American NRI college of Nursing (ANA)

1. INTRODUCTION

2. CONCEPT OF HEALTH
 Health is a state of complete physical ,
mental and social well being but not
merely absence of disease.
 Acc to World health organization
 It describes how wellbeing is more
than simply an absence of illness, but
also incorporates the individual's
mental and emotional health.

3. CONCEPT OF WELLNESS AND WELL BEING
 Wellness is a state of well being
 Well being is:
-- subjective perception of vitality and
feeling well.
-- described, measured and
experienced objectively.
-- plotted on a continuum

4. Dimensions of wellness
1. Physical dimension
--- ability to perform ADL.
--- ability to achieve fitness.
--- ability to maintain nutrition.
--- ability to avoid abuses.
2. Social dimension
--- ability to interact successfully.
--- ability to develop and maintain intimacy
--- ability to develop respect and tolerance towards others.
3. Emotional dimension.
--- ability to manage stress.
--- ability to express emotion.

5. 4. Intellectual dimension.
--- ability to learn.
--- ability to use the information effectively.
5. Spiritual dimension.
--- belief in some force that serves to unite
6. Occupational dimension.
--- ability to achieve balance between work
and leisure.
7. Environmental dimension.
--- ability to promote health measures that
improves,…
Standard of living
Quality of life.

6. MODELS OF HEALTH AND WELLNESS
I. Holistic health models.
II. Health belief model.
III. Health promotion model.

7. I. Holistic health model

8. II. Health belief model- Rosenstock

9. III. Health promotion model- Pender

10. MASLOW’S HIERARCHY OF NEEDS
 Basic human needs are elements that
are necessary for human survival and
health.
Ex: food, water, safety , love,….
 Maslow’s hierarchy of need’s is a
model that nurses use to understand
the interrelationship of basic human
needs.
 Acc to this model certain basic human
needs are more basic than others.
 Self actualization is the highest

12. ILLNESS WELLNESS CONTINUUM
 Wellness is a process, never a static
state.
 The Illness-Wellness Continuum is a
graphic illustration of a wellbeing
concept first proposed by John W.
Travis in 1972.
 It describes how wellbeing is more
than simply an absence of illness, but
also incorporates the individual's
mental and emotional health.

14.  Travis believed that the standard
approach to medicine, which assumes
a person is well when there are no
signs or symptoms of disease, was
insufficient.
 This led to his development of the
Continuum. The right side of the
Continuum reflects degrees of
wellness, while the left indicates
degrees of illness.

15.  The Illness-Wellness Continuum has been
used to highlight how, even in the absence of
physical disease, an individual can suffer
from depression, anxiety or other conditions
indicating a lack of wellness.
 While traditionally medicine typically treats
injuries, disabilities, and symptoms, to bring
the individual to a "neutral point" where no
illness is present, the Wellness Paradigm
seeks to move the individual’s state of
wellbeing further along the continuum
towards optimal emotional and mental states.
 The concept is premised on the idea that
wellbeing is a dynamic rather than a static
process.

17.  The Illness-Wellness Continuum proposes
that individuals can move further to the right,
towards health and wellbeing, through
awareness, education, and growth.
 Conversely, worsening states of health are
reflected by signs, symptoms, and disability.
In addition, a person's outlook plays a major
role in moving along the Continuum in either
direction.
 A positive outlook will enhance the
individual’s health and wellbeing, while a
negative outlook will hinder it, independent of
present health status.
 For example, a person who demonstrates no
symptoms of disease, but is constantly
complaining, would be facing the left side of
the Continuum, toward an early death.

18.  However, a person having a disability, but still
maintaining a positive outlook, will be facing
to the right, toward a high level of wellness. It
is less important where a person is on the
continuum than which direction they are
facing.
 The Illness-Wellness Continuum has been
praised for promoting preventive treatment—
improving wellbeing before an individual
presents with signs or symptoms of illness,
as well as educating people to be aware of,
and consequently avoiding risk factors,
protecting against pathology and an early
death.

