the community provides the
incentive to attain and maintain the highest possible degree of
ethical conduct.
Article II – Registered Nurses and People

1. Values, customs, and spiritual beliefs held by individual shall be
represented.
2. Individual freedom to make rational and unconstrained decisions shall
be respected.
3. Personal information acquired in the process of giving nursing care
shall be held in strict confidence.
Article III – Registered Nurses and Practice

1. Human life is inviolable.
2. Quality and excellence in the care of patients are the goals of
nursing practice.
3. Accurate documentation of actions and outcomes of delivered care
is the hallmark of nursing accountability.
4. Registered nurses are the advocates of the patients: they shall
take appropriate steps to safeguard their rights and privileges.
5. Registered Nurses are aware that their actions have professional
ethical, moral and legal dimensions. They strive to perform their
work in the best interest of all concerned.
Article IV – Registered Nurses and Co-workers

1. The RN is in solidarity with other members of the health care team in
working for the patient’s best interest.
2. The RN maintains collegial and collaborative working relationship
with colleagues and other health care providers.
Article V – Registered Nurses, Society, and Environment

1. The preservation of life, respect for human rights, and promotion of
healthy environment shall be a commitment of a RN.
2. The establishment of linkages with the public in promoting local,

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national, and international efforts to meet health and social needs of

the people as a contributing member of society is a noble concern of
a RN.
Article VI – Registered Nurses and the Profession

1. Maintenance of loyalty to the nursing profession and preservation of
its integrity are ideal.
2. Compliance with the by-laws of the accredited professional
organization (PNA) and other professional organizations of which the
RN is a member is a lofty duty.
3. Commitment to continual learning and active participation in the
development and growth of the profession are commendable
obligations.
4. Contribution to the improvement of the socio-economic conditions
and general welfare of nurses through appropriate legislation is a
practice and visionary mission.
Article VII – Administrative Penalties, Repealing Clause and Effectivity

The certificate of registration of the RN shall either be revoked or
suspended for violation of any provisions of this Code pursuant to Sec. 23 (f),
Art.IV of R.A. No. 9173 and Sec. 23 (f), rule III of Board Res. No. 425, Series of
2003, the IRR.
HEALTH LAWS AFFECTING PRACTICE OF PUBLIC HEALTH NURSING

Public health nurses need to know the laws affecting health and nursing
practice in the Philippines.
A. Republic Act No. 7305- Magna Carta for Health Workers
B. Presidential Decree No. 856- Sanitation Code
C. Republic Act No. 6675- Generic Act
D. Republic Act No. 7875- National Health Insurance Act (PhilHealth)
E. Republic Act No. 7719- National Blood Services Act
F. Republic Act No. 11332- Laws on Notifiable Diseases
G. Republic Act No. 7432- Senior Citizen Laws
H. Republic Act No. 6425- Revised Dangerous Drugs Law
I. Republic Act No. 9502 of 2008- Act on Cheaper Medicines
J. Republic Act No. 9262- Violence Against Women
K. Republic Act No. 10121- Disaster Risk Reduction Management
L. Republic Act No. 7600- Rooming-in and Breastfeeding Act of 1992 (Milk
Code)
M. Republic Act No. 10354- Responsible Parenthood and Reproductive
Health Law of 2012
N. Presidential Decree No. 996- Mandatory Infants and Children Health
Immunization Act of 2011
O. Republic Act No. 10666 -Children Safety on Motorcycles Act of 2015
P. Republic Act No. 10821- Children’s Emergency Relief and Protection
Act of 2016
Q. P.D. 603- Child and Youth Welfare Code of the Philippines
R. Republic Act No. 9211- Tobacco Regulation Act of 2003
Other Related Laws
R.A. 2382 – Philippine Medical Act.

 This act provides for and shall govern (a) the standardization and
regulation of medical education; (b) the examination for registration of
physicians; and (c) the supervision, control and regulation of the practice
of medicine in the Philippines..

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R.A. 1082 – Rural Health Act.

 It created the 1st 81 Rural Health Units.
 amended by RA 1891; more physicians, dentists, nurses, midwives and
sanitary inspectors will live in the rural areas where they are assigned in
order to raise the health conditions of barrio people ,hence help decrease
the high incidence of preventable diseases
R.A. 6425 – Dangerous Drugs Act

 It stipulates that the sale, administration, delivery, distribution and
transportation of prohibited drugs is punishable by law.
R.A. 9165 – the new Comprehensive Dangerous Drug Act of 2002

 “the state needs to enhance further the efficacy of the law against
dangerous drugs as being one of today’s serious social problems.
P.D. No. 651

 Requires that all health workers shall identify and encourage the
registration of all births within 30 days following delivery.
P.D. No. 996

 Requires the compulsory immunization of all children below 8 yrs. of age
against the 6 childhood immunizable diseases.
P.D. No. 825

 Provides penalty for improper disposal of garbage and other forms of
uncleanliness.
R.A. 8749 – Clean Air Act of 2000

 An act providing for a comprehensive air pollution control policy and for
other purposes.
P.D. No. 856 – Code on Sanitation

 It provides for the control of all factors in man’s environment that affect
health including the quality of water, food, milk, insects, animal carriers,
transmitters of disease, sanitary and recreation facilities, noise, pollution
and control of nuisance
R.A 6758 – Compensation and Classification Act of 1989

 Standardizes the salary of government employees including the nursing
personnel.
R.A. 6675 – Generics Act of 1988

 Which promotes, requires and ensures the production of an adequate
supply, distribution, use and acceptance of drugs and medicines identified
by their generic name.
R.A. 6713 – Code of Conduct and Ethical Standards of Public Officials and
Employees
 It is the policy of the state to promote high standards of ethics in public
office. Public officials and employees shall at all times be accountable to
the people and shall discharges their duties with utmost responsibility,
integrity, competence and loyalty, act with patriotism and justice, lead
modest lives uphold public interest over personal interest.
R.A. 7305 – Magna Carta for Public Health Workers

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 This act aims: to promote and improve the social and economic well-being
of health workers, their living and working conditions and terms of
employment; to develop their skills and capabilities in order that they will
be more responsive and better equipped to deliver health projects and
programs; and to encourage those with proper qualifications and excellent
abilities to join and remain in government service.
R.A. 8423
 Created the Philippine Institute of Traditional and Alternative Health Care.
P.D. No. 965

 Requires applicants for marriage license to receive instructions on family
planning and responsible parenthood.
P.D. NO. 79
 Defines, objectives, duties and functions of POPCOM
RA 4073
 advocates home treatment for leprosy
Letter of Instruction No. 949

 legal basis of PHC dated OCT. 19, 1979
 promotes development of health programs on the community level
RA 3573
 requires reporting of all cases of communicable diseases and
administration of prophylaxis
Ministry Circular No. 2 of 1986

 includes AIDS as notifiable disease
R.A. 7875 – National Health Insurance Act

R. A. 7719 – National Blood Services Act
R.A. 8172 – Salt Iodization Act (ASIN LAW)
R.A. 7277- Magna Carta for PWD’s
 provides their rehabilitation, self-development and self-reliance and

integration into the mainstream of society
A. O. No. 2005-0014- National Policies on Infant and Young Child Feeding:

1. All newborns be breastfeed within 1 hr after birth
2. Infants are exclusively breastfeed for 6 months.
3. Infants be given timely, adequate and safe complementary foods
4. Breastfeeding be continued up to 2 years and beyond
EO 51- Phil. Code of Marketing of Breast milk Substitutes

R.A. – 7600 – Rooming In and Breastfeeding Act of 1992
R.A. 8976- Food Fortification Law
R.A. 8980-promulgates a comprehensive policy and a national system for ECCD
A.O. No. 2006- 0015-defines the Implementing guidelines on Hepatitis B
Immunization for Infants
R.A. 7846-mandates Compulsory Hepatitis B Immunization among infants and
children less than 8 yrs old

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THINK!
Activity 1
Read the instructions carefully and answer the
questions that follow. Write/ encode your answer on the
template provided then send a digital copy (image/ picture/
softcopy) to the respective email of your instructor. You will
be graded using the rubrics provided.
1. Why do you think ethics is important in the provision of

health care? Give some situations.
2. Why do you think these laws are important in the

provision of health care? Give some situations.
Lesson 2
 Filipino culture, values

and Practices in relation
to Health Care of
Individual and Family
Introduction
Filipino values are, for the most part, centered at maintaining social
harmony, motivated primarily by the desire to be accepted within a group. The
main sanction against diverging from these values are the concepts of "Hiya",
roughly translated as 'a sense of shame', and "Amor propio" or 'self-
esteem'. Social approval, acceptance by a group, and belonging to a group are
major concerns. Caring about what others will think, say or do, are strong
influences on social behavior among Filipinos.
According to the anthropologist Leonardo Mercado, the Filipino
worldview is basically 'nondualistic'. Based on his linguistic analyses of Filipino
value terms like loob (Cebuano buot), he concludes that Filipinos desire
harmony, not only in interpersonal relationships, but also with nature and
religion, while still remaining nondichotomous.
A. Family Solidarity

