Community health nursing | Nursing homework help

WINDSHIELDSURVEYASSIGNMENTSOC2024.docx

Windshield Survey: A Community Assessment Strategy

Assignment 1: Clinical Activity Windshield Survey

Background:

· Students will be conducting a windshield survey of a chosen community. The student will drive and walk as appropriate thorough the community.

· You may drive, walk, or take public transportation to move about your community to make systematic observations that will help you understand more about the characteristics and health status of the community.

During the tour, the student should look for and consider the following:

· Who are the people in this community? In other words, who do you see? Consider age, ethnicity, and family types.

· How do people travel and get around in this community? Do they use a car, train/bus (public transportation), bike, or walk? Horse and buggy? Are there safe biking/walking paths?

· What sorts of businesses and places of employment are in this community? What sorts of jobs are available?

· What types of signs are visible (e.g., political, homes for sale, advertisements, graffiti, handmade or professional signs)?

· Where do people get their groceries? What types of restaurants are available? Where do people shop? Chain stores? Locally owned stores?

· What types of organizations provide services for children and families (e.g., schools, churches/places of worship, youth centers, day cares, Head Start programs, libraries, places of higher education)?

· What types of housing is available in this community? Describe the housing conditions.

· What healthcare services and resources are available in this community? Full-service clinics? Retail clinics? Specialty clinics? Hospitals? Dental services? CAM (complementary alternative medicine)/CAT (complementary alternative therapy)?

· Look for the recreation and exercise opportunities in this community? Are there parks/green space/playgrounds? To what extent are these areas maintained?

· As you traverse through Knox County, consider the community’s assets and factors that impact the overall health of this community and its members. What characteristic(s) are the most influential to the PHN who works within this community?

· Construction – roads, housing, commercial.

· You should take ever opportunity to interact with the citizens of Knox County. Stop at local stores. Buy your lunch and or a cup of coffee at small out of the way places.

Assignment 2: Develop a way to record and organize the data discovered during your Windshield Survey using the information from Assignment #1 as your guide. You will use this data to create a paper in which you will discuss the data discovered and contrast the data from various parts of your chosen commnity. Once you start writing your paper you may need to return to the community if you determine that your do not have adequate material to complete your paper.

CommunityDiagnosis1.docx

COMMUNITY HEALTH NURSING DIAGNOSIS

1. COMMUNITY HEALTH NURSING DIAGNOSIS Individual, Family, and Community Diagnoses

2. NURSING PROCESS Source: www.allnurses.com

3. INTRODUCTION • Creating nursing diagnoses requires the application of detailed assessment skills, critical thinking, and decision making. The formulation of nursing diagnoses is related to competency in diagnostic reasoning.

5. DEFINITIONS A diagnosis is a that synthesizes (brings together) assessment It is a label that situation (or state) and implies an etiology (reason) and gives evidence to support the inference.

6. NANDA-I • The North American Nursing Diagnosis Association (NANDA) defines nursing diagnosis as a clinical judgment about individual, community or family responses to community to actual or potential health problems or life processes.

7. FAMILY A family nursing diagnosis is an extension of a diagnosis to the family system and/or subsystems is the outcome of family assessment. It includes or potential health problems. Diagnoses statement: Single diagnosis (no etiology included BUT adding family member who had problems)

8. COMMUNITY A community diagnosis in that it is focused on an aggregate or a community (rather than an individual). It requires a multidisciplinary action to address or treat, multiple determinants must considered when planning interventions. Outcomes of action may not be visible for long time

9. WELLNESS DIAGNOSIS Characteristics: • Sometimes called positive or health oriented diagnoses. • Focus is on an individual, family, community or aggregate. • There is usually a desire for a higher level of wellness. • Sometimes an effective program or status is present and there is a desire to improve the functioning. • Usually require multidisciplinary action to address or enhance. • Multiple determinants must be considered when planning interventions. • Outcomes/ actions may not be visible in the short term. • Focus is on existing or potential individual/family/community strengths.

10. WELLNESS DIAGNOSIS: Nurse’s Role in Wellness Diagnoses: • The role of the nurse is basically to facilitate healthy responses in order to reach a higher level of health oriented goals. There is a progression from one level of wellness to a higher level of wellness. For example, the nurse can help clients to complete transitions, to achieve higher levels of wellness or to attain wellness status. • Health promotion plays a significant role.