19. FACTORS INFLUENCING
HEALTH

20. I) Biological factors:
 (a)Pathogenic microorganism
 (b) Biologic-heredity factor
 (c) Other factors: age, sex, growth and
development
II) Environmental factors
(a) Natural environment: air pollution, climate,
water pollution, soil pollution, radiation, noise.
(b) Social environment:
 political and economic system in the society
 social and cultural system
III) Life style
IV) Psychological factors
 Psychological factors → emotion and
feelings → Physiological function

21. Physical environment – safe water and
clean air, healthy workplaces, safe
houses, communities and roads all
contribute to good health.
Employment and working conditions
people in employment are healthier,
particularly those who have more control
over their working conditions
Social support networks – greater
support from families, friends and
communities is linked to better health.
Culture - customs and traditions, and the
beliefs of the family and community all
affect health.

22. Genetics - inheritance plays a part in
determining lifespan, healthiness and the
likelihood of developing certain illnesses.
Personal behavior and coping skills –
balanced eating, keeping active,
smoking, drinking, and how we deal with
life’s stresses and challenges all affect
health.
Health services - access and use of
services that prevent and treat disease
influences health.
Gender - Men and women suffer from
different types of diseases at different
ages.

23. Income and social status - higher
income and social status are linked to
better health. The greater the gap
between the richest and poorest
people, the greater the differences in
health.
Education – low education levels are
linked with poor health, more stress
and lower self- confidence.

24. THE DETERMINANTS OF HEALTH
The determinants of health include:
 The social and economic environment,.
 The physical environment.
 The person’s individual characteristics
and behaviors.

27. ILLNESS
A disease or period of sickness
affecting the body or mind.
A specific condition that prevents your
body or mind from working normally :
a sickness or disease.
A condition of being unhealthy in your
body or mind.

28. ILLNESS BEHAVIOUR
It is any behavior undertaken by an individual
who feels ill to relieve that experience or to
better define the meaning of the illness
experience.
Illness is a social state.
It is not just a disturbance of body and has
social meanings and impact i.e. it is partially
the result of disease but is also determined
by social and cultural factors.
Sometimes a distinction is made between
disease (medical definition) and illness (lay
person’s perception). Can be sick but no
symptoms, can feel ill but no
disease/condition

29. SICK ROLE
Two Rights
 Sick people are exempt from
performing their normal social roles.
 Sick people are exempt from
responsibility for their own state.
Two Obligations
 To get better as soon as possible.
 To consult and co-operate with
medical experts whenever severity of
condition warrants it.

30. Component of sick role.
1. Promotes individual health.
2. Social control of occupancy of status
‘sick’.
3. Doctor as gatekeeper (legitimates
illness and occupancy of sick role).
4. Privileges dependent on duties.
5. Promotes health of society.
6. Controls number of people opting out
of normal roles & responsibilities.
7. Returns sick people to health.

31. STAGES OF ILLNESS EXPERIENCE
 Edward Suchman (1965) devised an orderly
approach for studying illness behavior with his
elaboration of the five key stages of illness
experience:
 (1) symptom experience.
 (2) assumption of the sick role.
 (3) medical care contact.
 (4) dependent patient role.
 (5) recovery and rehabilitation.
 Each stage involves major decisions that must
be made by the individual that determine whether
the sequence of stages continue or the process
is discontinued.

33. IMPACT OF ILLNESS ON
PATIENT AND FAMILY

34. Impact of illness on patient
Short – term and minor illnesses
awoke few behavioral changes in the
functioning of the patient or family.
Severe illness can lead to more
extensive emotional and behavioral
changes such as anxiety, shock,
denial, anger and withdrawal.

35. Impact on family roles
When an illness occurs, the role of
patients and family may change.
This change may be subtle and short
term or drastic and long term.
The patient and family require specific
counseling and guidance to assist
them in coping with the role changes
during illness.

36. When serious illness or disability strikes a
person, the family as a whole is affected by
the disease process and by the entire health
care experience.
Patients and families have different needs for
education and counseling.
Because each person in a family plays a
specific role that is part of the family’s
everyday functioning, the illness of one family
member disrupts the whole family.
When a family member becomes ill, other
family members must alter their lifestyle and
take on some of the role functions of the ill
person, which in turn affects their own normal
role functioning.

