Evaluation (CHN context)

Based on professional practice include conformity with accepted community

and public health standards of practice, continued refinement and
enhancement of nursing skills through continued field experience and a
program of continuing education

Evaluates responses of clients to interventions to note progress toward goal

achievement, revise data base, diagnoses and plan

TYPES OF EVALUATION

QUANTITATIVE EVALUATION

-It simply measures how much of the desire objectives were attained

QUALITATIVE EVALUATION

- Evaluates the effectives of Nursing Care done or changes in behavior, condition,

or compliance
ASPECTS OF EVALUATION
1. Process Evaluation
-

Includes the Nursing process (Assessing, Planning, Implementing, and

Evaluating)

Is used to evaluate the process by which the program is implemented

2.

Impact Evaluation

-measures the program effectiveness in terms of intermediate objectives and

changes in the predisposing, enabling, and reinforcing factors

- Include the physical settings, instrumentalities, and conditions through

which nursing care is given (objectives, building, organizational, structure,
financial resources such as budget, equipment, and staff)

3. Outcome Evaluation
-

Measures change in terms of overall objectives and changes in health and

social benefits or the quality of life. It takes a very long time to get results
and it may take years before an actual change in the quality of life is seen

Changes in the client health status that result from nursing intervention.
(mod. of signs, symptoms, knowledge, skills level and compliance with
treatment regimen)

GUIDELINES IN DEVELOPING AN EVALUATION PLAN

1.Specify the learning outcomes/competencies and the testing condition
under which the learners are to be evaluated.
2.Determine the performance standards and specific criteria/ indicators to measure
the achievement of the standards
3.Identify evaluation methods appropriate to the learning outcomes.
4.Specify the sources of evaluation data.
5. Use appropriate evaluation tools to measure achievement of the learning
outcomes.
PROGRAM EVALUATION
(Monitoring)

Performance monitoring is a kind of evaluation strategy that considers

quantitative indicators that focus on programs or service delivery. It involves
monitoring of systems, and tracking of indicators, with routine and periodic
reporting of results.

METHODS AND TOOLS

The most commonly used instruments in program evaluations are:

Survey (self-administered or administered by evaluation staff)

Interview (in person or telephone)
Focus group
Document review
Observation
Journals
Critical incident reports

Core Concepts ask the question What are the major areas this program
addresses?
Key Indicators ask the question What evidence might we look for to show
that the Concepts are being addressed?
Methods ask the question How will we gather the evidence to demonstrate
what we want to know? At this stage, the evaluator identifies or develops
appropriate methods and tools by which to collect the information for each
indicator, and identifies sources of the data. This refers to the instruments.

Sources of information ask the question From whom or where will we obtain
the necessary information?

FIELD HEALTH SERVICES AND INFORMATION SYSTEM (FHSIS)

Objectives
-

To provide summary data on health service delivery and selected program

accomplished indicators at the barangay, municipality/city, district,
provincial, regional and national levels.

To provide data which when combined with data from other sources, can be
used for program monitoring and evaluation purposes.

To provide a standardized, facility level data base which can be accessed for
more in-dept studies.

To ensure that the data reported to the FHSIS are useful and accurate and are
disseminated in a timely and easy to use fashion.

- To minimize the recording and reporting burden at the service delivery level in
order to allow more time for patient care and promotive activities.
Components
-

Family Treatment Record

Target Client List

Reporting Forms

Output Report

Treatment Record
-

The fundamental building block or foundation of the field health service

information system is the treatment record.

This is the document, form, or piece of paper upon which recorded the
presenting symptoms or complaints of the patient on consultation and the
diagnosis (if available), treatment and date of treatment.

This record will be maintained as part of the system of records at each

BHS/BHC/RHU/MHC, or hospital outpatient by facility on all patients seen.

If in the facility, there is no formal treatment record for individual patient

visits/ consultations, one must be created.

