MINISTERIO DE SALUD DIRECCIÓN REGIONAL REGIONAL DE SALUD DE DE HUANCAVELICA RED DE SALUD DE HUANCAVELICA
MICRO RED ACORIA PUESTO DE SALUD DE LIRIO DISTRITO DE ACORIA PROVINCIA DE HUANCAVELICA DEPARTAMENTO DE HUANCAVELICA
INFORME FINAL SERUMS NERY LUZ RAMOS QUISPE Lic. en Enfermería C.E.P. 63648 UNIVERSIDAD NACIONAL DE HUANCAVELICA
(SERUMS REMUNERADO) FECHA DE INICIO: 06 DE MAYO DEL 2012 FECHA DE TÉRMINO: 05 DE MAYO DEL 2013 HUANCAVELICA – PERÚ 2013
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A mis hijas y a mi esposo quienes me dieron su apoyo moral y fortaleza para la culminación de mi serums.
A todo el personal de la Micro red
de
Acoria
por
la
oportunidad que me brindo para el desarrollo de mi profesión y por hacerme sentir
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INTRODUCCCION El servicio rural y urbano marginal de salud (SERUM), debe ser realizada por todo profesional de enfermería egresado y titulado, como parte de su formación profesional, ya que es aquí donde se practica todo lo adquirido y aprendido de una forma global puesto que se realizaran labores asistenciales, preventivo promociónales, docencia y administrativas en el lugar asignado PUESTO DE SALUD LIRIO, establecimiento de salud de nivel I. El Serum Remunerado Remunerado se inició el 06 DE MAYO DEL 2012, HASTA EL 05 DE MAYO DEL AÑO 2013, en el PUESTO DE SALUD DE LIRIO, ubicado ubicado en el Centro Poblado del mismo mismo nombre, distrito de de Acoria, provincia y departamento departamento de Huancavelica. El SERUMS REMIUNERADO tiene como objetivo, brindar atención integral de salud a las poblaciones más vulnerables, atendiendo y asistiendo
a
los
pacientes,
realizando
actividades
preventivos
promocionales para disminuir las enfermedades mas frecuentes como las IRA y EDA, también la prevalencia de la desnutrición, incrementar las coberturas en la área CRED y ESNI, mejorar los estilos de vida de la comunidad a través de la promoción de salud, realizar alianzas con las instituciones educativas y municipio a través de la sensibilización, actividades administrativas y capacitaciones. El desarrollo del SERUMS REMUNERADO en el Puesto de Salud Lirio es una experiencia inolvidable y de nuevos conocimientos, ya que la población tiene una realidad diferente al de las zonas urbanas, como sus características socio económicas y culturales que limitan el logro de los objetivos trazados; razón a ello se permitió intercambiar ideas, creencias y otras similares, que de esta manera, la educación, información y comunicación permanente, benefician la mejora de los estilos de vida saludable de los pobladores en sus diferentes etapas de vida. El presente informe muestra un análisis de la situación socio económico y
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promociónales con experiencias propias de cada comunidad y así demostrar nuestra capacidad profesional y humana hacia toda la población obteniendo la satisfacción de haber dado el apoyo profesional para mejorar la calidad de vida de la comunidad de Lirio que me brindo brindo su, cooperación y apoyo. NERY L. RAMOS QUISPE Lic. Enfermería CEP: 63648
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INDICE PRESENTACIÓN. DEDICATORIA. INTRODUCCIÓN INDICE LINEAMIENTOS DE POLÍTICAS........................... ............. .......................... .......................... .................... ....... 07 DATOS DE FILIACIÓN. ..........................................................................08 ..........................................................................08 III. DIAGNÓSTICO SITUACIONAL ......................................................... 08 3.1. Región Natural ..........................................................................08 .......................................................................... 08 3.2. Límites ......................................................................................09 ......................................................................................09 3.3. Superficie..................................................................................10 Superficie..................................................................................10 3.4.Población Total ..........................................................................10 ..........................................................................10 3.5. Altitud .......................................................................................13 .......................................................................................13 3.6. Características Climatológicas ................................................. 13 3.7. Densidad Poblacional ...............................................................13 ............................................................... 13 3.8. Ámbito Geográfico ....................................................................13 .................................................................... 13 3.9. Accesibilidad Geográfica .......................................................... 