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Background and Rationale

By Travis Peterson,2014-08-10 16:22
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Background and Rationale

    LIST OF CONTENTS

    EXPRESSION OF GRATITUDE……………………………………... I LIST OF ABBREVIATIONS AND TERMS………………………... ii PART I: CURRICULUM

     BACKGROUND AND RATIONALE...…………………………… 1

     NURSING DIPLOMA STUDY PROGRAM.……………. 9

     VISION………………………………………………………… 9

     MISSION……………………………………………………… 9

     PHILOSOPHY……………………………………………….. 10

     CONCEPTUAL FRAME ……………………………………… 12

     GRADUATION CHARACTERISTIC………………………….. 18

     STUDENT REQUIREMENTS…………………………………. 18

     OBJECTIVE OF STUDY PROGRAM………………………… 19

     OBJECTIVE OF DIPLOMA III NURSING EDUCATION. 20

     COMPETENCE OF EACH LEVEL AND EDUCATION YEAR 21

     CURRICULUM STRUCTURE ELEMENT…………………….. 23

     Vertical String…………………………………………………. 24

     Horizontal String………………………………………………. 24

     PROGRAM ESSENCE …………………………………………….. 26

     GROUP OF SCIENCE AND SUBJECT… ………………….. 26

     CURRICULUM STRUCTURE AND SUBJECT SPREAD IN

     THE SEMESTER……..……………………………………… 28

     SUBJECT DESCRIPTION AND BROAD OUTLINES……….. 31 PART II: SAMPLE OF TEACHING LEARNING

     GUIDELINES……………………………………………….. 71

     Subject: Family Nursing (NG 23331) …..……………... 72

     Subject: Community Nursing I (NG 23332) ………….. 90 PART III: LEARNING MATERIALS ….…………………………….. 106 LIST OF REFERENCE…………………………………………… 111

    APPENDIX:

     1. General Nurse Competence Standard (ICN) and Nursing

    Practice Competence (WHO)…………………………..

    113

    2. Nurse Competence and Activities in the Community……

    119

    3. Sample of Lecture Schedule……………………………

    122

    4. Curriculum Implementation Curriculum………………..

    128

    5. Name List of the Nursing Curriculum Work Group..…..

    139

    EXPRESSION OF GRATITUDE

    This Diploma III Nursing Curriculum can not be finalized without the support from various parties. In this opportunity, I would like to express my gratitude to the government of Timor Leste, in this case the Minister for Health, Vice- Minister for Health as well as the Director of of the Institute of Health Sciences, who through EC-SIHSIP, have given me the opportunity to assist in the Curriculum development.

    I thank Sr. Euan Lindsay-Smith, Head of the EC-SIHSIP Team, who has facilitated and established a conducive work environment for me, in order to finalize this curriculum on time, commencing from the orientation program, coordination of various visits, organizing workshops, up to the work meetings. I also thank Sr. Lorenzo Camnahas, Director General of ICS, who has always provided input and support during the finalization of the curriculum and has released the ICS Staff as the counterpart and nursing work group, to be active in the curriculum development process.

    I also express my endless gratitude to the Nursing Work Group, which has contributed with full dedication in the preparation of this curriculum:

    Dir.Academica ICS 1. Ana do R. Leite, SKp

    ICS-Counterpart 2. Ns.Domingos Soares, S.Kep

    ICS 3. Gorge Guterres

    ICS 4. Jose Ximenes, S.Kep

    AETL 5. Claudino do Rosario

    AETL 6. Bernardo A. do Rosario

    HNGV 7. Santana Martins

    HP Balibar 8. Lucia de Fatima Lemos

    HNGV 9. Paulina Pinto

    CHC Metinaro 10 Luis Alves Dias

    CHC Comoro 11. Abel B dos Santos

    CHC Becora 12. Santana da Silva

    I thank the members of the SIHSIP Team, namely Christina Mudokwenyu Rawdon, Peter Lloyd, Edi Setyo and Cate Keane, for the togetherness and their support.

    The daily administrative and technical support, provided by Sra Widya W Indrasari, SIHSIP Office Manager, Judite and Manuel, are certainly determining the finalization of my duties. I thank them for this.

    Thanks to all who have given the attention and support in whatever form, which I am not able to mention one by one, including the informants during the feasibility study, PPNI Central Management and my Superiors as well as colleagues at the Nursing Faculty of Universitas Indonesia.

