1. ALTERNATIVE HEALTH CARE SYSTEM AND
REFERRAL SYSTEM
SUBMITTED TO:-
Mrs. Talita.k. Bara
(Clinical tutor)
College of Nursing
RIMS Ranchi
SUBMITTED BY:-
Name:- Ruby Kiran
Roll no.:- 29
Basic BSc Nursing 4th year
Session – 2017- 2021
College of Nursing
RIMS, Ranchi

2. CONTENTS
ALTERNATIVE HEALTH
CARE SYSTEM
Introduction
Definition
Types
Ayurveda
Siddha
Unani and tibbi
Homeopathy
Naturopathy
Herbal medicine
Nurtional therapy
Meditation
Guided imagery
Chiropractic
Massage therapy
Acupuncture
Aromatherapy
Spiritual therapy
Dance therapy
Cupping therapy
Music therapy
REFERRAL SYSTEM
Introduction
Definition
Purpose
Requirements of effective referral system
Selection of referral cases
Cases requiring immediate care
Advantages
Key points to effective referral system
Nurses role
Reference
Bibliography

3. ALTERNATIVE
HEALTH CARE
SYSTEM

4. INTRODUCTION
• Alternative systems of health include various healing approaches
that originate from around the world and that are not based on
conventional western medicine. There therapies are called
alternative system of health as they are used alone as
complementary medicine or these can be used with conventional
medicine.

5. DEFINITION
• Alternative system of health defines as the absence of disease is
usually thought to result from isolated factor and treatment often
involves drugs and surgery.

6. TYPES
1. Alternative medical system
2. Biologically based treatment
3. Mind body techniques
4. Manipulative and body based methods
5. Energy therapy
6. Other therapy

7. 1. Alternative medical system :- This includes Ayurveda, siddha,
unani and tibbi , homeopathy and naturopathy.
2. Biologically based treatment:- This includes herbal medicine
and nutritional therapy.
3. Mind body techniques :- This includes meditation,
hypnotherapy, biofeedback, and guided imaginary.
4. Manipulative and body based method :- This includes yoga and
chiropractice .

8. 5. Energy therapy:- This includes massage therapy and
accupuncture.
6. Other therapy:- This includes aromatherapy, spiritual therapy,
dance therapy , cupping therapy and music therapy.

9. • AYURVEDA:- Ayurveda is a system of medicine with historical roots
in the Indian subcontinent. Globalized and modernized practices
derived from Ayurveda traditions are a type of alternative
medicine.
• SIDDHA:- Sidhha medicine is a system of traditional medicine
originating in ancient TAMILAKAM in South India. Sidhhars were
spiritual adepts who possessed the ashta Siddhi a or the eight
supernatural powers.
• UNANI AND TIBBI:- It is the term for Perso- Arabic traditional
medicine as practiced in Mughal india and the Muslim culture in
South Asia and modern day central Asia

10. • HOMEOPATHY:- It can be based on the concept that disease can be
treated with drugs with which are capable of producing the same
symptoms in healthy people as the disease itself.
• NATUROPATHY:- it is the system of therapy based on preventive care and
on the use of heat, Water, light, air and massage as primary therapies
for disease.
• HERBAL MEDICINE:- Herbal medicine has always attracted some scientific
interest and many well known drugs are plant derived.eg. DIGOXIN from
foxgloves and MORPHINE from poppies
• NURTIONAL THERAPY:- It is a system of healing based on the belief that
food as nature intended provides the medicine we need to obtain and
maintain a state of health.

11. MEDITATION
• Meditation involves focusing the mind upon a sound, phrase,
prayer, object, visualized image, the breath or consciousness in
order to increase awareness of the present moments, promote
relaxation, reduce stress and also enhance the spiritual growth.

12. HYPNOTHERAPY
• Hypnotherapy is a type of alternative medicine in which hypnosis
is used to create a state of focused attention and increased
suggestibility during which positive suggestions and guided
imagery are used to help individuals deal with a variety of
concerns and issues.

13. BIO-FEEDBACK
• It is a technique that is used monitoring instrument to measure
and feedback information about the muscle tension, heart rate,
sweat responses and skin temperature or brain activity.
• The term associated with biofeedback include psycho physiology
or behavioral physiology.
• It is also viewed as a mind- body therapy use as an alternative
medicine.

