community course outline 2

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Course Outline for NUR 121 Community NursingSemester 1, 2011Faculty of Health Sciences

SEMESTER 1 2011

COURSE: Community Nursing

CODE: 121

COURSE DESCRIPTION

This course is consisted of thirteen units, which focus on family and community asclients and involves health promotion, health maintenance and health education.

CREDITS: 3

LEVEL: ASGN

PRE REQUISITES: Nursing ConceptsHealth AssessmentHistory of Nursing

AIM

This course introduces the students to the concept of Community Health Nursingthat is a combination of Nursing Practice and Community Health Practice applied toPromoting and preserving the health of populations.

UNITS

UNIT I -PAEDIATRIC IMMUNIZATIONSUNIT 2 - MANAGEMENT OF BREASTFEEDING

UNIT 3 - PRENATAL CARE

UNIT 4 - CARDIOPULMONARY RESUSCITATION (CPR)

UNIT 5 POST NATAL (POST PARTUM CARE) (MOTHER & INFANT)

UNIT 6 FAMILY PLANNING

UNIT 7 ENVIRONMENTAL HEALTH

UNIT 7.1 - ENVIRONMENTAL HEALTH CONSIDERATIONS

UNIT 7.2 WATER & WASTE WATER MANAGEMENT

UNIT 7.3 SOLID WASTE MANAGEMENT


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UNIT 7.4 PEST/VECTOR CONTROL

UNIT 7.5 FOOD HYGIENE

UNIT 7.6 SCHOOL HEALTH & INSTUTIONAL HYGIENE

UNIT 7.7 COMMUNITY ENVIRONMENTAL HEALTH EDUCATION

UNIT 7.8 OCCUPATIONAL HEALTH & SAFETY

UNIT 8 PRIMARY HEALTH CARE

UNIT 9 FIRST AID

UNIT 10 COMMUNITY HEALTH NURSING

UNIT 11 EPIDEMIOLOGY

UNIT 12 COMMUNICABLE DISEASES

UNIT 12 B NON-COMMUNICABLE DISEASES

UNIT 13 DISASTER NURSING

UNIT I - PAEDIATRIC IMMUNIZATIONS

OVERALL OBJECTIVES

At the end of the unit the students will be able to apply the knowledge, skills andattitudes gained in the paediatrics immunizations.

Specific Objectives

1 Explain the Recommended childhood Immunizations schedule in Dominica

2 Outline the standards for Paediatric Immunizations Practice

3 Explain the contraindications and precautions to vaccine administration

4 Determine the parental education on risks of vaccination

5 Discuss the importance of maintaining accurate records/documentation on theclinic card/child health passport.

CONTENT


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1. Schedule1.1 BCG1.2 Pentavalent

1.2.1 DPT

1.2.2 HEP B1.2.3 HIB

1.3 Polio1.4 MMR1.5 DT (3 5yrs)1.6 DT (9- 12yrs)1.7 Rubella (Post Natal)

2. Standards for practice2.1 Policy2.2 Care of vaccines and cold chain2.3 Safe vaccine administration

3. Contraindications3.13.2 Precautions

3.2.1 Pre-term infants3.2.2 Bleeding Disorders3.2.3 Hodgkins Disease3.2.4 Congenital disorders of immune function3.2.5 Children/Adults chemotherapy or immunosuppressive therapy3.2.6 HIV infection3.2.7 Asplenic children3.2.8 Vaccination of children with Sickle Cell Anemia

3.2.9 Vaccination during pregnancy3.2.10 Oncology and transplant patients3.2.11 Reaction to a previous dose3.2.12 Allergic to vaccine components3.2.13 Recent receipt of another vaccine, blood or immunoglobulin

4. Parental education4.1 Protection from diseases4.2 Care after immunization

5. Records importance5.1 Immunization card5.2 Child Health Passport

Learning Activities

1 During clinical rotation

Obtain a copy of the clinical card/child health passport


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Participate under supervision in a paediatric immunization clinic or

work with nurses who routinely immunize children. If possible, help toscreen children for possible contraindications. Document onappropriate record/forms. Also provide the required parent education.

(prepare by reviewing relevant material, to be ready for opportunitiesfor health promotion and education)

Record impressions in log and share with group/class

REQUIRED TEXTS

1. Mc Ewen, M. (2002). Community Based Nursing An Introduction. (2nd

Edition). Philadelphia : W.B. Saunders

2. Commonwealth of Dominica Immunization Manual, 2006.

RECOMMENDED TEXTS

1. Hart, R.H. Bailey, M.A. and Tarimo, E. (1990). Integrating Maternal and childhealth services with primary health care. Pp 61-65 W H O. Geneva 1990

Unit 2

MANAGEMENT OF BREASTFEEDING

OVERALL OBJECTIVES

At the end of the unit the students will be able to apply the knowledge, skills andattitudes gained in the management of breastfeeding.

Specific Objective

1 Explain ten (10) steps to successful breastfeeding2 Discuss the advantages/benefits of breastfeeding3 Describe the techniques/guidelines for breastfeeding4 Identify common problems associated with breastfeeding and ways to alleviate

these discomforts.5 Discuss the contraindications to breast feeding.


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CONTENT

1. Steps

1.1 Written policy1.2 Staff training1.3 Benefits & management Pregnant women1.4 Initiation1.5 Demonstration1.6 Medically indicated1.7 Rooming in1.8 On demand1.9 No artificial teats or dummies1.10 Support Groups

2. Advantages/benefits

2.1 Baby2.1.1 Protection - infection2.1.2 Protection - allergies2.1.3 Cot death2.1.4 Childhood diabetes, cancer, ear infection2.1.5 Response to vaccination2.1.6 Dental problems2.1.7 Psychomotor, emotional, social development

2.2 Mother2.2.1 Uterus contraction2.2.2 Energy efficient

2.2.3 Delay menses2.2.4 Low risk breast & ovarian cancer2.2.5 Postpartum depression2.2.6 Work load infant feeding2.2.7 Physical recuperation2.2.8 Emotional bonding2.2.9 Convenience2.2.10 Spoilage, lack of supply, shortages

2.3 Society2.3.1 Cohesiveness2.3.2 Cost

2.3.3 Purchase of substitutes2.3.4 Family time preparation2.3.5 Cost medicals2.3.6 Spacing2.3.7 Production

3. Techniques/guidelines3.1 Positions

3.1.1 Cradle hold


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3.1.2 Cross-cradle hold3.1.3 Football-hold3.1.4 Side-lying

4. Problems

4.1 Engorgement4.2 Deep breast pain4.3 Mastitis4.4 Non-infective mastitis4.5 Infective mastitis4.6 Breast abscess4.7 Blocked ducts4.8 White spots4.9 White granules4.10 Epithelial overgrowth4.11 Feeding difficulties baby

4.11.1 Cleft lip4.11.2 Cleft palate4.11.3 Tongue tie4.11.4 Blocked nose4.11.5 Down syndrome4.11.6 Prematurity4.11.7 Illness or surgery

5. Contraindications5.1 Medications5.2 Cancer5.3 Breast surgery

5.4 Breast injury5.5 One breast only5.6 HIV infection

Learning Activities

During Clinical Rotation

Visit National Breastfeeding Committee, Maternity Ward and

Community clinics to obtain information on breastfeeding policy

Visit breastfeeding mothers in comprehensive clinics, at the

maternity ward and in the homes to encourage breastfeeding

Conduct health teaching session with individual or groups of

mothers on

(i) advantages of breastfeeding


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(ii) techniques of breastfeeding(iii) ways to alleviate common breastfeeding problems(iv) guidelines for breastfeeding/importance of breastfeeding

participate in breastfeeding seminar/workshops if available

Observe the nurse in a comprehensive clinic who routinely counsels

clients on breastfeeding


REQUIRED TEXTS

1 Mc Ewen, M. (2002). Community Based Nursing An Introduction. (2nd


2. Breast-feeding Policy Commonwealth of Dominica, 2006.

RECOMMENDED TEXTS

1.A joint WHO/UNICEF Statement Protecting, Promoting and SupportingBreastfeeding the special role of Maternity Services World Health OrganizationGeneva 1989

2. Carra, S. King, Masters, E. & Sonawane, M. (2003). Peace Corps Volunteersand The Health Promotion Resource Centre Ministry of Health and SocialSecurity, Commonwealth of Dominica. A Health Education Manual 2003.