    Sincerely,

    Achir Yani S. Hamid

    LIST OF ABBREVIATIONS AND TERMS

AETL Asosiasi Perawat Timor-Leste (Association of Timor Leste

    Nurses)

    Aldeias Sub-Village

    ARI Acute Respiratory Infection

    BSP Basic Services Package

    CHC Community Health Centre

    DOTS Directly Observed Treatment Supervised EC European Commission

    HAST HIV/AIDS/Tuberculosis

    HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency

    Syndrome

    HNGV Hospital National Guido Valadares HP Health Post

    ICN International Council of Nurses

    ICS Instituto de Ciénçias De Saúde

    IDP Internal Displaced Persons

    HIS Institute for Health Sciences

    IMCI Integrated Management of Childhood Illness IMR Infant Mortality Rate

    IPA Ilmu Pasti Alam (Mathematical Natural Science) KK Family

    MB Mobile Clinic

    MCQ Multiple Choice Questions

    MDGs Millennium Development Goals

    MEQ Multiple Essay Questions

    MMR Maternal Mortality Rate

MoH Ministry of Health

    MTBS Manajemen Terpadu Balita Sakit (Integrated Management of

    Sick Children Below Five Years)

    PHC Primary Health Care

    SIHSIP Technical Assistance to Support to the Implementation of the

    Health Sector Investment Program

    SKS Sistem Kredit Semester (Semester Credit System) SMA Sekolah Menengah Atas (Senior High School) SMP/SLP Sekolah Menengah Pertama/ Sekolah Lanjutan Pertama

    (Junior High School)

    SPK Sekolah Perawat Kesehatan (Health Nurse School) STIs Sexually Transmitted Illnesses

    Suco Village

    TBC Tuberculosis

    TTL Tempat dan Tanggal Lahir (Place and Date of Birth) UAS Ujian Akhir Semester (Final Semester Examination) UTS Ujian Tengah Semester (Mid Semester Examination) WHO World Health Organization

    CURRICULUM

BACKGROUND AND RATIONALE

    The country of Timor-Leste occupies a half portion of Timor island with an extent of 14,610 square meters, and consists of 13 districts, 67 sub-districts, 498 villages (suco) and 2,336 sub-villages (aldeias). The total population of

    Timor-Leste is 1,015,187 citizens in 2006. Fifty five percent of the population lives in the central area, 20% in the western area, and 25% in the eastern area of Timor-Leste. Two major cities are Dili and Baucau, which are occupied by 29% of the population, while 70% occupies the rural areas. There are 16 ethnic languages, but the main language is Tetum.

    Two of the five citizens are in poor condition, and are in general living in rural areas, particularly in the western area. The income of twenty percent of the population is only US$ 1 per day, and more than 60% has less than US$ 2 per day, which is worsened by the high unemployment rate (43%). This condition is one of the factors affecting the high mortality and sickness rates of the Timor-Leste population. The latest data showed that Timor-Leste occupies the sequence of 142 from 177 countries for the Human

    Development Index (MoH, 2007)

    Among the health indicators, apparently the infant mortality rate, the below five years children mortality rate and the mother mortality rate, show the poor health status of the population. The infant mortality rate is 88 per 1000 live birth. The Neonatal mortality rate is 33 per 1000 live birth and the below five years children mortality rate is 130 per 1000 live birth. The high infant and below five years children mortality rates are due to the high proportion of children, namely more than fifty percent, who died because of malnutrition or poor nutrition, and less than 25% of the children with fever symptoms or ARI are taken to the health service facilities to obtain sufficient treatment (BSP, 2007; MoH, 2007).

