Finally. outcome slcmdunls define both 11w de$ircd rc:-ult:-10 be. ichil. !vl!d aml the \mdesirablc ret OUIL. " lo be a,vidcd. Each health faci Hty/orgnnir. ::lliun should 11:wc-(and rcg\11:u·ly review) stnndnrds on healt. h care del. i\'ery. mouitl"r :ind ;,,,<1hmtc-its prncti<·l's nncl !'\!solve pr:ictice/hc;;ilth care delh-e-~· probl-c. ms. Sine~ m:iny of the struc-t11rl· st:mdurds,ire dependent on the :\\'nilability of financi:11 !"1>-!<0Urc-t?'s. hc-:ilth workl'n-sl1011ld,·11lisl the comm ii ment of the 1oca1 political leaders aud dcc L'-fon makcn; :mcl administratin: personnel. Se11trcmg Sigla Mot CTT1cn t M~· LGUs h,we stnrtt-d their quality us-o;urance proi;rams by respnndjng to the DOH's QA initiati,·e. the &ntr-o:ig Sigla. Tl" ~l·nt:·0119 Sig In !\lovemcnt c1ims lo make quality health,otf"'\-ic,·s t\\":lilabl4. ' and :1cee...--siblc to Filipinos. Its main compon ent is the certific. "lt ion,ind reco~nition ofht!:1l1h focilitics. ln Phase 1. the focus is RH Us am] health center. :. lne r~rnm'-' th~1t. 1r,· induc:fo-d :il"'t!: exp:m<led program on i11rn1uni7. at;on, disea. _~ sur Yeillanrc. contn,1 nf acme re. <. piratory infections. control nf cliarrhe;,il dl--eases. micronutrients-. uppleme nt;;ition/ nutrition. family planni 11p.. tt1bcrculosis control. sexual!:-tr. :insrnitt-ed di;. eases/ Al DS prc Ycntion,u1d control. cm;ronmcntal health arid snnita:tio n, canc-cr oontrol, p. i. nicula rly cef\-ic:ul cancer screening. {DOH) The standards are basically on structure or inputs for the deli,·cr) of the iden1ified sen. ;ces or progrnms. The a,-. sumption of the focus oo st TIJcturt> is that if all the aec. ts Slny infrastrucrure. equipmen t, pharmaceutic:. 1 ls. supplies and t. rai n ing programs or acti,.-ities are a,-:ulable, the likelihood of de U"erin~ "quality-sen·iccs is ~realer. The second pbe..-. e of &ntrong Sigla focu. s~ on proccs.-, stundard. s or the,vny he1c1lth workers deliver health sel"\;ccs, and outcome stnndards or the r~u. lt of the internction between ctn1cture and pn:>ees-<. st:ind:trdc.. The Sc:mtron!] Sigln h::i<: :i l)ualtry Stand. ards List.,,;th a !loo<! numberofstand:irds under four major hcadin~-facility and srs1cm. s. int~ted public bealtl1 fuocti-,ns. bao;ic cur. 11h·e !<(!n;ccs function, and n..ogulatory funct:ioru:. PHNs acth-ety participate in the Q1\ efforts of their local he. ii th departmcn L<;/ units by :idopting and im-plcm<'Tlting I. he program St.."-ndards. Nursing audtt :-. ~ng audi1 i,; part of the 11'--ernll qualtty a SS1Jrancc cffor L'i of an llii,Cll(..")'. It is n metl1od of t:"'-:1lu;;1 in~ the qu:oilit) of care g_ivcn 10 clients t J1roug. h the sys! cmut le rc,.-iew of cli E-nt ~l"d IPhanc-uf in C'l:men~Stnn,: rt al. 1991:852). It i<: a proccs~. not :m outcome~ aluation h j,., pr,,m1,..-d on the h(lid that ii thr· proc-c<, t)f dtli\'fring care/ sen,,~ ltr)i::,«th.,, "'it. h cctru<'lur PJ '",n :. c_conlanc" with r,;tahllshed stanc. J. :1rds, then t. hel"E' mu-..t be quality fnutmm<>J And. th::i nurcc1,c, documc:nt1:d in the dicnt's records t. heir a..s..,;,essment. inter>'e Titinn'-and e-,<1l1Latir,n 1>f c-an:. Por nursing. iudit purposes, it is assumed that what,.-a« not wriacn.....,a, nm done-. In commu nity he. 11th nursin~. Phan'!ufi< (1976) "<-"'en cnre c,tnndarcl..ci can bl! adopted or sli Jthtly modified as a fr. un--,,rl, fm nursinit audit O:. t;, coll<'ction instruments that \ooi U be t L"c:d to re,.,~ the ri'CO'ni'-retlt-ct th~· <;tand:ir<lc. : ( 1 J :\r,plic:i I ion ;1 nd execution of phv'!i1nan ~ I/Sl1. al ordt:r-. 12Joh-. t-r,a11<111 nf,\'mµtmn« and r,ac-tion. s: (3) :,upcrvisi6 n of th<.-pan,-. n1, (4)-. uf)Pl"'\·1-ion nf th,,.... p.,n1np,11n~ in ti..-car<': (~) reporting nnd n:-oording 16) apphc1st1on nf nu M-ini:, pn~-du rr<-,md,,~hniqut<;;,,r Hl, (7) prnmntiori of health b~ d. u,4"i. l,:,,n and t;-achin~ CChm Pn'-tonl ('t al.. p. 85'. L). u~in R I he-. e stand::ircl. s as. guide. data c-ntln:non instrum,-nl S <Jlould he-ahle l CJ provide-an'-wen: tn questions such as these: b(l",o,' d Jd tht-nurses <it the he;i Jlh cenh!r tnke c;,re of a baby who was 