3. Fraser, D. M. & Cooper, M. A. (2009). Myles Textbook for Midwives. (15theds.). UK: Church Hill Livingstone Elsevier. Chp 41

4. Mattson, S. & Smith, J. E. (2004). Core Curriculum for Maternal NewbornNursing. (3rd eds.). USA: Elsevier. Chp 14

UNIT 3

PRENATAL CARE

OVERALL OBJECTIVES


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At the end of the unit the students will be able to apply the knowledge, skills andattitudes gained in prenatal care.

Specific Objective

1) Define Prenatal (Ante natal) Care2) Explain the importance of prenatal care3) Outline activities performed at a clinic on a first visit for prenatal care4) Identify what happens at subsequent prenatal care visits

CONTENT1. Terminology

1.1 prenatal care

2. Importance2.1 Developing partnership2.2 Holistic approach to care2.3 Promoting awareness of public health issues2.4 Exchanging information2.5 Advocate2.6 Complications recognition2.7 Facilitation meeting demands2.8 Informed choice feeding2.9 Parenthood education

3. Activities first visit

3.1Booking3.2 Physical examination

4. Subsequent visitsSubsequent admission and assessment

1.1 Second Visit1.1.1 Reviews discuss and record results1.1.2 Reassess planned pattern of care1.1.3 Fetal heart rate1.1.4 Diphtheria and Tetanus Toxoid (DT)1.1.5 Prophylactic iron and vitamin supplement1.1.6 Referral DMO

1.2Third Visit1.2.1 Physical examination1.2.2 Fetal heart rate1.2.3 Laboratory results1.2.4 Ultra Sound Screening1.2.5 DMO1.2.6 Patient education1.2.7 Iron and Vitamin intake


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1.2.8 Diet and Nutrition1.2.9 Breast care/feeding/expression, storage1.2.10 Arrangements for delivery

1.3Fourth Visit

1.3.1 SFH1.3.2 Fetal heart rate1.3.3 Verbal information, antenatal classes, group sessions and written

information1.3.4 Diabetes screening (i.e. OSullivan Test)

1.4Fifth Visit1.4.1 For all pregnant women1.4.2 Offer a second screening for anemia1.4.3 Investigate hemoglobin level of less than 10.5g/100 ml1.4.4 Perform breast examination (teach self breast examination)1.4.5 Education

1.4.5.1 Physiology of labour, verbal information, antenatal classes,written information

1.4.6 Sixth Visit1.4.6.1 Nulliparous: Schedule appointment1.4.6.2 Verbal information, Antenatal classes, Written information1.4.6.3 Results of screening tests1.4.6.4 Reassess planned pattern of care1.4.6.5 Assess malpresentation1.4.6.6 Refer: DMO, Lab

1.4.7 Seventh Visit1.4.7.1 Rhogam

1.4.7.2 Results of screening tests1.4.7.3 Fetal well being, movement1.4.7.4 Education:

1.4.7.4.1 Preparation for labour and delivery1.4.8 Eighth Visit

1.4.8.1 All pregnant women1.4.8.2 Baby position1.4.8.3 USS report1.4.8.4 Education

1.4.8.4.1 Breastfeeding technique and management,1.4.8.4.2 Care of the new born, self care, depression and

postnatal contraception1.4.9 Ninth Visit

1.4.9.1 All pregnant women1.4.9.2 Test urine1.4.9.3 Monitor BP1.4.9.4 SFH1.4.9.5 Education

1.4.9.5.1 Management of prolonged pregnancy


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1.4.9.5.2 Antenatal classes1.4.10 Tenth Visit

1.4.10.1 Nulli-parous women1.4.10.2 Fetal movement chart (FMC)

1.4.10.3 BP1.4.10.4 Urine Test1.4.10.5 SFH1.4.10.6 Education

1.4.10.6.1Management of prolonged pregnancy1.4.10.6.2Refer: admission

1.4.11 Eleventh Visit1.4.11.1.1Women 41 weeks and >1.4.11.1.2BP1.4.11.1.3Test urine1.4.11.1.4SFH

1.4.11.1.5Refer: if awaiting labour1.4.11.1.6 All primigravida hospital delivered

Learning Activities

During clinical rotation: (under supervision)

Observe/participate in assessment and other activities in the prenatal period

(prenatal care)

Document interventions on appropriate forms, records

Provide the required parent education. (Prepare by reviewing relevant

material, to be ready for opportunities for health promotion and education) e.g.nutrition, breastfeeding, milestones in pregnancy.

Identify whether there is a problem of teenage pregnancies. If so what efforts

have been made to decrease teenage pregnancy and minimize the long-termassociated problems?

Identify the components of the antenatal record



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REQUIRED TEXTS

1.Mc Ewen, M. (2002). Community Based Nursing An Introduction. (2nd Edition).Philadelphia : W.B. Saunders

RECOMMENDED TEXTS

1.Carra, S. King, Masters, E. & Sonawane, M. (2003). Peace Corps Volunteers andThe Health Promotion Resource Centre Ministry of Health and Social Security,Commonwealth of Dominica. A Health Education Manual 2003.

2. Family Care International http://www.familycareint/.org

3. Fraser, D. M. & Cooper, M. A. (2009). Myles Textbook for Midwives. (15theds.). UK: Church Hill Livingstone Elsevier. Chp 17, 41

2 Kostenbauder, M. (1989) Maternal Newborn Nursing

3 Maternal & Child Health Commonwealth of Dominica, 2006.

4 World Health Organisation: http://www.who.ch

Unit 4

CARDIOPULMONARY RESUSCITATION (CPR)

OVERALL OBJECTIVES

At the end of the unit the students will be able to construct the knowledge, skills andattitudes gained in the cardiopulmonary resuscitation.

Specific Objectives

1 Define CPR2 Explain reasons for performing CPR3 Describe the general procedure for CPR4 Explain information and directions for practice sessions in CPR5 Discuss Rescue Breathing for (i) adult

(ii) child
http://www.familycareint/.orghttp://www.who.ch/http://www.familycareint/.orghttp://www.who.ch/


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(iii) infant

CONTENT1.Terminology

1.1 CPR2. Reasons

2.1 Save lives2.2 Prevent Cardiac Arrest2.3 Circulation2.4 Survival Chances

3. Procudure3.1 Conscious victim3.2 Unconscious victim

4. Information4.1 Directions

5. Rescue breathing5.1 Adult5.2 Child5.3 Infant

Learning Activities

During Clinical Rotations

Attend scheduled practice sessions with Clinical instructor/Fire Officer on

(i) Rescue Breathing for an adult(ii) Rescue Breathing for a child(iii) Rescue Breathing for an infant

Obtain skill assessments and certification in CPR with Clinical instructor/Fire

Officer as per schedule

Record impressions in log and share with group/class.

Required texts

1 American Red Cross CPR:Basic Life Support for the Professional Rescuer 1998

2 American Red Cross Community CPR 1988

3 Standard First aid and Personal Safety2nd Edition American Red Cross


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UNIT 5POST NATAL (POST PARTUM) CARE (MOTHER & INFANT)

OVERALL OBJECTIVES

At the end of the unit the students will be able to apply the knowledge, skills andattitudes gained in the post natal period.

Specific Objectives

1 Define Post Natal Care

2 Explain assessment and care of the mother and infant in the(i) immediate post partum period(ii) ongoing/subsequent post partum period

3 Demonstrate procedures for the following post natal skillsI. speculum examination

II. episiotomy careIII. sitz bath

CONTENT

1.Terminology1.1 Post natal care

2. Assessment and care immediate2.1 Mother

Bonding2.1.2 Fluid volume2.1.3 Position2.1.4 Blood loss2.1.5 Fundus palpation2.1.6 Bladder2.1.7 Lochia2.1.8 Vital signs2.1.9 Perineum2.1.10 Discomfort2.1.11 Rest2.1.12 Ergot/oxytocin


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2.2 Baby2.2.1 Observation during & after resuscitation2.2.2 Babys condition

2.2.3 Prevention of heat loss2.2.4 Clearing the airway2.2.5 Stimulation2.2.6 Cutting the cord2.2.7 Identification of baby2.2.8 Bonding2.2.9 Congenital abnormalities2.2.10 Vital signs2.2.11 Vitamin k12.2.12 Chloramphenicol eye drop

2.2.13 Weight

2.2.14 Breastfeed

3. Assessment and care subsequent3.1 Mother

3.1.1 Bonding3.1.2 Fluid volume3.1.3 Position3.1.4 Blood loss3.1.5 uterus contractility3.1.6 Bladder3.1.7 Lochia amount/odour

3.1.8 Vital signs3.1.9 Perineum3.1.10 Discomfort/pain3.1.11 Rest3.1.12 Breasts3.1.13 Breastfeeding experience3.1.14 Support system3.1.15 Self care3.1.16 Handwashing3.1.16 Intake & output3.1.17 Neurological status

