PICOT (TT)  T - Type of Question (Is this a diagnosis,

therapy, prognosis, etiology/harm, or

EVIDENCED BASED prevention question?)
PRACTICE  T -Type of Study Design (What study design
would best answer this question? Cohort,
PREPARED BY:
Case Series, etc.
LIEZLUY, RN MAN
 Question: In POPULATION, does
WHAT DOES PICOT STANDS FOR? INTERVENTION as compared to
COMPARISON/CONTROL GROUP result in
 To formulate questions in Evidence Based
OUTCOME?
Practice, use the PICOT format.
 Keep in mind, you may not have all the
 PICOT stands for:
pieces depending on your type of
 Population/ Patient Problem: Who is question, but it's a great jumping off
your patient? (Disease or Health status, point.
age, race, sex)
 Intervention: What do you plan to do for
WHAT IS THE PURPOSE OF PICOT?
the patient? (Specific tests, therapies,
medications)Sep 21, 2020  The PICOT format is a helpful approach for
summarizing research questions that
 This model helps us create searchable
explore the effect of therapy: (P) –
clinical questions before we start looking
Population refers to the sample of subjects
at the literature.
you wish to recruit for your study.
 P - Population
 I - Intervention
Why is Picot important in nursing?
 C - Comparison or Control
 O - Outcome (desired or of  It is a mnemonic for the important parts of a
interest) well-built clinical question. It also helps
formulate the search strategy by identifying
 T- Time period - Type of Question the key concepts that need to be in the
(Is this a diagnosis, therapy, article that can answer the question.Jun 25,
prognosis, etiology/harm, or 2020
prevention question?)
 T -Type of Study Design (What
study design would best answer WHAT IS A CLINICAL QUESTION?
this question? RCT, Cohort, Case
 These types of questions typically ask who,
Series, etc.
what, where, when, how & why about things
like a disorder, test, or treatment, or other
aspect of healthcare. For example: What are
the clinical manifestations of menopause?
What causes migraines? Foreground
questions ask for specific knowledge to
inform clinical decisions.Sep 9, 2020
EBP: PICO FORMAT
 Evidence-based practice (EBP) is the P I C O
process of collecting, processing, and
implementing research findings to improve Population Intervention Comparison Outcome
clinical practice, the work environment, or Patient Or
patient outcomes. ... Utilizing the EBP Problem Exposure
approach to nursing practice helps us Who are What do What do we What
provide the highest quality and most cost- the we do to compare Happens?
efficient patient care possible. patients? them? the
What is
intervention
What is What are the
with?
WHAT IS AN EXAMPLE OF EVIDENCED the they outcome?
BASED PRACTICE? problem? exposed
to?
 Giving oxygen, which is the correct
treatment based on the evidence, can
enhance COPD patients' quality of life and Example 1 - THERAPY
help them live longer. Nurses should
measure blood pressure according to  Scenario: You have a female patient who
evidence-based practice because accurate has recently been diagnosed with SLE. Her
measurements are an essential part of rheumatologist suggested she start on
effective treatment.Dec 20, 2016 Plaquenil for her joint pain, but she is
interested in alternative therapies because
she heard about success a neighbor had
What is an example of a PICO question? with turmeric tea.
 P- patients with SLE
 PICO is a mnemonic used to describe the  I- turmeric tea
four elements of a good clinical foreground
question: P = Population/Patient/Problem -  C- Plaquenil (standard drug therapy)
How would I describe the problem or a  O- reduction of joint pain
group of patients similar to mine? I =
Intervention - What main intervention,  Question: In adult patients with SLE, is
prognostic factor or exposure am I consuming turmeric tea more effective than
considering?Sep 20, 2020 Plaquenil at reducing joint pain?
 This question could be more specific
(Gender specific? What counts as a
reduction in joint pain?), but is still a therapy
question. We're comparing an alternative
therapy (turmeric tea) with a more standard
drug therapy (Plaquenil).
Example 2 - Diagnosis/Diagnostic Test Example 3 - Etiology

 Scenario: Your patient has a history of blood  Scenario: Your female patient is concerned
clots and after they came in to your clinic about her risk of developing breast cancer.
with right calf discomfort and tightness, Her friend was recently diagnosed, and
you're concerned about DVT. You mentioned that her smoking might have
remember reading about the limitations of been a factor. Your patient and her wife
duplex ultrasound and calfveins, and are have lived together for 10 years, and while
wondering if a d-dimer assay can help you she doesn't smoke, her partner does. Is she
rule out DVT more accurately. at an increased risk over someone without
daily exposure to second-hand smoke?
 P- adults
 P- female non smokers w/ daily second
 I- d-dimer assay
hand smoke exposure
 C- ultrasound
 I-
 O- more accurate diagnosis of DVT
 C- female non smokers w/o daily smoke
 Question: Is d‐dimer assay more accurate at exposure
ruling out deep vein thrombosis compared to  O- develop breast cancer
ultrasound?
 T- over ten years
 EXAMPLE NO.2
 EXAMPLE NO.3
 Question: Is d‐dimer assay more
accurate at ruling out deep vein Question: Are female non-smokers with daily
thrombosis compared to ultrasound? exposure to second-hand smoke over a period
of ten years or greater more likely to develop
breast cancer when compared with female non-
smokers without daily exposure to second hand
smoke?
Example 4 - Prognosis PICO QUESTIONS #2 :
Simultaneous Literature Review
 Scenario: Your patient, who owns a bakery,
 Population - Post-operative complications
recently participated in their employer's
presented in patients following bowel
wellness program. Their BMI is within a
resection surgery: pain, GI dysfunction and
normal range, but they have a family history
immobility
of obesity, and are concerned about the
impact carbs may have on maintaining a -Hospitalized Adult patients post-op following
healthy weight. bowel resection surgery
 P- pts w/ family history of obesity  Intervention -Dedicated surgical unit with
pre-op education,early ambulation,limited
 I- carb intake; specific diet?
use of NG tubes and Foley Catheters, pain
 C- control, management of N&V (Fast Track
Order Set)
 O- keeping BMI below 25; healthy weight
management  Comparison- Retrospective chart review of
patient admitted and received traditional
 Question: Does dietary carbohydrate
care prior to the intervention
intake influence healthy weight
maintenance (BMI <25) in patients who  Outcome- length of stay, days of NG and
have family history of obesity (BMI >30)? Foley use, symptom presentation and
management, introduction of diet

PICO QUESTIONS #1 :
PICO QUESTIONS #3 :
Does daily exercise other physical activity during
pregnancy reduce the risk of preterm delivery Question: In premenopausal using combined
compared to those who do not exercise during OCP’s, does continuous cycling increase the
pregnancy? risk of long-term complications compared to
traditional OCP cycling?
 Population - Pregnant Women
 Population - PATIENT POPULATION OR
 Intervention - Daily Exercise/physical
PROBLEM
activity?
 Premenopausal women using
 Comparison- No exercise
combined OCP’s
 Outcome- reduce the risk of preterm
 Intervention - INTERVENTION
delivery
 Continuous cycling
 Comparison- CONTROL OR
COMPARATIVE INTERVENTION
 Traditional OCP cycling or placebo
 Outcome-OUTCOME
 Long term safety (endometrial or
ovarian ca, breast cancer,
cardiovascular, bone, fertility, etc.)
PICO QUESTIONS #4 : PICO QUESTIONS #6 :
Patients with heart failure have high readmission Working on the Developmental Assessment
rates. I propose implementing a discharge Team for school-aged children of mothers who
follow-up program that provides biweekly post- used cocaine during their pregnancy, you are
discharge home visits by nurse practitioners for interested in learning the developmental
2 weeks following hospital discharge. I will outcomes for these children as they begin
compare 30-day readmission rates for patients school compared to children not exposed to
during the 6 months prior to initiation of the cocaine during pregnancy.
program and for the 6 months after initiation of
 What is your clinical question in PICO
the program.
format?
 Population: Patients discharged from the
ANSWER:
hospital with a diagnosis of heart failure
 P - Mothers of school aged children
 Intervention: Biweekly home visits by nurse
( cocaine user)
practitioners
 Comparison: Patients discharged prior to
implementation of the intervention versus  I - Observing the physical ,
patients discharged after implementation developmental ( gross motor and fine
skills ), cognitive function and behaviors
 Outcome: 30-day readmission rates
of schoolagers.
 Time: 2 weeks

