# Situation: A newly assigned public health nurse at the Rural Health Unit (RHU) of an agricultural municipality orients herself to the local health system and its links with the Universal Health Care (UHC) Act (RA 11223). The nurse wants to find out which infants in one barangay are due for their next vaccine doses and which have missed doses. Which Field Health Services Information System (FHSIS) recording tool should she review?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627082  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: A newly assigned public health nurse at the Rural Health Unit (RHU) of an agricultural municipality orients herself to the local health system and its links with the Universal Health Care (UHC) Act (RA 11223).

The nurse wants to find out which infants in one barangay are due for their next vaccine doses and which have missed doses. Which Field Health Services Information System (FHSIS) recording tool should she review?

## 보기

1. The summary table
2. The target client list **✔ 정답**
3. The monthly consolidation table
4. The individual treatment records

**정답: 2**

## 해설

In the FHSIS, the target client list (TCL) lists the eligible clients of a program with the dates of each service, so it is used to plan and monitor care and to find clients due for services or who defaulted. The individual treatment record is the patient's consultation record, while the summary table and monthly consolidation table give totals for reporting, not names and due dates.

## 심화 해설

The question asks which FHSIS tool lets a nurse identify individual infants who are due for vaccines or who have missed doses. In the FHSIS, the target client list (TCL) is the registry that names each eligible client and records the dates when services were given. Because it is organized by client rather than by aggregate count, the nurse can scan the list, compare each infant’s last vaccination date with the expected schedule, and flag those who are overdue or defaulted. The TCL is the tool used for planning follow-up and tracing defaulters because it links a specific client to specific service dates.

The other options serve reporting or clinical documentation functions, not individual tracking for follow-up. The individual treatment record (ITR) is the patient’s consultation record; it captures what happened during a visit but is not designed as a master list for scanning an entire barangay’s immunization coverage. The summary table and monthly consolidation table (MCT) compile totals for reporting purposes—they show how many infants were vaccinated, but they do not contain names, birth dates, or due dates. Key point! The FHSIS distinguishes between *aggregate reporting tools* (summary table, MCT) and *client-level monitoring tools* (TCL). Only the TCL answers “who is due?” and “who missed a dose?”

This distinction matters for immunization programs because completion of all doses is necessary to achieve protective immunity. The cited cross-sectional study in urban Dhaka examined children aged 1–3 years and found that incomplete immunization was associated with missed opportunities—situations where a child was already in contact with the health system but did not receive a due vaccine. A nurse using the TCL can systematically identify children with missed opportunities and schedule catch-up doses before they become fully defaulted. The study relied on immunization card records or parental history to classify children as not fully immunized, which parallels how the TCL serves as the program’s official record for verifying which doses have been given and which remain outstanding.

In practice, the RHU nurse would review the TCL for the target barangay, look for infants whose next vaccine date has passed without a recorded dose, and generate a list of defaulters for home visits or community outreach. This is a core public health nursing function under the UHC framework: moving from passive service delivery to proactive population-based monitoring. Watch out! Do not confuse the TCL with the ITR. The ITR documents one patient’s encounter; the TCL is the program’s working list for an entire target population. If the question asks about finding *specific clients* who are due or defaulted, the answer is always the TCL, not any aggregate table.

| FHSIS tool | Content | Use for finding due/defaulted infants |
| --- | --- | --- |
| Target client list (TCL) | Names of eligible clients with dates of each service received | Yes — identifies who is due and who missed doses |
| Individual treatment record (ITR) | Consultation details for one patient visit | No — visit-specific, not a population registry |
| Summary table | Aggregate counts for reporting | No — totals only, no client names or dates |
| Monthly consolidation table (MCT) | Compiled monthly service statistics | No — reporting totals, not individual tracking |

The immunization context reinforces why the TCL is the correct answer. Vaccines requiring two or more doses depend on completing the series; a child who receives only the first dose remains vulnerable. The TCL allows the nurse to see the gap between the expected date of the next dose and the actual date recorded, which is the operational definition of “due” or “missed.” Without a client-level list that includes dates, a health facility cannot perform active defaulter tracing—it can only report how many doses were given. The study’s focus on missed opportunities highlights the same principle: children may visit a facility for other reasons and still not receive a due vaccine unless a system actively flags them. The TCL is that flagging system in the Philippine FHSIS.

## 임상 시나리오

FHSIS Target Client List for Immunization Follow-UpClient-level tracking for due and missed vaccine doses
Use the Target Client List to identify individual infants due for vaccines or who have defaulted. It links each client to service dates, allowing comparison with the immunization schedule.

Aggregate tools such as the summary table and monthly consolidation table report totals only and cannot answer who is due or missed a dose.

CautionDo not rely on the individual treatment record for barangay-wide follow-up; it documents consultations but is not a master list for scanning coverage.

## 핵심 개념

- **Target Client List (TCL)** — FHSIS registry listing eligible clients with service dates, used to plan care and trace defaulters.
- **Field Health Services Information System (FHSIS)** — National health information system for recording and reporting public health services.
- **Individual Treatment Record (ITR)** — Patient consultation record documenting services during a visit.
- **Monthly Consolidation Table (MCT)** — Aggregate reporting tool compiling service totals for a facility or area.
- **Universal Health Care Act (RA 11223)** — Philippine law mandating health system reforms and primary care integration.

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