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In the family context, the concepts of intergenerational solidarity is

most frequently used to shed light on the nature of the relationship between
adult children and their parents. ... This refers to the frequency of social
contact and shared activities between family members.
Structure of Filipino Family

• The typical Filipino family consists of a husband, wife and children,
extending to include grandparents, aunts, uncles and cousins. This circle is
often enlarged with the selection of a child's godparents.
B. Filipino Family Values

1. Communication- Filipinos have close family ties and always love to talk
about their extended family, especially about their children. So a good
conversation piece is asking about their family – which region or province they
come from, whether they have children, their ages and what grade in school
they are in
2. Helping Others and Gratitude- Filipino is known as hospitable, gentle,

friendly, kind and loving. We have traditional values these are:
 Respect ( po; opo )
 Helping Others ( pakikisama )
 Debt of Gratitude ( utang na loob)
 Prioritizing Family ( Pagpapahalaga sa Pamilya )
 Shame ( Hiya )
“Filipinos are generous people. Even when we have very little, we always
share with those around us”.
3. Respect- Paggalang the English translation of paggalang means to be

respectful or to give respect to a person. Filipinos are accustomed to using the
words “po,” “opo,” and “ho” when they are conversing with older people or,
sometimes, with those who are in a high role or a prestigious member of
society.
4. Independence (pagsasarili)
5. Service- the action of helping or doing work for someone;
6. Trust (tiwala)
C. Filipino Family Culture and Tradition
Culture is defined as the “totality of socially transmitted pattern of thoughts,

values, meanings, and beliefs” (Purnell 2005). It is not limited to any specific
ethnic group, geographical area, language, religious belief, manner of clothing,
sexual orientation, and socioeconomic status (Fisher 1996). In Revisiting
usog, pasma, and kulam, Tan explains that “culture is inscribed in our bodies
and in our minds” (Tan 2008). As such, the relationship of culture and health is
important to understand as it impacts an individual’s worldview and decision-
making process (Purnell 2005). Like in other fields of medicine, the impact of
cultural beliefs is increasingly being recognized as an essential component in
the genetic counseling process (Cohen et al. 1998; Edwards et al. 2008; Penn et
al. 2010).
The influence of culture on health is vast. It affects perceptions of health,
illness and death, beliefs about causes of disease, approaches to health
promotion, how illness and pain are experienced and expressed, where patients
seek help, and the types of treatment patients prefer.

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Seven common Filipino cultural beliefs:

namamana, lihi, sumpa, gaba, pasma, namaligno, and kaloob ng Diyos.
Namamana is the Filipino language translation of acquiring a behavioral or

disease trait from a parent. It is a belief that when a relative has the
condition, it is possible that he/she will pass on the trait to the younger
generation.
Lihi is a concept used to explain why some children are noted to have certain
specific characteristics. It is also during this time that the pregnant woman
develops intense craving for certain foods and intense liking for certain
objects. It is believed that an offspring will take the features of the food that
the mother has craved for while she is in the lihi period.
Pasma is roughly defined as an “exposure illness” which occurs when a

condition considered to be “hot” is attacked by a “cold” element and vice
versa (Tan 2008). An individual’s homeostasis is attained by a balance between
the hot and cold elements, and an illness is caused by a dominance of either
hot or cold.
Sumpa and Gaba are beliefs in the Filipino culture pertaining to a curse.

In sumpa, the curse is inflicted by a human being. In contrast, gaba is a curse
inflicted by a divine being and it is usually God. This is inflicted to a person
because he/she committed a social sin. The impact of sumpa and gaba is
shared with the whole family and extends to the next generation (Tan 2008).
To end its effect, the inflicted person and family members may pursue
ritualistic activities and wear amulets.
Namaligno is a Filipino belief that a disease is caused by an intervention of a

supernatural or a mystical being (Abad 2013). Usually, namaligno is used as an
explanation in conditions which remain to be mysteries because of the absence
of an apparent cause. One of this is the occurrence of sudden unexpected
nocturnal death syndrome (SUNDS) which is common in the Philippines
(Gervacio-Domingo et al. 2007). Locally, it is known as the bangungot. Filipino
folklore tells that the cause of bangungot as a deed of a mythical creature
called batibat, a huge dark monster covered with thick black hair. Batibat is
known to attack unsuspecting victims at night, oftentimes, torturing them by
sitting on their chest until the victims helplessly gasps for his breath eventually
succumbing to death. It is important to note that bangungot is described
similar to nightmares, and it is oftentimes accompanied by tightening of the
chest.
Kaloob ng Diyos means God’s will. When a Filipino individual experiences an

unexpected event in their life, whether negative or positive, it is typically
attributed to the grace of God. This concept helps families cope and accept
their life experiences. It provides access to personal empowerment and hope to
families. As a means for coping, this concept allows affected families to
emotionally move toward acceptance.
THINK!
Activity 2
Read the instructions carefully and answer the questions that
follow. Write/ encode your answer on the template provided
then send a digital copy (image/ picture/ softcopy) to the
respective email of your instructor. You will be graded using
the rubrics provided.
1. Why is it important to respect cultural differences?
17
LEARNING ACTIVITY
follow. Write/ encode your answer on the template provided then send a
digital copy (image/ picture/ softcopy) to the respective email of your
instructor. You will be graded using the rubrics provided.
1. RA 1054 is also known as the Occupational Health Act. Aside from the
number of employees, what other factor must be considered in
determining the occupational health privileges to which the workers
will be entitled?
a. Type of occupation,: agriculture, commercial, industrial
b. Location of the workplace in relation to health facilities
c. Classification of the business enterprise based on net profit
d. Sex and age composition of employees
2. RA 7160 mandates devolution of basic services from the national
government to local government units. Which of the following is the
major goal of devolution?
a. To strengthen local government units
b. To allow greater autonomy to local government units.
c. To empower the people and promote their self-reliance
d. To make basic services more accessible to the people
3. As an epidemiologist, the nurse is responsible for reporting cases or
notifiable diseases. What law mandates reporting cases of notifiable
diseases?
a. Act 3573
b. RA.3753
c. RA 1054
d. RA 1082
4. What law created the Philippine institute of Traditional and
Alternative Health Care?
a. RA 8483
b. RA4823
c. RA 2483
d. RA 3482
5. What is the legal basis of Primary Health Care approach in the
Philippines?
a. Alma Ata Declaration of PHC
b. Letter of Instruction No 949
c. Presidential Decree No. 147
d. Presidential Decree 996
6. Civil registries are important sources of data. Which law requires
registration of births within 30 days from the occurrence of the birth?
a. PD 651
b. Act 3573
c. RA 3753

18
d. RA 3375
7. In immunity school entrants with BCG, you not obliged to secure
parental consent. This is because of which legal document?
a. PD 996
b. RA 7864
c. Presidential Proclamation No. 6
d. Presidential Proclamation No. 46
8. In the decision-making process, ethical issues must be considered. A
patient has been diagnosed with cancer and must undergo long and
painful treatments such as surgery, radiation and chemotherapy to
prolong her life. The ethical principle applied here is:
a. Nonmaleficence
b. Beneficence
c. Autonomy
d. Utility
9. A professional nurse is a person who has completed a basic nursing
education program and is licensed in his/her country or state to
practice professional nursing. Within the context of public welfare
and safety, the expected utilization of interpersonal decision
making, psychomotor abilities, and knowledge application by a
licensed healthcare professional is an illustration of which of the
following?
a. Responsibility
b. Accountability
c. Competence
d. Standards of care
10. The Newborn Screening Act mandates all newborns to undergo

testing, ideally between the 48 th to 72nd hours of life. Which of the
following Republic Acts discuss this mandate
a. RA9388
b. RA9188
c. RA9288
d. RA9888
 MODULE SUMMARY
Ethical values are essential for all healthcare workers. Ethical practice is
a foundation for nurses, who deal with ethical issues daily. Ethical dilemmas
arise as nurses care for patients. These dilemmas may, at times, conflict with
the Code of Ethics or with the nurse's ethical values. Nurses are advocates for
patients and must find a balance while delivering patient care. There are four
main principles of ethics: autonomy, beneficence, justice, and non-
maleficence.
Each patient has the right to make their own decisions based on their
own beliefs and values. This is known as autonomy. A patient's need for
autonomy may conflict with care guidelines or suggestions that nurses or other
healthcare workers believe is best. A person has a right to refuse medications,
treatment, surgery, or other medical interventions regardless of what benefit

19
may come from it. If a patient chooses not to receive a treatment that could
potentially provide a benefit, the nurse must respect that choice.
Understanding the culture, health care beliefs, and practices of Filipino
nurses is important; as it affects the way they assess the needs and provide
care for their clients. This article provides a general profile of the health care
beliefs, behaviors, and practices of Filipino nurses in the United States within
the context of the general Filipino culture. Like any other ethnic group,
Filipinos have become acculturated at various levels after coming to work and
live in this country over the years. It is the integration of their cultural beliefs,
values, and behaviors that affects their caregiving attitudes and practices.

