• s the blueprint of the care that the nurse designs to systematically

minimize or eliminate the identified health and family nursing problems through explicitly
formulated outcomes of care (goals and objectives) and deliberately chosen set of
interventions, resources and evaluation criteria, standards, methods and tools.
Features FNCP:
1. The nursing care plan focuses on actions which are designed to solve or minimize existing
problem. The plan is a blueprint for action. The core of the plan are the approaches,
strategies, activities, methods and materials which the nurse hopes will improve the
problem situation.

2. The nursing care plan is a product of a deliberate systematic process. the

planning process is characterized by logical analyses of data that are put together to arrive

at rational decisions. The interventions the nurse decides to implement are

chosen from among alternatives after careful analysis and weighing of available options.

3. The nursing care plan, as with all plans, relates to the future. It utilizes
events in the past and what is happening in the present to determine patterns. It also
projects the future scenario if the current situation is not corrected.

4. The nursing care plan is based upon identified health and

nursing problems. The problems are the starting points for the plan, and
the foci of the objectives of care and intervention measures.

5. The nursing care plan is a means to an end, not an end in itself. The goal in
planning is to deliver the most appropriate care to the client by eliminating barriers to

family health development.

6. Nursing care planning is a continuous process, not a one-shot-deal. The results of the
evaluation of the plan’s effectiveness trigger another cycle of the planning process until

the health and nursing problems are eliminated.

The assessment phase of the nursing process generates the health and nursing problems which
become the bases for the development of nursing care plan. The planning phase takes off from
there.
Formulating a family care plan involves the following steps:
1. The prioritized condition/s or problems
2. The goals and objectives of nursing care
3. the plan of interventions
4. The plan of evaluating care

1. Efficient
○ plans with the people, organizes, conducts,
directs health education activities according to the
needs of the community
○ knowledgeable about everything relevant to his
practice; has the necessary skills expected of
him
2. Good listener
○ hears what’s being said and what’s behind the
words
○ always available for the participant to voice out
their sentiments and needs
3. Keen observer
○ keep an eye on the proceedings, process and participants’ behavior
4. Systematic
○ knows how to put in sequence or logical order the parts of the session
5. Creative/Resourceful
○ uses available resources
6. Analytical/Critical thinker
○ decides on what has been analyzed
7. Tactful
○ brings about issues in smooth subtle manner
○ does not embarrass but gives constructive criticisms
8. Knowledgeable
○ able to impart relevant, updated and sufficient input
9. Open
○ invites ideas, suggestions, criticisms
○ involves people in decision making
○ accepts need for joint planning and decision relative to health care in a particular
situation; not resistant to change
10. Sense of humor
○ knows how to place a touch of humor to keep audience alive
11. Change agent
○ involves participants actively in assuming the responsibility for his own learning
12. Coordinator
○ brings into consonance of harmony the community’s health care activities
13. Objective

○ unbiased and fair in decision making

14. Flexible
○ able to cope with different situations
Community Health Service provider

• carries out health services contributing to the promotion of health, prevention of illness,
early treatment of illness and rehabilitation.
• appraises health needs and hazards (existing or potential)
Facilitator
• helps plan a comprehensive health program with the people
• continuing guidance and supervisory assistance
Health Counselor
• provides health counseling including emotional support to individuals, family, group and
community
Co-researcher
• provides the community with stimulation necessary for a wider or more complex study or
problems.
• enforce community to do prompt and intelligent reporting of epidemiologic investigation
of disease.
• suggest areas hat need research (by creating dissatisfaction)
• participate in planning for the study in formulating procedures
• assist in the collection of data
• helps interpret findings collectively
• act on the result of the research
Member of a Team
• in operating within the team, one must be willing to listen as well as to contribute, to
teach as well as to learn, to lead as well as to follow, to share as well as to work under it
• helps make multiple services which the family receives in the course of health care,
coordinated, continuous and comprehensive as possible
• consults with and refers to appropriate personnel for any other community services
Health Educator
• health education is an accepted activity at all levels of public works. A health educator is
the one who improves the health of the people by employing various methods of
scientific procedures to stimulate, arouse and guide people to healthful ways of living.
She takes into consideration these aspects of health education:
○ information – provision of knowledge
○ education – change in knowledge, attitude and skills
○ communication – exchange of information
• . Pre-entry Phase
• A. Is the initial phase of the organizing process where the community/organizer looks for
communities to serve/help.

• B. It is considered the simplest phase in terms of actual outputs, activities

and strategies and time spent for it.

• Activities include:
• 1. Designing a plan for community development including all its activities and
strategies for care development.
• 2. Designing criteria for the selection of site
• 3. Actually selecting the site for community care
• II. Entry Phase

• A. Sometimes called the social preparation phase as to the activities done

here includes the sensitization of the people on the critical events in their life, innovating
them to share their dreams and ideas on how to manage their concerns and eventually
mobilizing them to take collective action on these.
• B. This phase signals the actual entry of the community worker/organizer into the
community. She must be guided by the following guidelines however.
• 1. Recognizes the role of local authorities by paying them visits to inform them of their

presence and activities.