11. COMMUNITY DIAGNOSIS IN NANDA -I • Commonly located at Domain 1 (Health promotion), but could be at other Domains • Commonly labelled as : - Deficient community health (D1, C2) - Readiness for enhanced health management (D1, C2) (NANDA International, Inc. Nursing Diagnoses: Definitions & Classification 2015–2017, Tenth Edition)

12. DEFICIENT COMMUNITY HEALTH •Definition Presence of one or more health problems or factors that deter wellness or increase the risk of health problems experienced by an aggregate.

13. DEFICIENT COMMUNITY HEALTH Defining Characteristics ■ Health problem experienced by aggregates or populations ■ Program unavailable to eliminate health problem(s) of an aggregate or population ■ Program unavailable to enhance wellness of an aggregate or population ■ Program unavailable to prevent health problem(s) of an aggregate or population • Program unavailable to reduce health problem(s) of an aggregate or population • ■ Risk of hospitalization experienced by aggregates or population • ■ Risk of physiological states experienced by aggregates or populations • ■ Risk of psychological states experienced by aggregates or population

14. DEFICIENT COMMUNITY HEALTH Related Factors ■ Inadequate consumer satisfaction with program ■ Inadequate program budget ■ Inadequate program evaluation plan ■ Inadequate program outcome data ■ Inadequate social support for program • Insufficient access to healthcare provider • ■ Insufficient community experts • ■ Insufficient resources (e.g., financial, social, knowledge) • ■ Program incompletely addresses health problem

15. READINESS FOR ENHANCED HEALTH MANAGEMENT •Definition A pattern of regulating and integrating into daily living a therapeutic regimen for the treatment of illness and its sequelae, which can be strengthened.

16. READINESS FOR ENHANCED HEALTH MANAGEMENT Defining Characteristics ■ Expresses desire to enhance choices of daily living for meeting goals ■ Expresses desire to enhance management of illness ■ Expresses desire to enhance management of prescribed regimens • Expresses desire to enhance management of risk factors • ■ Expresses desire to enhance management of symptoms ■ Expresses desire to enhance immunization/vaccination status

17. COMMUNITY 4 PARTS OF COMMUNITY DIAGNOSIS; 1. a description of the problem, response, or state (risk, concern, issue, potential or actual), 2. a statement of the aggregate, population, community, or focus (boundaries). THIS DIFFERS FROM THE NURSING DIAGNOSIS, the focus is added 3. an identification of factors etiologically related to the problem ( factors), and 4. those signs and symptoms (manifestations) that are characteristic of the problem. EXAMPLE: deficient community health among children aged 0-5 y.o in the area of Village A related to Insufficient access to healthcare provider as evidenced by Health problem experienced by children (malnutrition, etc), Program unavailable to eliminate health problem(s) of an aggregate or population (Ex: no health education)

18. COMMUNITY HEALTH NURSING : PLANNING

19. PLANNING Prioritize the community- health conditions and problems Define objectives and goals Develop the intervention plan Define persons, time, place, method, tools

20. CRITERIA TO ESTABLISH PRIORITIES OF CHN NURSING DIAGNOSES • Appropriateness to the community health nursing role • Prevalence of the risk in the community • Severity of the risk • Potential for risk reduction • The level of the community's interest in reduction of the risk • Availability of appropriate resources (personnel, money, equipment, space, time, etc.). Muecke, M. A. (1984). Community health diagnosis in nursing. Public Health Nursing,1(1), 31.

21. DEFINE OBJECTIVES AND GOALS • Formulate expected outcomes : c - onditions to be observed to show problem is prevented, controlled, resolved or eliminated  knowledge, behavior, status (signs & symptoms) • Individuals / families/ community responses or behaviors • Specific, measurable, community centered

22. DEVELOP INTERVENTION PLAN Categories of the intervention scheme: Primary preventions • Health teaching, guidance and counseling (assistance with decision making and problem solving) Secondary preventions • Treatments and procedures (decreasing and alleviating sign and symptoms) Tertiary preventions • Case management (coordination, advocacy and referral) Independent or collaborative intervention