 C - Compare developmental outcomes or

PICO QUESTIONS #5 : learning of schoolage children who had
been exposed to cocaine during
Review Point #1
pregnancy cpmpared to school aged
 Your patient is a 45-year-old female just children not exposed to on the said
diagnosed with mild hypertension. She does drugs.
not want to start taking pills and has asked
you if she can make other changes that
might bring her blood pressure back within  O- Developmental outcpmes Physical,
normal range. Developmental and behavior of school-
aged children.
 The PICO statement is:
 P 45-year-old female with mild
hypertension
 | lifestyle modifications
 C medication
 0 B/P within normal limits
 Is this PICO statementcorrectly stated
to help you answer your patient's
question? Yes or No?
 QUESTION DEFINITION TEMPLATE
TYPE
Intervention Used to determine which In treatrnent In________________________________ (P)
or therapy leads to the best outcome. how does__________________________(I)

compared with______________________(C)

affect_____________________________(O)

within_____________________________(T)

Etiology Used to determine the greatest risk Are______________________________(P)

factors or causes of a condition. who have_________________________(I)

compared with those without__________(C)

At ____________risk for_____________(O)

Over_____________________________(T)

Diagnosis or Used to determine which test is more In________________________________ (P)

diagnostic accurate and precise in diagnosing a are / is____________________________(I)
test condıtion.
compared with______________________(C)

More accurate in diagnosing___________(O)

Prognosis or Used to determine the clınical course In________________________________ (P)

prediction over time and likely complıcations of a how does__________________________(I)
condıtion.
compared with ______________________(C)

Influence___________________________(O)

Over______________________________(T)

Meaning Used to determine the meaning of an How do____________________________(P)

experience for a particular indıvidual, with_______________________________(I)
group or communıty.
perceive___________________________(C)

during_____________________________(T)

PICO (TT) MODEL FOR CLINICAL QUESTIONS SAMPLE

P Patient, Population, or Problem How would I describe a group of patients similar to
mine?

I Intervention, Prognostic Factor, or Exposure Which main intervention, prognostic factor, or

exposure am I considering?

C Comparison to lntervention (if appropriate) What is the main alternative to compare with the
intervention?

O Outcome you would like to measure or What can I hope to accomplish, measure,improve or
achieve affect?

T Therapy/Treatment, Diagnosis,Prognosis, What type of question are you asking?

HarmEtiology (may be referred to as
"domains" in PubMed)

T Type of study you want to find What would be the best study design/methodology?
THE 10 HERBAL PLANT
APPROVED BY DOH INTRODUCTION
Prepared by:  These days, people need more options on
how to strengthen their immunity and fight
LIEZL UY, RN MAN against common ailments.
1. SAMBONG  For some of our patients, it is a challenge for
2. AKAPULKO them to acquire conventional medication
especially if they are living in Geographically
3. NIYOG-NIYOGAN Isolated and Disadvantaged Areas (GIDA).
4. TSAANG GUBAT  These are areas where the commonly found
5. AMPALAYA clinics and pharmacies are very scarce if
none at all.
6. LAGUNDI
ROLE OF NURSES:
7. ULASIMANG BATO
 As Nurses, we have a vital role in reaching
8. BAWANG out to the people in our communities and
9. BAYABAS provide health education with regards to the
importance of these herbal medicines. We
10. YERBA BUENA should serve as role models to our people in
order to empower them by offering
alternative sources of medication outside the
Introduction conventional medicine that is commonly
used nowadays.
 To make sure that those people that are ill
have flexibility in their options for medication,  We should always keep in mind that some
we gathered the latest updates regarding 10 patients do not have access to these
Herbal Medicines that are approved by the conventional therapies. Hence, our role is to
Department of Health through Republic Act make sure that they don’t run out of choices.
No. 8423 known as the Traditional and
 By encouraging the people in our
Alternative Medicine Act (TAMA) of 1997;
communities to plant these simple herbal
this act created the Philippine Institute of
medicines in their backyards, it will be of
Traditional and Alternative Health Care
great aid for them in times of need.
(PITAHC) to further the development of
traditional and alternative medicines in the
Philippines.

 We have included in the list their uses,

preparation and where it’s commonly found.
It will be useful for the patients who have
difficulty in accessing commonly sold drugs
in the pharmacy.
1. LAGUNDI  This plant can also be pounded using a
pestle and mortar and can be applied to
 Lagundi (Vitex negundo L.) affected areas where there is pain, or
 It is one of the ten herbal medicines soreness.
endorsed by the Philippine Department of  For wounds, the decoction can be used as
Health as an effective herbal medicine with an alternative to hydrogen peroxide for
proven therapeutic value. Studies have wound dressing.
shown that Lagundi can prevent the body’s
production of leukotrienes, which are  Headache
released during an asthma attack.  Crush leaves may be applied on the
 Even in Japan, lagundi is becoming forehead
recognized as an effective herbal medicine,  Rheumatism, sprain, contusions, insect
especially since researches have shown that bites
it contains properties that make it an
expectorant and it has been reported to  -Pound the leaves and apply on affected
function as a tonic as well. More than that, area
most of the parts of the lagundi plant have
medicinal value.This medicinal plant had
recently been commercialized and many 2. Ulasimang-bato (Peperonia
pharmaceutical companies are making pellucida)
cough syrups out of it.
 Common names: Dangla (Ilokano); five-
 It is a small herb that grows from 1 to 1 1/2
leaved chaste tree, horseshoe vitex
feet. Pansit-pansitan can be found wild
 Indication: Leaves and flowering tops onlightly shaded and damp areas such as
decoction, syrup, tablets and capsules for nooks, walls, yards and even roofs.
coughs, colds, fever and asthma.
 Pansit-pansitan has heart shaped leaves,
 Found in: in humid places or along water succulent stems with tiny flowers on a spike.
courses, in waste places and mixed When matured, the small fruits bear one
openforest seed which fall of the ground and propagate.
This is a very popular traditional medication
 Parts used: Leaves and flowering tops
for gout as this herbal plant contains
 Special precautions: Make sure to have analgesic properties.
the five-leaved varieties, as there are
 Gout is the most common type of arthritis for
 other varieties of lagundi. Filipinos, according to the statistics of
Philippine Rheumatology Association (PRA),
 Preparation: Asthma, Cough & Fever around 1.6M Filipinos are suffering from
 USES:Decoction (the process of boiling the Gout.
leaves or other parts of a fruit/plant in a  It’s no surprise that this herbal medication is
couple of glasses of water for 15 minutes) is starting to become the center of attraction
the most convenient way to use this as a when looking for an alternative to the
medication.
 conventional treatment of gout, like  Common names: Guava, bayabas
Allopurinol. (Tagalog); guyabas (Iloko); Guava (English).
 Indications: anti-diarrheal and antiseptic
 Common names: Ulasimang-bato, pansit-  Found in:Common in the Philippines
pansitan (Tagalog); olasiman-ihalas
 Parts used:Leaves,fruits
 (Cebu,Bisaya); tangon-tangon (Bikol);
 Special precautions:Eating too much
peperonia (English)
guava fruit may cause constipation
 Indications: Infusion, decoction or salad for
 Preparation:
gout and rheumatic pains; pounded
 For washing wounds
 plant warm poultice for boils and abscesses
 Wash the leaves with running water
 Found in: In lowland rain forest, thickets,
before boiling it for at least 15 minutes.
hedges, waste places, and roadsides.
Wait until the decoction cools down into
 Parts used: aerial plant parts lukewarm temperature before rinsing the
wound with it. Be careful not to use it
 Special precautions: Avoid using with other
while it is still hot as it may cause burn.
pain relievers, diuretics
 Diarrhea
 Preparation:
 – May be taken 3-4 times a day
 Lowers uric acid (rheumatism and gout)
 As gargle and for toothache – Warm
 – One a half cup leaves are boiled in two
decoction is used for gargle. Freshly
glass of water over low fire. Do not cover
pounded leaves are used for
pot. Divide into 3 parts and drink one
toothache. Boil chopped leaves for
part 3 times a day
15 minutes at low fire. Do not cover
and then let it cool and strain.

