The memo speaks of the following interesting points:

• RNHeals Batch I will end on February 15, 2012.
• Certificate of Competency and Deployment shall be awarded for those nurses who have satisfactorily completed the project.
• RNHeals Batch III for 2012 shall train and deploy 10,000 nurses and 3,000 midwives.
• The recruitment selection shall be done by the CHDs and shall be completed by February 2012.
• Nurses and Midwives who have dropped out of the program are discouraged from re-entering the project.
• Graduates of RNheals Batch I can still apply if they have a satisfactory performance.
• The general orientation for RNHeals 3 shall commence of the first week of March 2012.
• Nurses are to receive 8,000 pesos while midwives shall receive 6,000 pesos per month. Both shall also have a  Philhealth Insurance worth 1,200 per year and Group Accident Insurance worth 500 per year.
• LGUs shall provide nurses and midwives an additional allowance of at least 2,000 pesos per month.

DOH Department Memorandum 2012-0030: Implementation of RNHeals Batch III and Rural Health Midwives Placement Program 2012. 

Relative to the implementation of the Deployment Program fo the Department of Health through the Registered Nurses for Health Enhancement and Local Service (RNHeals) Project and Rural Health Midwives Placement Program (RHMPP), all concerned offices are hereby guided accordingly:

1. RNHeals Project Batch I shall end on February 15, 2012. As such, CHDs shall award the Certificate of Competency and Deployment for the nurses who have satisfactorily completed the learning and deployment project. The certificate template/prototype has been forwarded to the CHD-HRD units for reproduction. The Regional Directors of the Department of Health (DOH) and Department of Social Welfare and Development (DSWD) shall be the signatories of the certificate.

2. The DOH Finance Service shall sub-allot/transfer fund to CHDs, ARMM and DOH Hospitals for the 2012 stipend of the nurses and midwives under the RNHeals Project Batch I and II. Relative to this CHDs, ARMM and DOH Hospitals shall submit their disbursement report every 10th day of the month to DOH Finance Service and HHRDB for monitoring purposes.

3. The RNheals Project Batch III shall train and deploy 10,000 nurses and 3,000 midwives for 2012. The recruitment and selection shall be done by the respective CHDs to be completed by February 2012. In as much as this is a training and deployment project, nurses and midwives who have dropped out are discouraged from re-entering the project. Graduates of RNHeals Project Batch I can re-enter the program based on a very satisfactory performance during their tour of duty. They shall be evaluated by the Immediate Supervisor, concurred by the Regional Project Management Team and approved by the concerned CHD Regional Director. For Midwives, CHD shall coordinate with the professional organizations to facilitate the recruitment as stated in Department Memorandum dated 26 October 2011.

4. The general orientation shall commence on the first week of March 2012 before the placement and deployment. Cost of the orientation shall be borne by the respective CHDs.

5. The nurses shall receive a stipend of Eight Thousand Pesos (8,000) per month whereas Midwives shall receive a stipend of Six Thousand Pesos (6,000) per month. Likewise, both shall be provided with Philhealth Insurance of One Thousand Two Hundred Pesos (1,200) per year and Group Accident Insurance enrollment of Five Hundred Pesos (500) per year.

6. The Local Government Units (LGUs) shall provide the Nurses and Midwives an additional allowance of at least Two Thousand Pesos (2,000) per month as Memorandum Circular No. 2011-0044 dated August 4, 2011.

Previously, we have posted different application guidelines for RNHeals 3 in: Calabarzon, Aklanon, and Northern Mindanao.

Source:
Deparment of Health

RNHeals 2012 Batch 3: Official Memorandum by the DOH Original source at: Nurseslabs

Below is a list of the ego defense mechanisms.

Defense Mechanisms List Original source at: Nurseslabs

CAD is the most common type of heart disease. Lifestyle changes, medicines, and/or medical procedures can effectively prevent or treat CAD in most people. Other names for Coronary Artery Disease are Atherosclerosis, Coronary heart disease, Hardening of the arteries, Heart disease, Ischemic heart disease, and Narrowing of the arteries.