Target/Client Lists
The target client/client lists constitute the second building block of the FHSIS and
are intended to serve 4 purposes:
1. To plan and carry out patient care and service delivery. Such lists will be of
considerable value to midwives/nurses in monitoring services delivery to clients in
general, and in particular to groups of patients identified as targets or eligibles
for one another of the Department. The primary advantage of maintaining the
Target/client Lists is the midwife/nurse does not have to go back to individual
patient/family records as frequently in order to monitor patient treatment or
services to beneficiaries.
2. To facilitate the monitoring and supervision of services.
3. To report services delivered again, the objective is to avoid having to go back to
individual patient/family records in order to complete the FHSIS Reporting Forms.
For service/program areas in which a Target/Client List has been deemed useful for
service delivery purposes, the format of the list gas been developed in such a way
so as to facilitate reporting. Service/program areas not covered by the Target/Client
List will have a Tally sheet to facilitate reporting.
4. To provide a clinic-level data base which can be accessed for further studies, e.g.
follow-up and special prospective studies, record surveys, etc. The introduction of
standardized Target/Client Lists maintained in hard bound cover is design to result
in permanent records of facility health care delivery activities which can be served
as a facility level data base. The complete set of Target/Client List will be collected
periodically at the end of each year or every and two years and stored in a
maintenance of such a data base. In the revised FHSIS will be crossed reference
through the use of unique family serial number to patient/family records and as
appropriate, program-specific treatment record in order to enhance the value of
Target/Client Lists.
The important difference between the Target/Client Lists in the revised FHSIS and
the Master Lists utilized previously is that the Target/Client Lists will no longer be
transmitted from the clinic. Data from the Target/Client Lists will be transmitted
monthly/quarterly/annually through the use of FHSIS reporting forms, but the lists
themselves will remain in the clinic. The practice of submitting the lists from one
facility to another will be discontinued in the FHSIS.

The Target/Client Lists to be maintained in the revised FHSIS are as follows:

- Target group list for eligible population(EP)
- Target/Client List of children 0 to 59 months
- Target/Client List for Nutrition
- Client List for Pre-Natal Care
- Client List for Postpartum Care
- Client List for Family Planning (Non-Surgical Methods)
- List for TB Symptomatic
- Client List for TB Cases under short courses Chemotheraphy (SCC)
- Client List for TB Cases under Standard Regimen (SR)
- Client List Leprosy Cases
- Tally/Reporting Forms
FHSIS reports constitutes the only mechanism through which data routinely
transmitted from one facility to another in the revised FHSIS. The mojority of FHSIS
reports are prepared and submitted either monthly or quarterly. Although one
reports are prepared weekly, several annually and some instances, every few
minutes as relevant events occur, e.g. maternal and neonatal deaths.
In the FHSIS reports are prepared and submitted by the unit person responsible for
the service/activity being provided and sent directly to the provincial Health Office.
The bulk of the data reported from the RHU/MHC/BHS/BHC level are activities which
are undertaken or are the responsibility of midwife/nurses within the facility will be
linked up with the data reported by other during the data processing phase of the
operation.
Output Reports
Output reports or Tables will be produced at the PHO (or alternate data
processing site in the province) from the data reported in FHSIS reporting
forms. Computer generated output reports will then be disseminated
down to the RHU/MHC and up through the DOH system to the Regional
Health Office. The objective in designing the output formats is to make the
reports useful for monitoring/management purposes at each level of DOH
management.
Records, Reports and Patient Flow
The use of the system of records and reports is relatively simple. All
information related to the client/patients history, complaint, diagnosis,
service and/or treatment is contained in three documents or recdords:
1. The individual treatment record
2. The Target/Client List (TCL) for the several public health programs,
and
3. The tally sheet/report forms which have a dual purpose that is to
tally events as they occur and the purpose of reporting periodically
to higher levels. The process of use to these documents as the
exclusive set of records in the BHS/RHU is as follows:
-

As a client enters the clinic/facility, their individual treatment record

is pulled out the file. If the client/patient has come to the clinic for
program service for which there is a Target/Client list, an

appropriate entry is made in the TCL and an entry in the treatment

record to show what the finding or urine test results are.
The monthly (or the period) report is then simplified in preparation
by a combination of adding up ticks on the Tally/report summary
itself, or consulting certain services or events directly from the
entries on the Target/Client Lists and entering them on the tally
report form.