Principles and Standards of CHN with Levels of Care

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Basic Principles of Community Health Nursing (CHN)

1. The community is the patient in CHN, the family is the unit of care and there are four levels of clientele: individual, family, population group (those who share common characteristics, developmental stages and common exposure to health problems - e.g. children, elderly) and the community
2. In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of care
3. CHN practice is affected by developments in health technology, in particular, changes in society, in general
4. The goal of CHN is achieved through multi-sectoral efforts
5. CHN is part of health care system and the larger human service system

Levels of Care

1. Primary Level of Care - is devolved to the cities and the municipalities. It is health care provided by center physicians, public health nurses, rural health midwives, barangay health workers, traditional healers and others at the barangay health stations and rural health units. The primary health facility is usually the first contact between the community members and the other levels of health facility.
2. Secondary Level of Care - Secondary care is given by physicians with basic health training. This is usually given in health facilities and district hospitals and out-patient departments of provincial hospitals. This serves as a referral center for the primary health facilities. Secondary facilities are capable of performing minor surgeries and perform some simple laboratory examinations.
3. Tertiary Level of Care - rendered by specialists in health facilities including medical centers as well as regional and provincial hospitals, and specialized hospitals such as the Philippine Heart Center. The tertiary health facility is the referral center for the secondary health facilities. Complicated cases and intensive care requires tertiary care and all these can be provided by the tertiary care facility.