1

I.

INTRODUCTION
Hospitals give different impressions to children. Sometimes going to a hospital

and meeting people in white uniforms give fear, anxiety and apprehensions to the kids. The strangers, the environment and the anticipation of having a procedure done to them that mostly deals with pain could be very stressful. This could lead to different reactions like just simply being quiet and subdued or being scared, frustrated, and anxious. Some of them cry, loss control, scream or cling to their parents. The ambiance can be contagious making other children feel the same or worse. Nurses are known not only to provide holistic care to the patients. Nurses not only focus in meeting the needs of the patients physically but also emotionally and psychologically. From different studies in nursing and psychology, good rapport gives positive response from patients undergoing different procedures. It makes the procedure smoother and more comfortable for a patient and parents. The environment plays a major role in how children respond emotionally. Positive environment makes them feel happier and more comfortable. How to create a positive environment? These are some components in creating a positive environment. First, the physical surrounding and the atmosphere, such as color of walls, furniture, pictures, etc. Second, and one that is often overlooked, is the uniforms nurses wear. Where the surroundings make the overall environment feel comfortable, the uniform creates an added friendlier approach. Having different uniform themes not only brightens up atmosphere, it frequently serves as a distracter where children focus on characters and not on the procedure that is being done. Children identify with some of the more popular characters such as Disney and other well-liked

2 cartoons. Prints of flowers, different types of vehicles, or designs helps children to relax even more. Several studies were conducted and have positive results about nurses wearing multicolored uniforms. Studies reveal that these uniforms helped children feel relieved or even help ease communication and relationship between a nurse and apprehensive kid. It also allows more effective communication between staff and families. These uniforms help ease patients discomfort experience due to hospitalization. Children feel more positive about the nurses who were caring for them. A particularly significant result was that the parents did not see the new uniforms as less professional. Not only in research, but also in our experience children who come to our unit for procedures respond positively to the multicolored clothes when we wore civilian outfits during the Garantisadong Pambata week. They spontaneously verbalize their satisfaction and amusement. Parents who accompany children have reported that they prefer the non conventional clothes and that they dont see the degration of professionalism. Based on nationally recognized studies and our experience in the Child Survival Center, VSMMC should consider the multicolored and themed uniforms as a way to improve childrens moral and ease the pain of their condition.

II.

VISION
To make Medical Non-Communicable Ward of Vicente Sotto Memorial Medical

Center as an improved safe unit for patients leading to a decrease number of accidents among admitted individuals.

III.

MISSION
It aims to create a bed safe environment to clients with the use of a safety device

in a form of bedrails wherein it reduce the risk of a patient accidentally slipping, sliding, falling or rolling out of bed following a full, documented risk assessment, and it also provide a hand-hold for getting into or out of bed, which can lead to safer and comfortable bed environment.

IV.

SITUATIONAL ANALYSIS

SWOT ANALYSIS OF VSMMC

Strengths Periodical evaluation of nursing staffs Availability of in-service education programs Health care providers development (doctors, nurses, multi-disciplinary team) Different program development through continuous education department and

training program Strong informal communication channels among the hospital departments High commitment of hospital policies and regulations Qualified, experienced and committed staffs There are existing preventive and promotive health programs Hospital staff willing to provide preventive health services over and above

assigned tasks Cost-effective quality health care Commitment to providing quality care

Weaknesses Lack of resources support time (time, money and support) for the development Lack of work innovations and creativity work atmosphere Lack or practices that depend on evidenced-based practice Lack of conducted statistical studies about hospital indicators Inability to create professional practice environment

5 Staffs sometimes forget proper usage of therapeutic communication

Opportunities Strong relationships and form collaboration with other government hospitals and

health departments Location of hospital serves large population, more available connection and

resources Opportunity to create training program and courses in health by collaboration of

health care facilities in the hospitals Increasing awareness of Outpatient Departments function

Threats Lack of technology advancement and update device Insufficient central funding resources High population growth rate Low average income, prone to neglect preventive health practices

STAKEHOLDER ANALYSIS OF VSMMC

STAKEHOLDERS

INTEREST

POWER/ INFLUENCE

POTENTIAL PROJECT IMPACT

1. Chief of hospital - The medical center chief is responsible for overseeing health care. He serves as the liaison between the medical staff and administration. He

Medium

High

As one who is in a high position in the level of management, the approval and the benefits of the project that the chief of hospital foresees has great influence in the feasibility of improving

preventive health care. The vast responsibility of the chief of the hospital might be a small

also oversees quality and improvement in the health care

diversion but nevertheless the primary goal is patient safety.

programs.