3. Guava (Psidium guajava L.)

 Guava (Psidium guajava L.)

 Guava (Psidium guajava L.)Bayabas or
guava is a tropical plant, which is locally
known for its edible fruit. In the backyards of
Filipino homes in the country, this plant is
commonly seen, and grown because of its
many uses as fruit and as traditional remedy
to treat various ailments.
 As shown by many research studies, almost
all of the parts of this plant have medicinal
qualities and value, and thus, making it as
one of the most popular therapeutic plants in
the Philippines
4. Bawang (Alium sativum L.)  Uses & Preparation:
 Hypertension

 Bawang (Alium sativum L.)  – Maybe fried, roasted, soaked in

vinegar for 30 minutes, or blanched
 Bawang (Alium sativum L.)This herb is one in boiled water for 15 minutes. Take
of the most widely used herbal medicines in 2 pieces 3 times a day after meals.
the Philippines and can also be found
commonly in the kitchen of Filipino  Toothache
households as it is used to spice up food  – Pound a small piece and apply to
preparations. affected area
 The Philippines bawang or garlic variety is
more pungent than the imported ones. Its
medicinal properties have been known for a 5. Yerba Buena (Clinopodium
long time and have been especially proven
during World War II when it was used to
douglasii)
treat wounds and infections of soldiers.
 Garlic antibacterial compound known as  Yerba Buena (Clinopodium douglasii)
allicin, saved many lives of the soldiers as  Yerba Buena has been consumed for
this property prevented the wounds from centuries as tea and herbal medicine as a
being infected and developing into gangrene pain reliever(analgesic).
at a later stage by extracting the juice of
bawang or garlic and applying to the wounds.  Native American Indians used it even before
the “white men” colonized the Americas.
 Common names: Ajos (Bisaya); garlic Today, this folk medicine’s efficacy has been
 Indications: Fresh cloves, capsules for validated by scientific research.
lowering blood cholesterol levels;antiseptic.  In the Philippines, Yerba Buena is one of the
 Found in: cultivated all over the world. 10 herbs endorsed by the Department of
Probably originated from Central Asia Health(DOH) as an effective alternative
medicine for aches and pains.
 Parts used: Leaves and bulbs (cloves)
 Common name: Peppermint
 Special precautions: Avoid taking with
medicines for lowering blood sugar, and  Indications and preparations: for pain,
medicines for thinning blood. Dosage must cough, colds, nausea, dizziness, and
not exceed 6-8 cooked cloves a day. pruritus

 Stomach ulcer may develop if garlic is eaten  Parts utilized: leaves, sap of plant
raw  Uses & Preparation:
 Pain (headache, stomachache)
 – Boil chopped leaves in 2 glasses
of water for 15 minutes. Divide
decoction into 2 parts, drink one part
every 3 hours.
 Rheumatism, arthritis and headache 6. Sambong (Blumea balsamifera
 – Crush the fresh leaves and L. DC)
squeeze sap. Massage sap on
painful parts with eucalyptus
 Sambong (Blumea balsamifera L. DC)
 Cough & Cold
 Sabong is an amazing medical plant.
 – Soak 10 fresh leaves in a glass of Coming from the family of Compositae, it
hot water, drink as tea. (expectorant) goes by several names locally. It is known in
 Swollen gums the Visayas as bukadkad and as subsud in
ilocos. This plant possesses a multitude of
 – Steep 6 g. of fresh plant in a glass properties that make it worthy of the DOH
of boiling water for 30 minutes. Use approval.
as a gargle solution
 Common names: Sambong (Tagalog);
 Toothache lakad-bulan (Bikol); Ngai camphor (English)
 – Cut fresh plant and squeeze sap.  Indications: Diuretic in hypertension;
Soak a piece of cotton in the sap dissolves kidney stones
and insert this in aching tooth cavity
 Found in: In roadsides, fields, lowland and
 Gas pain mountainous regions
 – Soak a handful of leaves in a lass  Parts used: Leaves and flowering tops
of boiling water. Drink infusion.
 Special precautions: Avoid using with other
 Nausea & Fainting diuretics. When taking diuretics, eat at least
 – Crush leaves and apply at nostrils one banana a day.
of patients
 Insect bites
7.Akapulko (Cassia alata L.)
 – Crush leaves and apply juice on
affected area or pound leaves until
Akapulko (Cassia alata L.)
like a paste, rub on affected area
Akapulko (Cassia alata L.)Akapulko is a shrub
 Pruritis
found throughout the Philippines. It is known
 – Boil plant alone or with eucalyptus under various names in different regions in the
in water. Use decoction as a wash country.
on affected area.
Common names: Katanda (Tagalog); andadasi
(Ilokano);palochina (Bisaya);
ringworm bush,seven golden candlesticks,
bayabas-bayabasan
Found in: Abundantly naturalized in South East
Asia, and occasionally planted
throughout the region for medicinal and
ornamental purposes
Parts used: Leaves
Preparation: 9.Tsaang Gubat
Anti-fungal (tinea flava, ringworm, athlete’s foot  Tsaang Gubat (Carmona retusa (Vahl)
and scabies) Masam.)
– Fresh, matured leaves are pounded. Apply  Tsaang Gubat is a shrub that grows
soap to the affected area 1-2 times a day. abundantly in the Philippines.
 In folkloric medicine, the leaves has been
8.Niyog- Niyogan (Quisqualis Indica L.) used as a disinfectant wash during child
birth, as cure for diarrhea, as tea for general
good heath and because Tsaang Gubathas
 Niyog- Niyogan (Quisqualis Indica L.) high fluoride content, it is used as a mouth
gargle for preventing tooth decay.
 Common names: Tartaraok (Tagalog);
balitadham (Bisaya); Rangoon creeper,  Research and test now prove it’s efficacy as
an herbal medicine. Aside from the
 Chinese honeysuckle, liane vermifuge.
traditional way of taking Tsaag Gubat, it is
 Indications: Fruit (kernel) anthelmintic; now available commercially in capsules,
leaves poultice for headache tablets and tea bags.
 Found in: In forest margins at low altitude,  Common names: Putputai (Bikol); alangit
in gardensand backyards. Native to Asian (Bisaya); forest tea, wild tea.
tropics and throughout Malaysian region.
 Indications: pills, leaf decoction for
 Parts used: Fruits gastroenteritis; as gargle to prevent cavities
 Special precautions: Follow recommended  Found in:In secondary forests at low and
dosage. Overdose causes hiccups. medium altitudes. Sometimes cultivated as
ornamentals.
 Preparation:
 Parts used:Leaves
 Anti-helmintic
 Preparation:
 -The seeds are taken 2 hours after
supper. If no worms are expelled,  Diarrhea
the dose may be repeated after one
 – Boil chopped leaves into 2 glasses
week. (Caution: Not to be given to
of water for 15 minutes. Divide
children below 4 years old)
decoction into 4 parts. Drink 1 part
every 3 hours
 Stomach ache
 – Boil chopped leaves in 1 glass of
water for 15 minutes. Cool and strain.
10. Ampalaya (Momordica FAMILY CARE PLAN
charantia (L.) DC) Prepared by:
LIEZL UY, RN MAN
 Ampalaya (Momordica charantia (L.) DC)
FAMILY NURSING CARE PLAN
 Ampalaya has been for used even by the
Chinese for centuries. DEFINITION:

 The effectively of Ampalayaas an herbal  Is the blueprint of the care that the nurse
medicine has been tried and tested by many designs to systematically minimize or
research clinics and laboratories worldwide. eliminate the identified health and family
nursing problems through explicitly
 In the Philippines, the Department of Health formulated outcomes of care (goals and
has endorsed Ampalaya as an alternative objectives) and deliberately chosen set of
medicine to help alleviate various ailments interventions, resources and evaluation
 Common names: Ampalaya (Tagalog); criteari, standards, methods and tools.
paria (Ilokano); palia (Bisaya); bitter
PURPOSES OF FAMILY NCP
gourd,bitter cucumber, bitter melon (English)
 The nursing care plan focuses on actions
 Indications: lowers blood sugar levels
which are designed to solve or minimize
 Found in: In lowland rain forest, thickets, existing problem. The plan is a blueprint for
hedges, waste places, and roadsides. action. The cores of the plan are the
approaches, strategies, activities, methods
 Parts used: Young leaves
and materials which the nurse hopes will
 Special precautions: Blood sugar levels improve the problem situation.
should be monitored regularly. The native
variety with small bitter fruit is recommended
 The nursing care plan is a product of a
 AMPALAYA
deliberate systematic process. The planning
 Preparation: process is characterized by logical analyses
of data that are put together to arrive at
 Diabetes Mellitus (Mild non- rational decisions. The interventions the
insulin dependent) nurse decides to implement are chosen from
among alternatives after careful analysis and
 – Chopped leaves then boil in a
weighing of available options.
glass of water for 15 minutes. Do not
cover. Cool and strain. Take 1/3 cup
3 times a day after meals.
PURPOSES OF FNCP: Formulating a family care plan
 The nursing care plan, as with all plans,
involves the following steps
relates to the future. It utilizes events in the 1. The prioritized condition/s or
past and what is happening in the present to
determine patterns. It also projects the future problems.
scenario if the current situation is not 2.The goals and objectives of
corrected.
nursing care
3.The plan of interventions
 The nursing care plan is based upon
identified health and nursing problems. The 4.The plan of evaluating care
problems are the starting points for the plan,
Prioritize the Health Conditions and
and the foci of the objectives of care and
intervention measures. Problems based on:
 Nature of condition or problem

 The nursing care plan is a means to an end,  Modifiability

not an end in itself. The goal in planning is to  Potential
deliver the most appropriate care to the
client by eliminating barriers to family health  Salience
development.

 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.

DEFINE GOALS AND OBJECTIVES OF

Steps in Making Family Nursing Care CARE
Plan
Formulate:

 The assessment phase of the nursing  Expected Outcomes:

process generates the health and nursing  Conditions to be observed to show
problems which become the bases for the problem is prevented, controlled,
development of nursing care plan. resolved or eliminated
 Client response/s or behavior
 The planning phase takes off from there.  Specific, measurable Client-centered
statements/ Competencies
 FNCP:
 This is a schematic presentation of the
nursing care plan process.
 It starts with a list of health condition or
problems prioritized according to the nature,
modifiability, preventive potential and
DEVELOP THE EVALUATION PLAN salience.
 Decide on:  The prioritized health condition or problems
 Measures to help family eliminate: and their corresponding nursing problems
become the basis for the next step which is
 Barriers to performance of healthy the formulation of goals and objectives of
tasks. nursing care.

 Underlying cause/s of non-  The goals and objectives specify the

performance of health tasks expected health/clinical outcomes, family
response/s, behavior of competency
 Family-centered alternatives to outcomes.
recognize/detect,monitor, control or
manage health condition or problems Four Criteria for Determining
 Determine Methods of Nurse-Family Contact Priorities:
 Sepcify Resources Needed  Prioritizing Health Problems
 Nature of the condition or problem
 categorized into wellness state/potential,
health threat, health deficit of
foreseeable crisis.
 Modifiability of the condition or problem
 refers to the probability of success in
enhancing the wellness state improving
DEVELOP THE INTERVENTION PLAN the condition minimizing, alleviating or
totally eradicating the problem through
Specify: intervention.
 Criteria / Outcomes based on objectives of  Preventive potential
care
 refers to the nature and magnitude of
 Methods / tools future problem that can be minimized or
totally prevented if interventions are
done on the condition or problem under
consideration.
 Salience
 refers to the family’s perception and
evaluation of the condition or problem in
terms of seriousness and urgency of
attention needed or family readiness.
NATURE OF THE CONDITION B. Readiness for Enhanced Capability
for:
OR PROBLEMS:
1) Healthy lifestyle
CATEGORIES
2) Health maintenance/health management
WHAT IS Wellness Potential ?
3) Parenting

 Wellness Potential 4) Breastfeeding

 – stated as potential or Readiness-a 5) Spiritual well-being

clinical or nursing judgment about a 6) Others. Specify.
client in transition from a specific level of
wellness or capability to a higher level.
 Wellness potential is a nursing judgment What is a health threat?
on wellness state or condition based on
client’s performance, current  These threats include immediate crises.
competencies, or performance, clinical  conditions that are conducive to disease and
data or explicit expression of desire to accident, or may result to failure to maintain
achieve a higher level of state or wellness or realize health potential.
function in a specific area on health Examples of this are the following:
promotion and maintenance.
 A. Presence of risk factors of specific
diseases (e.g. lifestyle diseases,
Examples are the following metabolic syndrome
 B. Threat of cross infection from
communicable disease case
A. Potential for Enhanced Capability
for:  C. Family size beyond what family
resources can adequately provide
1. Healthy lifestyle-e.g. nutrition/diet,
exercise/activity  D. Accident hazards specify.

