MODULE 2: NURSING PRACTICE IN THE COMMUNITY (Week 3-4)

LESSON 1: THE COPAR PROCESS

COPAR or Community Organizing Participatory Action Research is a vital part of public health nursing.
COPAR aims to transform the apathetic, individualistic and voiceless poor into dynamic, participatory and
politically responsive community.

Definition
● COPAR stands for Community Organizing Participatory Action Research
● A social development approach that aims to transform the apathetic, individualistic and voiceless poor into
dynamic, participatory and politically responsive community.
● A collective, participatory, transformative, liberative, sustained and systematic process of building people’s
organizations by mobilizing and enhancing the capabilities and resources of the people for the resolution of
their issues and concerns towards effecting change in their existing oppressive and exploitative conditions
(1994 National Rural Conference).
● A process by which a community identifies its needs and objectives, develops confidence to take action in
respect to them and in doing so, extends and develops cooperative and collaborative attitudes and practices
in the community (Ross 1967).
● A continuous and sustained process of educating the people to understand and develop their critical
awareness of their existing condition, working with the people collectively and efficiently on their
immediate and long-term problems, and mobilizing the people to develop their capability and readiness to
respond and take action on their immediate needs towards solving their long-term problems (CO: A manual
of experience, PCPD).

Emphasis of COPAR
1. Community working to solve its own problem.
2. Direction is established internally and externally.
3. Development and implementation of a specific project less important than the development of the
capacity of the community to establish the project.
4. Consciousness raising involves perceiving health and medical care within the total structure of
society.

Importance COPAR
1. COPAR is an important tool for community development and people empowerment as this helps the
community workers to generate community participation in development activities.
2. COPAR prepares people/clients to eventually take over the management of a dvelopment.programs
in the future.
3. COPAR maximizes community participation and involvement; community resources are mobilized
for community services.

Principles of COPAR
1. People especially the most oppressed, exploited and deprived sectors are open to change, have the
capacity to change and are able to bring about change.
2. COPAR should be based on the interest of the poorest sector of the community.
3. COPAR should lead to a self-reliant community and society.

Critical Steps of COPAR Process

1. Integration
2. Social Investigation
3. Tentative program planning
4. Groundwork
5. Meeting
6. Role Play
7. Mobilization or action
8. Evaluation
9. Reflection
10. Organization
 MODULE 2: NURSING PRACTICE IN THE COMMUNITY (Week 3-4)

Phases of COPAR
COPAR has four phases namely: Pre-Entry Phase, Entry Phase, Organization-building phase, and sustenance
and strengthening phase.

1. Pre-Entry Phase
Is the initial phase of the organizing process where the community organizer looks for
communities to serve and help. Activities include:

Preparation of the Institution

● Train faculty and students in COPAR.
● Formulate plans for institutionalizing COPAR.
● Revise/enrich curriculum and immersion program.
● Coordinate participants of other departments.

Site Selection
● Initial networking with local government.
● Conduct preliminary special investigation.
● Make long/short list of potential communities.
● Do ocular survey of listed communities.

Criteria for Initial Site Selection

● Must have a population of 100-200 families.
● Economically depressed.No strong resistance from the community.
● No serious peace and order problem.
● No similar group or organization holding the same program.

Identifying Potential Municipalities

● Make long/short list of potential municipalities

Identifying Potential Community

● Do the same process as in selecting municipality.
● Consult key informants and residents.
● Coordinate with local government and NGOs for future activities.

Choosing Final Community

● Conduct informal interviews with community residents and key informants.
● Determine the need of the program in the community.
● Take note of political development.
● Develop community profiles for secondary data.
● Develop survey tools.
● Pay courtesy call to community leaders.
● Choose foster families based on guidelines

Identifying Host Family

● House is strategically located in the community.
● Should not belong to the rich segment.
● Respected by both formal and informal leaders.
● Neighbors are not hesitant to enter the house.
● No member of the host family should be moving out in the community.
MODULE 2: NURSING PRACTICE IN THE COMMUNITY (Week 3-4)

2. Entry Phase
Sometimes called the social preparation phase. Is crucial in determining which strategies for
organizing would suit the chosen community. Success of the activities depend on how much the
community organizers has integrated with the community.

Guidelines for Entry

● Recognize the role of local authorities by paying them visits to inform their presence and activities.
● Her appearance, speech, behavior and lifestyle should be in keeping with those of the community
residents without disregard of their being role model.
● Avoid raising the consciousness of the community residents; adopt a low-key profile.

Activities in the Entry Phase

● Integration. Establishing rapport with the people in continuing effort to imbibe community life.
o living with the community
o seek out to converse with people where they usually congregate
o lend a hand in household chores
o avoid gambling and drinking
● Deepening social investigation/community study
o verification and enrichment of data collected from initial survey
o conduct baseline survey by students, results relayed through community assembly

Core Group Formation

● Leader spotting through sociogram.
o Key Persons. Approached by most people
o Opinion Leader. Approached by key persons
o Isolates. Never or hardly consulted

3. Organization-building Phase
Entails the formation of more formal structure and the inclusion of more formal procedure of
planning, implementing, and evaluating community-wise activities. It is at this phase where the
organized leaders or groups are being given training (formal, informal, OJT) to develop their style in
managing their own concerns/programs.