    Timor-Leste is one of the countries with the highest Maternity Mortality Rate in Southeast Asia, where the estimation is up to 880 maternity deaths in 100,000 live births. Approximately 400 mothers died from around 45,000 deliveries per year, which means that more than one mother died every day (BSP, 2007). The main cause of the high maternity mortality rate is related to pregnancy and infant birth complication. This condition is worsened by the large proportion of pregnant mothers (90%) who give birth at home and are only assisted by unskilled persons, such as a delivery shaman, which not onle causes the death of the mother, but also the neonatus/infant. One of 16 Timorese women died during pregnancy.

     of infants, below five years children, In addition to the high mortality rates

    and mothers, the sickness rate of the population is also quite high, particularly due to tuberculosis and diseases infected through vector, namely malaria, dengue, STI and HIV/AIDS. Tuberculosis is an endemic disease in Timor-Leste, with the estimation of 140 tuberculosis cases for 100,000 citizens. It is reported that more than 20 25% consultation at

    health facilities are directly related to diseases caused by mosquitoes. Malaria falcifarum and malaria vivax are approximately the same, while dengue occurred at the sporadic epidemy. Likewise is HIV/AIDS, and although the data is insufficient, the behavior level, which has a risk potential, shows that this problem will affect all age levels.

    One of the challenges that should be faced by the health staff is the environment factor that affects health. During the visit to the house of a patient with TBC problem in Aileu Vila, it was found among others that the room is very limited for a large number of family members, lack of ventilation and direct sun ray into the house, a dirty house environment, in addition to the non-existing healthy life attitude. The life habit is less supporting health, such as never drying the mattress directly under the sun, not well maintained environment cleanliness inside and outside the house, disposal of garbage anywhere, and not applying the disease prevention principles from one family member to another family member. The DOTS

    program is not implemented correctly, shown by the case where the lung TBC patient is not given medicine on a holiday.

    Similar health problems and health disruption risks were also found in Remexio Sub-District during the direct visit in September 2007. There were a lot of poor nutrition cases at all age groups, particularly at children and women. The weakness due to not knowing, caused by the high illiteracy rate or low education of most of the population, affects the ability to understand the consequences of high risk behavior. The dangerous cultural practice, such as disparity in the decision making process and negative

    behavior to obtain health services, seems to be contributing to the not optimum utilization of health services. Women have also a low status in the family, in addition to the heavy work load and household responsibilities.

    The Government of Timor-Leste is commited to efficiently and effectively provide qualified health services in the efforts to overcome various health problems that are experienced by the citizens. The Department of Health has initiated the Health National Development Program in order to provide qualified health services that are needed to achieve the MDGs objective, which is targeted in 2015.

    The national health programs that are determined by the Government of Timor-Leste are:

    1. Mother and Child Health Program, which covers basic emergency

    obstretical service, essential caretaking of new born infants,

    Integrated Management of Sick Below Five Years Children (IMCI),

    option of reproductive health service.

    2. Promotion, Protection and Prevention Program, which covers the

    national immunization program, use of mosquito net, education on

    nutrition, and promotion for growth and healthy nutrition, mental

    health, alcohol, misuse of drugs and tobacco, STIs, HIV/AIDS, eye

    treatment, Mouth treatment, safe drinking water and food security,

    vitamin A and supplement of ferrum and iodine.

    3. Epidemic Disease Prevention and Control Program.

    4. Integrated Management Program for several certain diseases, such

    as Malaria, Dengue, HAST/STIs & HIV/AIDS & TB], Leprosy,

    Respiratory Tract Infection, Diarrhea, Parasite disease, Hypertension

    and Diabetes, and diseases associated to the habit of smoking.

    5. Emergency service at trauma and accident cases, such as traffic

    accident and accident at home and at the work place.

    The national health program, which is promulgated and gradually implemented by the Government of Timor-Leste, needs adequate management and support from various sources. The achievement of target is strongly depending on the availability of various forms of services, including nursing services. The nursing service role is very important for the performance of the health service system, in the framework of three core functions, namely stewardship, source availability, and provision of service. The importance of sufficient nursing and midwifery service staff and the competence level as well as the distribution of nurses and midwives, need to be underlined, since this health staff group is the infrastructure component for essential health services.

    Nurses are the majority of health staff, with constant, continuous, coordinated and advocated nursing caretaking characteristics, namely closely and continuously working with the community that need assistance at all health service structures. The Government of Timor-Leste needs a number of competent nurses to provide nursing care and to work in health teams at each health service structure and level, particularly to make the national health program successful, which can provide optimal benefit to the community.

    The average ratio of nurses and midwives, who are working in 13 districts, is 1:2,106 and 1:4,743. The challenge faced by nurses and midwives is working without sufficient preparation of knowledge and skill to critically analyze health problems and to make correct decisions. This is worsened by the less adequate supporting system and less condusive working condition. In addition, the reference system and the repatriation planning of

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