1 Decreased Cardiac Output

Cad causes narrowing of blood vessels. This condition leads to intense pressure exerted on the walls of the blood vessels. The body’s compensatory mechanism is to increase the work load of the heart and thus the patient has decreased cardiac output.

5 Coronary Artery Disease Nursing Care Plans Original source at: Nurseslabs

Below is a list of reference drug sites that you can use to find information for you drug studies.

Mims.com.ph

MIMS is one of my favorite sites when looking for those “hard do find drugs”. It has a good sum of information for each drug. You’ll have to register (for free) to access its database. Also, MIMS publishes a yearly drug reference book which you can buy on your favorite bookstores.

Druglib.com

DrugLib.com is one of the most comprehensive drug database I have ever seen so far. It provides almost all the information you need related to your drug interest.

RNpedia.com

Although RNpedia.com doesn’t have a  vast reference for drugs, what I like about it is its formatting of commonly used drugs.

Drugs.com

Who among student nurses does not know this website? Its probably the most used and most sough-after drug reference site. I cannot blame you because it is the most complete and dynamically updated drug reference site.

Nursingcrib.com

Nursingcrib has been providing not just information about drugs, but also about nursing.

Nurseslabs.com

Of course, we may not have the vast list of drugs (yet), we do have references about the commonly used drugs that are not found yet on reference books.

Have we missed anything?

Did we forget to mention as drug reference website you might know? Therefore, comment below!

6 Drug Reference Sites You Must Bookmark! Original source at: Nurseslabs

Much of the stigma attached to electroconvulsive therapy is based on early treatments in which high doses of electricity were administered without anesthesia, leading to memory loss, fractured bones and other serious side effects.

Electroconvulsive therapy is much safer today. Although electroconvulsive therapy still causes some side effects, it now uses electrical currents given in a controlled setting to achieve the most benefit with the fewest possible risks.

Nurses have an important role to take when their client is to undergo Electroconvulsive Therapy. Find out what are the responsibilities and activities of the nurse during electroconvulsive therapy.

1. Emotional and Educational Support to the Client & Family

• Encourage the client to discuss feelings, including myths regarding ECT.
• Teach the client and the family what to expect with ECT.

2. Pretreatment Protocol for ECT

• Ascertain if the client and the family have received a full explanation, including the option to withdraw the consent at any time.
• Withhold food and fluids for 6 to 8 hours before treatment.
• Remove dentures, glasses, contact lenses, hearing aids, hair pins and etc.
• Have client void before the treatment.
• Give preoperative medications as ordered:
• Give either glycopyrrolate (Robinul) or atropine to prevent potential for aspiration and to help minimize brady-arrhythmias in response to electrical stimulants.

3. Nursing Care During the Procedure

• Place a blood pressure cuff on one of the client’s arms.
• As the intravenous line is inserted and EEC and ECG electrodes are attached, give a brief explanation to the client.
• Put on the pulse oximeter to the client’s finger.
• Monitor blood pressure throughout the threatement.
• Medications to be given:
• Short-acting anesthethic (Brevital)
• Muscle relaxant (Succinylcholine)
• 100% oxygen by mask via positive pressure
• Check if the bite block is placed in prevent biting of the tongue
• Electrical stimulus given (seizure should last 30 to 60 seconds).

4. Posttreatment nursing care

• Have the client go to a properly staffed recovery room.
• Once the client is awake, talk to the client and check the vital signs.
• Give frequent orientation and reassurance to allay confusion.
• Check the gag reflex before giving client fluids, medications or breakfast.

Sources:

• Mayo Clinic Electroconvulsive Therapy
• Image Source 

Electroconvulsive Therapy Nursing Care Original source at: Nurseslabs

Source via:  Forensic Science Colleges

13 Things You Didn’t Know about Cells & DNA: Cells & DNA Infographic Original source at: Nurseslabs

Description

• Pneumothorax is the accumulation of atmospheric air in the pleural space, which results in a rise in intrathoracic pressure and reduced vital capacity.
• It is the loss of negative intrapleural pressure results in collapse of the lung.
• A spontaneous pneumothorax occurs with the rupture of a bleb.
• An open pneumothorax occurs when an opening through the chest wall allows the entrance of positive atmospheric pressure into the pleural space.
• Diagnosis of pneumothorax is made by chest x-ray film.