3.1.18 Urine test3.1.19 Observe for infection3.1.10 Observe emotional response3.1.11 Participation in care

3.2 Baby

3.2.1 Physical examination3.2.1.1 Resuscitation


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3.2.1.2 Bonding3.2.1.3 Physical examination 24 hrs3.2.1.4 Vital signs3.2.1.5 Breastfeed

3.2.1.6 Intake and output3.2.1.7 Weight3.2.1.8 Skin colour3.2.1.9 Adaptation3.2.1.10 Observe for infection

3. Procedures

4.1 Speculum examination4.2 Episitomy care4.3 Sitz bath

Learning Activities

1. Practise the following skills obtain check lists)(i) speculum examination(ii) episiotomy care(iii) sitz bath

During clinical rotations

Observe post natal assessments for mothers and infants

Participate in caring for post natal mothers and their infants

Observe/assist with the following procedures for post natal mothers(i) speculum examination(ii) episiotomy care(iii) sitz bath

Obtain assessments in(i) speculum examination(ii) sitz bathepisiotomy care

Conduct health teaching sessions on aspects of Post-natal-care

Record impressions in your logs and share with group/class

REQUIRED TEXTS


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RECOMMENDED TEXTS

1. Doenges, M. E. & Moorhouse, M. F. (1999). Matrenal Newborn Plans ofCare. Guidelines for Individualizing Care. (3 rd eds.). USA: F. A. DavisCompany. Chp 6

2. Fraser, D. M. & Cooper, M. A. (2009). Myles Textbook for Midwives. (15theds.). UK: Church Hill Livingstone Elsevier. Chp 39

3. Jenson & Bobak Maternity and Gynaecologic Care The Nurse and theFamily edition three C.V. Mosby Company St. Louis 1985

4. Kostenbauder, Mary. Dirr RN, CNM, M Ed, MSN. Maternal NewbornNursing Springhouse Rotation Guides 1989

Unit 6

FAMILY PLANNING

OVERALL OBJECTIVES

At the end of the unit the students will be able to examine the knowledge and skillsgained in family planning.

Specific Objectives

1 Discuss issues related to Family Planning including

(i) Contraception options(ii) Treatment of infertility(iii) Pre conception counselling(iv) Breast Self Examination (BSE)(v) Pap Smear (vi) General Physical Examination

CONTENT


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1. Issues1.1 Hormonal Contraceptive options

1.1.1 The combined hormonal contraceptive pill

1.1.2 The combined hormone injectable (Lunelle)1.1.3 The combined hormone patch1.1.4 The combined hormone vaginal ring1.1.5 The progesterone only pills1.1.6 Long acting reversible contraception

1.2 Barrier methods of contraception1.2.1 The male condom1.2.2 Female condom1.2.3 Diaphragam

1.3 Emergency Contraception1.4 Natural family planning

1.4.1 Fertility awareness1.4.2 Fertility monitoring device1.4.3 Lactational amenorrhoea method

1.5 Male and female sterilization1.6 Treatment of infertility

1.6.1 Sexual Problems (Impotence/premature ejaculation)1.6.1.1 Behavioural terapy1.6.1.2 Medicine

1.6.2 Too few sperm1.6.2.1 surgery1.6.2.2 Surgically remove sperm

1.6.2.3 Antibiotics1.6.3 Sperm movement

1.6.3.1 Surgery

1.6.4 Medicine (women)

1.6.4.1 Clomiphene citrate (Clomid

1.6.4.2 Human menopausal gonadotropin or hMG (Repronex,Pergonal)

1.6.4.3 Follicle-stimulating hormone or FSH (Gonal-F, Follistim

1.6.4.4 Gonadotropin-releasing hormone (Gn-RH) analog:

1.6.4.5 Metformin (Glucophage):

1.6.4.6 Bromocriptine (Parlodel):


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1.7 Pre-conception counselling1.7.1 Things you should take

1. Folic acid tablets2. Vitamin D supplements

3. Blood test4. Healthy diet5. Strict food hygiene6. Wear gloves when you are gardening.

Things you should avoid

1. Too much vitamin A2. Listeriosis

Things you should stop or cut down

1. Caffeine in tea, coffee, cola, etc,2. Alcohol3. Smoking

4. Street drugs

Other things to consider:

1. Immunisation2. Medication (herbal and 'over the counter)3. Work environment4. Medical conditions5. Screening tests

1.8 Breast Self Examination1.8.1 Definition1.8.2 Purpose1.8.3 Steps

1.8.3.1 Steps 1-3 Inspection1.8.3.2 Step 4 palpation1.8.3.3 Step 5 palpation nipple1.8.3.4 Step 6 palpation - breast

1.5 Papsmear1.5.1 Definition1.5.2 Preparation1.5.3 Procedure1.5.4 Results1.5.5 Risks

1.6 Physical examination1.6.1 Definition1.6.2 Procedure

1.6.2.1 Inspection1.6.2.2 Palpation1.6.2.3 Auscultation1.6.2.4 Percussion


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Learning Activities

Observe the following procedures

- Breast Self Examination (BSE)- Pap Smear

During clinical rotation

Observe/participate in screening activities for women

- observe for opportunities to teach Breast Self Examination(BSE) to women/men

- assist in obtaining Pap Smears- observe for signs of domestic/dating violence

Observe contraception (Family Planning) Counselling

- what issues are discussed between counsellor and client?- what factors appear to determine the womans choice?- are all relevant factors (e.g.) effectiveness of method, possible complications

and side effects, cost, proper use) presented and discussed?- how is treatment of infertility managed?

Record impressions in your logs and share with group/class

REQUIRED TEXTS



RECOMMENDED TEXTS

1. Birth Control.com http://www.birth.control.com

2. Carra, S. King, Masters, E. & Sonawane, M. (2003). Peace CorpsVolunteers and The Health Promotion Resource Centre Ministry of Healthand Social Security, Commonwealth of Dominica. A Health EducationManual 2003.

3. Dominica Planned Parenthood Association

4. Fraser, D. M. & Cooper, M. A. (2009). Myles Textbook for Midwives. (15th

eds.). UK: Church Hill Livingstone Elsevier. Chp 37
http://www.birth.control.com/http://www.birth.control.com/


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5 MedicineNet.com (2011). Infertility.http://www.medicinenet.com/infertility/page5.htm

6.Planned Parenthood Association http://www.plannedparenthood.org/bc/

Unit 7

ENVIRONMENTAL HEALTH

OVERALL OBJECTIVES

At the end of the unit the students will be able to apply the knowledge, skills andattitudes gained in environmental health.

Specific Objectives

1 Discuss Environmental Health Considerations (Introduction)

2 Describe Environmental Health Management specific to including Legalframework.

(i) Water and waste water (ii) Solid waste(iii) Pest Vector Control(iv) Food Hygiene(v) School Health and Institutional Hygiene(vi) Community Environmental Health Education(viii) Occupational Health and Safety

CONTENT1. Considerations1.1 Determinants

1.1.1 Workplace1.1.2 Housing1.1.3 Sanitation1.1.4 Air quality1.1.5 Others
http://www.plannedparenthood.org/bc/http://www.plannedparenthood.org/bc/


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1.2 Risks1.2.1 Chemical1.2.2 Physical1.2.3 Biological

2. Management legal framework2.1 Water and waste water2.2 Solid Waste2.3 Pest Vector Control2.4 Food Hygiene2.5 School Health1.5 Institutional Hygiene

2.6Community Education2.7 Occupational Health & Safety

Unit 7.1

ENVIRONMENTAL HEALTH CONSIDERATIONS

1 Define

Environmental sanitation

Public Health/Veterinary Public Health

Health Problem

2 Discus briefly, the importance of sanitation in relation to community Health

3 Describe environmental factors affecting community health e.g. physical,social, biological

4 Explain the components of the disease cycle

5 Explain how transmission of infection can be prevented/controlled..

CONTENT

1. Terminologies1.1 Environmental Sanitation1.2 Public Health/Veterinary Health

1.3 Health Problem2. Sanitation Importance


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2.1 Disease prevention2.2 Rules and regulations2.3 Violations2.4 Health & Safety

