CLUSTER 3:

JENAR BUTED
EVANGELYN BAGA
ROSALIE CANDIZ BASILIO

DEVELOPMENTAL PLAN – MMMH AND MC’S EMERGENCY ROOM

PHYSICAL SET UP AND ENVIRONMENT

Description:

The Mariano Marcos MEMORIAL HOSPITAL is Tertiary Hospital located at Bgy. San
Julian, Batac City, Ilocos Norte. From a mere emergency hospital when it was inaugurated on
February 18, 1968, it became a general hospital and finally a Medical Center on March 3, 1981
by virtue of Administrative Order No. 122, s. 1981. Since then, medical and health
services were not only made available to the populace of Ilocos Norte but the Medical Center
has also catered to patients from neighboring provinces - Ilocos Sur, Cagayan, Abra, Kalinga
and Apayao.
This health institution has had ten strong personalities who led in no small measure to its
progress and development over the past three decades. It was formally launched on May 5, 1994
as a Center of Wellness with emphasis on peoples’ participation. Four years ago, it was
designated as a blood bank center for Region I and Upper Cagayan. Designated by the DOH as
an Eye and Cancer Center for Northwestern Luzon it has 17 full time consultants, 16 part-time,
14 visiting consultants and 24 training residents. Six departments have accredited residency
training programs with their respective specialty boards – Pediatrics, Obstetrics and Gynecology,
ENT, Ophthalmology, Anesthesiology and Pathology. The accreditation of the other departments
are under process.
This health care facility is also affiliated with medical and paramedical schools for post-
graduate trainings/rotations in the clinical departments and internship for medical technologists,
pharmacists, physical therapists, nurses, radiologists, midwives and psychologists.
The main building is a five story building. Emergency room, admitting office, pharmacy,
and different laboratories were located at the first floor; operating room, surgical ward and
PACU can be seen at the second floor; delivery room, labor room,PICU, and OB-GYNE at the
third floor;MICU and medical ward were placed at the fourth floor; and pediatric ward as well as
CD ward at the fifth floor. The billing section was located first floor at the annex building while
ENT and ortho. ward can be seen at the second floor of the same building. The OPD complex
was demolished started last November 15,2010 as a 3-story OPD building will be constructed. In
the meantime, all OPD clinics was transferred to the ground floor of the main building as
follows: medicine, ENT, surgery, pedia and OB-GYNE. Opthalmology clinic was located first
floor at the annex building.
The Emergency room chatters all emergency case such as patient who is in trauma
(fracture, laceration cases, mulling, etc.), ob patient who is in their active labor, chronic and
acute diseases. It is one of the critical part of the hospital wherein it involves alertness and
critical decisions of all the health team members. The set up of the emergency room consist of 1
trauma room, 1 ob room, and medicine with 5 bed capacity.
Problem:

Florence Nightingale stated in her nursing notes that nursing "is an act of utilizing the
environment of the patient to assist him in his recovery," that it involves the nurse's initiative to
configure environmental settings appropriate for the gradual restoration of the patient's health,
and that external factors associated with the patient's surroundings affect life or biologic and
physiologic processes, and his development. She focused on the physical aspect of environment.
She believed that "healthy surroundings were necessary for proper nursing care."
Florence Nightingale developed and described the first theory of nursing. She focused on
changing and manipulating the environment in order to put the patient in the best possible
condition for nature to act. She believed that in nurturing environment, the body could repair
itself .

In Florence Nightingale’s theory on the environment, she linked health with eleven
environmental factors: (1) purity and freshness of air, (2) ventilation and warmth, (3) noise, (4)
bed and bedding, (5) purity of water, (6) food, (7) efficiency of drainage, (8) cleanliness of the
surroundings, (9) personal cleanliness, (10) availability of light (especially direct sunlight), and
(11) oobservation and management of the sick.
Being a nurse in the future, we want only the best for our patient. Providing the patient an
environment conducive for their health and faster recovery. Noise is one of the problem in the
emergency room since it is only adjacent to the OPD department, due to its present construction
which then increases the number of watcher who come in to assist patient for their check-ups.
Sometimes the waiting area in the emergency room is also being accumulated by watchers of
OPD patients.
The ill and injured are frequently sensitive to noise that normally would not
disturb them. Noise causes physiologic effects such as an increase in the heart rate, respiratory
rate and such (Kozier, 20040, hence affecting the condition of the patient.

General Objective:
This developmental plan would aim to lessen or minimize the noise in the Emergency
Room. This will be done within the shift (6-8 hours)

Specific Objectives Strategies Resources Time

Allotment
1. Discuss the Students will be ask on their 1. Man power – 10-20
importance of perception on the importance Students, CI minutes
quit of providing a quit
environment to environment for a patient in the
the group. E.R and also ways on how to
minimize it
2. Manimize the 1. As a student nurse we 4. Man power – Within the
noise in the should be the role Students, CI shift
waiting area and model. Assign someone (6-8 hours)
near OPD
in the group to remind
the co-groupmates if
 they are creating noise

2. Assign student nurse

( who does not have
still patient to care or to
admit) to control the
number of watcher (I
per patient as a protocol
of the hospital) and
noise in the waiting are
in the E.R and near the
OPD

3. Collaborate with other

nursing student in the
area (E.R) as well as
those who are assigned
in the OPD department
to in minimizing noise.

Evaluation
After 6-8 hours of the duty the noise in the emergency room has been lessen or minimize.