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Lesson 645 min read
Community Health Nursing
DOH Programs, Epidemiology, Family Planning & Public Health
DOH Priority Health Programs
Expanded Program on Immunization (EPI)
Goal: Reduce morbidity and mortality from vaccine-preventable diseases.
Target: All infants and children under 1 year, pregnant women
National Tuberculosis Control Program (NTP/DOTS)
DOTS = Directly Observed Treatment Short-course
- 6-month regimen for drug-susceptible TB
- 5 elements: Political commitment, microscopy, drug supply, surveillance, DOTS
Safe Motherhood Program
- Prenatal care (at least 4 visits)
- Skilled birth attendants
- Emergency obstetric care
- Postpartum care
Integrated Management of Childhood Illness (IMCI)
Strategy to improve child health by addressing major causes of under-5 mortality.
Basic Epidemiology
Incidence Rate
Number of NEW cases in a specific time period
Formula: (New cases / Population at risk) × 1000
Prevalence Rate
Number of EXISTING cases (new + old) at a point in time
Formula: (All cases / Total population) × 1000
Key Health Indicators
Crude Birth Rate: Births per 1000 population
Crude Death Rate: Deaths per 1000 population
Infant Mortality Rate: Deaths <1 year per 1000 live births
Maternal Mortality Rate: Maternal deaths per 100,000 live births
Family Planning Methods
Natural Methods
- Calendar/Rhythm: Avoid fertile days
- BBT: Temperature charting
- Cervical Mucus: Observe changes
- LAM: Lactational amenorrhea
Artificial Methods
- Pills: Combined or progestin-only
- Injectables: DMPA (Depo-Provera)
- IUD: Copper-T, hormonal
- Implants: Subdermal implants
- Barrier: Condoms, diaphragm
Contraindications for Combined OCP
- History of thromboembolism
- Breast cancer
- Liver disease
- Smoker over 35 years old
- Uncontrolled hypertension
- Migraine with aura
Cold Chain Management
Vaccine Storage Temperature
- +2°C to +8°C (refrigerator): Most vaccines (DPT, TT, Hepatitis B, OPV, Pentavalent)
- -15°C to -25°C (freezer): OPV (can be stored here)
- Never freeze: DPT, Hepatitis B, TT - becomes ineffective
Shake Test (for Freeze Damage)
- Shake the suspected vial and a control vial
- Let both settle for 30 minutes
- If suspected shows sedimentation = freeze damaged, discard
Important Nursing Mnemonics
SBAR - Communication
- S - Situation
- B - Background
- A - Assessment
- R - Recommendation
FAST - Stroke
- F - Face drooping
- A - Arm weakness
- S - Speech difficulty
- T - Time to call emergency
SAMPLE - History
- S - Signs/Symptoms
- A - Allergies
- M - Medications
- P - Past medical history
- L - Last oral intake
- E - Events leading to illness
OLDCARTS - Pain
- O - Onset
- L - Location
- D - Duration
- C - Characteristics
- A - Aggravating factors
- R - Relieving factors
- T - Treatment tried
- S - Severity (1-10)