3. Affecting factors3.1 Physical3.2 Social3.3 Biological

4. Components disease cycle4.1 Pathogen4.2 Carrier4.3 Host

5. Transmission Prevention/control5.1 Airborne5.2 Direct Contact

5.3 Vehicle5.4 Vector

Unit 7.2

WATER AND WASTE WATER MANAGEMENT

Specific Objectives

1 Explain graphically the hydraulic cycle

2 List the processes involved in the treatment of surface water

3 List the different methods of disinfecting water

4 Identify major pollutants of water

5 List ten (10) water borne/related diseases and outline their control measures

6 Define liquid waste

7 List the different types of liquid waste

8 Outline the different methods employed in disposing liquid waste

9 List the major diseases associated with liquid waste


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10 Explain the effects of liquid waste on the community

11 Identify channels of transmission of disease organisms from liquid waste to

man

CONTENT

1. Hydraulic Cycle1.1 Introduction1.2 Water budget1.3 Evaporation1.4 Condensation1.5 Precipitation

1.6 Ground water1.7 Transpiration1.8 Runoff

2. Processes treatment of surface water2.1Purification2.2 Sedimentation2.3 Filtration2.3 Disinfectant

3. Methods3.1 Disinfecting water

3.1.1 Physical

3.1.2 Chemical3.1.3 Chlorination

4. Pollutants of water4.1 Biological Impurities

4.1.1 Bacteria4.1.2 Virus4.1.2 Parasites

4.2 Inorganic Impurities4.2.1 Dirt & Sediment or Turbidity4.2.2 Total Dissolved Solids4.2.3 Toxic Metals or Heavy Metals

4.2.4 Asbestos4.2.5 Radioactivity

4.3 ORGANIC IMPURITIES:4.3.1 Tastes and Odors4.3.2 Pesticides and Herbicides4.3.3 Toxic Organic Chemicals4.3.4 Chlorine

5. Water borne diseases & Control measures


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5.1 Protozoal infections5.2 Parasitic Infections5.3 Bacterial infections5.4 Viral infections

6. Liquid waste6.1Definition

6.1.1Waste material liquid form7. Types

6.1 Industrial6.2 Biomedical

8. Methods of disposal8.1 Recycling8.2 Incineration8.3 Composting8.4 Dewatering & sedimentation

8.5 Solidification9. Related diseases

9.1Vector borne diseases9.1.1 Malaria

9.2 Fecal oral diseases9.2.1 Typhoid9,2.2 Cholera

9.3 Diarrhoea9.4 Scabies9.5 Leptospirosis9.6 Hepatitis

9.7 Malnutrition9.8 Others

10. Effects on community10.1 Effects on health10.2 Misdiagnosis and underdiagnosis10.3 Diagnostic dilemma10.4 Benign symptoms or self-limited illness10.5 Significant morbidity

11. Channels of transmission11.1 Contaminated drinking water systems11.2 Fecal oral route

RESOURCESHydraulic Cycle Online http://ww2010.atmos.uiuc.edu/(Gh)/guides/mtr/hyd/home.rxml

Excel Water Technologies Inc. (2007).http://www.excelwater.com/eng/b2c/about_3.php


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The American College of Preventive Medicine (ACPM) 2011). RecognizingWaterborne Disease And The Health Effects of Water Pollutionhttp://www.waterhealthconnection.org/

Unit 7.3

SOLID WASTE MANAGEMENT

Specific Objectives

1 Define- Solid waste- Refuse- Swill- Garbage- Ashes- Rubbish

2 Identify institutions responsible for the management of solid waste

3 Identify the functions for the institutions responsible for solid wastemanagement

4 State the rationale for solid waste management

5 Identify the major health problems associated with solid waste

6 Outline the factors to be considered when selecting a site for solid wastedisposal

7 Describe the major methods of managing solid waste in the Caribbean

CONTENT

1.Terminologies1.1 Solid waste1.2 Refuse1.3 Swill1.4 Garbage1.5 Ashes1.6 Rubbish

2. Responsible intuitions


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2.1 Solid waste Management Department2,2 Village Council/Town council2.3 Environmental Health Department

3. Intuitions functions

3.1 Collection3.2 Transfer3.3 Transport3.5 Recycling3.6 Treatment3.7 Final disposal

4. Rationale4.1 Manner - Environmentally and socially satisfactory4.2 Economical means

5. Major Health Problems5.1Chronic diseases/Infections

5.1.1 Chronic respiratory diseases5.1.2 Hepatitis B, C

5.2 Skin and blood infections5.3 Eye and respiratory infections5.4 Intestinal infections5.5 Injuries5.6 Water contamination5.7 chemical and radioactive hazards5.8 Air pollution

6. Site considered factors6.1 Starting out: principles and preconditions

6.2 Identification and selection of a site scheme of work6.2.1 Phase one: Data collection and exclusion of unsuitable areas ("negative

mapping")6.2.2 Phase two: Identification of possibly suitable areas ("positive mapping")6.2.3 Phase three: On-site-investigation

6.2.3.1 Environmental impact assessment6.2.3.2 Overview of on-site ground exploration

6.2.4 Phase four: Final proposal and final decision7. Major methods of management in Caribbean

7.1 Collection & disposal7.2 Recycling

7.3 Composting7.4 Landfills7.5 Incineration

RESOURCES

Health impacts of solid wastehttp://edugreen.teri.res.in/explore/solwaste/health.htm#impact


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Oeltzschner, H. (2011). Situation landfill. http://www.waste management-world.com/index/display/article-display/370424/articles/waste-management-world/volume-10/issue-5/features/situation-landfill.html

Unit 7.4

PEST/VECTOR CONTROL

Specific Objectives

1 Explain Pest Vector Control

2 Explain the rational for Pest Vector Control

3 Describe how pest control can be achieved

4 Explain different methods by which pests transmit diseases to man

5 Outline control measures for at least five pests Vectors of public healthsignificance

CONTENT1.Terminology

1.1Pest1.2 vector

2. Rationale2.1 Community protection2.2 Reduce or interrupt transmission of disease

3. Achievement Methods3.1 Chemical control3.2 Biological control

4. Methods - Transmission of diseases4.1 Vectors

4.1.1 Vehicles4.1.2 Direct contact

4.2 Pests

4.2.1 Direct contact4.2.1 Vehicle

5. Control Measures five pests5.1 Pests

5.1.1 Insects5.1.2 Mites5.1.3 Gastropods5.1.4 Mammals
http://www.waste/http://www.waste/


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5.1.5 Birds5.2 Vectors

5.2.1 Fleas5.2.2 Mosquitoes

5.2.3 Ticks5.3 Identification of causative agent5.4 Environmental hygiene5.5 Personal protection

Unit 7.5

FOOD HYGIENE

Specific Objectives

1 State the rationale for food hygiene

2 Explain how food becomes contaminated

3 Explain the causes of food poisoning

4 Differentiate between food intoxication and food infections

5 Outline the role of the community in food hygiene programmes

6 Explain the significance of food hygiene in community health

7 State the goals of food hygiene

8 List the methods of food preservation

9 Identify the factors necessary for bacterial growth in food

10 Identify the different types of spoilages in caused foods

11 Explain the causes of each type of canned food spoilage identified

12 Outline food safety principles

CONTENT

1.Rationale1.1 Prevention food borne illness

2. Contamination process2.1Direct contact2.2 Airborne

3. Causes food poisioning3.1Infectious agents


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3.1.1 Viruses

3.1.2 Bacteria

3.1.3 Parasites.

3.2Toxic agents3.2.1 Poisonous mushrooms3.2.2 Improperly prepared exotic foods3.2.3 Pesticides on fruits and vegetables

4. Differentiation4.1 Food intoxication

4.1.1Illness caused by toxins4.1.1.1 Staphylococcus

4.2 Food infections4.2.1 Illness caused by microorganisms

4.2.1.1 Salmonella4.2.1.2 Shigella4.2.1.3 Clostridium species4.2.1.4 Streptococcus4.2.1.5 Bacillus4.2.1.6 Typhoid fever bacteria

5. Role of Community5.1 Programmes

5.1.1 Safety5.1.2 Storage5.1.3 Hygiene5.1.4 Preparation5.1.5 Delivery

6. Significance6.1 Required Standard

6.1.1 Control hazards6.1.1.1 Production6.1.1.2 Manufacture6.1.1.3 Handling of food

7. Goals7.1 Prevent and reduce food borne illnesses

8. Methods Food preservation8.1 Drying8.2 Smoking8.3 Refrigeration8.4 Freezing8.5 Adding salt or sugar8.6 High heat processing8.7 Canning


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8.8 Chemical preservatives8.9 Ionizing radiation