37. Illness may cause additional strain as
the result of economic problems and
interruptions in career development. If
the patient is a young child, there may
be additional strain to the family if
there are siblings whose needs must
also be met.
Illness in the middle stage of family
life, when adolescents are trying to
break away from family ties and
parents are going through their own
mid- life transitions, may put further
strain on what is already a time of
potential family turmoil.

38. Illness in later age may have an impact
not only on grown children but also on
the older couple who had anticipated a
time of enjoyment together and are less
able to care for each other because of
their own physical limitations associated
with aging.
The extent of family disruption depends
on the seriousness of the illness, the
family’s level of functioning before the
illness, socioeconomic considerations,
and the extent to which other family
members can absorb the role of the
person who is ill.

39.  In some instances, a major illness
brings a family closer together; in
others, even a minor illness causes
significant strain.
 It is important to identify what the
illness means, not only to the
individual but also to the family.
 Asking them what they consider major
problems and how they plan to handle
specific situations can help you
assess the meaning of the patient’s
illness to the family.

40.  To achieve effective patient teaching
outcomes, you should make the family part of
your teaching plan.
 For example, if your patient’s wife does all the
cooking in the home, it is vital to include her
in diet teaching. Involving family members
may be an important future source of support
for the patient as he or she works at
behavioral change.
 Obviously it will be difficult for a husband to
be supportive of his wife’s blood pressure
treatment program if he does not understand
the reasons for the recommendations and the
consequences of not carrying them out.

41.  Long-term illness, even in the most
stable and supportive families, brings
changes in family relationships. Illness
produces disequilibrium in the family
structure until adjustments can occur.
 When teaching the patient and family,
it is important to identify patterns of
relationships and to be alert to
attitudes of family members.
 Illness in a family member tends to
raise the anxiety of all those close to
the patient.

42. BODY DEFENSES: IMMUNITY
AND IMMUNIZATION

43. INTRODUCTION
The environment contains a wide
variety of potentially harmful
organisms (pathogens), such as
bacteria, viruses, fungi, protozoa and
multi cellular parasites, which will
cause disease if they enter the body
and are allowed to multiply.
The body protects itself through a
various defense mechanisms to
physically prevent pathogens from
entering the body or to kill them if they
do.

44. DEFINITION
The term immunity refers to the body’s
specific protective response to an
invading foreign agent or organism.
The human body has the ability to
resist almost all types of organisms or
toxins that tend to damage the tissues
and organs. The capability is called
immunity

45. TYPES OF IMMUNITY

46. Types of immunity
Broadly there are two types of
immunity.
1. Innate or natural immunity
2. Acquired immunity

47. 1. Innate or natural immunity
 Immunity with which an individual is
born is called innate or natural
immunity.
 Innate immunity is provided by various
components such as skin, mucus
membrane, phagocytic cells etc,..
 Innate immunity acts as first line of
defense to particular microorganisms.

48. Mechanism of innate immunity
1. Anatomical barrier.
2. Physiochemical barrier.
3. Phagocytosis or phagocytic barrier.
4. Inflammation or inflammatory barrier.

49. I. Natural immunity
It is a nonspecific immunity present at
birth.
It is the ability to distinguish between
friend and foe or self and non-self.
Such natural mechanisms include 1.
Physical and chemical barriers – Skin
and mucous membrane –
Antimicrobial substance in body
secretions 2. The action of WBCs 3.
Inflammatory response.

50. Physical and chemical barriers Skin and mucous
membrane • Intact skin & mucous membrane -
physical barrier to invading microbes. • Sebum
and sweat secretion - contains antibacterial and
antifungal substances • Hairs in the nose acts as
a coarse filter. • One way flow of urine from the
bladder during micturation
Antimicrobial substance in body secretions 1.
Hydrochloric acid in gastric juice 2. Lysosomes 3.
Saliva 4. Immunoglobulin in nasal secretions and
saliva (IgG, IgA, IgM, IgD and IgE, which have a
range of functions.)
Inflammatory response • Major function of the
natural immune system. • Chemical mediators
assist this response by minimizing blood loss,
walling off the invading organism, activating
phagocytes and promoting formation of fibrous
scar tissue and regeneration of injured tissue

51. TYPES OF INNATE IMMUNITY:
 Species immunity
 Racial immunity
 Individual immunity

52. 1. SPECIES IMMUNITY
 If one species is resistant to certain infection and
the other species is susceptible to the same
infection then it is called as species immunity.
 Anatomic, physiological and metabolic
differences between species determine species
immunity. For example, Birds are resistant to
anthrax but Human are susceptible. It is simply
because higher body temperature of birds
kills Bacillus anthracis.
 Anatomic differences between species also
determine species immunity. For example,
Human are more susceptible to skin infection
whereas Cattles are more resistant to the same
skin infection. It is because of tough and hairy
skin (hides) of Cattles.