2. Healthy maintenance/health management 1. Broken stairs

3. Parenting 2. Pointed /sharp objects, poisons and

4. Breastfeeding 3. medicines improperly kept

5. Spiritual well-being-process of client’s 4. Fire hazards

developing/unfolding of mystery through
5. Fall hazards
harmonious interconnectedness that comes
from inner strength/sacred source/God 6. Others specify.
(NANDA 2001)
6. Others. Specify.
 HEALTH THREAT HEALTH THREAT
 E. Faulty/unhealthful nutritional/eating I. Unhealthy Lifestyle and Personal
habits or feeding techniques/practices. Habits/Practices. Specify.
Specify.
1. Alcohol drinking
1. Inadequate food intake both in
2. Cigarette/tobacco smoking
quality and quantity
3. Walking barefooted or inadequate
2. Excessive intake of certain nutrients
footwear
3. Faulty eating habits
4. Eating raw meat or fish
4. Ineffective breastfeeding
5. Poor personal hygiene
5. Faulty feeding techniques
6. Self medication/substance abuse
7. Sexual promiscuity
 F. Stress Provoking Factors. Specify.
8. Engaging in dangerous sports
1. Strained marital relationship
9. Inadequate rest or sleep
2. Strained parent-sibling relationship
10. Lack of /inadequate exercise/physical
3. Interpersonal conflicts between activity
family members
11. Lack of/relaxation activities
4. Care-giving burden
12. Non use of self-protection measures
(e.g. non use of bed nets in malaria and
filariasis endemic areas).
G. Poor Home/Environmental
Condition/Sanitation. Specify.
1. Inadequate living space J. Lack of Immunization/Inadequate
Immunization Status Specially of Children
2. Lack of food storage facilities
3. Polluted water supply
K. Family Disunity-e.g.
4. Presence of breeding or resting
sights of vectors of diseases 1. Self-oriented behavior of member(s)
5. Improper garbage/refuse disposal
6. Unsanitary waste disposal 2. Unresolved conflicts of member(s)
7. Improper drainage system
8. Poor lightning and ventilation 3. Intolerable disagreemen
9. Noise pollution
10. Air pollution
Presence of health deficits Presence of stress points/foreseeable
crisis situations
 Presence of health deficits
 Presence of stress points/foreseeable
 –instances of failure in health
crisis situations
maintenance.
 –anticipated periods of unusual demand
 Examples include:
on the individual or family in terms of
 A. Illness states, regardless of whether it adjustment/family resources. Examples
is diagnosed or undiagnosed by medical of this include:
practitioner.
A. Marriage
B. Pregnancy, labor, puerperium
 B. Failure to thrive/develop according to
C. Parenthood
normal rate
D. Additional member-e.g. newborn,
lodger
 C. Disability-whether congenital or
E. Abortion
arising from illness; transient/temporary
(e.g. aphasia or temporary paralysis F. Entrance at school
after a CVA) or permanent (e.g. leg
G. Adolescence
amputation secondary to diabetes,
blindness from measles, lameness from H. Divorce or separation
polio)
I. Menopause
J. Loss of job
K. Hospitalization of a family member
L. Death of a member
M. Resettlement in a new community
N. Illegitimacy
Isolation Precautions DEFINITION:
 Special precautionary measures, practices
Prepared By : Roseminda Yong Lamig RN, MAN and procedures used in care of patients with
Liezl Uy , RN MAN contagious or communicable diseases by
wearing nonporous articles such as
 Standard Precautions combine the major gloves,gowns,goggles, and face mask.
features of Universal Precautions (UP) 780,
896 and Body Substance Isolation (BSI) 640
and are based on the principle that all blood, PURPOSES:
body fluids, secretions, excretions except
sweat, nonintact skin, and mucous  To prevent cross contamination between
membranes may contain transmissible patients and hospital personnel
infectious agents.  To confine and contain any infectious
 Standard Precautions include a group of disease agent
infection prevention practices that apply to  To confine and contain all blood and body
all patients, regardless of suspected or fluids
confirmed infection status, in any setting in
which healthcare is delivered (Table 4).
These include: hand hygiene; use of gloves,
gown, mask, eye protection, or face shield, What are the principles of standard
depending on the anticipated exposure; and precautions?
safe injection practices.
 Also, equipment or items in the patient Standard Precautions
environment likely to have been  Hand hygiene.
contaminated with infectious body fluids
must be handled in a manner to prevent  Use of personal protective equipment (e.g.,
transmission of infectious agents (e.g., wear gloves, masks, eyewear).
gloves for direct contact, contain heavily
 Respiratory hygiene / cough etiquette.
soiled equipment, properly clean and
disinfect or sterilize reusable equipment  Sharps safety (engineering and work
before use on another patient). practice controls).
 Safe injection practices (i.e., aseptic
technique for parenteral medications).
 Sterile instruments and devices.
ISOLATION PRECAUTIONS: 1. STANDARD PRECAUTIONS
Visitors - report to nurses’ station  Hand Washing
before entering room.  PPE -
 Gloves
1. WASH HANDS BEFORE and AFTER  Masks
patient care.
 Goggles / Glasses
2. MASKS / PROTECTIVE EYEWEAR
 face mask
 Yes, if splashing is likely.
 Gowns
 Yes, for all persons entering room.
 PROPER
3. GLOVES
 Handling of soiled patient care
 Yes, when touching body substances. equipments
 Yes, for all persons entering room.  Environmental cleaning
4. NEEDLES / SYRINGES Place in disposal  Disposal of sharps
untis. DO NOT RECAP.
 Minimal handling of soiled linen
5. DISPOSAL in infectious waste container.
 Private room

ALWAYS FOLLOW

2007 GUIDELINE FOR ISOLATION STANDARD PRECAUTIONS

PRECAUTIONS- CDC / HICPAC 1. Perform Hand hygiene before and after every
patient contact
Centre for Disease Control and Prevention
distinguish two types of Isolation Precautions: 2. Clean and reprocess shared patient
equipment
1. STANDARD PRECAUTION
3. Follow respiratory hygiene and cough
etiquette
2. TRANSMISSION BASED
4. Use personal protective equipment when risk
PRECAUTIONS
of body fluid exposure
i. Airborne precautions
5. Use and dispose of sharps safely
ii. Droplet precautions
6. Use aseptic technique
iii. Contact precautions
7. Perform routine environmental cleaning
8. Handle and dispose of waste and used linen
safely
STANDARD PRECAUTIONS RESPIRATORY AND COUGH HYGIENE
1. Before touching a patient 1. Cough or sneeze into a clean tissue, not into
your hands
2. Before a procedure
2. Dispose of the tissue immediately into the
3. After a procedure or body fluid exposure risk
nearest waste bin
4. After touching a patient
3. If you do not have a tissue, cough or sneeze
5. After touching a patient’s surroundings into your upper sleeve.
4. Always clean your hands after coughing or
sneezing, either using soap and warm running
NEW ELEMENTS OF water, alcohol handrub or hand wipes.
STANDARD PRECAUTIONS  Note: this steps will help prevent the spread
 RESPIRATORY HYGIENE of colds,flu and other respiratory infections

 SAFE INJECTION PRACTICES

 USE OF MASKS SAFE INJECTION PRACTICES
 Safe injection practices include measures
taken to perform injections in a manner that
RESPIRATORY HYGIENE is safe for patients and providers. Such
 Respiratory hygiene and cough etiquette are measures are included in standard infection
terms used to describe infection prevention prevention practices and apply to all patients
measures to decrease the transmission of in all healthcare settings. Healthcare should
respiratory illness (e.g., influenza and cold not provide a pathway for transmission of
viruses). A respiratory infection is spread bloodborne viruses to patients or providers.
when a person who is infected with a virus  Asks about safe injection practices.
coughs or sneezes. Remember: One needle, One syringe, only
One time.