9. Factors bacteria growth9.1 Water

9.2 Food/nutrients9.3 Oxygen9.4 Temperature9.5 pH

10. Spoilages Types10.1 Physical spoilage10.2 Chemical spoilage10.3 Microbial spoilage

11. Causes11.1 During harvesting, processing or distribution1.1.2 Chemical changes/deterioration of structure

1.1.3 Micro organisms growing - spoilage12. Food safety principles

12.1 Contamination Prevention - food with pathogens12.2 Separation raw and cooked foods12.3 Appropriate length cooking12.4 Storage proper temperature12.5 Safe water and raw materials

RESOURCES

Healthy Eating Club (2001). Food preservation methods.http://healthyeatingclub.com/info/articles/food-proc/food-pres.htm

Unit 7.6

SCHOOL HEALTH AND INSTITUTIONAL HYGIENE

Specific Objectives

A. SCHOOL HEALTH

1. Outline four (4) reasons why school Health is important2. Explain the role of students in improving sanitation at school3. State the number of students per toilets/water fountains4. Outline activities of the school Health Nurse

CONTENT


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1.Reasons of importance1.1 Optimum development

1.1.1 Physical and emotional1.2 Betterment of relationships - health

1.3 Health facts and principles1.3.1 Production and consumption of goods and services

1.4 Civic responsibility2. Student roles sanitation improvement

2.1Participation2.2 Maintenance2.4 Support2.5 Commitment2.6 Behaviour change - improvements

3. Student3.1 Per toilet

3.2 Per water fountain4. Activities School Health Nurse

4.1 Sanitation4.2 Nutrition4.3 Health education4.4 Vaccination4.5 Counsellor4.6 Health promotion

B. NURSING HOMES, PRISONS

1. Describe special features of(i) nursing homes(ii) prisons

2. Identify environmental problems in Nursing homes and prisons3. State the major areas of environmental health that the health worker should be

cognisance of at nursing homes and prisons

CONTENT1. Special Features

1.1 Nursing Homes1.1.1 Clearly defined standards

1.1.2 Specific recommendations1.1.2.1 Hygiene of the hands1.1.2.2 Disinfection1.1.2.3 Hygienic treatment care1.1.2.4 Protective and professional clothing

1.1.2.5 Washing of textiles


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1.1.2.6 Disposal of waste1.1.2.7 House cleaning1.1.2.8 Handling of drugs and medicines.

1.2 Prisons

1.2.1 Personal hygiene1.2.2 Admission Kits

2. Environmental Problems2.1 Nursing Homes

2.1.1Overcrowding2.1.2 Abuse2.1.3 Cost2.1.4 Negligence2.1.5 Neglect

2.2 Prisons2.2.1Over crowding

2.2.2 Poor sanitation2.2.3 Abuse

3. Major areas3.1 Nursing Homes

3.1.1Care3.1.2 Nutrition3.1.3 Safety3.1.4 Needs

3.2 Prisons3.2.1 Housing/design3.2.2 Socialization

3.2.3 Ministry3.2.4 Skill

C. PORT HEALTH AND TOURIST FACILITIES

1. Describe the health problems associated with Tourist facilities2. Outline International quarantinable diseases3. Explain the role of the health worker in Port Sanitation

CONTENT1.Health Problems

1.1 Tourist Facilities1.1.1Physical environment1.1.2 Social environment

2. International Quarantinable diseases2.1 Yellow fever2.2 Plague


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2.3 Cholera3. Role Port Sanitation

3.1 Have rules and regulations3.2 Standards

3.2.1 Report/evacuate infectious cases3.2.1 Qualified medical personnel

RESOURCES

WHO REGIONAL OFFICE FOR EUROPE (2007).Meeting on health Risksassociated With tourist Establishments in The Mediterranean. Report on a jointWHO/UNEP Meeting Athens, Greece24-26 April 2007.http://www.pseconsultancy.com/artsaccessinternational/pdf/Report%20of%20the

%20Meetingwho.pdf

Unit 7.7

COMMUNITY ENVIRONMENTAL HEALTH EDUCATION

Specific Objectives

1. Identify and prioritize health problems affecting the Community

2. Plan Health Education Sessions for dissemination of information on healthproblems.

CONTENT

1.Problem1.1 Identification

1.1.1 Illness1.1.2 Human needs (Maslows Hierachy)

1.2 Prioritization1.2.1According to Marslows Hierachy

2. Sessions2.1Protection plan2.2 Training2.3 Education needs

2.4 Resources


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Unit 7.8

OCCUPATIONAL HEALTH AND SAFETY

Specific Objectives

1. List five occupational hazards at the workplace2. Explain what is meant by Occupational Health and Safety3. Plan Health Education Sessions to disseminate information on Occupational

health and Safety in the Community

CONTENT1. Hazards

1.1 Industrial accidents1.1.1 Chemical substances

1.1.1.1 Burns1.1.1.2 Air pollution

1.2 Injuries1.1.1 Lacerations1.1.2 Falls

2. Terminology

2.1 O.H.S3. Plan H.E sessions

3.1 Re Hazards

Learning Activity

1. Visit Environmental Health Department/Officer in community area to obtaininformation pertaining to specific units objectives

2.Prepare information for presentation in class as specific groups as per

schedule on designated times

During clinical rotations

Observe for illnesses or health conditions or risks associated with

environmental health treats encountered during your clinical experience. Howcould these risks be prevented or minimized. Record these in your log toshare with class/clinical group.


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Be prepared to teach clients about environmental threats to health and safety.

Identify times when health education is appropriate e.g. ways to reduce foodcontamination to school students.

REQUIRED TEXTS



RECOMMENDED TEXTS

1.Wigley, Richard and Cook. James R. Community Health concepts andIssues 1975 D. Van Nostrand CompanyNew York

Resources

1. Environmental Health Department

2. Health Education Resource Unit

3. Schools, Nursing Homes, Ports, DOWASCO, Tourism facilities, VeterinaryDepartment, Solid Waste Management Department

Groups for Environmental Health Search and Presentation

Presentation hour each group

Group 1

As designatedUnit 7.2Water and Waste Water Management

Group 2


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As designated

Unit 7.3Solid Waste Management

Group 3

As designatedUnit 7.4Pest-Vector Control

Group 4As designated

Unit 7.5

Food HygieneGroup 5

As designated

Unit 7.6School Health and Industrial Hygiene

Group 6

As designated Unit 7.7

Community Environment Health Education

Unit 8

PRIMARY HEALTH CARE

OVERALL OBJECTIVES

At the end of the unit the students will be able to apply the knowledge and skillsgained in primary health care.


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Objectives

1 Summarize the Declaration of ALMA ATA

2 Discuss Declaration Nos 6 and 7 of the ALMA ATA Declaration3 Identify the background against which the concept of Primary Health care

came into being

4 Summarize the main points in the discussion of the ALMA ATA Conferenceon Primary Health Care under the following sub headings

- current world health situation- Primary Health Care approach- Primary Health Care and development- Technical and Operational aspects- National strategies and International support

5 Outline the 22 Recommendations of the ALMA ATA Conference on PrimaryHealth Care

CONTENT

1. ALMA ATA Decleration1.1 The International Conference on Primary Health Care in Alma-Ata 19781.2 Need for urgent action

1.2.1 All governments1.2.2 All health and development workers1.2.3 World community

1.3 Protect and promote the health for all

2. Decleration2.1 D 6

2.1.1 Sustained2.1.2 Integrated, functional and mutually supportive referral systems2.1.3 Health care for all2.1.4 Priority need

2.2 D 72.2.1 Local and referral levels2.2.2 Health workers2.2.3 Trained socially and technically2.2.4 Health team

2.2.5 Respond to the expressed health needs3. Concept PHC3.1 Background

3.1.1 Standard of health - expectations3.1.2 H. C no equity3.1.3 Health services favored3.1.4 Right to health denied3.1.5 Rising Cost


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4. Summarize - main points4.1Current world health situation4.2Primary Health Care approach4.3Primary Health Care and development

4.4Technical and Operational aspects4.5National strategies and International support

5. Recommendations (22)5.1 Interrelationships between health and development

5.2 Community participation in primary health care5.3 The role of national administrations in primary health care5.4 Coordination of health and health-related sectors5.5 Content of primary health care5.6 Comprehensive primary health care at the local level5.7 Support of primary health care within the national health system5.8 Special needs of vulnerable and high risk, groups

5.9 Roles and categories of health and health-related manpower for PHC5.10 Training of health and health-related manpower for primary health care5.11 Incentives for service in remote and neglected areas5.12 Appropriate technology for health5.13 Logistical support and facilities for primary health care5.14 Essential drags for primary health care5.15 Administration and management for primary health care5.16 Health services research and operational studies5.17 Resources for primary health care5.18 National commitment to primary health care5.19 National strategies for primary health care

5.20 Technical cooperation in primary health care5.21 International support for'primary health care5.22 Role of WHO and UNICEF in supporting primary health care

Learning Activities

1. Prepare for classroom presentations as the designated three communitygroups as follows:

I. Group 1 objectives 1,2,3II. Group 2 objectives 4

III. Group 3 objectives 5


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3 Present the information in classroom as individual groups as per thescheduled lecture period


Observe the application/implementation of Recommendations5,7,8,9,10,11,13,14 of the ALMA ATA Declaration.