53. 2. RACIAL IMMUNITY
If one race is susceptible while other
race is resistant to same infection, then it
is called Racial immunity.
For examples; certain African race are
more resistant to malaria and yellow
fever where are Asian or Americans are
susceptible to same infection. Similarly
Orientals (East Asia) are relatively
resistant to syphilis.
Racial immunity is determined by
difference in Socio-economic status,
habitat, culture feeding habits,

54. 3. INDIVIDUAL IMMUNITY
If one individual of certain race or cast is
resistant while other individuals of same
race or cast are susceptible to certain
infection, then it is called as individual
immunity
Individual immunity is determined by
various factors such as health status,
nutritional status, previous illness,
personal hygiene, genetic differences
etc.
For examples; Individual with genetic
deficiency of glucose-6 phosphate
dehydrogenase are resistant to Malaria.

55. 2. Acquired or developed immunity
Immunity which is developed later in life after
microbial infection in host is called as
Acquired or developed immunity. For
example, If an individual is infected with
chicken pox virus, he/she become resistant to
same virus in later life.
Acquired immunity is provided by Antibodies
and certain T-lymphocytes.
Components of acquired immunity such as
Antibodies and T- cells are specific to
particular microorganism. Therefore acquired
immunity is also known as Specific immunity.

56. Characteristics of acquired immunity
1. Specificity
2. Self/non-self recognition
3. Immunological memory
4. Diversity

57. Types of acquired immunity:
Active immunity
Passive immunity
1. Active immunity:
If host itself produces antibodies, it is
called active immunity.
It is of two types; artificial active
immunity and natural active immunity.
 Artificial active immunity: Immunity
provided by vaccination.
 Natural active immunity: immunity
provided by natural infection.

58. 2. Passive immunity:
 If host does not produce antibodies itself
but antibodies produced in other host
provides immunity, than it is known as
Passive immunity.
 It is of two types; natural passive
immunity and Artificial passive immunity
Natural passive immunity: IgG antibody
produced in mother cross placenta and
protects fetus up to 6 month old age.
Artificial passive immunity: if preformed
antibody are injected into host for
immunity. Eg. Anti-venom, Rabies
vaccine (* it is not a vaccine, it is
preformed anti rabies antibody)

59. 1. IgG
 IgG (75% of total immunoglobulin)
 • Appears in serum and tissues (interstitial fluid)
 • Assumes a major role in blood borne and tissue infections.
 • Activates the complement system.
 • Crosses the placenta
2. IgA
 IgA (15% of total immunoglobulins)
 • Appears in body fluids (blood, saliva, tears, breast milk, and
pulmonary, gastrointestinal, and vaginal secretions).
 • Protection against respiratory, gastrointestinal and genitourinary
infections.
 • Prevents absorption of antigens from food.
 • Passes to neonate in breast milk for protection

60. 3. IgM
 IgM (10% of total immunoglobulins)
 Appears mostly in intravascular serum
 Appears as the first immunoglobulin produced in
response to bacterial and viral infections.
 Activates the complement system.
4. IgD
 IgD (0.2% of immunoglobulins)
 Appears in small amounts in serum
 Possibly influences B-lymphocytes differentiation, but
role is unclear.
5. IgE
 IgE (0.004% of immunoglobulins)
 Appears in serum
 Takes part in allergic and hypersensitivity of reactions
 Combats parasitic infections.

