Saint Louis University

School of Nursing

Community Health Nursing

Executive Summary Per Barangay
(note: this is consolidated by all CIs assigned in the barangay for the semester)

Semester/Term/Schoolyear: _______________
Community Area: ________________________

I. Family Nursing

A. Promotive/Preventive Activities

1. Health Promotion Campaigns Conducted ( list of families is attached per clinical group)

Health Advocacy Topics No. of Family Clients Attended Total

Grp 1 Grp 2 Grp 3 Grp 4 Families
Smoking cessation
Alcohol cessation
Nutrition
Exercise
Environmental sanitation
Hygiene
Waste management
Stress management
(add here other promotive programs
Note: If the same families were monitored based on the attached list of clients, the same number is plotted
by the next group. The total will be based on the highest number seen by all the groups- not the total of all
the groups

2. Health Screening ( list of names of clients is attached per clinical group)

Screening Activities No. of Individuals Total

Grp 1 Grp 2 Grp 3 Grp 4 Individuals
BP taking: Low BP
Normal BP
High BP
Weight Monitoring:
Below normal weight
Normal weight
Above normal weight
Physical examination
Breast Examination
( add other screening activities eg.
sputum exam, benedicts tests, etc)
Note: If the same individuals were monitored based on the attached list of clients, the same number is
plotted by the next group. The total will be based on the highest number seen by all the groups- not the
total of all the groups
3. Sitio Class/ Mothers Class on Disease Prevention and Management

Topic Description of No. of Date and Place

Participants Participants
( mothers, etc.)
Place here in the
chronological order
combined classes
conducted

4. Maternal and Child Services ( list of names of clients is attached per clinical group)
Services Number of Clients Total
Grp 1 Grp 2 Grp 3 Grp 4 clients
Antepartal care
Post partum care
Newborn care
Family planning acceptors
Follow-up of family planning
users
Note: If the same individuals were monitored based on the attached list of clients, the same number is
plotted by the next group. The total will be based on the highest number seen by all the groups- not the
total of all the groups

5. Immunization Services ( list of names of clients is attached)

Immunizations No. of Clients Total

Grp 1 Grp 2 Grp 3 Grp 4 Clients
BCG
Hepatitis
OPV
DPT
TT
Note: If the same individuals were monitored based on the attached list of clients, the same number is
plotted by the next group. The total will be based on the highest number seen by all the groups- not the
total of all the groups

B. Curative Activities ( may also include rehabilitative or palliative services, if any) 1.

Cases Handled ( list of names of clients is attached)

Cases Number of Clients Total

Grp 1 Grp 2 Grp 3 Grp 4 Clients
a. Communicable
diseases
Pulmonary tuberculosis
( add other diseases here)
b. Noncommunicable
diseases
Hypertension
( add other diseases here)
Note: If the same individuals were monitored based on the attached list of clients, the same number is
plotted by the next group. The total will be based on the highest number seen by all the groups- not the
total of all the groups

2. Referrals (Use the two-way referral system of SON)

Name of Client/ Chief Complaint Where/With Results of

Age/Address Whom Referred Referral/Remarks
Place here in
chronological order all
the referred cases

II. Community Development Activities

A. Community Activities/Projects Involvement

Community Activity Nature of Involvement Results of Activity/Partners

Place here in
chronological order all
the community activities
Involved in

B. Linkages and Networking

Agency/Contact Person Purpose of Results of Coordination

Coordination/Linkage /Remarks/Resources Involved
Place here in
chronological order all
Linkages and networking
done

Additional data needed for Level 3 &4

III. COPAR Phases/Critical Activities ( Please check activities performed-)

(Note: there should be evidence of progression of activities following the COPAR process)

Phases and Critical Activities Grp Grp Grp Grp Remarks

1 2 3 4
PRE-ENTRY PHASE
Initial consultations with community key
leaders
Formal communications
Courtesy calls: municipal level
Utilize secondary data for preliminary
social investigation
Agency orientation conducted
ENTRY PHASE
Courtesy call in barangay level
Ocular survey
Community awareness of the immersion
program
Community integration: specify methods of
integration done
Sociogramming
Core group formation/existing core group
identified
Groundworking of core group members
Tentative planning with community core
group members for research
Identifying research group from the core
group and other interested community
members
Training of research core group
Deepening social investigation with
research core group
Completed community diagnosis report
Presentation of research data to the
community
Community development plan formulation
with community
First set of ARAS with community
leaders/core group
ORGANIZATIONAL BUILDING PHASE
Developing/strengthening organizational
structures
Capability building activities/ training:
Core group
Health committees/BHWs
Other interest groups: Specify
Community integration: specify methods of
integration done
ARAS with community conducted as
needed
CONSOLIDATION, STRENGTHENING
AND SUSTENANCE PHASE
Organizational diagnosis
Continuing training/capability building of
peoples organizations (PO)/groups
Networks, linkages and alliance building
POs/groups planning and implementing
development projects/programs
Community integration: specify methods of
integration done
Regular ARAS conducted
Identifying/developing second liners
Income generating projects and other
sustaining mechanisms developed
PHASE OUT
Impact evaluation for phase out
Endorsements: Barangay level
Municipal level
Monitoring of community activities
Disengagement

Prepared by: _____________________________________

Printed Name and Signature of Faculty ( Grp 1)

______________________________________
Printed Name and Signature of Faculty ( Grp 2)

______________________________________
Printed Name and Signature of Faculty ( Grp 3)

______________________________________
Printed Name and Signature of Faculty ( Grp 4)

Date Submitted: ____________________________