Document in your logs and share with class group

REQUIRED TEXTS

1 PRIMARY HEALTH CARE ALMA ATA 1978World Health Organization, Geneva 1978Report of the International Conference on PHC. Alma Ata

USSR, 6-12 September, 1978

RECOMMENDED TEXTS

1. Health Promotion Glossary

2. http://www.cf-hst.net/UNICEF-TEMP/Doc-Repository/doc/doc459181.PDF

Unit 9

FIRST AID

OVERALL OBJECTIVES

At the end of the unit the students will be able to apply the knowledge, skills and

attitudes gained in first aid.

Objectives

1 Discuss First Aid under the following headingsdefinitionreasons


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valuegeneral directions for giving First Aid

2 Explain the First Aid Management of the following listed conditions using the

format given below

CONTENT1. Headings

1.1 Definition- causes- signs and symptoms- prevention- objectives of treatment- first aid measures

B. Conditions- wounds

- shock

- choking

- poisoning

- burns

- bone and joint injuries

fractures

dislocations strains

sprains

4.6 specific injuries

eye

head

neck

chest wounds

abdominal

back genital organs

legs and feet

hand

blisters

4.7 sudden illness

heart attack


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stroke

fainting

conversions

epilepsy

Learning Activities

1 Read the information in the listed books in the bibliography.2 Work in 3 existing community groups to prepare all the information as an out of

class assignment3 Discuss clinical experience in classroom setting as per lecture schedule

In Clinical Rotation

1 Attend skills seminar in Demonstration Room2 Attend practice sessions on First Aid in Demonstration Room as applicable3 Practice application of bandaging, slings and splints in Demonstration Room.

Practice with peers4 Observe/participate in application of first aid measures in Accident and

Emergency units/departments at hospitals and community health centres

Document your experiences in your logs and share with class.

Required texts

1.American Red Cross Standard FIRST AID and Personal Safety 2nd ed

UNIT 10

COMMUNITY HEALTH NURSING

OVERALL OBJECTIVES

At the end of the unit the students will be able to construct the knowledge and skillsgained in community health nursing.Objectives

1 Define Community Health Nursing2 Identify the three (3) categories of traditional community health nursing roles


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3 Explain basic Community Public Health Concepts4 Summarize the strategies and interventions for promoting health and

preventing disease when focusing on the Community as Client

Learning Activities

1 Read the information in the books listed in the bibliography2 Present the information in classroom in three community groups as per lecture

schedule as follows:group 1 objectives 1 and 2group 2 objectives 3group 3 objectives 4

3 Participate in classroom discussion on the case study The YORKES, using

the Zerwekhs family care-giving model pp 348-349 and pp 359-360 in theFAMILY HEALTH CARE NURSING text, as per lecture schedule.


1 Identify Nursing Roles in clinical practice at Community Nursing level

2 Observe/participate in strategies and interventions used in health promotionand disease prevention in community heath nursing

3 Record in your log the chronic conditions identified in community nursing

practice. What percentage of older persons encountered have more than onechronic condition? What are common combinations?

4 Observe for opportunities to share health promotion and disease preventionstrategies in all settings, particularly as they relate to the leading causes ofmorbidity and mortality. e.g. If you see patients at the comprehensive clinics,who have heart disease, stroke diabetes or hypertension, provide instructionon minimization and elimination of risk factors and management of the diseaseprocess.

Share your log recordings with your clinical group and class.

REQUIRED TEXTS



RECOMMENDED TEXTS


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1.Hanson, Shirley May Harmon Family Health Care Nursing Theory, Practice andResearch 2nd edition 2001 F.A. Davis Publishers, Philadelphia

3.Leahy, Kathleen M., Cobb, Marguerite M. and Jones, Mary c. Community

Health Nursing 3rd edition 1977 Mc Graw Hill Book CompanyNew York

4.Wigley, Richard and Cook. James R. Community Health concepts andIssues 1975 D. Van Nostrand CompanyNew York

Unit 11

EPIDEMIOLOGY

OVERALL OBJECTIVES

At the end of the unit the students will be able to examine the knowledge and skillsgained in epidemiology.

Objectives

1 Define Epidemiology2 Explain epidemiological terms and concepts3 Explain the difference between the following two basic types of epidemiology

descriptiveanalytic and give examples of each

4 State the seven uses of epidemiology5 Outline nine objectives related to epidemiology6 Explain the epidemiological triangle (host, agent, environment)7 Identify commonly used RATES in the measurement of morbidity and

mortality as follows and give examples of when they are used.(i) measures of morbidity

morbidity rate

incident rate

prevalence rate


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(ii) measures of mortality

neonatal mortality rate

post neonatal mortality rate

infant mortality rate

maternity mortality rate

crude death rate

cause specific death rate

8 Identify the role of the Health Statistical Unit as a source for generating dataon morbidity and mortality in Community Health Nursing

CONTENT1.

Terminology1.1 Epidemiology1.2 Terms

1.2.1 Agent1.2.2 Applied epidemiology

1.2.3 Association1.2.4 Attack rate1.2.5 Attributable proportion1.2.6 Bias1.2.7 Biological transmission1.2.8 Carrier1.2.9 Case1.2.10 Cause of disease1.2.11 Chain of infection1.2.12 Cluster1.2.13 Contact1.2.14 Contagious1.2.15 Determinant1.2.16 Endemic disease1.2.17 Epidemic1.2.18 Epidemiology1.2.19 Evaluation1.2.20 Host1.2.21 Immunity1.2.22 Incubation Period1.2.23 Risk

2. Concepts3. Types

1.4.1 Descriptive1.4.2 Analytic

4. Uses (7)


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1.5.1 In historical study1.5.2 For community diagnosis1.5.3 To study the workings of health services1.5.4 To estimate the individual's chances

1.5.5 To help complete the clinical picture1.5.6 In identifying syndromes1.5.7 In the search for causes

5. Objectives1.6.1 Contribution to health research1.6.2 Design, conduct, and analysis of studies1.6.3 Critical appraisal of studies, synthesis and integration of

research, and causal inference in research1.6.4 communication of scientific results

6. Triangle1.7.1 Host

1.7.2 Agent1.7.3 Environment

7. Rates7.1 Morbidity

7.1.1 Morbidity rate7.1.2 Incident rate7.1.3 Prevalence rate

7.2 Mortality7.2.1 Neonatal mortality rate7.2.2 Post neonatal mortality rate7.2.3 Infant mortality rate

7.2.4 Maternity mortality rate7.2.5 Crude death rate7.2.6 Cause specific death rate

8. Role of the Health Statistical Unit8.1 Meet the data needs health statistics

8.1.1 Local health professionals8.1.2 Community-based organizations8.1.2 General public

REQUIRED TEXTS

Mc Ewen, M. (2002). Community Based Nursing An Introduction. (2nd Edition).Philadelphia : W.B. Saunders

RECOMMENDED TEXTS

Fletcher & Fletcher (2005). Clinical Epidemiology The Essentials. (4th eds.).Philadelphia, Pennsylvania: Lippincot Williams & Wilkins.


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Curriculum Committee & Graduate Studies Committee (2008). Core learningobjectives in epidemiology and biostatistics (Masters degree, epidemiology stream,thesis and non-thesis programs) Department of Epidemiology, Biostatistics, and

Occupational Health McGill University. http://www.mcgill.ca/files/epi-biostat-occh/CoreLearningObjectivesEpidMScMcGill.pdf

Glossary of Epidemiology Termshttp://www.cs.columbia.edu/digigov/LEXING/CDCEPI/gloss.html

Oxford Journals (2001). The uses of 'Uses of Epidemiology'. International Journalof Epidemiology, 30(5), 1146-1155. doi: 10.1093/ije/30.5.1146

Learning Activities

1 Read the information in the books given in the bibliography2 Prepare for presentation in classroom a per 3 community groups as follows:

Group 3 objectives 1 and 2Group 2 objectives 3 and 4Group 1 objectives 5 and 6

3 All three (3) groups do the exercises on Calculation of Rates of the followingtwo (2) scenarios.

4 Attach scheduled classroom session for discussion of the Clinical Applicationof a hypothetical situation, illustrating the use of epidemiological data bynurses providing direct services and involved in planning at the communitylevel.

