This document discusses a survey given to student nurses at Lorma Colleges to evaluate the utilization and implementation of various health care services provided by the school clinic. The survey uses a 5-point Likert scale to rate the implementation of medical services, dental services, health education and counseling, and record keeping systems. It also identifies potential problems students may encounter, such as expensive medical or vaccination fees, unavailability of medical staff, lack of awareness of medical exam information, and inability to attend exams due to scheduling conflicts.

1. UTILIZATION OF HEALTH CARE SERVICES OF LORMA COLLEGES
SCHOOL CLINIC AMONG STUDENT NURSES
A. Instruction: Please answer correctly and honestly the questionnaire.
Put a check mark on each medical health services rendered by the school
to the student nurses. The 5 point Likert’s Scale will serve as a basis to
assess and evaluate extent of implementation of health care services
among student nurses where:
5 – Health care services are always implemented
4 – Health care services are often implemented
3 – Health care services are sometimes implemented
2 - Health care services are rarely implemented
1 – Health care services are never implemented
Extent of
Problems
Implementation
Encountered
ASSESSMENT 5 4 3 2 1
1.MEDICAL SERVICES
a.) I am allowed to visit
during illness.
b.)
c.) I receive medicine per
doctor’s order
d.) I receive immunization
annually
e.)
f.) I receive nebulization
g.) Performance of wound
dressing.
h.) Accuracy of first aid
treatment and initial
nursing assessments
during time of emergency
situation.
i.) Makes himself/herself
available during the time
of consultation.
2.DENTAL SERVICES
a.) Provides dental
checkups.
b.) Provides a corrective
services like tooth
extraction.

2. c.) Provides preventive
services like dental
cleaning.
d.) Makes himself/herself
available during the
scheduled time of
consultation.
e.) Provides follow up
checkups.
3. HEALTH EDUCATION
AND COUNSELING
a.)Disseminates
information like schedule
of immunization and
semestral checkup
b.)Orients/reorients higher
years about medical
examination prior to
enrolment (i.e pregnancy
test)
d.)Provides follow up
services
e.)Provides information
(stress management,
emotional problems)
f.)Provides counseling
services like conference
with parents or guardians
about student’s health
problems.
4. RECORD SYSTEM
a.)Files medical records of
student nurses.
b.) Stores or preserves
medical records.
c.) Protects confidentiality
of medical records.
d.) Allows access to
student’s medical records.
e.) Updates the medical
record during
consultation.

3. B. Put a check mark on the space provided for every item.
Yes No
1. Medical fee is expensive.
2. Hepatitis B vaccine is expensive.
3.Inavailability of the following prior to medical
examination:
a.) School Physician
b.) School Nurse
c.) School Dentist
4. Lack of awareness of the medical examination
information.
5. Inability to come on the day of schedule due to
unavoidable circumstances.
6. Presence of conditions that may interfere with accurate
result of medical examination.
7. Lack of financial assistance to complete all necessary
requirements.
8. There’s no schedules posted.
Others please specify:
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