Key Activities
● Community Health Organization (CHO)
o preparation of legal requirements
o guidelines in the organization of the CHO by the core group
o election of officers
● Research Team Committee
● Planning Committee
● Health Committee Organization
● Others
● Formation of by-laws by the CHO

4. Sustenance and Strengthening Phase

Occurs when the community organization has already been established and the community
members are already actively participating in community-wide undertakings. At this point, the different
committees setup in the organization-building phase are already expected to be functioning by way of
planning, implementing and evaluating their own programs, with the overall guidance from the
community-wide organization.

Key Activities
● Training of CHO for monitoring and implementing of community health program.
● Identification of secondary leaders.
● Linkaging and networking.
● Conduct of mobilization on health and development concerns.
● Implementation of livelihood projects.
 MODULE 2: NURSING PRACTICE IN THE COMMUNITY (Week 3-4)

LESSON 2: BAG TECHNIQUE

Definition of Terms
● Bag Technique- a tool use of a public health bag through which the public health nurse, during his/ her
home visit can perform nursing procedures with ease; knowing he/ she has with them their materials, it
saves time & energy with the end view of rendering effective nursing care
● Plan of visit- an essential tool in achieving the best results in home visiting
● Home visit- a professional face to face contact made by a public health nurse to the patient or the family
to provide health care activities
● Family-Nurse Contact- the within or behalf of the particular family &the nurse in achieving an
important goal for the success of delivering nursing care
● Public Health Bag- an essential & indispensible equipment for the public health nurse which he/she has
to carry along he/ she goes home visiting- contains basic medications which are needed for giving care
● Case Load- number & kind of families a caregiver will handle at a given time

Principles of Bag Technique

1. Performing bag technique will minimize, if not prevent the spread of any infection
2. It saves time and effort in the performance of nursing procedures
3. The bag technique should show the effectiveness of total care given to an individual or family
4. The bag technique can be performed in a variety of ways depending on the agency’s policy, the home
situation, or as long as principles of avoiding transfer of infection is always observed.

Contents
The following are the contents of a Public Health Nurse bag:
● Paper lining 12 ½’ – 18 ½” and 14’ – 20”
● Extra paper for making waste bag/paper waste bag
● Plastic/linen lining 13 ½’– 19 ½”
● Apron
● Hand towel
● Kidney basin
● Soap in a soap dish
● Thermometers (oral and rectal)
● 2 pairs of scissors (surgical and bandage)
● 2 pairs of forceps (curved and straight)
● Disposable syringes with needles (g. 23 & 25)
● Hypodermic needles (g. 19, 22, 23, 25)
● Sterile dressing
● Cotton balls
● Cord clamp
● Micropore plaster
● Tape measure
● catheter
● 1 pair of sterile gloves
● Baby’s scale
● Alcohol lamp
● 2 test tubes
● Test tube holders
● Solutions of:
o Betadine
o 70% alcohol
o Zephiran solution
o Hydrogen peroxide
o Spirit of ammnonia
o Ophthalmic ointment
o Acetic acid
o Benedict’s solution
*BP apparatus and stethoscope are carried separately and are never placed in the bag.
 MODULE 2: NURSING PRACTICE IN THE COMMUNITY (Week 3-4)

Arrangement of the contents of public health bag

● FRONT OF THE BAG (left to right)- oral thermometer (facing down), rectal thermometer, or digital
thermometer )facing down), syringes G23 & G25, Hypodermic needles G19, 22, 23, 25
● on the RIGHT SIDE OF THE BAG- test tube, test tube holder, alcohol lamp
● on the LEFT SIDE OF THE BAG (near to the front)- Baby’s scale
● BACK of the bag (left to right)- betadine, 70% alcohol, hydrogen peroxide, zephiran solution, spirit of
ammonia, Benedict’s solution, ophthalmic solution, acetic acid, and Benedict’s solution
● on the CENTER OF THE BAG- kidney basin, Kelly curve & Kelly straight, scissors, sterile dressing,
cotton balls, microphore, tape measure, hand towel- soap dish & soap, and apron.
● on the TOP POCKET- sterile gloves, catheter , cord clamp, paper waste bags
● TOP OF THE INNER COVER - 12 ½’ – 18 ½” paper lining; 13 ½’– 19 ½” plastic lining; 14’ – 20”
paper lining- for the bottom

Points to consider in the use of the bag

1. The bag should contain all the necessary articles, supplies and equipment that will be used to answer the
emergency needs
2. The bag and its contents should be cleaned very often, the supplies replaced and ready for use anytime.
3. The bag and its contents should be well protected from contact with any article in the patient’s home.
4. Consider the bag and its contents clean and sterile, while articles that belong to the patients as dirty and
contaminated.
5. The arrangement of the contents of the bag should be the one most convenient to the user, to facilitate
efficiency and avoid confusion.
MODULE 2: NURSING PRACTICE IN THE COMMUNITY (Week 3-4)