14. GUIDED IMAGERY
• Guided imagery also known as guided affective imagery or
katathym – imaginative psychotherapy (KIP) is a mind – body
intervention by which ba trained practitioner bor teacher helps a
participant or patient to evoke and generate mental images that
stimulate or re- create the sensory perception of sights, sounds ,
tastes.
• It is a form of focused relaxation that helps create harmony
between the mind and body. It is a way of focusing your
imagination to create calm, peaceful images in your mind thereby
providing “mental escape” .

15. YOGA
• Yoga is a group of physical, mental and spiritual practices or
disciplines which originated in ancient India.
• Yoga became popular as a system of physical exercise across the
western world. Yoga in Indian tradition, however, is more than
physical exercise, it has a meditative and spiritual core.
• Yoga uses combination of physical postures (ASANAS), breathing
techniques ( PRANAYAMAS), and meditation to promote relaxation
and enhance the flow of vital energy called prana.

17. CHIROPRACTIC
• It is the relationship between system of spine and function of
nervous system is thought to be in the key in maintaining or
restoring health.
• It improves health, sleep, stress, happiness, wellbeing, immune
system and strength life.
• It decreases illness pain, aches, injuries, bad posture, depression
etc.

18. MASSAGE THERAPY
• Massage involves working and acting on the body with pressure-
structured , unstructured, stationary or moving – tension, motion
or vibration done manually with or without mechanical aids.
• Massage can be applied with the hands, fingers, elbows,knees,
forearms, feet or a massage device.
• It is beneficial in treating sports injuries band other problems
affecting the musculature of the body such as postural
misalignment and many painful conditions.

20. ACUPUNCTURE
• A therapy within traditional Chinese medicine is one of the most
widely accepted alternative therapy in western world specific
points on the body are stimulated usually by inserting thin needle
into the skin and underlying tissues.
• Sometimes additionally stimulation is added by using very low
voltage electric current by twisting the needle or by warming the
needle stimulating the specific points.
• A variation of acupuncture is called acupressure uses localized
massage instead of needle to stimulate acupuncture points.

21. AROMATHERAPY
• Aromatherapy is a holistic healing treatment that uses natural
plant extracts to promote health and well being. Sometimes it’s
called essential oil therapy.
• Aromatherapy uses aromatic essential oils medically to improve
the health of the body, mind and spirit.
• It enhances both physical and emotional health.

22. SPIRITUAL THERAPY
• It is a regimen designed to heal ones spirit and psyche as well as
the body in many tradition is believed if one’s spirit is calling ones
whole being suffers.

23. DANCE THERAPY
• Dance therapy uses expressive movement as a therapeutic tool for
both personal expression and psychological or emotion healing.
Practitioner work with people with physical disabilities, additional
issues, sexual abuse histories, eating disorders and other
concerns.

24. CUPPING THERAPY
• It is a traditional chinese medical technique which applies suction
to diseased part of the body using ceramic glass or bamboo cups in
order to increase regional circulation and thereby promote
healing.

25. MUSIC THERAPY
• Music therapy is an allied health professions and one of the
expressive therapies, consisting of a process in which a music
therapist uses music and all of its facets – physical, emotional,
mental, social, aesthetic, and spiritual – to help the clients
improve their physical and mental health.
• Music therapists primarily help clients improve their health in
several domains such as cognitive functioning, motor skills,
emotional development.

26. REFERRAL
SYSTEM

27. INTRODUCTION
• At each level of health care infrastructure, there is need for
support from higher level of infrastructure band also from
secondary and tertiary level hospitals to strengthen and
promote credibility of primary health care system.

28. DEFINITION
• Referral system is defined as a system of transferring cases which
are beyond the technical competence of one infrastructure to a
higher level infrastructure/ institution having technical
competency and all other resources to provide desired health
services.

29. • The referral system is vertical in nature.
• The cases can be referred from village health post to SC/ PHC,
from SC to PHC/CHC and from PHC to CHC/ Secondary or tertiary
level hospital and from CHC to secondary or tertiary level
hospital.
• Provision is made for bypassing 1 or 2 level depending upon the
nature and seriousness of cases so that required medical and
nursing care can be given on time to the case and mortality and
morbidity can be prevented and controlled.