14 3.10. Medio de Transporte que se Emplea en Caso de Emergencia ........................................................................................................16 ........................................................................................................16 3.11. Idioma 3.11. Idioma o Dialecto Predominante ......................... ............ .......................... .................... .......16 16 3.12. Religión 3.12. Religión Predominante ...........................................................16 ........................................................... 16 3.13. Flora 3.13. Flora ....................................................................................... 16 3.14. 3.14. Fauna .....................................................................................16 .....................................................................................16 3.15. Medios 3.15. Medios de Comunicación Local .......................... ............. .......................... .................... ....... 17 3.16. Material 3.16. Material Predominante en las Viviendas ................................ 17 3.17. Servicios 3.17. Servicios Básicos ...................................................................18 ................................................................... 18 3.18. Eliminación 3.18. Eliminación de Excretas .........................................................18 ......................................................... 18 3.19. Eliminación 3.19. Eliminación de Residuos Sólidos .......................... ............. .......................... .................. .....19 19 3.20. Actividad 3.20. Actividad Económica Predominante .......................... ............ .......................... .............. 20 20 3.21. Servicios 3.21. Servicios de Salud ..................................................................21 .................................................................. 21 3.22. Medicina 3.22. Medicina Tradicional ...............................................................26 ............................................................... 26 3.23. Instituciones 3.23. Instituciones Publicas ............................................................. 26 26 3.24. Participación 3.24. Participación Comunitaria .......................................................28 ....................................................... 28 .............. ............. 30 IV. FORMULACION DEL PLAN OPERATIVO LOCAL ...........................
V. EJECUCIÓN DEL PLAN OPERATIVO LOCAL ................................. 58 5.1. Actividades Profesionales Según Profesión ........................... ............. ................ .. 58 5.2. Actividades Preventivo Promocionales por Profesión .............. 63 5.3. Capacitación Recibida .......................... ............. .......................... .......................... ...................... .........63 63
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VI. RESULTADOS DE SU SERVICIO COMO SERUMS ........................ 70 6.1. ¿Cómo encontró el establecimiento a su llegada? ................... ............ ....... 70 6.2. ¿Cómo se encuentra al final f inal de su servicio (SERUMS)? ......... 71 6.3. ¿La capacitación recibida fue adecuada o insuficiente? ....... ... 72 6.4. Indicar las dificultades o limitaciones que se presentaron durante la realización del servicio........................... ............. ........................... .......................... ........................ ...........73 73 VII. CONCLUSIONES ..............................................................................74 ..............................................................................74 VIII. RECOMENDACIONES RECOMENDACIONES ....................................................................75 ....................................................................75 IX. ANEXOS ............................................................................................77 ............................................................................................77
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I. LINEAMIENTOS DE POLITICA PROBLEMAS PRIORITARIOS
LINEAMIENTOS GENERALES 2002 – 2013
Alta prevalencia de Infecciones Promoción
de
la
salud
y
respiratorias agudas en niños prevención de la enfermedad. menores de 5 años Alta prevalencia de enfermedades Diarreicas
agudas en niños
menores de 5 años Elevada índice
de desnutrición
crónica Ausencia de agua segura inadecuada
e
eliminación
de
Elevada
prevalencia
de
parasitosis
intestinal
excretas en
la
población infantil Bajas coberturas de CRED y ESNI
Atención
integral
mediante
la
extensión y Universalización del aseguramiento en salud (Seguro Integral de Salud – SIS, Es salud, otros) Limitado
acceso
medicamentos.
a
los Política
de
suministro
y
uso
racional de los medicamentos.
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Impulsar un nuevo modelo de atención integral de salud. Financiamiento
insuficiente
e Financiamiento interno y externo
inequitativo.
orientado a los sectores más pobres de la sociedad.
Limitada participación ciudadana y Democratización de la salud. promoción de la misma.