61. Line of defence
Prevents infection through a number of non-specific and specific
mechanisms working on their own or together.
First lines of defense are external barriers that prevent germs from
entering.
Skin which acts as a strong, waterproof, physical barrier and very few
organisms are able to penetrate undamaged skin.
Skin
a strong physical barrier, like a waterproof wall.
Mucus
a sticky trap secreted by all the surfaces inside the body that are
directly linked to the outside, also contains antibodies and enzymes
Cilia
microscopic hairs in the airways that move to pass debris and mucus
up away from the lungs
Lysozyme
a chemical (enzyme) present in tears and mucus that damages
bacteria •
Acid
in stomach and urine, make it hard for any germs to survive
Fever
elevated body temperature making conditions unfavorable for
pathogens to survive

62. IMMUNIZATION

63. DEFINITION
 Immunization is the process whereby
a person is made immune or resistant
to an infectious disease, typically by
the administration of a vaccine.
 Vaccines stimulate the body’s own
immune system to protect the person
against subsequent infection or
disease.

64. ADVANTAGES OF VACCINE
1. Protect us from serious diseases
2. Prevent the spread of those diseases
3. Epidemics of once common
infectious diseases such as measles,
mumps, and whooping cough

66. HEALTH PROMOTION AND
PREVENTION

67. Health promotion: Activities to improve
health & well-being
Health prevention : The Management Of
Those Factors That Could Lead To
Disease So As To Prevent The
Occurrence Of the Disease.
- Mosby dictionary
Health promotion is about achieving the
best possible health for everyone. It is
difficult to improve an individual’s health
if the economic, environmental and
social conditions are bad. Interventions
are changes made to individual and
social circumstances to maximize
opportunities to achieve good health

68.  WHO defines health promotion as the
process of “enabling people to
increase control over, and to improve,
their health”. (1986)
 Health promotion is based around the
saying “Prevention is better than cure”
and it aims at preventing morbidity
and mortality.

69. Individual role in health promotion
 Individual’s play a key role in promoting their
health, because personal behavior is the major
determining factor of health status.
 For health promotion to be effective, individuals’
need to be empowered. This refers to an
individual’s ability to make decisions about, or
have personal control over their life.
 Individuals working in health-related areas are
able to assist people to gain control over their
health.
 Ex: general practitioners, counselors, dentists,
health workers, community nurses.
 Other individuals who are involved in improving
health also include health educators, social
workers, community workers and environmental
health officers.

70. Community groups and school
role in health promotion
Community groups and schools are
important settings for health
promotion, after all these are the
places where we live, work and play.
Communities should be able to
contribute to discussion and
participate in the setting of health
policies.
Our schools also need to places that
promote health among our young

71. Role of NGOs in health promotion
 Non-government Organizations are non-profit
making organizations that operate at local,
national or international levels.
 They are funded from a variety of sources
including government grants, public donations
and fundraising.
 Non-government organizations (NGO's) play a
crucial role in the health of Australians. For
example, many organizations such as
universities conduct health research into the
prevention, detection, and treatment of disease.
 While other NGO's contribute in various ways,
including raising funds for research, running
educational and health promotion programs,
providing support services and coordinating
voluntary care.

72. Role of state and local
government in health promotion
State Governments are also
responsible for campaigns that target
specific health promotion and disease
prevention programs.
Local Governments support the state
government in implementing health
promotion

73. LEVELS OF PREVENTION

74. Primordial prevention.
Primary prevention.
Secondary prevention.
Tertiary prevention.

75. I. Primordial prevention
 Definition: “It is the prevention of
emergence of risk factors in
populations, in which they have not
yet appeared”.
 INTERVENTIONS: The main
intervention in primordial prevention is
through individual and mass health
education.
II. Primary prevention
 Definition: Primary prevention can be
defined as action taken prior to the
onset of disease, which removes the
possibility that a disease will ever

76. Primary prevention Strategy…..
 Population (mass) Strategy: It is
directed at the whole population
irrespective of an individual risk levels.
 High- risk Strategy: It aims to bring
preventive care to individuals at
special risk. This requires detection of
individuals or high risk by the optimum
use of clinical methods.

77. General Health promotion
1. Health education.
2. Environmental modifications.
3. Nutritional interventions.
4. Lifestyle and behavioral changes.
5. Health education to improve healthy habits and
health consciousness in the community.
6. Improvement in nutritional standards of the
community.
7. Healthful physical environment (Housing, water
supply, excreta disposal, etc.)
8. Good working condition.
9. Marriage Counseling.
10. Periodic Selective examination of risk
population.