Causes

• The cause of a closed or primary spontaneous pneumothorax is the rupture of a bleb (vesicle) on the surface of the visceral pleura.
• Secondary spontaneous pneumothorax can result from chronic obstructive pulmonary disease (COPD), which is related to hyperinflation or air trapping, or from the effects of cancer, which can result in the weakening of lung tissue or erosion into the pleural space by the tumor.
• Blunt chest trauma and penetrating chest trauma are the primary causes of traumatic and tension pneumothorax.
• Other possible causes include therapeutic procedures such as thoracotomy, thoracentesis, and insertion of a central line.

Assessment

• Absent breath sounds on affected side
• Cyanosis
• Decreased chest expansion unilaterally
• Dyspnea
• Hypotension
• Sharp chest pain
• Subcutaneous emphysema as evidenced by crepitus on palpation
• Sucking sound with open chest wound
• Tachycardia
• Tachypnea
• Tracheal deviation to the unaffected side with tension pneumothorax

Complications

• Another collapsed lung in the future
• Shock

Nursing Diagnoses

• Impaired gas exchange related to decreased oxygen diffusion capacity
• Anxiety related to breathlessness and fear of suffocation
• Activity Intolerance related to insufficient oxygen for activites and fatigue
• Impaired Verbal Communication related to dyspnea

Nursing Care Plan

View this post for Pneumothorax Nursing Care Plans

Diagnostic Evaluation

• Chest x-ray reveals lung collapse with air between chest wall and visceral pleura. Lungs are not filled with air but rather are collapsed.
• Other Tests: Complete blood count, plasma alcohol level, arterial blood gases, rib x-rays, computed tomography (CT) scan.

Medical Management

• The priority is to maintain airway, breathing, and circulation. The most important interventions focus on reinflating the lung by evacuating the pleural air. Patients with a primary spontaneous pneumothorax that is small with minimal symptoms may have spontaneous sealing and lung re-expansion.
• For patients with jeopardized gas exchange, chest tube insertion may be necessary to achieve lung re-expansion.
• Maintain a closed chest drainage system; be sure to tape all connections, and secure the tube carefully at the insertion site with adhesive bandages. Regulate suction according to the chest tube system directions; generally, suction does not exceed 20 to 25 cm H2O negative pressure.
• Monitor a chest tube unit for any kinks or bubbling, which could indicate an air leak, but do not clamp a chest tube without a physician’s order because clamping may lead to tension pneumothorax.
• Stabilize the chest tube so that it does not drag or pull against the patient or against the drainage system. Maintain aseptic technique, changing the chest tube insertion site dressing and monitoring the site for signs and symptoms of infection such as redness, swelling, warmth, and drainage.
• Oxygen therapy and mechanical ventilation are prescribed as needed. Surgical interventions include removing the penetrating object, exploratory thoracotomy if necessary, thoracentesis, and thoracotomy for patients with two or more episodes of spontaneous pneumothorax or patients with pneumothorax that does not resolve within 1 week.

Thoracentesis

View this post to read about thoracentesis. 

Pharmacologic Highlights

• No routine pharmacologic measures will treat pneumothorax, but the patient may need antibiotics, local anesthesia agents for procedures, and analgesics, depending on the extent and nature of the injury. Analgesia is administered for pain once the patient’s pulmonary status has stabilized.

Nursing Interventions

• Apply a dressing over an open chest wound.
• Administer oxygen as prescribed.
• Position the client in high fowler’s position.
• Prepare for chest tube placement until the lung has expanded fully.
• Monitor chest tube drainage system.
• Monitor for subcutaneous emphysema.