II. DATOS DE FILIACION NOMBRE Y APELLIDOS DEL SERUMS
: NERY LUZ RAMOS QUISPE
PROFESIÓN
: LICENCIADA EN ENFERMERIA
UNIVERSIDAD DE PROCEDENCIA
: UNIVERSIDAD NACIONAL DE
HUANCAVELICA MODALIDAD DE SERUMS
: SERUM REMUNERADO
PRESUPUESTO
: NACIONAL
FECHA DE EJECUCIÓN DEL SERUMS
: 06 DE MAYO DE 2012 A AL L 05
DE MAYO DEL 2013 INSTITUCION
: MINISTERIO DE SALUD
DISA / DIRESA
: HUANCAVELICA
RED DE SERVICIOS DE SALUD
: RED DE SALUD
HUANCAVELICA DEPARTAMENTO
: HUANCAVELICA
PROVINCIA
: HUANCAVELICA
DISTRITO
: ACORIA
NOMBRE DEL ESTABLECIMIENTO DE SALUD: LIRIO
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LIRIO, es el nombre que proviene de aquella flor de lirio que aquellas épocas existía en los bordes de una laguna que se encontraba en dicha comunidad Actualmente ya no existe esta laguna en el lugar desde que el hombre empezó a poblar esta zona. Lirio fue creado como Centro poblado con resolución 004-79-DZ-VII-H y reconocida como tal con resolución
ministerial No 030-2007 -DR-XVII-H
por
participación activa de las autoridades comunales de aquel entonces, El Sr. Luis Huamán Sus autoridades actuales actuales son: Alcalde
:
Teniente gobernador: Regidores
Julián Paucar Romero. Segundino Benítez Serrano
: 1º Regidor Regidor Romualdo Romualdo Berrocal Berrocal Huamán 2º Regidor Regidor José Díaz Ataucusi Ataucusi 3º Regidor Néstor Sánchez Sánchez Benito Benito 4º Regidor Regidor Espíritu Tello Ramos Ramos 5º Regidora Natalia Ataucusi Sullca
En el otro ámbito que viene a ser la salud de la población, población, el Ministerio de Salud ingresa a esta zona a través del C.S. Acoria. Actualmente
basado en múltiples factores y necesidades del
pueblo y cumplir con los requisitos exigidos para crear el establecimiento de salud de acuerdo a la normatividad correspondiente y sustento necesario ha determinado crear y
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Por el Oeste: Con el Centro Centro poblado Pucuto y Maritana. Por el Norte: Con el Centro poblado de Conchan. Por el Sur
: Con el Centro poblado de Chaynapampa
3.3. SUPERFICIE La superficie total en Área es de 401,76 Km 2, del territorio de Nacional, que representa el 29,44% del territorio de la Provincia de Huancavelica y el 3.1% de la Superficie Departamental.
3.4. POBLACION TOTAL La jurisdicción de Puesto de Salud de Lirio cuenta con una población asignada por el INEI para el año 2012 de1095 habitantes. Según la población que asigna el INEI 2012 se tiene 1095 habitantes en el Centro Poblado de Lirio y según como describe el cuadro lo tenemos dividido por grupos atareos.
CUADRO N 01 POBLACIÓN POR GRUPOS ETÁREOS ETÁREOS P.S LIRIO LIRIO 2012 Grupos Etáreos
Total
Porcentaje (%)
< de 1 año
32
2.9 %
1 - 4 años
126
11.5%
5 - 11 años
202
18.4%
12 - 17 años
162
14.9%
18 - 29 años
250
22.9%
30 - 59 años
254
23.1%
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reproductiva que representan 50.3%, y seguido por grupo atareo entre 18 a 29 años donde representan el 22.9 % de la población. Con estos resultados se debe enfatizar en los programas de planificación familiar destinado a las MER.
CUADRO 02 PIRAMIDE POBLACIONAL P.S LIRIO 2012 Mas c ulino
48.40%
Femenino
51.60%
GRUPO
POBLACION
ETAREO
ASIGNADA
0-4
158
76
82
5-9
147
71
76
10 - 14
138
66
70
15 - 19
134
65
69
20 - 24
116
56
60
25 - 29
81
39
42
30 - 34
58
28
30
35 - 39
54
26
28
40 - 44
43
21
22
45 - 49
38
18
20
50 - 54
32
15
17
55 - 59
29
14
15
60 - 64
23
11
12
65 - +
36
22
24
Total
1095
537
558
MASCULINO FEMENINO
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GRAFICO N 01 PIRAMIDE POBALCIONAL DEL P.S. LIRIO DEL 2012
FUENTE: Oficina de estadística de la Red Huancavelica.
INTERPRETACION:
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aumentado la expectativa de vida para la población del centro poblado de Lirio, por ello debemos dirigir también nuestros programas a la adecuada atención del adulto mayor. Se observa mayor número de población femenina en todos los grupos atareos.