20
MODULE IV
Lesson 1 : New Technologies

Related to Public Health
Electronic Information
Lesson 2: Nursing Core Values as

A Community Health
Nurse
Lesson 3: Health-Related
Entrepreneurial
Activities in the
Community Setting

21
INTRODUCTION
This module talks about the innovations in health care in terms of new
technologies related to public health nursing. It further explains the
importance of information and communications technology (ICT) for public
health. It is also described in this module the existing implementation of ICT
for public health in the Philippines. The various roles of a community health
nurse have in implementing ICT for public health is also discussed in this
module.
Nursing core values in the community are also discussed in this module
for you to be able to deliver a good quality of nursing care to individuals,
families and the community.
Nursing entrepreneurship is also presented in this module for you to be
able to identify opportunities for entrepreneurial nursing practice.
OBJECTIVES
 After studying the module, you should be able to:

 Use appropriate technology to support the delivery of care to individuals
and families.
 Demonstrate caring as the core of nursing, love of God, love of country
and love of people.
 Manifest professionalism, integrity and excellence.
 Project the positive professional image of a Filipino nurse.
 Identify opportunities for entrepreneurial nursing practice.
 Apply strategic interventions to address health-related concerns of
individuals, families, communities and population groups to any health
care setting.
DIRECTIONS/ MODULE ORGANIZER
There are four lessons in the module. Read each lesson carefully then
answer the exercises/activities to find out how much you have benefited from
it. Work on these exercises carefully and submit your output through my email
account sllavore@dmmmsu.edu.ph / dragmac@dmmmsu.edu.ph . Essays will be
graded using the rubrics provided in the preliminaries of this module.
In case you encounter difficulty, we can discuss this during the face-to-
face meeting.
Good luck and happy reading!!!

22
Lesson 1
 New Technologies Related to

Public Health Electronic
Information
Introduction
Innovations in health care are continuously introduced. Health

care providers apply best practices from latest researches and use appropriate
tools to enhance the quality of health care delivered.
Patients appear to become more engaged in their care through

information available on the Internet, radio and television. Communication
problems between patients and health care providers, brought about by
geographical disparity, are easily solved by mobile phones. Computers are used
to store, retrieve and process important health data for better decision
making. Information and communications technologies (ICTs) are becoming
indispensable tools in addressing some challenges in health care.
ICTs are defined as, “diverse set of technological tools and resources
used to communicate, and to create, disseminate, store, and manage
information.” These technologies include computers, the Internet,
broadcasting technologies (radio and television), and telephony (Blurton,
2002).
This chapter explores the actual and potential application of ICTs geared
toward improving people’s access and utilization of health care in the
Philippine Community health setting.
What is eHealth?
eHealth is the use of ICT for health (World Health Organization, 2012).
On May 25, 2005, during the Fifty-Eighth World Health Assembly (WHA), a
resolution was adopted by the World Health Organization (WHO) member states
recognizing eHealth as the cost-effective way of using ICT in health care
services, health surveillance, health literature, health education, and research
(WHA, 2005).
Given the extensive capabilities of ICT, eHealth can be considered in any

of, but not limited to, the following:
 Communicating with a patient through a teleconference, electronic mail
(e-mail), short messaging service (SMS).
 Recording, retrieving, and mining data in an electronic medical record
(EMR)
 Providing patient teaching with the aid of electronic tools such as radio,
television, computers, smartphones, and tablets.
eHealth, often confused with telehealth or telemedicine, is the overall,
umbrella term. According to the WHO, eHealth encompasses three main areas:

23
 The delivery of health information, for health professionals and health

consumers, through the Internet and telecommunications.
 Using the power of information technology (IT) and e-commerce to
improve public health services, for example, through the education and
training of health workers.
 The use of e-commerce and e-business practices in health systems
management.
The Power of Data and Information
Nurses are knowledge managers. They constantly process raw patient

data into valuable information to deliver evidence- based and individualized
interventions. It is imperative for every eHealth practitioner to know the
importance and difference between the two.
Data are the fundamental elements of cognition (Gudea, 2005), and are
defined as unanalyzed raw facts that do not imply meaning. When meaning is
attributed to data and when data are processed and analyzed, then data
becomes information.
Consider, for instance, the number 39. It can be an age, house number,
jersey number, etc. This is data. The school nurse noted that it was written on
the respiratory rate field of the record of Grade 5 student Rosemarie. Number
39 now has a meaning to the nurse and has become information. Based on the
nurse’s knowledge that Rosemarie’s respiratory rate is above normal and
considering other findings, the nurse concludes that she is hyperventilating.
The nurse gave Rosemarie a brown paper bag to breathe into.
The health care system builds heavily on accurate recording of obtained

data. Paper-based methods may bring inconvenience especially when it comes
to interoperability of health services, information back up, and instant data
access. A number of bigger problems may also emerge:
1. Continuity and interoperability of care stops in the unlikely event
that a record gets misplaced.
If the patient suffers from chronic condition, previous findings
supporting this diagnosis, drug allergies, preexisting conditions, or even
past accounts of the patient’s previous visits may no longer be accessed
unless the health providers have made several copies of the same
record. The patient may also need to recount his/her condition for every
transfer of care.
2. Illegible handwriting poses misinterpretation of data.
A direct observational study of medication administration found
opportunities for errors associated with incomplete or illegible
prescriptions (Tissot et al., 2003).
3. Patient privacy is compromised.
Traditional, paper-based patient records are vulnerable to
unauthorized viewing since there is no trail of the usage of the chart.
The disclosure of highly private information arising from such an incident
can lead to loss of trust in the health facility or even legal risks.
4. Data are difficult to aggregate.
Manual data recording and tallying significantly delays
implementation of interventions and targeted health programs. Health
care monitoring is compromised as information is not readily available
and up-to-date on a daily basis.
5. Actual time for patient care gets limited.

24
Time spent by the community health worker searching for a

paper-based record is time lost for actual care.
Likewise, for both clinical and community settings, the overall

impact of the problems related to manual/ traditional data-gathering is
articulated as follows:
Internal and external changes affecting health care informatics

(Englebardt and Nelson, 2001):
1. The ability to manipulate large amounts of data
2. The ability to relate data to cohorts of people who share similar health
problems
3. The ability to link to genomic data
In contrast, having a well-managed patient information system can

have the following benefits:
1. Data are readily mapped, enabling more targeted interventions and
feedback.
Through a system that delivers real-time and accurate patient
and community information, health care providers are able to deliver
patient-centered care and targeted disease prevention and management
programs. The facility and staff are also provided feedback on their
performance through computer alerts, enabling them to continually comply
with standard guidelines and monitor monthly, quarterly or yearly health
targets. From the societal public health perspective, adhering to these
guidelines keeps individuals healthy and lowers the risk of disease outbreak
in communities.
Health professionals can also track the frequency and locale of
diseases in real time through EMR and Geography Information System (GIS)
like the Philippine Health Atlas of the Department of Health (DOH, 2012a).
GIS technology enables detailed maps to be generated with relative speed
and ease. In turn, this provides public health practitioners with the ability
to provide quick responses to questions or concerns raised in a community
meeting. GIS is not the complete solution to understanding the distribution
of diseases and the problems of public health, but at is an important way in
which to better illuminate how humans interact with their environment to
create or deter health.
2. Data can be easily retrieved and recovered.

In the event of force majeure, retrieval of patient information is not a
problem since data are automatically backed-up periodically in a secure
server.
3. Redundancy of data minimized.
Patient data that are frequently required in various health forms such as
unique identifying information (e.g., name, birthday, age, gender) need to
be recorded only once. These can be linked and organized automatically
into related record types through a database, allowing a better record
management and ease-of use.
4. Data for clinical research becomes more available.
The potential impact of health research in the country is often hindered
by the lack of quality data. Whenever data is gathered, it is often not
communicated to the rest of the research community. Having quality data
stored in databases provides faster and more reliable research outputs that
may eventually be translated to health care innovations and actual
interventions.
5. Resources are used efficiently.