Scenario 1

During 2001, 215 new cases of AIDS were reported in Grand River, a city of500,000. This brought the total of active cases of AIDS to 2280. During that time,105 deaths were attributable to the disease.

1 What is the incidence rate per 100,000 for AIDS during 2001?2 What was the prevalence rate of IDS per 100,000?3 What is the cause specific death rate for AIDS per 100,000?

Scenario 2

Sun City is a small city with a mid 2001 population of 120,000. During 2001, 342live births and 515 deaths occurred in Sun City. Sun City has a large elderly
http://ije.oxfordjournals.org/http://ije.oxfordjournals.org/http://ije.oxfordjournals.org/http://ije.oxfordjournals.org/


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population, with approximately 24,000 of the population being older than 65 years.Of the 515 deaths during 2001, 425 were in individuals older than 65.

4 What is the crude birth rate for Sun City for 2001 per 1000?

5 What is the crude death rate for Sun City for 2001 per 1000?6 What is the age specific death rate for individuals older than 65 for Sun City for

2001 per 1000?

ANSWERS TO CALCULATION

1 215 X 100,000 = 43 cases per 100,000

500,000

2 2280 X 100,000 = 456 cases per 1000,000500,000

3 105 X 100,000 = 21 deaths per 100,000500,000

4 342 X 1000 = 2.85 births per 1000120,000

5 515 X 1000 = 4.29 deaths per 1000120,000

6 425 X 1000 = 17.71 deaths over age 65 per 100024,000

REQUIRED TEXTS

1. 1 Mc Ewen, M. (2002). Community Based Nursing An Introduction.(2nd Edition). Philadelphia : W.B. Saunders

2. Community Based Nursing An Introduction, 2nd Edition W.B. SaundersPhiladelphia 2002

RECOMMENDED TEXTS

1.CAREC MANUAL


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2. Hanson, Shirley May Harmon Family Health Care Nursing Theory, Practiceand Research 2nd edition 2001 F.A. Davis Publishers, Philadelphia

3.Reading Material entitled Epidemiological Application in Community Health

Nursing pp 229-230 Clinical Application

4.Wigley, Richard and Cook. James R. Community Health concepts andIssues 1975 D. Van Nostrand Company New York

Unit 12 (A)

COMMUNICABLE DISEASES

OVERALL OBJECTIVES

At the end of the unit the students will be able to differentiate the knowledge andskills gained in communicable diseases.

Objectives

1. Define the following key terms used in study of Communicable diseases

- acquired immunity - environment - infectiousness

- active immunity - epidemic - natural immunity

- agent - epidemiologic trial - nosocomial infections

- communicable period - herd immunity - passive immunization

- control - horizontal transmission - resistance

- disease - host - surveillance

- elimination - incubation period - vertical transmission

- infection - zoonosis

- emergency infectious diseases

2. Explain the transmission of Communicable Diseases under the followingheadings


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Agent, Host, Environment

Modes of transmission

Disease development

Disease spectrum

3. Discuss the functions and elements of a surveillance system as follows

Elements of surveillance

List of notifiable (reportable) diseases

4. Discuss the factors leading to the emergence or re-emergence of infectiousdiseases as follows.

Emergence factors

Examples of emerging infectious diseases

5. Discuss the three levels of prevention and give appropriate examples ofpreventive interventions

Primary, Secondary and Tertiary

6. Discuss the multisystem approach to control of communicable diseases

Mulitsystem approach to control

CONTENT

1. Terminologies

1.1 acquired immunity

1.2 environment

1.3 infectiousness

1.4 active immunity

1.5 epidemic

1.6 natural immunity

1.7 agent

1.8 epidemiologic trial

1.9 nosocomial infections


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1.10 communicable period

1.11 herd immunity

1.12 passive immunization

1.13 control

1.14 horizontal transmission

1.15 resistance

1.16 disease

1.17 host

1.18 surveillance

1.19 elimination

1.20 incubation period

1.21 vertical transmission

1.22 infection

1.23 zoonosis

1.24 emergency infectious diseases

2. Transmission

a. Agent, Host, Environment

b. Modes of transmission

c. Disease developmentd. Disease spectrum

2. Surveillance system

3.1 Functions

3.2 Elements

3.3 Notifiable diseases

4 Factors

4.1 Emergence/Re-emergence

4.2 Examples

5 Levels of prevention

5.1 Primary

5.2 Secondary

5.3 Tertiary

6 Multisystem approach to control


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6.1

Learning Activities

1.Prepare for classroom presentation by working in groups. (3 community groups)

The groups for presentation of objectives are as follows:

Group 1 objective Non Communicable Diseases

Group 2 objectives 1, 2, and 3, Communicable Diseases

Group 3 objective 4, 5, 6, Communicable Diseases

Present information in classroom as per lecture schedule.


1. Visit the local Environmental Health Department to discuss surveillance andcontrol of Communicable diseases. Find out about local and regional trends incommunicable/non communicable diseases.

Learn about the process of reporting

Become familiar with the reportable diseases that are a problem in thearea.

Look at how many cases have been reported during the past month, 6months and year

Contrast these numbers with national statistics

Discuss outbreak procedures that may accompany the reporting of someof these diseases

If possible, go on an outbreak investigation

2. Spend time with a school nurse to see what infectious diseases are routinelyencountered in the educational settingDiscuss risk factors for disease in school aged youth and the strategiesemployed to prevent infectious diseases in the age group.

3. Visit a day care centre. Observe potential situations for communication ofinfectious diseases and discuss with the director, the steps taken to prevent


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and control infection, including immunization requirements and procedures forhand washing and food preparation.

4. In your log, compile an list of communicable diseases (illness encountered in

the clinical setting). When possible, participate in the process of reporting ofcommunicable diseases.

REQUIRED TEXTS

1. CARECEpidemiology Manual for the Caribbean

2.American Public Health Association James Chin editor Control of Communicablediseases in Man 17th edition 2000

RECOMMENDED TEXTS

1.Wilner, Walkey and Oneil Introduction to Public Health 7 th Edition Mc MillanPublishing Company Inc New York 1978

3. Reading Material Communicable Disease Risk and Prevention Francisco S. Sy& Susan C. Long-mainPp 755-776

Unit 12 (B)

NON COMMUNICABLE DISEASESObjective

1. Discuss control of chronic (Non Communicable diseases) under the followingheadings

PreventionDetectionTreatmentRehabilitation

Learning Activity


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1. In your log, compile a list of non communicable (chronic) diseases encounteredin the clinical setting. Where possible, participate in the process of reportingon non communicable diseases.

2. Utilize any of the following method of data collection to compile a list of majorchronic diseases in your assigned community

a. case registriesb. household interview/cardsc. examinations surveyd. health records surveye. health cardsf. data from chronic disease monitoring/mass screening procedures

3. Identify activities of the Community Health Nursing personnel in relation to

delivery of

(i) Comprehensive Care(ii) Continuity of Care for clients with non-communicable diseases

4. Share experiences with clinical group and class

CONTENT1. Control

1.1 Prevention1.2 Detection1.3 Treatment1.4 Rehabilitation

REQUIRED TEXTS

1. CARECEpidemiology Manual for the Caribbean

2.American Public Health Association James Chin editor Control ofCommunicable diseases in Man 17th edition 2000

RECOMMENDED TEXTS

1.Wilner, Walkey and Oneil Introduction to Public Health 7 th Edition Mc MillanPublishing Company Inc New York 1978


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3. Communicable Disease Risk and Prevention Francisco S. Sy & Susan C.Long-man Pp 755-776

Unit 13

DISASTER NURSING

OVERALL OBJECTIVES

At the end of the unit the students will be able to efficiently apply the knowledge andskills gained in disaster nursing.