31. PURPOSES
• To provide need based comprehensive care within the technical
competencies and resources at each level of primary health care
infrastructure efficiently and effectively.
• To help people avail specialised services available at higher level
institution which are beyond their reach.
• To streamline the appropriate use of PHC infrastructure and
specialized services on order to prevent overloading of specialized
institution by direct uses.

32. REQUIREMENTS FOR EFFECTIVE REFERRAL
SYSTEM
The referral units of PHC system need to :-
1. Well trained required number of professionals, medical
equipment and supplies, organization Structure etc.
2. Continuing training, guidance and supervision of community
health workers.
3. Guidance on sanitary measures and to disseminate information
on disease control methods.
4. Conduct health education sessions

33. 5 . Provide logistic supports in terms of equipment and supplies
required at PHC.
6. Establish liasion and functional relation with other sectors
involved in social and economic development.
7. Organise transportation facilities for cases to be referred.

34. THE REFERRAL HOSPITAL BAT SECONDARY AND
TERTIARY LEVEL NEED TO
1. Provide specialized clinical outpatient and inpatient care
continuosly.
2. Back up primary health care system by providing PH care
messages/ teaching.
3. Discourage people attending OPD’s directly i.e. To attend OPD
when they have referral card/ letter or a genuine emergency.
4. Act as teaching center for health professionals including
community health workers.

35. SELECTION OF REFERRAL CASES
1. The very serious patient requiring immediate medical care and
treatment.
2. Patients presenting serious signs and symptoms. He/she may not
be sick but requires immediate referral.
3. When special diagnostic procedures are required for diagnosis.

36. CASES REQUIRING IMMEDIATE CARE
The cases who may require immediate referral are as under:-
• Cases presenting any problem which cannot be handled during
pregnancy, labour and post natal period.
• Several diarrhea with dehydration or not responding to treatment.
• Pain in abdomen and vomiting with or without presence of bowel
sounds.
• Heart burn, dyspepsia, dysphagia, haematemesis and maleana etc.
• Continuous cough with or without sputum, haemoptysis.

37. • Fever with stiff neck.
• Fever not responding to treatment.
• Fever with severe joints pain, rashes, bleeding under the skin
• Breathing difficulty while walking, sleeping, doing physical work.
• Chest pain with or without pain in the left arm, restlessness and
vomiting.
• Jaundice, loss of appetite.
• Convulsions with fever.
• Coma, paralysis, fracture, severe injury, hemorrhage, poison etc.
•

39. ADVANTAGES OF REFERRAL CASES
• Beneficial to patients because they recieve effective care at the
primary level which is near to their home.
• Beneficial to health workers because they are able to take care of
patients which are within their level of competence and are not
frightened to handle difficult cases because they can refer them
to higher level centers and referral units.
• Beneficial to management because it is economical as highly
trained and highly paid doctors, nurses and other professionals
take care of patients with serious and complex problems at higher
level referral unit and patients with simple and minor problems
are taken care at much low cost by heath workers at lower level.

40. KEY POINTS TO EFFECTIVE REFERRAL SYSTEM
1. Mutual understanding of each others role.
2. Mutual respect.
3. Mutual cooperation.

41. NURSE’S ROLE IN REFERRAL SYSTEM
• Observe and collect information about the illness, trauma,
related situation, factors etc.
• Identifies the nature of illness/ emergency and it’s seriousness.
• Provide immediate treatment care within her competence,
standing orders and resources available.
• Assures the casuality/ family members/ any other person
accompanying
• Explains about the seriousness of the problem situation and need
fir reference to the casualty.

42. • Fills up the referral form as desired and hands over the same with
related documents to be given to health professionals in referred health
center.
• Arranges for transport of the patient according to feasibility as soon as
possible.
• May do the telephonic consultation or provide information to referred
health center.
• May accompany the casualty/ patient if required and feasible.
• Maintains the records and reports.
• Provide follow up care as per treatment and instructions prescribed by
the referral unit.

43. BIBLIOGRAPHY
• Swarnkar Keshav; Community Health Nursing; 4th edition; N.R
Brothers; page no. 125-126
• Sreevani.R; Mental Health and Psychiatric Nursing; 4th edition;
Jaypee publication; page no.154- 156
• Manivannan Shyamala D; Textbook of Community Health Nursing;
CBS Publication; volume 2.
• www.slideshare.net
• en.M.Wikipedia.org
• www.scribd.com