Documentation Guidelines

• Physical findings: Breath sounds, vital signs, level of consciousness, urinary output, skin temperature, amount and color of chest tube drainage, dyspnea, cyanosis, nasal flaring, altered chest expansion, tracheal deviation, absence of breath sounds
• Response to pain: Location, description, duration, response to interventions
• Response to treatment: Chest tube insertion—type and amount of drainage, presence of air leak, presence or absence of crepitus, amount of suction, presence of clots, response to fluid resuscitation; response to surgical management
• Complications: Infection (fever, wound drainage); inadequate gas exchange (restlessness, dropping SaO2); tension pneumothorax

Discharge and Home Healthcare Guidelines

• Review all follow-up appointments, which often involve chest x-rays, arterial blood gas analysis, and a physical exam. If the injury was alcohol-related, explore the patient’s drinking pattern.
• Refer for counseling, if necessary. Teach the patient when to notify the physician of complications (infection, an unhealed wound, and anxiety) and to report any sudden chest pain or difficulty breathing.

Further Reading

• NLM Pneumothorax. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001151/
• Wikipedia Pneumothorax.http://en.wikipedia.org/wiki/Pneumothorax

Pneumothorax Original source at: Nurseslabs

Read the scheduled activities of the Department of Health this 2012

January

• Deworming of School Children (Grades 1-6) Round 1
• National Cancer Consciousness Week January18-22
• Goiter Awareness Week January 24-30
• World Leprosy Day January 29

February 

• Heart Month
• Oral Health Month
• National Health Insurance Program Month
• National Mental Retardation Week February 1-5
• World Cancer Day February 4
• Leprosy Prevention & Control Week 3rd week
• National Rare Disease Week 4th week

March

• Colon and Rectal Cancer Awareness Month
• Rabies Awareness Month
• Burn Injury Prevention Month
• International Women’s Month
• International Women’s Day March 8
• World TB Day March 24

April 

• Cancer in Children Awareness Month
• World Health Day April 7
• Philippine Earth’s Day April 22
• Head and Neck Consciousness Week 4th week
• World Malaria Day April 25

May

• Cervical Cancer Awareness Month
• Road Safety Month
• World Asthma Day May 2
• Safe Motherhood Week May 10-14
• AIDS Candlelight Memorial Day May 15
• World Hypertension Day May 19
• World No Tobacco Day May 31

June

• Dengue Awareness Month
• National Kidney Month
• No Smoking Month
• Prostate Cancer Awareness Month
• Safe Kids Week June 14-18
• National Poison Prevention Week 4th week
• World Blood Donor Day June 14
• DOH Anniversary June 23
• National Patient Safety Day June 25

 July 

• Deworming of School Children ( Grades 1-6) Round 2
• National Blood Donors’ Month
• Nutrition Month
• National Disaster Consciousness Month
• Schistosomiasis Awareness Month
• National Allergy Day July 8
• World Population Day July 11
• National Disability Prevention and Rehabilitation Week July 12-17
• National Diabetes Awareness Week July 25-29

 August

• Family Planning Month
• Lung Cancer Awareness Month
• National Lung Month
• National Tuberculosis Awareness Month
• Sight -Saving Month
• National Breastfeeding Awareness Month
• Mother-Baby Friendly Hospital Initiative Week August 2-6
• National Hospital Week August 6-12
• Philippine National Research System Week August 11-17
• Asthma Week August 16-20
• National Tuberculosis Day August 19
• Brain Attack Awareness Week 3rd week

 September 

• Blood Diseases Month
• Generics Awareness Month
• Liver Cancer Awareness Month
• National Epilepsy Awareness Week September 1-7
• Obesity Prevention and Awareness Week September 7-11
• World Heart Day September 26
• World Rabies Day September 28