78. Specific protection:
1. Use of Specific immunization (BCG,
DPT,MMR vaccines).
2. Chemoprophylaxis (tetracycline for Cholera,
dapsone for Leprosy, Chloroquine for
malaria,etc.,).
3. Use of specific nutrients (vitamin A for
Children, iron folic acid tablets for Pregnant
mothers)
4. Protection against accidents (Use of helmet,
seat belt,etc.,)
5. Protection against occupational hazards.
Avoidance of allergens.
6. Protection from air pollution.

79. III. Secondary Prevention
Definition: The action which halts the
progress of a disease at its incipient
stage and prevents complications”.
 Objectives of secondary prevention:
• Complete cure and prevent the
progression of disease process.
• To prevent the spreads of disease by
curing all the known cases.
• To prevent the complications and
sequel of disease.
• To shorten the period of disability.

80. INTERVENTIONS:
 Individual and mass case-finding
measures.
 Screening surveys(urine examination
for diabetes, etc.,).
 Selective examination

81.  IV. Tertiary prevention
 Definition: All measures available to reduce or limit
impairments and disabilities, minimize suffering caused
by existing departures from good health and to promote
the patient’s adjustment to irremediable conditions
Modes of intervention :
 i) Disability limitation
 ii)Rehabilitation
Disability limitation:
 i) Disease Impairment
 Ii) Disability Handicap
Rehabilitation :
1. Medical rehabilitation: (restoration of Bodily Function).
2. Vocational rehabilitation:( restoration of the capacity to
earn a livelihood).
3. Social rehabilitation: (restoration of family and social
relationship).
4. Psychological rehabilitation: (Restoration of personal
dignity and confidence)

82. HEALTH CARE TEAMS
The health care team consists of a
group of people who coordinate their
particular skills in order too assist a
patient or his family.
The personnel, who comprise a
particular team will depend upon the
needs of a patient.

83. The Health Care Team consists of ---
1. Health Team Physicians Nurses
2. Social Workers
3. Auxillary Personnel
4. Village Health Guides
5. Trained Dais
6. Health Assistants

84. THE PHYSICIAN
 In hospital setting, the physician is
responsible for the medical diagnosis & for
determining the therapy required by a person
who is ill or injured.
 A physician is a person who is legally
authorized to practice medicine in particular
jurisdiction.
NURSE
 A number of nursing personnel may be
involved in the health team & may have their
own nursing team. A nursing team is
comprised of personnel who provide nursing
service to a patient or his family.
 The team leader “Head Nurse” is responsible
for delegation of duties to members of her
team & care given to the patients.

85. THE DIETITIAN
 When dietary & nutritional services are required
a dietitian may also the member of the health
team.
 Dietitians supervise the preparation of meals
according to the doctor’s prescription.
 The nutritionist in a community setting
recommends health diets for people & is
frequently involves in board advisory services in
regard to purchase & preparation of food.
THE PHYSIOTHERAPIST
 The physiotherapist provides assistance to a
patient who has problem related to his
musculoskeletal system.
 Their functions include; assessing mobility &
strength, providing therapeutic measures, &
teaching patients news skills & measures.

86. MEDICAL SOCIAL WORKER
THE SOCIAL WORKER
 The patient & his/her family member are assisted by
social worker with such problems such as finances, rest
home accommodation, counseling or marital problems,
adoption of children.
THE OCCUPATIONAL THERAPIST
 The occupational therapist assists patients with some
impairment of function to gain skills as they are related
to Activities of Daily Living (ADL) & help with a skill that
is therapeutic.
THE PARAMEDICAL TECHNOLOGIST
 It includes laboratory technologies, radio-logic
technologists.
 The Laboratory technologists examine & study
specimens such as urine, feces, blood & discharges
from wound.