PRACTICE RESPIRATORY HYGIENE

 CORONAVIRUS: 1. Safe injection practices are part of
Standard Precautions, providing for patient
 This means covering your mouth and safety and health care provider protections.
nose with your bent elbow or tissue According to the Centers for Disease Control
when you cough or sneeze. Then and Prevention (CDC), syringe reuse and
dispose of the used tissue immediately misuse of medication vials over the past decade
since the droplets spead virus. have resulted in dozens of infectious outbreaks
and the need to alert more than 100,000
patients to seek testing for infection with
hepatitis B virus, hepatitis C virus, and HIV. This
harm is preventable!
2. The One & Only Campaign DANGEROUS MISPERCEPTIONS:
The Centers for Disease Control and Prevention Here are some examples of dangerous
and the Safe Injection Practices Coalition lead misperceptions about safe injection practices:
the One & Only Campaign, a public health
initiative to increase awareness of safe injection MYTH TRUTH
practices. Its goal is to eliminate infections
resulting from unsafe injection practices. Changing the needles Once they are used., both
Remember “One Needle, One Syringe, Only makes a syringe safe for the needle and syringe are
One Time” for each and every injection! For reuse. contaminated and must be
discarded. A new sterile
example, use a new syringe and new needle
needle and a new sterile
when drawing up more propofol for an infusion.
syringe should be used for
Never re-use tubing for infusions between each injection and each
patients, even if it is auxiliary tubing inserted entry into a medication vial.
upstream into the patients main i.v. line.
Syringes can be reused Syringes and needles
as long as an injection is should never be reused.
administered through IV The IV tubing,syringe and
3. Sharps Disposal Containers tubing. other components represent
a single, interconnected
Used sharps need to be disposed of unit. Distance from the
immediately into a sharps container approved by patient, gravity or infusion
the U.S. Food and Drug Administration (FDA). pressure do not ensure that
These containers have been evaluated for small amounts of blood
safety and effectiveness to help reduce the risk won’t contaminate the
of injury and infections from sharps. FDA- syringe once it has been
cleared sharps disposal containers are made connected to the unit.
from puncture-resistant materials with leak- If you don’t see blood in Germs such as hepatitis C
resistant sides and bottom and a tight fitting, the IV tubing or syringe, virus and staph or MRSA
puncture-resistant lid. These containers are it means that those are invisible to the naked
labeled to warn of hazardous waste and marked supplies are safe for eye, but can easily infect
with a line to indicate when the container is reuse. patients even when present
considered full. Close and properly dispose of in microscopic qunatities.
the container when it is full. Do not reuse syringes,
needles or IV tubing.

It’s okay to use leftover Single-dose or single-use

medicine from use vials should not be used for
single-dose or single-use more than one patient
vials for more than one regardless of how much
patient medicine is remaining.
USE OF MASK AIRBORNE PRECAUTIONS
What does the N in N95 stand for? EVERYONE MUST:
 According to the Centre for Disease Control 1. Clean their hands, including before entering
(CDC), the “N” stands for “Not resistant to and when leaving the room.
oil”. The 'N95' designation means that when 2. Put on a fit-tested N-95 or higher level
subjected to careful testing, the respirator respirator before room entry.
blocks at least 95 percent of very small (0.3
micron) test particles.May 19, 2020 3. Remove respirator after exiting the room and
closing the door.
 Here is a breakdown of what an N95 mask is:
N: This is a Respirator Rating Letter Class. It 4. Door to room must remain closed.
stands for “Non-Oil” meaning that if no oil-
based particulates are present, then you can
use the mask in the work environment. AIRBORNE PRECAUTIONS
Other masks ratings are R (resistant to oil
for 8 hours) and P (oil proof).  TUBERCULOSIS
 MEASLES
 CHICKENPOX
SURGICAL MASK
 HERPES ZOSTER
 Surgical masks are fluid-resistant,
disposable, and loose-fitting devices that  SMALL POX
create a physical barrier between the mouth
and nose of the wearer and the immediate
environment. They are for use in surgical AIRBORNE PRECAUTIONS
settings and do not provide full protection
from inhalation of airborne pathogens, such in addition to Standard Precautions.
as viruses.
1. VISITORS see nurse
2. Clean HANDS
AIRBORNE PRECAUTIONS 3. Wear P2 AOR N95 MASK & Perform FI
 Airborne Precautions refer to infection 4. Keep DOOR CLOSED
prevention and control interventions to be
used in addition to Routine Practices.
Airborne Precautions are used for diseases
that are spread by airborne transmission.
What PPE is used for airborne precautions?
 A particulate respirator must be worn by
anyone entering the patient's room that is on
airborne precautions. This may be an N95
respirator or powered air purifying respirator
or PAPR. Respirators are specifically
designed to provide respiratory protection by
efficiently filtering out airborne particles.
DROPLET PRECAUTIONS BASICS DROPLET PRECAUTIONS
 Intended to prevent spread of infectious  DROPLET PRECAUTIONS
agents transmitted by respiratory secretions
or mucous membrane contact.  Droplet isolation precautions—used for
diseases or germs that are spread in tiny
 Droplets do not travel far and do not require droplets caused by coughing and sneezing
special ventilation systems (examples: pneumonia, influenza, whooping
cough, bacterial meningitis). Healthcare
workers should: Wear a surgical mask while
DROPLET PRECAUTIONS in the room.

EVERYONE MUST: CONTACT PRECAUTIONS

1. Clean their hands, including before entering EVERYONE MUST:
and when leaving the room.
1. Clean their hands, including before entering
2. Make sure their eyes, nose and mouth are and when leaving the room.
fully covered before room entry.
PROVIDERS AND STAFF MUST ALSO:
3. Remove face protection before froom exit.
2. Put on gloves before room entry. Discard
gloves before room exit.
DROPLET PRECAUTIONS 3. Put on gown before room entry. Discard gown
before room exit.
 Meningitis
4. Do not wear the same gown and gloves for
 Influenza
the care of more than one person
 Mumps
5. Use dedicated or disposable equipment.
 Pertussis Clean and disinfect reudsble equipment before
use on another person.
 Rubella
 Common cold CONTACT PRECAUTIONS

 Measles 1. Hepatits - A

 Diptheria 2. Antibiotic resistant bacteria

 rubella 3. Scabies
4. Impetigo
5. Lice
DROPLET PRECAUTIONS in addition
to Standard Precautions. 6. MDRO s-MRSA, VRE..

1. VISITORS see nurse CONTACT PRECAUTIONS in addition

to Standard Precautions.
2. Clean HANDS
1. VISITORS see nurse
3. Wear surgical MASK
2. Wear GOWN
4. Keep DOOR CLOSED
3. Clean HAND & wear GLOVES
REVERSE ISOLATION REVERSE ISOLATION
 Isolation procedure designed to protect a PROTECTIVE ISOLATION / NEUTROPENIC
patient from infectious organisms that might PRECAUTIONS
be carried by staff, other patients, visitors or
Protecting the Pt. Against Infection
on droplet in air or equipment or materials.
 Chemo / radiation
WHAT IS EXACTLY IS REVERSE
ISOLATION?  Depressed resistances

 Isolation precautions protect other  Extensive burns

people from the patient's infectious  WASH HANDS
disease.
 PPE
 Reverse isolation protects the patient from
the other people, usually because they have  STERILE / DISINFECTED EQUIPMENT
a weakened immune system and can't fight  PRECAUTIONS
against the bacteria and other infections that
live on and around us all the time.  Flowers / Plants / Fresh produce

 Reverse isolation would entail a private

room with a special air ventilation system,
everybody that goes into the room would be
CONCLUSION
required to wear masks, gloves and a gown  As with all infection control measures,
and to wash their hands thoroughly before isolation precautions are designed to
putting all that on. No gifts like flowers would prevent the spread of infection from one
be allowed in the room. Extra precautions person to another. The RESPONSIBILITY
would be taken to cleanse or sterilize for the practice of infection control lies in the
anything that would be taken in. hands of every HEALTH CARE WORKER.