25
By making patient information more readily available, EMRs reduce

costs related to chart pulls as well as supplies needed to maintain paper
chart. Studies have also shown that having an EMR as opposed to a paper
file can result in reduced transcription costs through point-of-care
documentation and other structured documentation procedures. In
developing countries, health care information systems have been driven
mainly by the need to report aggregate statistics for government or funding
agencies. Improvements in drug supply management using medication data
from EMR systems can offer the most measurable cost benefits at present; a
well-managed drug supply also improves availability and quality of patient
care.
Good Data Qualities

The nursing process begins with obtaining data through assessing the
patient’s signs and symptoms. These data are interpreted by the health care
professional into useful information and a diagnosis. This is then followed by
necessary interventions and again ends with gathering new data from
evaluating the results. Without data, it will be difficult for a health
professional to assist the patient.
Human error, viruses, bugs, and hardware issues pose a great threat to
the integrity of data. ICT can help decrease these errors by putting safeguards
in place, such as backing up files on a routine basis and error detection. In
order for information to be valuable, data must have the following
characteristics:
1. Accuracy. This ensures that documentation reflects the event as it
happened. All values should be correct and valid. In a computerized
system, a computer can be instructed to check specific fields for
validity and alert the user to a potential data collection error. In
electronic systems, format requirements must be followed (e.g., if
date required is mm-dd-yyyy, then it should be presented as 03-24-
1989).
2. Accessibility. This is a data characteristic which ascertains data
availability should the patient or any member of the health care staff
needs it. An example is readily available reports or statistics when
needed by decision makers.
3. Comprehensiveness. Data inputted should be complete. This is done
by making sure that all required fields in the patient’s record are
properly filled up.
4. Consistency/Reliability. Having no discrepancies in data recorded
makes it consistent. This means that when John Lloyd Dela Cruz is
written on the first page of the patient record, it should not be Jon
Lloyd Dela Cruz in the next. This potential error is reduced through
error detection and alerts by the computer.
5. Currency. All data must be up-to-date and timely. This is
exemplified when the community health nurse records data at the
point-of-care when it happened.
6. Definition. Data should be properly labeled and clearly defined. For
example, 36 is just an ordinary number unless it is labeled as an age
of a person.
eHealth Situation in the Philippines
The developing world suffers from inadequate health care and medical
services. Lack of health care professionals and infrastructure contributes to
this problem, making it more difficult to deliver health care to people in rural
and remote communities of the developing world.

26
The ubiquity of mobile technologies and availability of Internet services

in the Philippines create a promising ground for eHealth access. In 2001,
roughly 2.5% of the country’s population had Internet access. In the span of 10
years, this rate steadily increased to 29%. The Philippines has also a mobile
penetration rate of 80%, with 73 million subscribers as of 2009. In addition, the
country is ranked first in terms of short messaging service (SMS) usage in the
entire world.
ICT has changed how Filipinos access information and how the
government has utilized this to inform its citizenry. Examples of these include
regular updates of traffic conditions, current events, and critical weather
reports through various social media.
The health sector has also begun utilizing ICT to improve its services.
The DOH has introduced a number of health information systems that aim to
improve the access of health data, such as the Electronic Field Health Service
Information System, Online National Electronic Injury Surveillance System, the
Philippine Health Atlas, and the Unified Health Management Information
System.
Factors Affecting eHealth in the Country
As mentioned earlier, numerous limitations impede the development of

eHealth in the country, especially in the community setting. However, various
innovations have allowed eHealth implementations to gain ground. Both
limiting and advancing factors are discussed in this section.
Limited health budget

-as mentioned in Chapter 1, the budget allocation for health care is
relatively small. This is one of the many reasons advancements in eHealth are
postponed. ICT projects usually require a huge budget, take a long period to
implement, and are occasionally seen as risky endeavors.
The emergence of free and open source software
- In eHealth, the cost of software procurement or development often
takes up a huge portion of the budget. In addition, using ready-made propriety
software can be limiting at times, especially when users want to modify the
software to fit their workflow better.
To modify the software, its source code needs to be changed. The source
code is like the ingredients of a recipe. If one wants to modify the recipe, one
will need to adjust some of the ingredients. Like some recipes, some source
codes are kept secret too, which may cause the buyer of the proprietary
software to remain locked in to the seller’s support and maintenance. Since
the sellers own the code of the program, they are the only ones who can
modify the program. This may entail additional and unplanned costs, adding to
the problem of health budgetary limitations.
Decentralized government
- Under RA 7160 of the Local Government Code of 1991, local government
units (LGUs) are autonomous, and therefore in control of their own basic
services, including the budget. Because of this, it is typical to see diverse and
unrelated eHealth projects developing all over the country such as the Wireless
Access for Health (WAH) in Tarlac, the Secured Health Information and Network
Exchange (SHINE) in Iloilo, and the numerous Community Health Information
Tracking System (CHITS) installations in municipalities all over the Philippines.
LGUs may develop their own systems. These efforts have accelerated the

27
development of eHealth in community health. However, to maximize

advantages derived from these systems and to produce a nationwide impact,
the different health information systems will eventually need to connect with
each other, having one EMR system for all health centers will make consulting
in different facilities easier. But unifying and harmonizing the different existing
systems for this future benefit, though not impossible, will expectedly be
difficult.
Target users are unfamiliar with the technology

- eHealth is not only about technology. Along with software development
and hardware procurement, staff training and maintenance of the system are
key factors in determining its effectiveness. Recognition of the cultural aspects
of community life is important in starting them off into a new direction such as
computerization and automation.
One possible pitfall of eHealth implementations is focusing on software
development before accomplishing an assessment of the needs of health
professionals in the field. Most health center personnel are not familiar with
the use of computers. Implementing an eHealth system requires training of
health personnel on basic computer skills, use of software, and maintenance of
the equipment. No matter how technologically advanced the tools are, the
success of an eHealth implementation will eventually depend on the end-user’s
willingness to learn and accept the technology.
Surplus of “digital native” registered nurses

- Because of logistic limitations, government hospitals and health
care centers are mostly understaffed despite the estimated 200,000
underemployed or unemployed nurses in the country
One of the measures of DOH to address the accumulation of unemployed
professional nurses is the Registered Nurses for Health Enhancement and Local
Services (RN Heals) Project. It aims to provide nurses with one-year
employment in underserved and remote areas in the country as well as to
provide underserved areas with additional professional health workers
Overall, the Philippines is progressing in its use of eHealth for the
benefit of its citizens. How eHealth specifically affects community health will
be taken up in greater detail in the next section.
Using eHealth in the Community

As mentioned earlier in this module, the major goal of community health
nursing is to preserve the health of the community. This is best achieved by
focusing on health promotion and health maintenance of individuals, families,
and groups within the community. This section gives details as to how eHealth
enables the community health nurse in contributing towards the achievement
of this goal.
Universal Health Care and ICT

In the Philippines, making health care accessible to all remains a great
challenge. Lack of financial health care coverage leads to high out-of–pocket
expenses. The marked mass migration of health professionals leaves the
remote and rural areas of the country – with 7,107 islands – makes health care
delivery even more challenging.
A series of health reforms have been implemented. The DOH, through
Administrative Order No. 2010-0036, outlined the policy directions of the
Universal Health Care. Also known as Kalusugan Pangkalahatan (KP), this
reform agenda has three priority health directions:
1. Financial risk protection through expansion in National Health
Insurance Program enrolment and benefit delivery

28
2. Improved access to quality hospitals and health care facilities

3. Attainment of the health-related Milleniun Development Goals
(MDGs)
One of the aims of KP is to attain efficiency by using IT in all aspects of
health care.
One of the key instruments it underlines is the use of Health Information
to establish a modern information system that shall provide evidence for policy
and program development and support for immediate and efficient provision of
health care and management of province-wide health systems.
The DOH also recognizes the valuable purpose of ICT for health and has
drafted its National eHealth Strategic Framework for 2010-2016, with the vision
of ICT supporting UHC to improve health care access, quality efficiency, and
patient’s safety and satisfaction, for reducing cost and enabling policy makers,
providers, individuals, and communities to make the best possible health
decisions.
Electronic Medical Records

EMRs are basically comprehensive patient records that are stored and
accessed from a computer or server. Community health centers have the
capacity to rapidly adapt EMRs because they utilize a standard process
nationwide. For example, the work flow with a patient at a health center in
Quezon City is basically the same as that of a health center at Batanes.
In contrast, EMRs are more difficult to implement in hospitals because
each hospital has its own set of protocols coupled with its own system of
documentation. Even government- owned hospitals do not have a standard
system of health service provision and of maintaining patient records. This
difficulty in implementing information systems in the health sector highlights
the importance of certain standards.
Another reason EMRs are vital to community health centers is that each
patient record is usually used more frequently. For instance, a patient
undergoing treatment for tuberculosis needs to make regular visits to the
health center for TB-DOTS (Tuberculosis Directly-Observed Treatment Short
course). A young child is brought to the health center regularly for child care
health services, such as immunizations, deworming and micronutrient
supplementation. Community health centers make health care services
available to families, enabling the community health worker to observe familial
predispositions to certain diseases and provide appropriate health promotion
and prevention measures.
Ideally, a person can utilize health center services from womb to tomb.
This ideal scenario is made more likely if patient encounter is properly
documented and the patient recording system is set up with accuracy and
efficiency in mind.
As stated earlier in this module, community health nurses should be
aware of health patterns and health indicators within their catchment area.
Vital statistical indicators such as mortality and morbidity rates must come
from reliable data, which can be derived from reliable data, which can be
derived from accurate and thorough EMRs. EMR systems also allow
computerized processing of indicators, making it easier for nurses to focus on
other important aspects of health care.
One of the most widely used community-based EMR in the country id
CHITS, which began in 2004 and was funded by the International Development
Research Center (IDRC). It was created by Dr. Herman Tolentino of the
University of the Philippines- Medical Informatics Unit (UP-MIU) and is currently
implemented at health centers in Pasay, Navotas, Quezon City and several
other municipalities nationwide. Training on how to optimize the EMR for
community use and on-site follow-ups of the health workers were done. This