2. Administrators - Decides and plans on the appropriate

Medium

High

As the people are part of the top management, the approval of the proposed project lies on how the administration foresees its

steps to be taken to bring the health care services hospital level of to the higher

benefits. Also, the budget for the realization of the project is part of the decision of the administration.

7 3. Nurse supervisor With general she nursing patients, High High Along with ensuring that the activities in the area are well facilitated, the nurse

direction, monitors care to

supervisor has an important role of voicing out benefits of the proposal, she becomes the liaison between and the her top

plans and oversees area staff nursing and

activities

subordinates management.

endures the delivery of competent nursing service and ensures the delivery of quality nursing care,

adheres to policies, procedures standards operation. and of

4. Resident physicians and consultants - Provides diagnosis and decides

High

Medium

As one who decides and orders for the treatment of the patients, the desire of the physicians to improve the

delivery of care is important to help reduce fear, stress to children and improve recovery of the patients.

treatment of illness of patients with the goal of reducing mortality and improving

recovery of patients.

5. Staff nurses Carry out

High

Medium

The front liners of delivering health care, the nurses, will be the one to give holistic care to the patients. Not only will they focus on the physical needs of the patient but also the emotional and psychological aspect as well.

treatments, deliver care and attend to the needs of the patient them wellness. 6. Maintenance personnel - Responsible for the repair and Low Low bringing towards

Though with reduced interest, they still are included in the delivery of health care to the children or patients.

maintenance of the machine area. in the

V.

SUMMARY OF CURRENT SITUATION

BACKGROUND INFORMATION OF VSMMC

Vicente Sotto Memorial Medical Center (VSMMC) is a public general and tertiary medical center located at B. Rodriguez Street in Cebu City. It is also a training medical facility for the medical practitioners and one of the biggest medical center in the country which has an authorized bed capacity of 800 through the mandate of RA 8658 on June 22, 1998. It aims to provide health care services that are available, affordable, accessible and acceptable to all regardless of social status.

Vicente Sotto was originally named hospital Del Sur, and then it eventually changed its name to Southern Islands Hospital. It started operating in 1911 and was formally established in 1913 starting with a 30 bed capacity. When it was levelled up as a medical center in the year 1984, it already had 350 beds to cater patients from the province of Cebu.

At present, the hospital has a total bed capacity of 800 covering services of the following departments: general surgery, internal medicine, obstetrics and gynaecology, paediatrics, anaesthesia, radiology, pathology, ENT, Ophthalmology, Orthopaedics, Neurosurgery, Urology, Rehabilitation, Emergency services, out -patient services, Operating room services and training programs.

INFORMATION OF VSMMC- CHILD SURVIVAL CLINIC

10 The Child Survival Center of Cebu began to operate last 1952 and is only the second Child Survival Center established anywhere in the world. Philosophy of the Child Survival Center of Cebu It is a basic right of every Filipino mother and child to be assured of a better future through the delivery of effective and comprehensive health care services. The Child Survival Center of Cebu, through integrated services, training and research capabilities, will help to ensure the development, support, protection and the survival of Filipino mothers and children by the year 2000.

Goal of CSC Cebu

To reduce the morbidity of mothers and children in Region VII and throughout the Philippines through the efficient and effective delivery if integrated and comprehensive health services. Profile of the Unit

The mother and child clinic is a reaction of the Child Survival Center located on the first floor which offers effective and comprehensive maternal and child health services. The unit is divided into subsection namely the Under Six Clinic, Over Six Clinic, Prenatal Clinic, Preventive Dentistry and Nutritional Clinic. The under-six clinic is located at the left side upon entrance to CSC which caters to the needs of the newborn up to 72 months old child. At the right side is the Over Six Clinic which attends to children 6 years old to 14 years old. The Prenatal Clinic offers prenatal, postnatal and interpregnancy services in coordination with other departments.