REVERSE ISOLATION
 Private room
 Staff and visitors must wear gloves & mask
 For prolonged contact with pt you must wear
necessary PPE
 PT should leave room as little as possible
and wear a mask when doing so
Isolation Techniques Tier Il- Transmission Categories
(Fundamentals of Nursing )  Airborhe Precautions-
Prepared By : Roseminda Yong Lamig RN, MAN  Droplets <5 micrometers
Isolation  I.e- chicken pox,

 Special measures are needed to prevent the  measles,

spread of communicable diseases;such as
 pulmonary or laryngeal TB
measles and tuberculosis.Throughout a
health care institution.  Private room, negative flow rooms,
mask or respiratory protection
 In 1996 the CDC published revised
guidelines for isolation.  Droplet Precautions
 Droplets >5 micrometers

CDC's 2 Tiered System  I.e. diptheria

 Tier 1 Standard Precautions  Streptoccal pharyigitis

 Standard precautions are used when carinig  Petussis

for all clients in any setting regardless of  Mumps
medical diagnosis
 Private room or clients w/ like
 Includes hand washing in all situations diseases, mask
and the use of gloves, masks, eye
protection, or gowns as needed.  Contact Precautions
 Direct client or environmental contact
 Can be colonization or infection w/
Standard Precgutions eandave MRSA, RSV, enteric pathogens
 Personal Protective Equipment including such as shigella and clostridium
gloves, mask, yown, and eye protection are difficle
worn when there is risk of coming in contact  Private room or clients w/ like
with the following: diseases, gloves, gown
 Blood
 All body fluids, secretions, and excretins
 Non-intact skin
 Mucous membranes
Psychological lmplications of Isolation Delivering Care in an Isolation Room
 Body image Disturbahce  Medication Administration
 Interventions:  Use precautions to prevent cross-
contamination if all equipment used cannot
 Teach client and family how to prevent
remiain in room
the spread of disease
 Blood Pressure Cuff
 Provide sensory stimuli
 Stethoscope
 Deliberately plan time to see the client
 Watch
 Specimen Collection
Protective Environmment  Removing protective clothing
 Private room is ideal  Transporting clients
 May be able to room together if same
microorganism is infecting
Role of the Iniection Control Nurse
 If possible avoid taking any reuseable
article or equipment  A nurse specially trajned in the control and
prevention of infection (pg. 801)
 Use disposable items when possible
 Responsibilities include:
 Advising hospital personnel in infection
Personal Protective Equipment control matters
 Gowns  Monitoring hospital infections/ isolations
 Use to prevent soiling of clothes duing  Staff education
client contact
 Writing and reviewing policies/
 Masks procedures
 Used to protect nurse from organisms in
client's respiratory tract
 Masks should fit snugly over mouth/nose
 A mask that becomes moistened is
ineffective Change q 1 hour
 Client wears mask when leaving room
for procedure
 Gloves
 Cuffs pulled over gown when worn
together
 Eye Protection
ENVIRONMENTAL SANITATION COMPONENTS of Environmental
Prepared by: LIEZL UY, RN MAN Sanitation
OBJECTIVES:  TOWN PLANNING

1.Define Environmental Sanitation.  SANITARY HOUSING

2. Identify the Importance of Environmental  VENTILATION AND AIR POLLUTION

Sanitation.  WATER SANITATION
3.Explain the Components of Environmental  WATER DISPOSAL
Sanitation.
 FOOD SANITATION
4. Discuss Sanitation at household level
 VECTOR AND RODENT CONTROL
5. Apprecaite Sanitation at Community level
6. Narratenon World Environment Day
7. Understand Laws protecting the Environment. WATER SANITATION
 The provision of Safe Water Sanitation and
Hygiene are crucial for human health and
ENVIRONMENTAL SANITATION well-being.

 The art and science of applying sanitary,  Safe water Drinking Provision System and
biological and physical science principles to Cooler in schools
and KNOWLEDGE to IMPROVE and  Boiling water in household
CONTROL the environment for
PROTECTION OF HEALTH and WELFARE  Awareness and sensitization sessions in
of the public. schools and community
 Maintenace of Toilets
 Clean water drives
IMPORTANCE OF
 Rain water harvesting
ENVIRONMENTAL HEALTH
 PROMOTES HEALTH
 PREVENTS DISEASE TRANSMISSION
 ELIMINATES BREEDING PLACES
 IMPROVES QUALITY OF LIFE
WASTE DISPOSAL C. INCNERATION
 Waste management includes activities and  Incineration is a thermo-decomposition
actions required to manage waste from its process where the components present in
inception to its final disposal. the waste stream are ionized into harmless
elements at a higher temperature in the
 This includes: presence of oxygen.
 COLLECTION  What can I put into an Incinerator?
 TRANSPORT OF WASTE  Burning stuff doesn’t make it entirely
 TREATMENT AND DISPOSAL OF disappear, even once the ash is
WASTE disposed of. Part of the mass of the
original rubbish is converted into carbon
 MONITORING AND REGULATION OF dioxide and released into the
WASTE MANAGEMENT PROCESS. atmosphere.
 But this pollution may beat the
alternative. If the same volume of waste
METHODS OF WASTE were tossed into landfills, eventual
DISPOSAL emissions of methane, a more powerful
greenhouse gas, would be even worse
A.DUMPING for the atmosphere.
 Dumping or Land Filling is an old way of
disposing off wastes. It is an easy method
of disposal of dry refuse. D. COMPOSTING
 In this process, solid wastes are dumped in  Composting is a process by which organic
a low lying area and as a result of bacterial wastes are broken down by microorganisms,
action, refuse decreases considerably in generally bacteria and fungi, into simpler
volume and are converted gradually into forms.
humus  The microorganisms use the carbon in the
waste as an energy source. The degradation
of the nitrogen- containing materials results
B. CONTROLLED TIPPING OR in the breakdown of the original materials
SANITARY LAND –FILL into a much more uniform product which can
be used as a soil amendment.
 Controlled tipping or controlled burial
is similar in principle to sanitary landfill but at  Heat generated during the process kills
a smaller scale that is appropriate in rural many unwanted organisms such as weed
areas. seeds and pathogens. Advantages of
composting include reduction of waste
 In controlled tipping/burial, solid waste is volume, elimination of heat-killed pests, and
disposed of into a dug pit and is regularly the generation of a beneficial and
covered with soil to avoid attracting disease marketable material.
vectors such as flies and rodents
 Adding compost to soil increases organic FOOD SANITATION
matter content. This, in turn, improves many
soil characteristics and allows for the slow FOOD SAFETY PRACTICES:
release of nutrients for crop use in
 Practice good personal hygien
subsequent years.
 Clean utensils and cooking equipment
 Seperate raw and readt to eat foods
E. MANURE PITS
 Wash fruits and vegetables
 Manure pit systems are used primarily on
livestock farms (including dairy operations)  Use appropriate tools for food preparartion
to allow for the easy cleaning of animal  Food handlers should maintaine hygiene
confinement buildings and the efficient and health
underground storage of large amounts of
raw manure.  Keep Dry foods deperate from liquid
preparations

F. BURIAL
 COOK FOOD AT AN APPROPRIATE
 Burial methods are disposal practicesin TEMPERATURE
which plants and dead animals (contami-
nated biomaterials) are placed in earth-filled  KEEP AWAY INSECTS AND PEST
trenches or pits. AWAY FROM THE FOOD AREA