29
resulted in EMR features that are customized to the needs of the health center
and the community. More importantly, involving the target end users in the
development process of the EMR gave them a sense of ownership of the
program, allowing easy acceptance and utilization of CHITS.
Telemedicine
One of the five strategic goals of the DOH’s National eHealth Strategic
Framework for 2010-2016 is to capitalize in ICT. This in order to reach and
provide better health services to geographically isolated and disadvantaged
areas (GIDAs), to support MDG attainment, and to disseminate information to
citizens and providers through telemedicine and mobile health (mHealth)
services.
The WHO defines telemedicine as, “the delivery of health care services,
where distance is a critical factor, by all health care professionals using
information and communications technologies for the exchange of valid
information for diagnosis, treatment and prevention of disease and injuries,
research and evaluation and for the continuing education of health care
providers, all in the interests of advancing the health of individuals and their
communities”.
WHO further underscores four elements that are specific to
telemedicine.
1. Its purpose is to provide clinical support.
2. It is intended to overcome geographical barriers, connecting users
who are not in the same physical location.
3. It involves the use of various types of ICT.
4. Its goal is to improve health outcomes.
In the Philippines, the UPM-NTHC has been using telemedicine to provide

health services to remote and underserved areas of the country since 2004. It is
a partner of the DOH in the Doctors to the Barrios programs. It enabled
Municipal Health Officers to teleconsult difficult cases with trained telehealth
medical specialists via SMS or e-mail. The teleconsults, which are received by a
server, are then triggered by the NTHC telehealth nurses to appropriate
medical specialists.
In collaboration with the Philippine Council for Health Research and
Development of the Department of Science and Technology (DOST-PCHRD), the
BuddyWorks project of UPM-NTHC was continued from 2007 to 2010 as the
National Telehealth Service Program (NSTP).
A specific example of how telemedicine was applied in the community
was the discovery of a rare skin disease called tinea imbicata in a tribe from
Kiamba, Saranggani in Mindanao. The municipal Health Office of Kiamba,
Saranggani referred multiple cases of strange, ring-like formations on a
patient’s skin. Images were sent to the UPM-NTHC telehealth nurse and were
referred to a dermatology specialist at the Philippine General Hospital, who
gave the initial diagnosis of tinea imbricate- which has only been reported in
the Philippines three times since 1789. The recommended treatment was
effective. Case finding for patients with similar condition sought. This
eventually led to a medical mission by the dermatology specialists and has
fellow dermatologists in cooperation with the local government of Kiamba to
help the patients affected by the disease.
As can be seen from the example, telemedicine has the capacity to
bridge the gaps in the health referral system. It is understandable that this is
not a universal solution and may be applicable only in specific scenarios. The
goal of a patient receiving the best care as soon as possible despite an
unfavorable location or other adverse circumstances may be reached through
telemedicine.

30
eLearning
Health education, which is essential in health promotion and
maintenance, can be facilitated by ICT.
eLearning is basically the use of electronic tools to aid in teaching. It
can be done synchronously, asynchronously, or in a combination of both. This
can be in the form of simple instructional videos and information text blasts to
social network help groups and interactive simulations. ELearning can be
especially useful in correcting misconceptions about health and health care. It
permits access to reliable information about health. For example, control of
communicable diseases frequently requires community participation. With the
use of eLearning technology, community health nurses can elicit community
interest by showing instructional videos on measures to control a particular
disease.
eLearning can also be used to educate fellow health professionals . With
eLearning, continuing education sessions can be frequently availed of, with less
time, effort and expense involved in the process. Continuing professional
education of nurses can be undertaken by attending online and virtual seminars
through teleconferences and multiuser virtual environments.
Examples of eHealth Projects in the Community
In the table below is a summary of eHealth projects, past and present

that target community health. Note that some projects are a combination of
EMRs, telemedicine, eLearning, and other ways by which ICTs impact health.
The similarities among the projects and their implementations are
noteworthy. Also, they are scattered in different parts of the country. The
working of these projects usually does not interfere each other, creating
potential problems as previously explained.
NAME TYPE KEY INFORMATION

BuddyWorks Telemedicine - Implemented in 2004 by the
and eLearning University of the Philippines Manila-
National Telehealth Center (UPM-
NTHC) through the eGovernment Fund
of the commission on Information and
Communications Technology (CICT).
- Allowed RHU physicians in GIDAs to
send telereferrals to medical
specialists at the Philippine General
Hospital (PGH) via short message
service (SMS) and e-mail.
CHITS Electronic - Developed in 2004 by Dr. Herman
(Community medical Tolentino of the UPM College of
Health record Medicine- Medical Informatics Unit
Information (MIU). Project initially began in Pasay
System) health centers and has been
implemented in more than 48 health
centers since then.
- Program is divided into different
modules based on existing DOH
programs (EPI, NTP, etc.) and is a
Free and Open Source Software
(FOSS).
- A demo of CHITS can be accessed

31
online at htpps://demo2010.chit.ph
(username: user, password: user)
(UPM, NTHC 2010).
eFHSIS Health - An online version of the FHIS
(Electronic information developed by the DOH where you can
Field Health system and upload FHIS data.
Service electronic
information reporting
System)
eIMCI eLearning - Developed in 2009 by the Ateneo
(Electronic Innovation Center.
Integrated - An electronic version of IMCI
Management accessible in mobile devices.
of Childhood
Illness)
NTHC eLearning - Funded by the United States Agency
eLearning for International Development (USAID)
videos and developed by UPM-NTHC
- Created eLearning videos on
tuberculosis, stroke, bird flu, and
child poisoning.
RxBox Telemedicine - Funded by the DOST-PCHRD and
developed through the collaborative
efforts of the University of the
Philippines Manila- Electrical and
Electronics Engineering Institute
(UPM-EEEI), University of the
Philippines Manila- National Institute
of Physics (UPM-NIP) and UPM-NTHC.
- It is a mobile computer connected
with medical devices such as ECG,
pulse oximeter, and electronic blood
pressure and heart rate monitors that
is intended for mobile deployment to
rural health centers.
- It is also able to store and send
patient information and allow video
and chat conferencing with a medical
specialist.
SEGRHIS Electronic - An electronic medical record created
(Segworks medical for rural health units.
Rural Health record - Developed by Segworks, a local
Information software company based in Davao.
System)
SHINE (Secure Electronic - An electronic medical record
Health medical developed by Smart Communications.
Information record and - A demo can be accessed online at
Network SMS reporting https://shine.ph.
Exchange)
SPASMS SMS alert - Add-onto WAH (Wireless Access for
(Synchronize system Health),SPASMS is an SMS reminder
d Patient for patients who are due for follow-up
Alert SMS)
SPEED Disaster - A project of the World Health
(Surveillance management Organization (WHO) and the
in Post and SMS Department of Health- Health

32
Extreme reporting Emergency Management Staff (DOH-

Emergencies HEMS).
and - Allows community health nurses to
Disasters) submit daily reports of prevalent
diseases, immediately after disasters
via SMS, e-mail and other information
and communication technologies.
- SPEED also sends immediate
notification alerts (INAs) to
community health nurses for possible
outbreaks based on available data.
WAH Health - Implemented in 2010 in the Tarlac
(Wireless information Province through the Public-Private
Access for system and Partnership (PPP) of Qualcomm, UPM-
Health) electronic NTHC, USAID, Smart, DOH-IMS, Center
medical for Health Development (CHD) Region
record III, RTI International, National
Epidemiological Center (NEC), Tarlac
State University, and the local
government.
- WAH augmented the existing CHITS by
connecting health centers through
broadband Internet access.
- WAH Website:
sites.google.com/site/wahphil.
Roles of Community Health Nurses in eHealth
Community health nurses’ roles are significantly diversified by eHealth.