3.5.
ALTITUD El centro poblado Unión Lirio tiene variedad de pisos ecológicos desde 3200 msnm parte baja como son las comunidades de Ccocha, Chunca y Lirio, llegando hasta una latitud de 3600 msnm las comunidades de Auquis y Jatuspata.
3.6.
CARACTERISTICAS CLIMATOLOGICAS El centro poblado Unión Unión Lirio cuenta con un clima variado desde templado, frio con una Temperatura de 2º C, 18º C sobre todo en los meses de Mayo a Setiembre por la época de frio, las precipitaciones fluviales se intensifican en los meses de Noviembre a Abril ocasionando huaycos y desastres naturales por ser la tierra de característica arcillosa .
3.7.
DENSIDAD POBLACIONAL
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decir actividades correspondientes a la vida del campo que se dedican los hombres y las mujeres y de su cosecha que ellos obtienen para su consumo y para la venta.
3.9. ACCESIBILIDAD GEOGRAFICA Vías de comunicación: Terrestre (X)
Fluvial ( )
Aéreo A éreo ( )
Marítimo ( )
Condiciones de la vía terrestre: Trocha (X)
Afirmada (X)
Asfaltada ( )
Tipo de transporte: A pie (X)
acémila ()
ómnibus (X)
Veh. Particular
(X).
Frecuencia de transporte: Una vez por semana ( )
Interdiario ( )
Diario (X )
El transporte hacia Huancavelica o Huancayo es diario incluso domingos y feriados, mediante autos los cuales realizan servicio
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AUQUIS
5KM
1 H. Y 30 MIN
CHUNCA
6KM
1HORA
40 MIN
40MIN
FUENTE: Archivo P. S. LIRIO
CUADRO N 04 DISTANCIA PARA LOS ESTABLECIMIENTOS DE SALUD DE REFERENCIA DE MAYOR NIVEL DE CAPACIDAD RESOLUTIVA DEL P.S. LIRIO DEL 2012 ESTABLECIMIENTOS DISTANCIA EN DE SALUD
KILOMETROS
P.S LIRIO AL C.S ACORIA
TIEMPO DE TRASLADO EN MINUTOS A PIE
EN CARRO
EN MOTO
2 HORA Y 20 KM
30MIN
½ HORA
½ HORA
60 KM
10 HORAS
2 HORA
2 HORA
P.S. LIRIO AL HOSPITAL DE HUANCAVELICA
FUENTE: P.S. LIRIO (Transportes)
MAPA DE HUANCAVELICA HUANCAVELICA Y UBICACIÓN DEL CENTRO CENTRO POBLADO POBLADO DE LIRIO DEL 2012
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3.10. MEDIO DE TRANSPORTE QUE SE EMPLEA EMPLEA EN CASO DE EMERGENCIA En caso de emergencia se emplea el transporte móvil, no se puede realizar el traslado del paciente en acémila o a pie ya que las distancias son considerables a un establecimiento de mayor nivel de capacidad resolutiva
3.11. IDIOMA O DIALECTO PREDOMINANTE El idioma predominante predominante en la Centro poblado Unión Lirio es el quechua, siendo la población adulto mayor
y de las
comunidades alejadas donde predomina este idioma, en en la jurisdicción también usa el castellano, siendo mayor en la población joven.
3.12. RELIGION PREDOMINANTE La religión predominante predominante es la católica en un 30 %, seguida de la cristiana evangélica en un 60%.
3.13. FLORA Cuenta con una una zona de gran diversidad de plantas debido debido al clima templado que posee, entre los representantes de la flora
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de la fauna tenemos vizcachas, zorrillo, águila, loros, picaflores, etc.
3.15. MEDIOS DE COMUNICACIÓN LOCAL El centro Poblado de Unión Lirio
desde años anteriores
presenta comunicación mediante vía telefónica (Movistar) (Movistar) lo cual podemos comunicarnos comunicarnos con con el Centro de de Salud de Acoria para el traslado de las emergencias. . Emisoras: El Centro Poblado Menor, no cuenta con una emisora local Pero se se capta capta la señal de emisoras del Distrito Distrito de Acoria
Se
cuenta con un medio de perifoneo local de propiedad del municipio.