• 2. The appearance, speech, behavior and lifestyle should be in keeping with those of the
community residents without disregard of their being role models.
• 3. Avoid raising the consciousness of the community residents; adopt a low-key profile.
• III. Organization Building Phase
• A. Entails the formation of more formal structures and the inclusion of more formal

procedures of planning, implementation, and evaluating community-wide

activities. It is at this phase where the organized leaders or groups are being given
trainings (formal, informal, OJT) to develop their skills and in managing their own
concerns/programs.
• IV. Sustenance and Strengthening Phase
• A. Occurs when the community organization has already been established and the
community members are already actively participating in community-wide undertakings.
At this point, the different communities setup in the organization building phase are
already expected to be functioning by way of planning, implementing and evaluating
their own programs with the overall guidance from the community-wide organization.

• 1. Strategies used may include:

• a. Education and training
• b. Networking and linkaging
• c. Conduct of mobilization on health and development concerns
• d. Implementing of livelihood projects
• e. Developing secondary leaders
• Definitions of COPAR:
• • A social development approach that aims to transform the apathetic, individualistic and
voiceless poor into dynamic, participatory and politically responsive community.
• • A collective, participatory, transformative, liberative, sustained and systematic

process of building people’s organizations by mobilizing and enhancing

the capabilities and resources of the people for the resolution of their issues and concerns
towards effecting change in their existing oppressive and exploitative conditions (1994
National Rural Conference)

• •A process by which a community identifies its needs and objectives,

develops confidence to take action in respect to them and in doing so, extends and
develops cooperative and collaborative attitudes and practices in the community (Ross
1967)

• • A continuous and sustained process of educating the people to understand

and develop their critical awareness of their existing condition, working with the

people collectively and efficiently on their immediate and long-term

problems, and mobilizing the people to develop their capability and

readiness to respond and take action on their immediate needs towards

solving their long-term problems (CO: A manual of experience, PCPD)
• Importance of COPAR:

• 1. COPAR is an important tool for community development and people

empowerment as this helps the community workers to generate community participation in
development activities.
• 2. COPAR prepares people/clients to eventually take over the management of a
development programs in the future.

• 3. COPAR maximizes community participation and involvement;

community resources are mobilized for community services.
• Principles of COPAR:

• 1. People, especially the most oppressed, exploited and deprived sectors

are open to change, have the capacity to change and are able to bring about change.
• 2. COPAR should be based on the interest of the poorest sectors of society
• 3. COPAR should lead to a self-reliant community and society.

• COPAR Process:
• • A progressive cycle of action-reflection action which begins with small, local and

concrete issues identified by the people and the evaluation and the
reflection of and on the action taken by them.
 • • Consciousness through experimental learning central to the COPAR
process because it places emphasis on learning that emerges from concrete action and
which enriches succeeding action.
• • COPAR is participatory and mass-based because it is primarily directed towards and
biased in favor of the poor, the powerless and oppressed.
• • COPAR is group-centered and not leader-oriented. Leaders are identified, emerge and
are tested through action rather than appointed or selected by some external force or
entity.
Expended program for Immunization (EPI)
• Principles of EPI include:
1. Epidemiological situation
2. Mass approach
3. Basic Health Service
• The 7 immunizable diseases are:
1. Tuberculosis
2. Diptheria
3. Pertussis

4. Measles
5. Poliomyelitis
6. Tetanus
7. Hepatitis B

Administration of vaccines:
Vaccine Content Form & Dosage # of Doses Route
BCG Live attenuated Freeze dried 1 ID
bacteria infant- 0.05ml
Preschool-0.1ml
DPT DT- weakened liquid-0.5ml 3 IM
toxin
P-killed bacteria
OPV weakened virus liquid-2drops 3 Oral
Hepa B Plasma derivative Liquid-0.5ml 3 IM
Weakened virus Freeze dried- 1 Subcutaneous
0.5ml
Measles
Schedule of Vaccines:
Vaccine Age at 1st dose Interval between Protection
dose
BCG At birth
DPT 6 weeks 4 weeks DPT
OPV 6weeks 4weeks Poliomyelitis
Hepa B @ birth @birth,6th week,14th HepaB
week
Measles 9m0s.-11m0s.

measles

6 months – earliest dose of measles given in case of outbreak

9months-11months- regular schedule of measles vaccine

15 months- latest dose of measles given

4-5 years old- catch up dose
Fully Immunized Child (FIC)- less than 12 months old child with complete immunizations of

DPT, OPV, BCG, Anti Hepatitis, Anti measles.