 These contaminated bioma- terials are  USE CLEAN WATER TO PREPARE

disposed of in a properly selected, enclosed FOOD
environment and may be mixed with soil and  CLEAN THE KITCHEN AND MOP THE
solid waste in landfills. FLOOR AFTER EACH FOOD
 In handling contaminated animals and plants, PREPARATION.
the objectives of burial methods are to:•  KEEP KITCHEN UTENSILS,
 Provide the conditions that impede the SPONGES,CLEANING CLOTHES AND
growth and spread of pathogens from the REPALCE REGULARY
contaminated materials and to limit access
to them by vermin
 Convert the contaminated materials into
inert compounds (mainly minerals)• Control
nuisance odors
 Dispose of and degrade the materials so
that they neither pose a health hazard nor
pollute the air, water, leachate or soil Burial
and landfilling can be used only , allowed by
permits and the depths of the soil and water
table.
5 STEPS TO FOOD SAFETY: AIR SANITATION
1. Be clean, Be Healthy AIR SANITATION
 Wash hand when necessary  The concept of sanitizing the air is
essentially rendering microbes such as
 Do not work with food if you are ill
viruses, fungi, and bacteria harmless.
 Never touch ready-to-eat food with bare
 This can be accomplished in various
hands
ways including Ultraviolet Germicidal
2. Keep it cool, keep it Hot light, Ozone oxidation, or chemical
cleansing such as chlorine.
 Wash Keep cold foods at 41•F / 5℃ or
below HEALTH EFFECTS OF AIR POLLUTION
SHORT TERM EFFECTS
 Keep hot foods at 140•F / 60℃ orabove
 Headache
3. Don’t Cross-contaminate
 Ice inflammation
 Don’t store raw foods over cooked or
ready-to-eat foods.  Coughing

 Never prepare ready-to-eat foods on  Painful

the same surface or with the same  Pneumonia
utensils used to prepare raw animal
proteins.  Breathing

4. Wash, Rinse and Sanitize  Bronchitis

 Wash  Skin irritation

 Rinse LONG TERM EFFECTS

 Sanitize  Affects central nervous system

 Properly wash, rinse and sanitize all  Cardiovascular diseases

food contact utensils and equipment  Respiratory diseases
5. Cook It and Chill It  Impacts on liver
 Cook food until it reaches a proper  Impacts on productive system
internal temperature
 Rapidly cool food 41•F / 5℃ or below to
or below
HEALTH EFFECTS OF AIR POLLUTION MAINTENANCE OF GOOD
FINE PARTICLES (PM 2.5) VENTILATION AND AIR
Pollution can cause:  TO REMOVED THE RESUMED AIR
FROM THE BUILDING
 Shortness of breath
 TO SUPPLY OXYGEN FOR HUMAN
 Wheezing
 TO REMOVE EXCESSIVE MOISTURE
 Coughing
 TO COOL THE BODY AND REMOVE
 Chest pain EXCESSIVE HEAT
 Fatigue  TO PREVENT SUFFOCATION IN
THEATERS, ASSEMBLY HALLS AND
PUBLIC MEETINGS.
Fine particles can make these conditions
worse:  TO COOL THE SURROUNDING
OBJECTS AND FRESHEN THE
 Cardiovascular and heart disease ATMOSPHERE.
 Asthma and COPD

PREVENTION OF AIR POLLUTION

GROUND-LEVEL ZONE STEPS TO REDUCE AIR POLLUTION
Pollution can cause:  Walk or bike more
 Difficulty breathing deeply  Carpool or use public transportation
 Shortness of breath  Maintain your vehicle
 Sore throat  Combine errands to reduce driving
 Wheezing, coughing  Drive smart
 Fatigue  Accelerate slowly
  Drive slower
Ozone can make these conditions worse:  Avoid letting your car idle
 Asthma and COPD  Do not smoke
 Emphysema  Avoid using products in aerosol spray cans
 Use a push or electric lawn mower instead
of gas-powered
 Avoid chemicals or cleaners that emit fumes
 Maintain gas appliances and heaters
PREVENTION OF AIR POLLUTION EFFECTS OF GLOBAL WARMING
 INDOOR MENTAL HEALTH
 KEEP AIR PURIFYING INDOOR  Stress
PLANTS
 Anxiety
 OPEN WINDOWS
 Depression
 USE ORGANIC PRODUCTS
 Grief
 USE ESSENTIAL OILS
 Sense of loss
 CLEAN DUST
 Strains on social relationships
 USE AIR PURIFIERS
 Substance abuse
 Post-traumatic stress disorder

GLOBAL WARMING
 Global warming is the long-term COMMUNITY HEALTH
warming of the planet's overall  Increased interpersonal aggression
temperature.
 Increased violence and crime
 The excess heat in the atmosphere has
caused the average global temperature  Increased social instability
to rise overtime, otherwise known as  Decreased community cohesion
global warming. Global warming has
presented another issue called climate
change.

EFFECTS OF GLOBAL WARMING

MEDICAL AND PHYSICAL HEALTH
 Changes in fitness and activity level
 Heat-related illness
 Allergies
 Increased exposure to waterborne and
vector-borne illness
PREVENTION OF GLOBAL WARMING ENVIRONMENTAL HEALTH
WAYS TO STOP GLOBAL WARMING
PROGRAM

 PLANT TREES https://doh.gov.ph/environmental-health-

programs
 REDUCE WASTE
ENVIRONMENTAL HEALTH
 CONSERVE WATER PROGRAM
 REDUCE FOSSIL FUEL USE
 Vision
 WALKING
 Environmental Health (EH) related
 RECYCLE diseases are prevented and no longer a
public health problem in the
 REDUSE
Philippines (based on on-going Strategic
 REUSE Plan 2019-2022)

SANITATION AT HOUSEHOLD LEVEL

 Personal hygiene, including frequent  Mission
handwashing
 To guarantee sustainable Environmental
 Proper cleaning and sanitizing of all food Sanitation (ES) services in every
contact surfaces and utensils; community
 Proper cleaning and sanitizing of food
equipments
 Objectives
 Good basic housekeeping and
maintenance.  Expand and strengthen delivery of
quality ES services
 Institute supportive organizational, policy
SANITATION AT THE COMMUNITY and management systems
LEVEL  Increase financing and investment in ES
 Basic sanitation is described as having  Enforce regulation policy and standards
access to facilities for the safe
disposal of human waste (feces and  Establish performance accountability
urine), as well as having the ability to mechanism at all levels
maintain hygienic conditions, through
services such as garbage collection,
industrial/hazardous waste management,
and wastewater treatment and disposal.
 Program Components ENVIRONMENTAL HEALTH PROGRAM

 Drinking-water supply,
 Policies and Laws
 Sanitation (e.g excreta, sewage and
septage management),  PD No. 856 – Code on Sanitation of the
Philippines
 Zero Open Defecation Program (ZODP),
 EO No. 489 s. 1991 – The Inter-Agency
 Food Sanitation,
Committee on Environmental Health
 Air Pollution (indoor and ambient), (IACEH)
 Chemical Safety,  National Objectives for Health (NOH)
2011-2016
 WASH in Emergency situations,
 DOH A.O. 2010-0021 - Sustainable
 Climate Change for Health and Health Sanitation as a National Policy and a
Impact Assessment (HIA) National Priority Program of the DOH
 DOH A.O. 2014-0027 – National Policy
 Partner Institutions on Water Safety Plan (WSP) for All
Drinking-Water Service Providers
 DENR,
 DOH A.O. 2017-0006 – Guidelines for
 DILG, the Review and Approval of the Water
 DPWH, Safety Plans of Drinking-Water Service
Providers
 DA,
 DOH A.O. 2017-0010 – Philippine
 PIA National Standards for Drinking Water
(PNSDW) of 2017
 World Health Organization (WHO),
 UNICEF,
WORLD ENVIRONMENT DAY 2021
 USAID,
 World Environment Day is celebrated on
 AusAID
June 5th globally
 The theme for 2021 is “ECOSYSTEM
RESTORATION”
 Aim is to promote activities that protect the
environment