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adquisición para la población. El material predominante de los techos son calaminas, tejas, tejas, pajal cual se construye sin ningún supervisión ni control alguno de personal calificada, la superficie o piso de cada vivienda es de tierra, pero algunas de las viviendas ya están deterioradas y ponen en riesgo la vida del propietario.
3.17. SERVICIOS BÁSICOS CUADRO N 06 SERVICIOS BASICOS COMUNIDAD DE LIRIO – 2012 COMUNIDAD
LUZ
AGUA
DESAGUE
Lirio
100%
100%
0%
Jatuspata
100%
100%
0%
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ELIMINACION COMUNIDAD
DE EXCRETAS
Lirio
90%
Jatuspata
80%
Auquis
80%
Tacceyocc
70%
Ccocha
60%
Chunca
60%
FUENTE: C.P. Lirio
INTERPRETACION:
En el Centro poblado Unión Lirio la
eliminación de excretas
son
en letrinas que han sido
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La comunidad de LIRIO en su conjunto práctica la eliminación de residuos sólidos por medio del relleno sanitario que cuentan cada familia a espaldas espaldas de sus casas y los residuos residuos de sus animales lo utiliza como combustible y/o abono. Todavía no existe un tratamiento y disposición correcta de la basura siendo esto un foco de contaminación para los niños, la familia y la comunidad en general, haciendo que existan enfermedades diarreicas agudas y problemas gastrointestinales.
3.20. ACTIVIDAD ECONOMICA PREDOMINANTE PREDOMINANTE Agricultura: Es una de las primeras fuentes de producción agrícola netamente natural sin utilización de tecnología, se prepara el terreno para el sembrado a partir del mes de
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3.21. SERVICIOS DE SALUD El puesto de de salud de Lirio en cuanto a infraestructura cuenta desde el año 2011 2011 con local propio, la infraestructura es de material noble y cuenta con los siguientes ambientes:
01 consultorio de enfermería (con baño)
01 consultorio de obstetricia
01 ambiente de farmacia
01 ambiente de tópico compartida con triaje
01 ambiente de cadena de frio
01 ambiente para sesiones demostrativas
01 ambiente de admisión
01 sala de espera
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Programa CRED
Programa PAI
Programa CEDCO
Programa CIRA
Programa de Materno Perinatal
Programa de Salud Mental
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PROFESIONALES DE LA SALUD POR CADA 1000 HABITANTES DEL P.S. LIRIO DEL 2012 NO 01
PROFESIONAL Enfermera Técnico
NOX C/1000Hab. 01
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inferiores 5
Dorsopatias
(m40- m54)
77
4.7
6
Helmintiasis
(b65-b83)
55
3.3
7
Enfermedades del
(k20-k31)
49
2.3
esófago,
del
estómago, y del
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CUADRO N 12 DIEZ PRIMERAS CAUSAS DE MORBILIDAD ESPECÍFICA DE LA PROFESIÓN PROFESIÓN DEL PUESTO DE SALUD LIRIO - 2012 Nº
Enfermedad
CIE
Nº Casos
%
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CUADRO N 13 DIEZ PRIMERAS CAUSAS DE MORTALIDAD GENERAL DEL PUESTO DE SALUD LIRIO – 2012
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IV.
FORMULACION DEL PLAN OPERATIVO LOCAL PLAN OPERATIVO LOCAL DEL P.S. LIRIO DEL 2012
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años
años Sesión
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12
-TBC
1
1
1
1
1 1 1 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1
15
100
12
80%
13
Consejería
1
1
1
1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
12
100
12
100%
14
-PPFF
1
1
1
1
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 1 1 1
15
100
12
80%
15
-salud ambiental
2
2
1
1
3 3 1 1 1 1 4 4 2 2 1 1 3 1 2 2 1 1 4 2
25
100
22
88%
16
-Capacitación
1
0
1
0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
12
100
10
1
1
1
1
2 2 2 2 1 1 3 3 3 2 3 2 1 1 2 2 3 3 2 2
24
100
22
92%
de
1
0
1
1
0 0 1 1 0 0 1 1 0 0 1 1 0 0 1 1 1 1 0 0
6
100
5
83%
Capacitación a promotores promotores de
2
2
1
1
3 3 1 1 1 1 4 3 2 2 1 1 3 3 2 2 1 1 4 2
25
100
22
88%
a programas
83%
sociales 17
-Salud mental
18
Capacitación del
personal personal
salud 19
salud
62
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5.2.