Vaccine Minimum age % protected Duration of

interval Protection
TT1 As early as possible 0% 0
TT2 4 weeks later 80% 3 years
TT3 6 months later 95% 5 years
TT4 1year later/during 99% 10 years
next pregnany
TT5 1 year later/third 99% Lifetime
pregnancy
 • There is no contraindication to immunization except when the child is
immunosuppressed or is very, very ill (but not slight fever or cold). Or if the child

experienced convulsions after a DPT or measles vaccine, report such to

the doctor immediately.
• Malnutrition is not a contraindication for immunizing children rather, it is an indication
for immunization since common childhood diseases are often severe to malnourished
children.
Cold Chain under EPI:
 Cold Chain is a system used to maintain potency of a vaccine from that of manufacture
to the time it is given to child or pregnant woman.
 The allowable timeframes for the storage of vaccines at different levels are:
o 6months- Regional Level
o 3months- Provincial Level/District Level
o 1month-main health centers-with ref.
o Not more than 5days- Health centers using transport boxes.
 Most sensitive to heat: Freezer (-15 to -25 degrees C)
o OPV

o Measles
 Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celcius)
o BCG
o DPT
o Hepa B
o TT
 Use those that will expire first, mark “X”/ exposure, 3rd- discard,
 Transport-use cold bags, let it stand in room temperature for a while before storing DPT.

 Half life packs: 4hours-BCG, DPT, Polio, 8 hours- measles, TT, Hepa B.

FEFO (“first expiry and first out”) – vaccine is practiced to assure that all
vaccines are utilized before the expiry date.

Proper arrangement of vaccines and/or labeling of vaccines

expiry date are done to identify those near to expire vaccines.

Expended program for Immunization (EPI)
• Principles of EPI include:
1. Epidemiological situation
2. Mass approach
3. Basic Health Service
• The 7 immunizable diseases are:
1. Tuberculosis
2. Diptheria
3. Pertussis

4. Measles
5. Poliomyelitis
6. Tetanus
7. Hepatitis B

Administration of vaccines:
Vaccine Content Form & Dosage # of Doses Route
BCG Live attenuated Freeze dried 1 ID
bacteria infant- 0.05ml
Preschool-0.1ml
DPT DT- weakened liquid-0.5ml 3 IM
toxin
P-killed bacteria
OPV weakened virus liquid-2drops 3 Oral
Hepa B Plasma derivative Liquid-0.5ml 3 IM
Weakened virus Freeze dried- 1 Subcutaneous
0.5ml
Measles

Schedule of Vaccines:
Vaccine Age at 1st dose Interval between Protection
dose
BCG At birth
DPT 6 weeks 4 weeks DPT
 OPV 6weeks 4weeks Poliomyelitis
Hepa B @ birth @birth,6th week,14th HepaB
week
Measles 9m0s.-11m0s.

measles

6 months – earliest dose of measles given in case of outbreak

9months-11months- regular schedule of measles vaccine

15 months- latest dose of measles given

4-5 years old- catch up dose
Fully Immunized Child (FIC)- less than 12 months old child with complete immunizations of

DPT, OPV, BCG, Anti Hepatitis, Anti measles.

Vaccine Minimum age % protected Duration of

interval Protection
TT1 As early as possible 0% 0
TT2 4 weeks later 80% 3 years
TT3 6 months later 95% 5 years
TT4 1year later/during 99% 10 years
next pregnany
TT5 1 year later/third 99% Lifetime
pregnancy

• There is no contraindication to immunization except when the child is

immunosuppressed or is very, very ill (but not slight fever or cold). Or if the child

experienced convulsions after a DPT or measles vaccine, report such to

the doctor immediately.
• Malnutrition is not a contraindication for immunizing children rather, it is an indication
for immunization since common childhood diseases are often severe to malnourished
children.
Cold Chain under EPI:
 Cold Chain is a system used to maintain potency of a vaccine from that of manufacture
to the time it is given to child or pregnant woman.
 The allowable timeframes for the storage of vaccines at different levels are:
o 6months- Regional Level
o 3months- Provincial Level/District Level
o 1month-main health centers-with ref.
o Not more than 5days- Health centers using transport boxes.
 Most sensitive to heat: Freezer (-15 to -25 degrees C)
o OPV

o Measles
 Sensitive to heat and freezing (body of ref. +2 to +8 degrees Celcius)
o BCG
o DPT
o Hepa B
o TT
 Use those that will expire first, mark “X”/ exposure, 3rd- discard,
 Transport-use cold bags, let it stand in room temperature for a while before storing DPT.

 Half life packs: 4hours-BCG, DPT, Polio, 8 hours- measles, TT, Hepa B.

FEFO (“first expiry and first out”) – vaccine is practiced to assure that all
vaccines are utilized before the expiry date.

Proper arrangement of vaccines and/or labeling of vaccines

expiry date are done to identify those near to expire vaccines.