87. RADIOLOGIST
 The radiologic technologist assist with wide
variety of x-ray procedures, from simple chest
radiograph to more complex fluoroscopy.
 Through radio active materials, nuclear
medicine technologist can provide diagnostic
information about functioning of a patient’s
liver etc.
THE PHARMACIST
 The pharmacist prepares & dispenses
pharmaceuticals in hospitals & community
settings.
 The role of pharmacist in monitoring &
evaluating the actions of medications on
patients is becoming increasingly prominent

88. THE INHALATION THERAPIST
 The inhalation therapist or respiratory technologist is
skilled in therapeutic measures used in care of patients
with respiratory problems.
 These therapist are knowledgeable about oxygen
therapy, devices, intermittent positive pressure
breathing respirators, artificial mechanical ventilators,
accessory devices used for inhalation.
PSYCHOLOGIST
 The clinical psychologist constitutes an important
member in the health care team.
 The psychological dimension of a person is looked into
and the health care services are accordingly planned.
CLERGY
 The spiritual dimension of a patient comes into play
more during a person’s illness.
 Patients who draw their spiritual strength from God are
the ones who successfully cope with illness. The role of
a clergy is therefore very important.

89. HEALTH CARE AGENCIES
ASSIGNMENT

90. HOSPITALS

91.  Hospitals are organized Institutions,
which are mainly designed to care for
the sick, injured and the well.
 The later are usually admitted for
physical check up and investigations
which cannot be done elsewhere.
 The word hospital is derived from the
Latin word "hospess“ which means a
guest or a host.
 This is quite true for a patient leaves
his home and comes to the hospital as
a guest for brief periods of stay.

92. DEFINITION
“ A hospital is an integral part of a social
and medical organization, the function
of which is to provide for the
population, the complete care both
curative and preventive and whose out
patient services reach out to the family
and his home environment”
- Acc to WHO

93. TYPES OR CLASSIFICATION OF
HOSPITALS.
I. Acc to the type of patient or service
offered:
 General hospital
_ Care is given to many kinds of
conditions such as medical, surgical,
pediatric and obstetrics including
psychiatry and communicable
diseases.
 Special hospital
_ It limits its services to particular
condition or sex or age such as
tuberculosis, maternity etc,…

94. II. Acc to the ownership:
 Government hospital
_ These government hospitals may be general
or specialized according to he need of the
community
 Medical college hospital
 District hospital
 City or town or head quarter hospital
 Primary health centre
 Rural hospital
 ESI hospital
 Non government or private hospital
 Medical college hospital
 Mission hospital
 Private hospital
 Industrial

95. III. Acc to the size of the bed capacity:
 Small hospital
100 or less than hundred beds
 Medium size hospital
 101-300 beds
 Large hospitals
301-1000 bedded hospital

96. IV. Acc to the bed strength:
 Teaching or referred hospital
500 or above beds
 District hospital
 200 -300 beds
 Taluk hospital
50-200 bedded hospital
 Community health centre
 30-50 beds
 Primary health centre
 06-10 beds

97. V. Acc to the Objectives:
 Teaching cum referred hospital
 General hospitals
 Specialized hospitals
 Isolation hospitals
VI. Acc to the System:
 Allopathic hospital
 Ayurvedic hospital
 Homeopathic hospitals
 Unani hospitals

98. VI. Acc to the Management:
 Union govt/ Govt of India
 State government
 Local bodies
 Autonomous bodies
 Private
 Voluntary hospital

99. Functions of hospital
The main aim of a hospital is patient care
and comfort and the nurse has much to
contribute in not only doing her functions,
but also in coordinating the activities of
the health team.
Besides the basic functions of a hospital
such as care of the sick and injured,
diagnosis, treatment and rehabilitative
services, many undertake education of
doctors, nurses, technicians etc., as an
added function.
Some hospitals do research work.

100.  So as to list down, the functions are as
follows—
1. Investigation, disease and care of the
sick and injured people.
2. Health supervision and prevention of
disease.
3. Education of medical workers as
doctors, nurses, dieticians, social
workers… etc.
4. Medical research.
5. Promotion of health.
6. Rehabilitation.
7. Scientific therapy of hygiene and
mental therapy.

101. There are various departments in a
hospital like medical, nursing, pharmacy,
and dietary.
Every hospital and its departments have
own policies and rules, which govern
their various activities.
The nurse should acquaint herself with
the policies and interpret those
connected with the patient's admission,
treatment and discharge to the patient's
relatives in a simple language.
They must be careful and get the
guidance of seniors when dealing with
accident patients and other patients with
legal implications (medico-legal).

102. ORGANIZATIONAL CHARTS
OF A HOSPITAL
--- ASSIGNMENT

103. THANK YOU