ACTIVIDADES PROFESIONALES SEGÚN PROFESION ACTIVIDADES
META
META
PROGAMADA EJECUTADA
% LOGRO
Vacunación de BCG
10
7
80%
10
7
80%
25
19
94%
25
19
94%
25
18
82%
25
16
70%
20
19
93%
10
09
88%
20
15
70%
50
25
50%
adulto
20
2
10%
Vacuna virus
20
00
0%
150
130
91%
Vacunación HvB pediátrica Vacunación APO Vacunación Pentavalente Vacunación Rotavirus Vacunación Antineumococo Vacunación SPR de 01 a 04 años Vacunación Antiamarílica. Vacunación DPT de 01 a 04 años Vacunación DT MER Vacunación HvB
papiloma humano Administración de vitamina A de 01 a
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micronutrientes
150
128
91%
200
180
91%
100
75
80%
200
150
82%
80
63
66%
300
280
74%
200
192
96%
24
24
100%
20
18
70%
100
88
100%
8
04
40%
110
85
63.3%
30
17
47%
chispita de 01 a 04 años Control CRED en menores de 1 año Control CRED de 01 año Control CRED de 02 a 04 años Control CRED de 05 a 09 años Plan de AIS Conserjería nutricional Sesiones demostrativas Lactancia materna exclusiva Alimentación complementaria adecuada Atención inmediata del RN Atención a niños menores de 5 años con IRA Atención a niños menores de 5 años con EDA
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pero no se logra ya que se debe a la migración de los pobladores para mejorar su situación económica, migrando toda la familia padres e hijos de manera temporal o definitiva.
5.3. ACTIVIDADES PREVENTIVO PROMOCIONALES PROMOCIONALES POR PROFESION ACTIVIDADES
META
META
PROGAMADA EJECUTADA
% LOGRO
Sectorización y mapeo
01
01
100%
12
09
75%
12
12
100%
05
01
20%
05
04
80%
demostrativas
24
24
100%
Visitas
60
50
83%
12
12
100%
Capacitación a promotores de salud Sesiones educativas a la población Sesiones educativas a docentes de las I.E. Sesiones educativas a autoridades Sesiones
domiciliarias Reuniones multisectoriales
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INTERPRETACION: En el presente cuadro se observa que la mayoría de los logros se llego al 100%, debido que los personales de salud del establecimiento trabajaron en coordinación
para
las
actividades
preventivos
promocionales.
5.4. CAPACITACION RECIBIDA
NOMBRE DEL
Nº HORAS
EVENTO
ACADEMICAS
Inducción para el
2 días
2 días
inicio
ORGANIZACI
LUGAR
FECHA
DIRESA HVCA
Hvca
Mayo 2012
Micro red
Acoria
Mayo 2012
Acoria
JULIO
ÓN
del
SERUMS. Inducción para el inicio
del
Acoria
SERUMS. Capacitación sobre
2días
Microred acoria
salud
2012
ocular 1 día
DIRESA HVCA
Acoria
CAPACITACION DE
Noviembre 2012
GESTION
DE CALIDAD LAMZAMIENTO DE
AMERICAS
Micro red de Acoria
VACUNACION DE
1 DIA
LAS
Acoria
18 BRIL 2013
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5.5. ANÁLISIS ANÁLISIS FODA FACTORES FACILITADORES DE LA GESTION FORTALEZAS 1-Presencia de Profesionales de 1-Presencia de profesional en salud capacitados en los diferentes calidad de SERUMS programas para la solución de problemas.
2-Mística, iniciativa y motivación del 2-Inquietud por mejorar el personal de salud para mejorar la servicio de atención. atención del paciente.
3- Moderna Ambientes
infraestructura
físicos
con 3- Adecuación Adecuación
de
los
independientes ambientes.
para cada servicio.
4-Trabajo en Equipo a pesar de las 4-Vocación del personal de horas de contrato (atención de salud emergencias las 24 horas del día).
por
servir
a
la
comunidad.
5 Sistema de información información , oportuna oportuna 5- El HIS es entregado en su y fiable acorde al HIS y programas oportunidad de salud -
por
cada
Estadístico
(semanalmente) personal del
Centro
al de
salud.
6.- Atención integral por el SIS
El Seguro Integral de Salud es
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comunitarios
para
cada
con
tres
comunidad.