With the advent of eHealth, nurses are made available to several clients at a
single time, making health care delivery more efficient. Advances in IT may
also help the nurse in optimizing efforts towards maintaining an open line of
communication with clients, paving the way for establishing and maintaining
rapport. IT literally at the fingertips of the nurse provides greater opportunity
to learn more about clients and their conditions; eHealth, however, cannot be
a replacement for actual patient care. It is best viewed as a powerful tool for
nurses- bridging gaps and improving access especially in a resource-constrained
country like the Philippines.
The following are the major roles of an eHealth nurse in the Philippine
community setting:
Data and Records Manager
As data and records managers, community health nurses monitor the

trends of diseases though EMR, allowing for targeted interventions for health
promotion, disease prevention, curative services, or rehabilitation. Nurses also
maintain the quality of data inputs in the EMRs, making sure that information is
accurate, complete, consistent, correct, and current. Nurses also participate in
regular data audits.
Change Agent
Nurses act as change agents by working closely with the community and
implementing eHealth with them and not for them. Change agents do not force

33
technology on the community, but inform and guide the community in selecting
and applying appropriate ICT tools.
Change agents also collaborate with health leaders, policy makers

stakeholders, and other community health professionals to determine their
knowledge and awareness on eHealth and appropriate ICT tools. Nurses then
build on the baseline eHealth knowledge and help develop appropriate eHealth
tools for the community.
Educator
Nurses provide health education to individuals and families through ICT

tools (e.g., teleconference, SMS, e-mail, and virtual/simulated environment).
They may also participate in making eLearning videos on specific diseases (e.g.,
diabetes mellitus, tuberculosis), which the patients can watch during their
waiting time at health centers. Such videos may also be installed in the clients’
personal phones (if supported) and watched at a time convenient to them.
Nurses may also use scheduled text messages to patients among the
catchment population to send important health information, reminders, etc.
Telepresenter
In the event that a patient needs to be referred to a remote medical

specialist through telemedicine, nurses may function as a telepresenter. This
means that the nurse may need to present the patient’s case to a remote
medical specialist, noting salient points for case assessment, evaluation, and
treatment. This usually occurs via a teleconference.
Client Advocate
As client advocates, community health nurses must safeguard patient

records, ensuring that security, confidentiality, and privacy of all patient
information are being upheld. This becomes more challenging especially
because with technology, transfer of information can happen instantly.
The client must also be well informed about the benefits and challenges
of EMRs, telemedicine and other eHealth tools. Nurses must ensure that
personal and health information handling through eHealth (i.e., collection,
storage, and transmission) is well explained. Clients Must sign an informed
consent, if necessary.
Nurses must also guarantee that all eHealth interventions are performed
in a safe and ethical manner, making sure that personnel involved in eHealth
are competent and have received eHealth training/certification.
Researcher
Using eHealth tools (e.g., EMRs), patients records can easily be retrieved
and analyzed retrospectively by community eHealth nurses. They are
responsible for identifying possible points for research and developing a
framework, based on data aggregated by the system.
An eHealth nurse researcher also pursues continuing nursing informatics

education, with the goal of developing a research framework which will be
beneficial to the community.

34
THINK!
Directions: Answer the questions below. Write/ encode your

answer on a short bond paper then send a digital copy
(image/picture/softcopy) to the respective email of your
1. Discuss the following:

a. Other possible reasons causing delay in
implementing eHealth systems in the country.
b. Potential problems that eHealth may pose in
relation to the delivery of community health
services. Give examples.
2. Search for other existing community-based

electronic medical records and telemedicine
projects that may be applicable in the
Philippines. (Note that there are a number of
Free Open Source Software and demo websites
available in the Internet that you can use.)
3. If you were to initiate an ICT project that can

improve community health, what features would
be installed? What community health problems
would it address? How can you ensure that the
target end users would use this technology?

35
Lesson 2

Nursing Core Values as a
Community Health Nurse
INTRODUCTION
Values are goals and beliefs that establish a behavior and provide a basis
for decision making. In a profession, values are standards for action that are
preferred by experts and professional groups and establish frameworks for
evaluating behavior. Nursing is a profession rooted in professional ethics and
ethical values, and nursing performance is based on such values.
Core values of nursing include:
1. Altruism
Altruism is the name for the feeling that people should help one another
without regard for compensation or reward. People display altruism when they
do things for other people with the other person's well-being in mind. This
sense of the other person's well-being is part of what separates altruism from
other ideals, like a sense of duty. The difference is subtle in some cases, but
the bottom line for the altruist is the best interest of the person they are
helping for that person's own sake. A sense of duty for a nurse may include this,
but may also include other factors like duty to an employer or established set
of practices. While other ideals certainly may be successful in caring for a
person, there are some effects of altruism that enhance the experience of both
nurse and patient.
2. Autonomy
Autonomy refers to the ability to act according to one's knowledge and
judgment, providing nursing care within the full scope of practice as defined by
existing professional, regulatory, and organizational rules. Every time they
educate a patient or advocate for a patient they are engaging in autonomous
professional acts. For instance, a nurse's patient is struggling to breathe a little
bit, so the nurse listens to his lungs and finds them 3/4 full of rales.
3. Human dignity
Human dignity is a vague, complex, multidimensional, and fundamental
concept in the nursing profession. It means having respect
for human individuality and treating each individual as a unique human being. .
It is also an important aspect of nursing care.
4. Integrity
Integrity is defined as the quality of being honest, and fair; possessing
high moral principles. When you’re faced with challenges as a nurse, your
integrity is what will keep you standing tall. Having a high degree of integrity,
in your nursing career, and in your day-to-day life, is the ability to know, in
your very fiber, that you’ve done right by everyone concerned.

36
Your honesty, forthrightness, ability to keep confidences and overall

trustworthiness cannot be put on. Your patients see who you are and count on
you to do the right thing, as it pertains to their care and comfort. This kind of
trust relationship is what makes a successful nurse, and a nurse who possesses
integrity among her core character traits, is well suited for success in patient
care.
5. Honesty
Honesty is important in all careers, but it is especially crucial for people
with nursing jobs, as they are frequently required to handle sensitive
materials, deal with patients in difficult situations and rely closely on their co-
workers. Unsurprisingly, many people consider nurses to have an inordinate
amount of integrity. In fact, according to a recent Gallup poll, nurses once
again earned the top spot in terms of professional honesty and ethical
standards.
6. Social justice
Social justice is the view that everyone deserves equal economic,
political and social rights and opportunities. Social justice is a
core nursing value and the foundation of public health nursing. Social
justice ideology requires nursing students to uphold moral, legal, and
humanistic principles related to health. ... Social justice implies that there is a
fair and equitable distribution of benefits and burdens in a society.
One example of social justice in health care is training nurses to
advocate for patients. The role of nurses revolves around intervening on behalf
of patients, providing efficient, compassionate medical care. Nurses carry out
the ethics and values of the medical facilities they work for.
The core ethical values are generally shared within the global
community, and they are a reflection of the human and spiritual approach to
the nursing profession. However, the values in the care of patients are affected
by cultural, social, economic, and religious conditions dominating the
community, making it essential to identify such values in each country.
THINK!
Directions: Answer the questions below. Write/ encode your
answer on a short bond paper then send a digital copy
(image/picture/softcopy) to the respective email of your
1. Give examples of situations where the core values

stated in this chapter can be applied in the profession.
2. Give at least five (5) more values that can be practice

in nursing.

37
Lesson 3
 Health-Related Entrepreneurial
Activities in the Community
Setting
Introduction
Nurse entrepreneurs fill the gaps in the current health care delivery
system by supporting the development of targeted products and services,
enhanced technology, software, and safety systems.
A nurse entrepreneur has been defined as “a proprietor of a business
that offers nursing services of a direct care, educational, research,
administrative, or consultative nature”. Nurse entrepreneurs may build their
businesses to develop and distribute medical products or devices, offer direct
patient care or patient advocacy, educate or train other professionals or
community members, or provide health care-related consultation, among other
functions.
As more nurses move beyond the bedside to explore entrepreneurship, it
is important to identify best practices and the skill sets that are transferable
from direct caregiving to business leadership. It is also important to learn
about how nurses have shifted perspective to make the transition, including
the need for self-care.
Despite the challenges that nurse entrepreneurs face, entrepreneurship
can provide opportunities for nurses to have a more significant impact, achieve
greater career and life satisfaction, and experience an enhanced sense of
empowerment.
Nursing Entrepreneurship
In human’s perception, nurses are designed only for caring and assisting
sick people. Due to their medical learning background, people cannot avoid to
refer their job mainly in medical services.
Nursing is no longer just about offering services to patients, and working
in hospitals and homes. Today, experienced nurses can become entrepreneurs,
and be their own boss. While becoming a nurse entrepreneur can be exciting,
the job also has challenges and difficulties, something that is part of all
businesses.
Having your own business can be very rewarding, as health and social
care are changing all the time, long as you approach it in a business-like way.
Nurse Entrepreneurs
Nurse Entrepreneurs combine their nursing background with business and
utilize their individual creativity and resourcefulness to start their own
companies. The Nurse Entrepreneur may provide patient care, equipment,
consulting services and education as it relates to nursing while assuming
inherent risks of business accountability.
These men and women apply their skills and training toward
establishing, promoting, or consulting in business ventures in the health care
industry. They can build on their nursing knowledge to develop medical devices
or computerized systems for delivering healthcare, freeing staff nurses to
spend more time caring for patients.
The ICN guidelines on the nurse entrepreneur providing nursing service:

38
• Three to five years nursing experience

• Continuing education relevant to your area of practice
• Competence in communication, negotiation, marketing, time
management, public relations, time management and accounting
skills
• Knowledge of legal, insurance, grants and tax matters
How to Become Successful Nurse Entrepreneur:

Here are some ways to becoming a successful nurse entrepreneur:
1) Hands on Approach
You need to know and understand the needs of your patients. Apart from
that, you need to combine various approaches to provide the best healthcare
possible, from educational to management and training. The American
Association of Diabetes Educators, for example, provides training and advice to
potential nurse entrepreneurs, and helps them start a nursing business.
2) Getting Started
Make plans before you start with your business. How will you source
funds for your business? How much time can you devote to it? What kind of
property and equipment do you need to invest in? How about stationery with
logo on it, and business cards? Every little detail needs to be taken care of
before you can become a nurse entrepreneur.
3) Think Positive
Nothing works like a positive attitude. You need to be a good leader and
motivate people in order to make a success of your nursing business.
4) Don't Put All Eggs in One Basket
Since you are a newcomer to nurse entrepreneurship, you do not know
how successful your business might be. If it does not work out, you should have
a fall back option. Think about nursing consultancy services, speaker,
education etc.
Advantages of Becoming a Nurse Entrepreneur:

1) Opportunities
The nursing profession has a problem of shortage, so anyone with
experience in nursing is welcome at hospitals and healthcare sector.
2) Flexibility
Being your own boss means that you can choose you working hours to
some extent. Apart from hospitals, you can also be associated with old age
homes, maternity homes and similar sectors.
Setting up your own business is a decision that needs careful consideration.
To go it alone you must:

• Be passionate about developing an area of interest
• Be willing to take risks
• Be willing to make a commitment
• Be enthusiastic
• Believe in yourself and your dream
• Have a strong self-image and plenty of self- confidence
• Have the drive to achieve and succeed
• Have a strong ‘customer’ orientation.
Make sure you consider the risks involved in becoming self-employed. These
include:
• Spells without work
• Irregular and unpredictable income
• Having no one else to take the responsibility for mistakes
• No employer contributions towards sickness, annual leave and pensions.

39
The main types of business ownership:

1. Sole traderships or sole proprietorship were generally only one person
funds the business activity is a for-profit business owned by one person.
Advantages of Sole traderships:
• There are relatively simple formalities involved in setting
up
• There is no obligation to submit copies of accounts for
public scrutiny
• There are no limitations on capital, assets and the scope of
business as there are with a limited company
• There is no requirement to share business decisions as sole
control is retained.
Disadvantages:
• The individual is personally liable for all business debt
• The responsibility of being solely charged with all business
decisions can be onerous
• The available business expertise is limited to that of the
individual
• The absence of public accounts can make it difficult to
demonstrate the true financial position and may deter
larger potential customers.
2. Partnerships, where two or more people band together to finance or run a

venture.
• All partners contribute capital equally
• All partners share profits and losses equally
• No partner shall have interest paid on his or her capital
• All partners have an equal say in the management of the
business
Advantages
• There are relatively simple formalities involved in setting
up, although it is important to get a legal partnership deed
drawn up
• It’s less lonely than starting up by yourself
• There is no obligation to submit copies of accounts for
public scrutiny
• You can start your business with more capital than if you
were on your own
• There are no limitations on capital, assets and the scope of
business as there are with a limited company.
Disadvantages
• Each partner is liable for the debts of the partnership,
regardless of who actually incurred the debt
• There is a risk of personality clashes between partners
• The death or bankruptcy of any partner automatically
dissolves a partnership, but liability remains against the
other individuals, unless there is an agreement to the
contrary
• The absence of public accounts can make it difficult to
demonstrate the true financial position and may deter
larger potential customers.

40
3. Corporations/limited companies where it is possible for many thousands to

subscribe for a share in business ownership and, in theory at least, a say in
its governance and direction. Corporations can be either government-owned
or privately-owned, and privately-owned corporations can organize either
for-profit or not-for-profit. The directors are charged with the responsibility
of making the business decisions and the shareholders are the owners of the
company. A minimum of one shareholder and one director is required to
form a company. Companies pay corporation tax on their taxable profits.
Advantages
• Financial liability of directors and shareholders is limited
to the amount of money they have paid for shares,
providing there has been no fraud or negligence
• The management structure makes it easy to appoint,
retire or remove directors
• Extra capital can be raised by selling more shares
privately, making it simple to admit more members
• The death, bankruptcy or withdrawal of capital by one
member does not affect the company’s ability to trade
• The disposal of the whole or part of the business is easily
arranged
• The company may have higher status with potential
customers.
Disadvantages
• The company has to be registered with Companies House
and must provide audited annual returns and accounts,
which involves extra administration work. There are legal
penalties for failing to make returns
• Limited Company statutory details must be available for
public inspection at its appointed ‘Registered Office’,
which negates some business confidentiality
• LLCs can be more expensive to set up, and you may need
professional help
4. Co-operatives. This is the least common form. A cooperative differs from a

for-profit corporation in that it has members, as opposed to shareholders,
who share decision-making authority. A cooperative is owned and controlled
by the people working in it.
Advantages
• They are a good way of setting up with a large group of
people
• Co-operatives are democratic
• Liability is more limited than with a partnership
Disadvantages
• Setting up may require professional help
• The seven-member minimum may be difficult to sustain.
IMPORTANT:
Remember that it is important to register your business to avoid any
legal problems once business operations start. Furthermore, it’s common
practice for competitors to check on you if you have all the necessary
registrations completed because if not, this will be an opportunity for them to
disrupt and delay your operations by notifying the proper authorities.

41
Depending on the structure of your business, your first step is to get a

certificate of registration for your business name in one of these agencies:
1. Department of Trade and Industry (DTI) – for single proprietorship

2. Securities and Exchange Commission (SEC) – for partnerships or
corporations
3. Cooperative Development Authority (CDA) – for cooperatives
After getting your certificate of registration, you will need to visit the
following offices:
1. Homeowners Association – for businesses inside villages and
subdivisions, you need to get a homeowner’s clearance
2. Barangay Hall – secure a barangay clearance to operate your business
3. Local Government Unit (LGU) – visit the municipality or city hall office
and process your business permit
4. Bureau of Internal Revenue (BIR) – apply for a business taxpayer
identification number (TIN), register your books of accounts, point-of-
sales (POS) machines and receipts
At this point, you may now legally start your business operations, but
you’ll need to then register your employees (which may include yourself) to the
following agencies:
1. Social Security System (SSS) – secure an SSS number for yourself and
your employees
2. Department of Labor and Employment (DOLE) – for businesses with five
workers or more, register your business with DOLE
3. Home Development Mutual Fund (HDMF) – as required by RA 7742, SSS
members earning at least P4,000 a month must be registered with HDMF.
This agency administers the Pag-Ibig Fund.
4. Philippine Health Insurance Corp. (PhilHealth) – all employers of are
required to register their employees to this agency as stated in the New
National Health Insurance Act (RA 7875 / RA 9241). PhilHealth manages
and administers the government health care system.
Marketing
The total of activities involved in the transfer of goods from the
producer or seller to the consumer or buyer, including advertising, shipping,
storing, and selling
A formal approach to this customer-focused marketing is known as SIVA
(Solution, Information, Value, and Access). This system is basically the four Ps
renamed and reworded to provide a customer focus. The SIVA Model provides a
demand/customer-centric alternative to the well-known 4Ps supply side model
(product, price, placement, promotion) of marketing management.

42
Business Ideas for Those with Training as a Nurse

Nursing is a thriving field at the moment. But it’s not all about the job
numbers. If you have the education and experience necessary to work as a
nurse, you could also consider running your own business. There are plenty of
entrepreneurial opportunities where you could use the same skills and knowledge.
1. Home Health Aide Service

Home healthcare is a thriving industry. You simply visit patients in their
homes to provide care, rather than working out of a hospital or doctor’s office.
You would likely have a number of clients that you visit on a regular basis.
2. Private Nurse Service

A slightly more in-depth service, working as a private nurse may require
you to have fewer clients that you spend more time caring for. You may even
work on a contractual basis with just one at a time.
3. In-Home Senior Care

This is a more specialized form of home care. Working for seniors may
require you to handle some basic errands and chores as well as tending to their
medical needs.
4. Hospice Service
Hospice care is normally about helping to improve comfort for a terminal
patient. You may work with the family to ensure that their loved one can spend
their last days at home and relatively pain-free.