Specific Objectives:

1. To provide basic prenatal services to expectant mothers for the attainment of good maternal health to have successful deliveries of healthy infants.

11 2. To provide basic postnatal services to post partum mothers to ensure them a quality of care and child survival. 3. To provide services for the reproductive health of mothers before and between pregnancies. 4. To provide general consultation on children 0-71 months and 6-14 years old to promote child growth and development in its fullest sense. 5. To serve as laboratory for affiliates on community health nursing activities, health education, family planning, nutrition program, environmental sanitation,

immunization, preventive dentistry program and other wellness program.

Under Six Clinic

The Philosophy of this clinic is that the staff believes that the CSC is a practical approach to the attainment, maintenance and promotion of optimum level of health for children below six years old.

To reduce incidence of malnutrition, mortality and morbidity rates in children 0-6 years old is its general objective and with the following specific objectives: Supervision of health of all children up to the age of six; Prevention of malnutrition, TB, Pertusis, Tetanus, Diptheria, measles and heap b; provision of simple treatment of diarrhea with or without dehydration, pneumonia, skin conditions and other common diseases; and education of parents to promote health and family planning.

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VI.

GOAL SETTING / OBJECTIVE GOAL

General Objective:

This study aimed to lessen the tension and stress of children under care in the Child Survival Center- Under Six Clinic of Vicente Sotto Memorial Medical Center by creating an energetic atmosphere while providing treatment for the patients.

Specific Objective:

This study aimed to: 1. Let the administration of VSMMC understand the achievability of the proposed project; 2. Determine the level of fear of children in the Child Survival Center-Under Six Clinic; 3. Check the quality and effectiveness of the multicolored printed uniforms or scrub suits; 4. Know the benefits of changing the work outfit; 5. Ease childrens pain and fear in a positive way; 6. Gain cooperation during the medication administrations and other necessary procedures needed; 7. Increase and smoothen the progress of developing rapport with the children; 8. Allow quick movements on emergency situations; 9. Provide a more relaxed and comfortable environment for care and treatment; 10. And to heighten accommodation of children.

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VII.

PLAN

Areas of Concern

Specific Objectives

Strategy

Persons Involve

Time Frame

Expected Output

1. Nursing Service, Administration

Get approval Submit a proposal Proposing for the project. about the project. Team, Nurse Supervisor, Chief Nurse, Medical Center Chief

1 week after submittin g the project

Project will be approved.

2. Accounting, Budget and Finance

Come up with a budget proposal and set an over-all budget for the project (i.e. materials, labor, fees, food, etc.)

Liquidation of possible expenses through a budget proposal.

Accountant, , Nurse

1 day

A budget proposal is made and budget will be set for the project.

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3. Funding and Sponsorship

To gather support from Non

Search for possibilities to gather support

Medical Center Chief, Chief Nurse, Nurse

1 day

Gain the support from a certain NGO for the making of the project may be in full or partial support.

Government from certain groups Offices to help or organizations; in the project.

present the project Supervisor, and mission. proposing team, NGO officials

materializing and share its vision Nurses from

4. Nursing Service, Maintenance

Buy materials and equipment to be used.

Canvass and purchase things needed.

Nurse

2 days Materials and equipment will be bought.

15 VIII. CONCLUSION AND RECOMMENDATION

Conclusion In conclusion, enhancing patients bed safety is one of the most critical aspects in responding to the needs of the patients. Making them feel comfortable and safe in the bed lessens their anxiety. Safety is always the top priority of the nurses in dealing with the patients.

Recommendation

With the fast growing population of the people with different health problems, there is a need to increase the beds in the ward. Beds should have side rails to ensure patient safety. Bed linens, pillow and pillow cases must be in sufficient number and must be changed as needed to ensure patient comfort ability and cleanliness. There is a need to have a proper lighting in each ward to prevent patient from falls.