3-. instituciones educativas en el 3.centro poblado
contamos
instituciones educativas, para la intervención en salud.
COMENTARIO TECNICO EXPLICATIVO: Las fortalezas y las oportunidades son beneficios internos que nos permitió desarrollar las actividades programadas y por lo tanto mejorar la salud de la población en su fase preventiva y recuperativa. El equipo conformado por los profesionales y no profesionales (Agentes (Agentes comunitarios) se trabajó coordinadamente en las diferentes actividades, tanto en la promoción prevención y atenciones integrales de salud.
FACTORES RETARDADORES DE LA GESTION DEBILIDADES 1-Escasez capacitación
Participación y
cursos
en 1- El de
no
contar
capacitaciones y cursos de
actualización de personal de salud
actualización
sobre
personal de salud
el
manejo
operativo
y
administrativo de formatos y el trabajo asistencial
con
para
el
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4-Deficit conocimiento en
4.-El
acreditación de un establecimiento
capacitaciones en temas de
no
contar
con
acreditación
5-escasez de documentos para
5-El no contar con documentos
poder acreditar el establecimiento
que sustenten para acreditar el
en una evaluación interna
establecimiento
AMENAZAS 1-Influencia de patrones
1-Nivel cultural de la
socioculturales muy arraigados e
comunidad
inadecuados para la salud.
2-Saneamiento ambiental y servicios
2-Debido a la extrema pobreza
básicos deficientes en la comunidad.
de la población y la lejanía de esta.
3-El corto periodo de contrato del
3-Corto periodo de contrato,
profesional de salud (SERUMS)
produciendo incertidumbre en
estancando las metas trazadas.
el trabajador.
4- Inoportuno reembolso del SIS.
4.-dificultando el pago oportuno ya que no contamos con caja chica.
5-Falta de mantenimiento de
5-Por su nivel cultural y el
carreteras.
peligro de las carreteras en épocas de lluvia.
Comentario Técnico Explicativo: Las debilidades y amenazas son factores que retrasan los objetivos, pero como en toda
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VI. RESULTADOS DE SU SERVICIO COMO SERUMS 6.1. ¿CÓMO ENCONTRÓ EL ESTABLECIMIENTO A SU LLEGADA? Se encontró en el establecimiento de salud un solo
personal técnico en enfermería el cual labora
por
municipio hace un mes en el establecimiento . Al iniciar el SERUM el establecimiento de salud se
encontraba el local local antiguo bien desordenado desordenado y en el local nuevo también de igual forma el almacén del ambiente nuevo se encontraba en completo desorden
Se hizo reconocimiento reconocimiento del puesto de salud en general donde se encontró encontró materiales y formatos desordenados y empolvados en el piso.
El ambiente de tópico no era adecuado, adecuado, ni cómodo para la atención de los pacientes, como para las curaciones y suturas.
En cuanto los medicamentos se encontraban en desorden.
En cuanto al servicio servicio de enfermería se contaba con con un ambiente pequeño y poco materiales para el control CRED, los cuadernos de seguimiento de CRED, ESNI, CEDCO Y CIRA no estaban al día, así como los cuadros estadísticos, en cuanto a cadena de frio, la refrigeradora no era la adecuada para las vacunas.
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No contaba con pozo séptico
No contaba contaba con con servicio servicio de agua potable
Toda la población presentaban los seguros antiguos,
faltaba la actualización de seguros y la integración de familias al seguro.
6.2.
¿CÓMO SE ENCUENTRA AL FINAL DE SU SERVICIO (SERUMS)? El establecimiento de salud se encuentra en el local
nuevo y propio construida de material noble y en buen estado, la mudanza se realizo a través de una faena en coordinación y participación de las madres y
la
comunidad. Aprovechando la mudanza se ordeno y limpio los
materiales y formatos.
Uno de los ambientes en el local nuevo nuevo es exclusivo exclusivo para tópico donde se ordenaron materiales y equipos para la atención adecuada y cómoda del paciente.
Farmacia se acondiciono en uno de los ambientes, donde donde los medicamentos se encuentran ordenados de forma alfabética en los estantes.
Hay un ambiente exclusivo exclusivo para el servicio de enfermería, cuenta con materiales para el adecuado control de peso, talla, para el control CRED
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Contamos
con
ambiente
exclusivo
para
el
almacenamiento de los alimentos y papillas de los beneficiarios. Contamos con un consultorio de obstetricia para una
adecuado
atención de las gestantes con camilla
adecuada y un set de parto, mesa para la atención del recién nacido en caso que ocurriera un parto eminente.