43
5. Respite Care Service

As a respite care provider, you would offer short-term services that give
family caregivers a chance to rest and recharge, while still feeling confident
that their loved one is in capable hands.
6. Child Care
Many parents feel more confident leaving their children in the care of
someone with proper medical training. So as a nurse, you could open your own
child care center or simply offer in-home child care.
7. Doula Service
Doulas provide guidance and support for mothers through the pregnancy
and childbirth process. You don’t always need official nurse training, but it
would certainly help to prepare you.
Childbirth Education Service
For a less intensive approach, you could also offer classes or training programs
designed to help expecting parents prepare for childbirth.
8. Lactation Consulting
Some new mothers could also use the assistance of a lactation
consultant to help with the breastfeeding process.
9. Fertility Consulting
For those who are hoping to become parents, you could provide
consulting and guidance aimed at helping them overcome certain fertility
issues.
10. Concierge Nurse Service

A concierge nurse is often a private medical service aimed at affluent
patients who prefer to pay out of pocket for in-home visits or for personalized
care through their particular treatment process.
11. Patient Care Consulting

You might also offer consulting services for patients that would like an
independent medical professional to help them review treatment options
navigate insurance issues or make other important decisions.
12. Telehealth Service

Telehealth is an emerging trend in the healthcare field. Basically, you
would provide consultations and appointments via phone or video chat rather
than meeting with patients in person.
13. Nutrition Services

As a nurse, you should have a fair amount of knowledge about nutrition
and diet issues. So you could use that to help individuals craft weight loss or
health plans. Note that some states may have legal requirements before you
could hold yourself out as a “licensed nutritionist” or “registered dietitian” or
certain other professions.
14. Wellness Coaching

Or you could offer a more general service that includes dieting, meal
plans, fitness, and general wellness items.

44
15. Health Blogging

Instead of working with individual patients, you might share your
expertise on a wider scale by writing a health related blog.
16. eBook Sales

Another way to share information to a lot of potential customers, write
and self-publish an eBook related to health and wellness.
17. Public Speaking

You could also offer to share your expertise by speaking at public events
for other nurses, medical professionals or those simply interested in improving
their health.
18. Massage Therapy

You certainly don’t need a nursing degree to start a massage therapy
business. But your experience likely helps you understand the various parts of
the body that may need assistance.
THINK!
follow. Write/ encode your answer on the template provided
then send a digital copy (image/ picture/ softcopy) to the
respective email of your instructor. You will be graded using
the rubrics provided.
 You are to put up a Health-Related business in your

company, choose one among the ideas presented in
this lesson and discuss how you will go about your
chosen business. (Provide a step by step actions that
you will do from the formulation of idea/business to the
implementation of the services you will provide) You
may use a concept map in presenting your ideas.
 MODULE SUMMARY
Fundamental to technological development is the establishment of

human, political and economic arrangement that ensures the efficient use and
application of technology. And although more often than not, the perception
that a technologically competent nurse is a person who demonstrates less
caring to the patient, it should be emphasized that technology was never
meant to replace the nurse to provide quality and holistic care, but rather to
make each caring situations meaningful both for the nurse and for the patient.
Time and again, the purpose of technology is to make our lives easier.
Similarly eHealth has improved community health by empowering its workers
with eLearning, making information accessible using EMRs, and bridging the
gaps of communication through telemedicine. However, it is important to note
that these tools make the job of community health nurses easier. These tools,
however, will ultimately be useless if not utilized properly.

45
Any professional group has primary standards called professional values.

These values are considered as the guideline and motivation of professional
behavior for the members of a certain profession. According to Weis and
Schank, professional values are standards for action that are accepted by
professional groups and individuals, and are used to evaluate the integrity of
the individual or organization. In addition, professional values are necessary to
reinforce individuals’ the professional identity and performance. Professional
values are rooted in personal values, which are influenced by family, culture,
environment, religion, and ethnicity. The process of acquisition such values is
gradual and evolutionary and occurs throughout an individual’s lifetime.
Nurses, as the largest health care group, have well-known and important
professional values. The use of these values in nursing practice increased the
quality of patients care, nurses’ occupational satisfaction, their retention in
nursing and commitment to the organization. Professional values are a source
to promote nurses’ ethical competencies in clinical settings and dealing with
ethical concerns in the present era. Most nurses are aware of ethical issues,
but they do not use them in their clinical practice. Furthermore, in many
cases, they lack sufficient power and support to demonstrate their reaction in
this regard or they are not aware of its importance. Thus, professional values
are a solution to the current problems in nursing profession. Today,
globalization, migration, nursing shortage, new diseases, ageing population,
and demand for high-quality care are complicated issues that result in ethical
problems for nurses. Therefore, they are expected to be aware of professional
values and apply them to their decision makings while dealing with such ethical
problems.
Values are acquisitive; this means they learned either directly or
indirectly by observing others’ behavior. Following academic education,
development of professional values in nurses is mainly influenced by experts in
the profession, colleagues, patient care situations, and organizational values
Entrepreneurship is becoming increasingly important within nursing care

as societal changes give space for new entrepreneurs in the field.
Entrepreneurship means that salaried nurse develops, promotes, and delivers
an innovative health care or nursing practice. Nursing role and responsibilities
are continually changing with developments in medical science, policy
directives and movements in priorities in health care, and advances emanating
from nursing and scientific research. Hence, there is a need for entrepreneurial
nurses, to maintain and improve the individual care. Nurse need to understand
the process of the introduction and management of change so as to determine
and carry through his/her position in the change process and participate as
valid. Therefore education about entrepreneurship is becoming an important
concept in nursing education. For entrepreneurship to be improved severity in
nursing, nursing education must ensure that students are provided with the
opportunity to develop the necessary knowledge and skills.
SUMMATIVE TEST
An online exam will be scheduled by your instructor.

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Don Mariano Marcos Memorial State University

South La Union Campus

COMMUNITY HEALTH NURSING I

COMMUNITY HEALTH NURSING 1 / 2022-2023 BACHELOR OF SCIENCE IN NURSING II

 The course consists of four (4) modules. Community Health Nursing 1

COURSE LEARNING OUTCOMES

At the end of the course, the students will be able to:

COMMUNITY HEALTH NURSING 1 / 2021-2022

12.Apply techno-intelligent care systems and processes to perform safe and

To pass this course, students must:

COMMUNITY HEALTH NURSING 1 / 2021-2022

NOTE: Essays will be graded accordingly using the rubrics below.

(8-10 points) (6-7 points) (4-5 points) (0-3 Points)

COMMUNITY HEALTH NURSING 1 / 2021-2022

COURSE STUDY GUIDE

COMMUNITY HEALTH NURSING 1 / 2021-2022

COMMUNITY HEALTH NURSING 1 / 2021-2022

Lesson 1 : Ethical Considerations

Lesson 2 Filipino Culture,

COMMUNITY HEALTH NURSING 1 / 2021-2022

Cultural awareness is a prerequisite prior to achieving cultural

This module talks about the ethical considerations in community health

After studying the module, you should be able to:

DIRECTIONS/ MODULE ORGANIZER

COMMUNITY HEALTH NURSING 1 / 2021-2022

Basic concepts of the Code of Ethics

1. Rights – According to the Webster dictionary, a right means “something to

2. Autonomy – Is synonymous to “free, independent, and sovereign. While al

3. Beneficence and nonmaleficence – Beneficence means performing a deed

4. Fidelity – Faithfulness to a person, cause, or belief, demonstrated by

In the Philippines for instance, the Professional Regulatory Board and

COMMUNITY HEALTH NURSING 1 / 2021-2022

14, 2004. Each nurse practicing in the Philippines must be aware of such in

Article II – Registered Nurses and People

Article III – Registered Nurses and Practice

Article IV – Registered Nurses and Co-workers

Article V – Registered Nurses, Society, and Environment

COMMUNITY HEALTH NURSING 1 / 2021-2022

national, and international efforts to meet health and social needs of

Article VI – Registered Nurses and the Profession

Article VII – Administrative Penalties, Repealing Clause and Effectivity

HEALTH LAWS AFFECTING PRACTICE OF PUBLIC HEALTH NURSING

Other Related Laws

R.A. 2382 – Philippine Medical Act.

COMMUNITY HEALTH NURSING 1 / 2021-2022

R.A. 1082 – Rural Health Act.

R.A. 6425 – Dangerous Drugs Act

R.A. 9165 – the new Comprehensive Dangerous Drug Act of 2002

P.D. No. 651

P.D. No. 996

P.D. No. 825

R.A. 8749 – Clean Air Act of 2000

P.D. No. 856 – Code on Sanitation

R.A 6758 – Compensation and Classification Act of 1989

R.A. 6675 – Generics Act of 1988

R.A. 7305 – Magna Carta for Public Health Workers

COMMUNITY HEALTH NURSING 1 / 2021-2022

P.D. No. 965

Letter of Instruction No. 949