October 

• National Children’s Month
• Breast Cancer Awareness Month
• Elderly Filipino Week October 1-7
• National Mental Health Week October 4-8
• National Newborn Screening Week October 4-8
• World Mental Health Day October 10
• World Sight Day October 11
• Bone and Joint Awareness Week October 11-15
• Garantisadong Pambata Week October 11-15
• Global Handwashing Day October 15
• Health Education Week October 18-22
• National Attention Deficit /Hyperactivity Disorder
• Awareness Week October 18-22
• Food Safety Awareness Week October 25-29
• World Psoriasis Day October 29

November

• Cancer Pain Awareness Month
• Filariasis Awareness Month
• Traditional & Alternative Health Care Month
• Malaria Awareness Month
• Chronic Obstructive Pulmonary Disease ( COPD)
• Awareness Week November 1-5
• National Food Fortification Day November 7
• National Skin Disease Detection and Prevention
• Week 2nd Week
• Deaf Awareness Week November 8-12
• World Diabetes Day November 14
• Drug Abuse Prevention and Control Week November 15-19
• World Toilet Day November 19
• Climate Change Consciousness Week November 19-25
• National Consciousness Week Against
• Counterfeit Medicine November 21-25
• Population and Development Week November 22-26
• 18- Day Campaign to end Violence Against Women (VAW) Nov. 25-Dec. 12

December 

• Firecrackers Injury Prevention Month
• World AIDS Day December 1
• Ear, Nose and Throat Consciousness Week December 3-9
• National Youth Health Day December 10
• Linggo ng Kabataan 2nd Week
• National Health Emergency Preparedness Day December 6

Source:
http://www.doh.gov.ph/annual_calendar

Department of Health (DOH) Health Calendar 2012 Original source at: Nurseslabs

• reducing exclusion and social disparities in health (universal coverage reforms);
• organizing health services around people’s needs and expectations (service delivery reforms);
• integrating health into all sectors (public policy reforms);
• pursuing collaborative models of policy dialogue (leadership reforms); and
• increasing stakeholder participation.

Brief History of PHC

• May 1977. The 30th World Health Assembly adopted resolution which decided that the main social target of governments and of WHO should be the attainment by all the people of the world by the year 2000 a level of health that will permit them to lead a socially and economically productive life.
• September 6-12, 1978. International Conference in PHC was held in this year at Alma Ata, USSR (Russia)
• October 19, 1979. The President of the Philippines (Ferdinand Marcos) issued Letter of Instruction (LOI) 949 which mandated the then Ministry of Health to adopt PHC as an approach towards design, development, and implementation of programs which focus health development at the community level.

Definitions

1. WHO

An essential health care made universally acceptable to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country and afford at every stage of development.

2. Alma Ata

Eight essential ELEMENTS based on the Alma Ata on PHC:An essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally, accessible to individuals and families in the community by means of acceptable to them, through their full participation and at a cost that community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.

1. Health Education
2. Treatment of Locally Endemic Diseases
3. Expanded Program on Immunization
4. Maternal and Child Health
5. Provision of Essential Drugs
6. Nutrition
7. Treatment of communicable and non-communicable diseases
8. Safe water and good waste disposal

Major Strategies of PHC

1. Elevating Health to a comprehensive and sustained national effort
2. Promoting and Supporting Community-Managed Health Care
3. Increasing efficiencies in the Health Sector
4. Advancing essential national health research

Types of PHC workers

1. Barangay Health Worker or Village Health Worker
2. Intermediate level Primary Health Worker

4 Pillars of PHC

1. Active Community Participation
2. Intra and Inter-sectoral linkages
3. Use of appropriate technology
4. Support mechanism made available

Image source: 1

Primary Health Care: History, Elements, Strategies, & Pillars Original source at: Nurseslabs

What does HOB or ROM means? Are you knowledgeable about the different medical terminologies & abbreviations?

We in the fields of nursing and medicine have our unique set of vocabulary. These terminologies are important for us to have a more understandable communication. Abbreviations are shortened form of a word. In the field of health care, we have a long list of abbreviations.

Below is a list of the common medical terms, abbreviations and their meanings: 

Medical Terminologies & Abbreviations List/Cheat Sheet Original source at: Nurseslabs