Contamos
con
un
ambiente
para
las
sesiones
demostrativas que se hace con las madres de la comunidad. Se cuenta con 5 agentes comunitarios activos
para
realizar trabajos en las comunidades.
Se implementó con con algunos materiales y equipos, pero pero que aún no son suficientes para las necesidades de los pacientes
Contamos con una moderna residencia para el personal de salud.
Se ha implementado implementado la sala sala situacional situacional
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Cabe resaltar que se observa una discriminación entre el personal nombrado, contratado por las diferentes modalidades, en relación al personal SERUMS para asistir a Cursos de Capacitación en la red de Huancavelica. Es limitado la participación del personal SERUMS.
En LA red de salud de Huancavelica, no hubo
capacitaciones como se esperaba para para los SERUMS. SERUMS.
6.4. INDICAR LAS DIFICULTADES O LIMITACIONES QUE SE PRESENTARON DURANTE LA REALIZACIÓN DEL SERVICIO Las dificultades que se encontraron durante el año del SERUMS fueron:
Idiosincrasia, costumbres costumbres y patrones patrones socioculturales que representa una barrera para brindar servicios de salud adecuadas.
El acceso a las comunidades, comunidades, por su lejanía lejanía y trochas accidentadas, el cual es desfavorable para la referencia
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La alta tasa de migración, ya que no permitían el
seguimiento adecuado de los niños y causan la disminución en las coberturas.
Migración temporal de gestantes, ya que que solo vuelven vuelven a sus comunidades para su parto y luego retornan a sus lugares de residencia.
Mucha carga administrativa, el cual no permite una
atención con calidad y calidez al usuario.
VII.
CONCLUSIONES
En cuanto cuanto a las IRAS y EDAS EDAS se realizó un constante e intenso intenso trabajo de sensibilización a la población.
Para los casos de IRAS se realizo las siguientes siguientes intervenciones, intervenciones, sesiones educativas a las madres de familia y niños en las instituciones educativas, esto contribuirá en la disminución de casos.
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Se cuenta con local local propio y una adecuada adecuada infraestructura, el cual mejora la calidad de atención de la comunidad.
En cuanto a promoción de salud salud se trabajo enfatizando más viviendas y familias saludables.
Se logró logró afiliar al 100% de la población población mediante el seguro seguro universal de salud (aus), lo que ha permitido el incremento de las atenciones en todas las edades sobre todo en la población adulto y adulto mayor.
Actualmente se cuenta con agentes comunitarios activos y
entusiastas gracias a las capacitaciones que se les brindo por parte del equipo de salud.
VIII.
RECOMENDACIONES
El puesto de salud de Lirio debería contar con un equipo mínimo de tres profesionales, profesional de enfermería y obstetricia y técnico en enfermería para así mejorar y aumentar las coberturas.
La red de de salud y DIRESA Huancavelica debe de organizar mayores capacitaciones para los profesionales SERUMS, los
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Realizar capacitaciones periódicas y permanentes a los agentes comunitarios para el trabajo coordinado coordinado y la contribución en la mejora de la salud en las comunidades lejanas.
Considerar al puesto de salud
para la obtención de una
movilidad que ayudaría bastante en los casos de referencia por emergencias.
Mayor participación y coordinación con la municipalidad de Lirio para involucrar más a nuestras autoridades en el sector salud.
Continuar con la sensibilización y educación a la población para mejorar su estilo de vida y así romper barreras que todavía mantienen ideas y costumbres costumbres negativas. negativas.
Priorizar el trabajo en equipo para trabajar en en coordinación coordinación y así elevar las coberturas programadas en los grupos de riesgo.
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ORGANIGRAMA ESTRUCTURAL ESTRUCTURAL DEL PUESTO SALUD LIRIO GOBIERNO REGIONAL
DIRECCION REGIONAL DE SALUD HUANCAVELICA
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FLUXOGRAMA DE ATENCION DEL PUESTO SALUD LIRIO
SI
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3.4. CROQUIS DEL DEL CENTRO CENTRO DE SALUD.
AREA NUTRICION
BAÑO
TRIAJE Y ADMISION