JagjotDulay
Healthy Communities Nursing Theory and Practice
Debora Spartaco
d) Primary Health Care‐how have the values and principles of Primary Health Care been reflected in the work you are involved with? How does it directly influence your clients?
The Values of The basic principles of primary health care identified in the Alma Ata declaration are to be modified into national health policies so as to sustain the vision of primary health care as part of a comprehensive health care system which is in consonance with other sectors, these principles include
Equitable distribution of health care, Community Participation, Health workforce Development, Use of Appropriate technology and Multi-sectional approach. according to the principle of equitable distribution of health care, it is important that the primary health care offered in a by community meet the major health needs of the community and this service must be provided to all individuals in the community irrespective of their age, gender, color, social class or location. In the case of St Joseph's Health center, it meets all these criteria for the provision of primary health care. The clinic is located at the Queensway where it is accessible to all members of the community. There is no form of discrimination against any one that seeks medical attention in the hospital. The hospital caters for the health needs of all individuals irrespective of religion, race, color or social background. In this way, the hospital fulfills this principle of provision of primary health care to the community.
According to the principle of Community participation, it is important for the community to have an input in the setting up and running of the care facility so that the self-sufficiency that primary health care possesses would be upheld. In the case of St Joseph’s Clinic, the hospital was set up by collaborating with people of the local community.
In terms of health workforce development, primary health care relies a lot on the adequacy of the number and distribution of trained health care personnel including Doctors, Nurses, and all other allied health care professionals who all work as a team in order to actualize the aims and objectives of primary health care. In the case of St Joseph's, there is a strong collaboration among the entire cadre of health workers that work in the Clinic. They are all in cooperation in bringing primary health care to the doorstep of the people of the community by practicing their skills to tackle the health issues of individuals in the community. Moreover, the hospital makes it a point of duty to periodically organize seminars for health workers on various issues that affect the care given to patients. This goes a long way in sharpening the skills of these health workers to further deliver the dividends of a good primary health care system to members of the community (Adrian, 2009).
In terms of the use of appropriate technology, part of the principles of primary health care is that there should be a provision of medical technology which is affordable, accessible, feasible and culturally acceptable to members of the community. In the case of st josephs, the renal Management clinic operates 34 dialysis machines which are utilized for the management of the end stage renal disease patients who are on maintenance hemodialysis.
In terms of using a multi-sectional approach, the fact that health interventions cannot be improved within only the formal health sector, it is important to note the usefulness of other sectors which would contribute to an improved health of individuals of the community. In view of these sectors such as the agricultural sector, communication, housing, public works rural development and industrial sectors are all important because they contribute in one way or the other to the overall well-being of the individual. At St. Joseph’s, there is collaboration with professionals in these other sectors so, that there is an improvement in the health care of members of the community.
The types of primary health care provided by St Joseph’s can be classified into health promotion, prevention, rehabilitation and palliative.
Health Promotion Services
According to WHO, health promotion is the process by which an enabling environment is created whereby people take control over and improve their health. It is a concept that goes beyond a focus on interventions targeted at individuals and shifts towards interventions that are targeted towards the community in general. These interventions can be in form of social or environmental interventions.
Part of the health promotion activities undertaken by St Joseph’s is the staffing of a wellness center which aims at promoting good health among the people of the community. A resource person is always stationed at the wellness center. The resource person does not participate prescribe or administer medications, neither does the person perform invasive procedures. The resource person, however, functions as a health counselor that provides detailed information to people regarding their health and gives them advice on how to stay healthy and live a quality life. The resource person also serves as a liaison with other organizations that provide health promotion services in order to promote wellness and preventive health services among members of the community.
Prevention Services
Prevention is one of the cardinal components of primary health care. It has been said that prevention is cheaper than cure. To this end, preventive health services hold the key to the avoidance of disease conditions by keeping them from afflicting the individual in the first instance. In reality, the Community Renal clinic adheres to the CHN standard of Health maintenance, palliation and restoration to a larger extent as opposed to rendering services bordering on preventive health because a lot of the patients who are referred to this hospital already have chronic kidney disease. Nevertheless, some form of preventive health care is still rendered to the patient in the form of health teaching. This form of health teaching is detailed and it provides the patient with information regarding the management of their disease to prevent further progression of the disease to end-stage renal disease. This invariably allows the patient to enjoy quality life and a t the same time, remove the need for renal replacement therapy which entails dialysis and renal transplantation.
Rehabilitation
Rehabilitation is also an integral component of the management of chronic health conditions like chronic kidney disease. rehabilitation involves the management of the condition in such a way that symptoms of the condition are reduced to the barest minimum while the individual is allowed to live more quality time by the appropriate use of medications to control the symptoms of the disease.
Rehabilitation services are rendered by the nephrologists at St Joseph’s outpatient center. These nephrologists prescribe medications to patients who have already complicated their hypertension by the development of chronic kidney disease with potent antihypertensives that also protect the kidney against further deterioration. Symptomatic relief is also given to patients who have developed some complications of chronic renal failure who present with symptoms such as vitamin D deficiency, painful joints, and anemia. Also for patients who have developed chronic kidney disease as a result of having diabetes mellitus, referral to the endocrinologist is ensured so that blood glucose is tightly controlled. The dietitian is not left out in the holistic care of the patient. The dietitian contributes to improvement in the quality of life of the patients by educating them on the right diet appropriate for them.
St Joseph clinic also has a dialysis unit that operates up to 15 hemodialysis machines which it uses as one of the forms of renal replacement therapy for patients that have such low renal reserves that they need an external device to aid the removal of toxins from the body. Moreover, the hospital is also involved in the home peritoneal dialysis programme. Peritoneal dialysis is another form of renal replacement therapy which also aids removal of toxins from the body. The hospital is one of the national centers for piloting the home peritoneal dialysis programme which is meant to perform peritoneal dialysis procedures in the patient’s home. This project is said to improve the quality of life of the patient.
In conclusion, it is evident that the values and principles of Primary Health Care are evident in the activities of St Joseph hospital. It is also clear that the patients are the primary target of all interventions. The hospital takes part in a lot of programmes aimed at reducing the mortality and morbidity associated with chronic kidney disease thereby improving the quality of life of patients.
REFERENCES
Adrian A (2009). Primary Health Care in Australia: A nursing and midwifery consensus view. Australian Nursing Federation.
Canadian Community Health Nursing, 2011. Standards of Practice in Community Health Nursing: A Literature Review Undertaken to Inform Revisions to the Canadian Community Health Nursing Standards of Practice (updated March 2011). Community Health Nurses. Retrieved July 02, 2013, from http://www.chnc.ca/nursing-standards-of-practice.cfm
Harris M & Lloyd J (2012).The role of Australian primary health care in the prevention of chronic disease.Australian National Preventive Health Agency. Centre for Primary Health Care and Equity, University of NSW.
St Joseph's (2013).Community Renal Centre. St Joseph's Health Centre, Toronto. Retrieved July 02, 2013, from http://www.stjoe.on.ca/programs/family/renal_centre.php
St Joseph's (2013).Renal Therapy Centre. St Joseph's Health Centre, Toronto. Retrieved July 02, 2013, from http://www.stjoe.on.ca/programs/family/renal_therapy.php