Objectives

1. Define (a) disaster (b) major disaster

2. Explain the epidemiology of disaster under the following headings

3. Types of disaster4. Disaster agents5. Host factors6. Environmental factors7. Psychological factors8. Post traumatic stress disorder syndrome

3. Outline the phases of a disaster under the following headings

(i) Pre-impact phase(ii) Impact phase(iii) Post impact Phase(iv) Effects of disaster on a community

4. Explain the following dimensions of a disaster

(i) Predictability

(ii) Frequency(iii) Controllability(iv) Time(v) Scope and Intensity

5. Discuss the responsibilities of agencies and organizations in DisasterManagement, using the following headings


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(i) Planning

Local government

State/Central Government

Red cross(ii) Prevention and Mitigation(iii) Emergency Response

NEPO

Principles of Disaster Management

Triage

6. Explain Community Nursing responsibilities in a disaster, using the followingheadings

(i) Planning

Nursing Care goals for disaster nursing Developing a response plan Primary Prevention

Education(ii) Emergency Care

Survey assessments

Emergency assessments

Determining immediacy of care

Major health concerns after a disaster

Role of emergency aid stations

Psychological needs of victims(iii) Recover

(iv) Personal Response of Care Providers to disaster(v) Ethical and legal implications

CONTENT1. Terminologies

1.1 Disaster1.2 Major disaster

2. Epidemiology of disaster2.1Types of disaster2.2Disaster agents

2.3Host factors2.4Environmental factors2.5Psychological factors2.6Post traumatic stress disorder syndrome

3. Phases3.1Pre-impact phase3.2Impact phase3.3Post impact Phase


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3.4Effects of disaster on a community4. Dimensions

4.1Predictability4.2Frequency

4.3Controllability4.4Time4.5Scope and Intensity

5. Responsibilities - agencies and organizations in Management

e. Planning5.1.1 Local government5.1.2 State/Central Government5.1.3 Red cross

5.2 Prevention and Mitigation5.3 Emergency Response

5.4 NEPO5.5 Principles of Disaster Management5.6 Triage

6. Community Nursing responsibilities6.1 Planning

6.1.1 Nursing Care goals for disaster nursing6.1.2 Developing a response plan Primary Prevention6.1.3 Education

6.2 Emergency Care6.2.1 Survey assessments6.2.2 Emergency assessments

6.2.3 Determining immediacy of care6.2.4 Major health concerns after a disaster6.2.5 Role of emergency aid stations6.2.6 Psychological needs of victims

7 Recover 8 Personal Response of Care Providers to disaster9 Ethical and legal implications

Learning Activities

1.Prepare for presentation in four (4) groups (see schedule)2.Present information in groups as per lecture schedule3.Develop a personal Disaster Plan



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1. Visit /call your local branch of Red Cross and ask about the kind of activitiesrelated to disaster relief the agency has undertaken in the past five years.

2. Visit emergency shelter(s) and/or speak with emergency shelter managersabout the activities which occur in emergency shelter(s) during all phases ofdisasters

3. Identify your local command emergency operation centre (EOC). If you areunsure about how to find this information, call your local police or firedepartment and ask for the information.

4. Seek opportunities to assist in updating disaster plans for (i) hospital(ii) community

5. Ask other health personnel if they have had personal experiences taking careof victims in disaster or emergency situations

6. Consider what your response might be in an emergency situation. What if youwitnessed a car or bus crash/wreck? If no, why not? If yes, what would you dofirst? If you were home and heard about the wreck/crash on a radio newsbulletin, would you report to work?Would you report to work if you supervisor called asked you to come in?If you were not employed, would you call the Red Cross and volunteer yourprofessional services? Would you go to the scene.

7. Seek opportunities to participate in drills/simulations if possible.

8. Do a search on a major disaster that has occurred in Dominica/RegionalIsland(s) over the past ten years. Identify the health needs of the population.

According to your search accounts was the disaster handled efficiently by thedisaster health personnel? Were any areas singled out as needing improvedperformance? Can you identify any areas for improvement based on yourfindings? Readings?

9. Visit the Disaster Preparedness office and speak with the Disaster Coordinatorin relation to assignments on Disaster nursing.

Document your experiences in you log and share with clinical group and class

REQUIRED TEXTS

1. CAREC ManualEpidemiology for the Caribbean


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2. Reading Material entitled Nursing in a DISASTER by Barbara Sanamariapp 382 400 Chapter 15

Other Resources

7. Disaster Preparedness coordinator/officers

8. Red Cross Headquarters Director/officers

9. Fire and Ambulance Services

10. Police Department

11. Hospitals and Health Centres

12. National Disaster Plan Manual Prime Ministers Office

Groups for Assignment on Disaster Nursing

Group 1 Objectives 1 & 2, 4, 7

Group 2 Objective 3, 4, 7, 9

Group 3 Objective 4, 6, 7, 8

Group 4 Objective 5, 4, 7

Assignment (Individual)

Topic: Documentation and Reporting System in Community Nursing Standards and Protocols

1. Identify standards and protocols for Documenting and Reporting client datain the Community in relation to


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i Home health care documentationii Post home visit activitiesiii Vaccinations/Immunizationsiv Health centre/comprehensive clinic activities

v Emergency situationsvi OTHER eg. Referrals

2. (i) List the forms, charts, records used for documenting and reporting clientdata

(ii) State the specific use(s) of these documentation forms.

Learning Activity

1 Search with permission and obtain copies of the various forms itemised.

Include other/new forms

2 Identify their specific use(s)

3 Present information in classroom discussion as per schedule

Assessment/Evaluation methods:

Course work 50 %Health Teaching 10%Family Assessment 10%Mid - Semester Examination 20%Case presentation - 10%

Final Examinations 50% Written Examination 50%


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WEEKS

TOPIC METHOD RECOMMENDED READING

1 Introduction toCommunity NursingPaediatricImmunizations

DiscussionPPP

C/Wealth of Dca.Immunization Manual

Mgt. of Breastfeeding Discussion Mattson & Smith (2004)chp14

2 Mgt. of Breastfeeding Video

Discussion

Frazer & Cooper (2009)chp

41B/feeding Policy C/wealth ofDca (2006).Mattson & Smith (2004)chp14

Prenatal Care PPP Frazer & Cooper (2009)chp17, 41Mc Ewen (2002)

3 CPR Videos/Mannequin

Demonstration

First Aid Manual

CPR Demonstration First Aid Manual

4 Postnatal Care DiscussionHAND INASSIGNMENTII

Dooenges & Moorehouse(1999) chp 6Dooenges & Moorehouse(1999) chp 39

Family Planning Group Work Frazer & Cooper (2009) chp37Planned Parenthood

Association5 Environmental Health Group work

Environmental Health Group work

6 Environmental Health GROUPWORK


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Environmental Health GROUPWORK

7 MIDTERM EXAM

Primary Health Care Discussion Health Promotion Glossary(2004)

8 Primary Health Care Discussion Mc Ewen (2002)

HOLIDAY

9 First Aid DiscussionGroupwork/Roleplay

First Aid Manual

HOLIDAY

10 Community HealthNursing

Group work Mc Ewen (2002)

Community HealthNursing

Presentation

11 Epidemiology Discussion Saunders (2002)

CommunicableDiseases

Chin (2000)

12 Non-CommunicableDiseases

Presentation Chin (2000)

Disaster Nursing Video/GroupDiscussionRole play

13 PRESENTATION(Assignment III)

REVIEW

Community AssignmentAssignment I - Health Teaching (Groups of two) 10 %

Community nurses identify and investigate health problems within thecommunity and work towards solutions. They inform and educatecommunities about various public health issues and present healtheducation programs to individuals, families, and groups in the clinic,home, or community setting. The nurses also provide health services tothe community on health issues and topics related to special needs.Identify a special group in the Roseau Health District, choose a topic ofneed and interest that group then prepare a clinical teaching to be done


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in that chosen area using the criteria of assessment, planning,implementation and evaluation for your teaching.You are to make preparations for your presentation.Date of teaching plan submission: Two days before teaching in the

community (To be discussed with supervisor).Assignment II (Individual) 10 %ScenarioOver the past decade the health care delivery system has changeddrastically. There is little doubt that health care delivery is moving froman acute care focus and hospital based delivery of care to illnessprevention and management and community based delivery of care(McEwen, 2002). Discuss.Guidelines for discussion

1. Discussion must be original work presented.

2. Copyrighted material will not be accepted.

3. Discussion must be in sequence that is easy to follow.

4. Must have an introduction, body and conclusion.

5. Letters from text must be used throughout the discussion (calibri).

6. Double space all text.

7. The discussion length must be two pages.

8. APA referencing is mandatory.

Date of Submission both online and paper: September 27, 2011 by4pm.

Assignment III (Group work) Family Assessment 10 %McEwen (2002).Community - Based Nursing pg 361.You are responsible for choosing a family of interest in your communitybased on needs assessment. Based on your family needs assessment,select a priority need, where you will support the family in meeting thisneed. Evidence of support is necessary.Prepare a case presentation to present in class. Duration will be sevenminutes.Date of submission: November 28 @4pm

community course outline 2

Documents