23. REFERENCES: Freidman, M.M., Bowden, V.R., & Jones, E.G. (2003). Family nursing: Research, theory, and practice. (5th ed.). New Jersey: Prentice Hall. Muecke, M. A. (1984). Community health diagnosis in nursing. Public Health Nursing,1(1), 31. Sparks, S.M., & Taylor, C.M. (2001). Nursing diagnosis reference manual. (5th ed.). Pennsylvania: Springhouse. Stammler, L.L. & Yiu, L. (Eds.). (2008). Community health nursing: A Canadian perspective. (2nd.ed.). Toronto: Pearson. Stolte, K.M. (1996). Wellness: Nursing diagnosis for health promotion. Philadelphia: J.B. Lippincott. Vollman, A.R., Anderson, E.T. & McFarlane, J. (2004). Canadian community as partner: Theory and practice in nursing. Philadelphia: Lippincott Williams & Wilkins.

CAPaperInstructionsandRubric.pdf

Instructions: After reading about the implementation of the nursing process at the community

level in Chapter 17, you will complete a community assessment and plan of care. This

assignment is designed to give you an opportunity to participate in the assessment of a whole

community. Data gathered will be used to determine the health status of the selected

community and to formulate community health nursing diagnoses. You will propose (you will

not actually be implementing these interventions) nursing interventions for primary, secondary,

and tertiary levels of prevention to improve or maintain the health of the selected community.

You will submit a paper with your data findings and plan of care for the community.

The steps of a community assessment are:

1. Data Collection

2. Problem Clarification

3. Analysis of Problem

4. Resource Identification

5. Resource Utilization

6. Action Plan (Community Nursing Care Plan)

Using the nursing process, the student will:

1. Select appropriate data sources to assess a selected community.

2. Identify factors that promote wellness and factors that are detrimental to the health of

a community.

3. Interpret data collected for the community assessment to determine the health status of

a community.

4. Formulate nursing diagnoses that reflect assets and liabilities of the community. 5.

Identify the role of the community health nurse in improving the health status of the

community.

6. Communicate effectively with key people in the selected community to obtain required

data.

7. Demonstrate accountability for professional practice as a team member in conducting a

community assessment.

8. Formulate goals and nursing interventions that could improve the health of the selected

community, using primary, secondary and tertiary levels of prevention.

9. Evaluate outcomes based on goals and interventions. GENERAL TOOLS TO USE FOR DATA COLLECTION:

1. Windshield Survey

2. Existing data sources (national, state and local: see Sources for Data below)

3. Surveys – sample a specific population to get opinions

4. Interviews – key informants and community members and/or leaders

5. Community forums – get input from members of the community

WINDSHEILD SURVEY:

The best initial step in assessing a community is to walk or drive around the community, looking at physical or environmental characteristics of the community. The next step is to conduct research regarding your chosen community (see Sources for Data Collection below). There will be a lot of information to cypher through; here are some suggested categories to help organize your data:

· Physical/Environmental · Political · Social · Economic · Health

A partial listing of data that should be considered is as follows:

· Income statistics/taxes · Transportation services · Churches, stores, recreational areas · Air quality · Waste disposal systems · Climate · Noise levels · Highways/streets/access · Crime statistics/police coverage/lighting · Morbidity and mortality statistics · Educational levels/resources · Accident rates · Health care facilities/practitioners · Presence of natural resources such as grass, trees, rivers · Housing · Demographic statistics · Observed health hazards

· Factories/businesses · Meals on Wheels and other health care resources · Geography of the area · Water and air quality · Fire departments/emergency services · Government offices/type of government: mayor, city council, etc. · History of the community

SOURCES OF DATA AND WHERE TO FIND THEM

DATA SOURCES

Census data Local government planning office Chamber of Commerce

Online

Morbidity and mortality statistics State/Local Health Department Online

Vital records State Health Department Local government vital statistics

registrar

Demographic data Local government planning office Public Library

Chamber of Commerce

Health Department

Information for special studies and projects Source of recipient of study

Hospital admission and discharge statistics Hospital website

Department of Health annual

hospital report

Disease-specific data State/Local Health Departments; Disease-specific organizations such

as the Cancer Society, etc.

Small population group data Community surveys, Household interviews,

Questionnaires

Family and individual client data Interviews, assessments and past medical

records

Air and water quality data State/Local Health Dept.

COMMUNITY-ORIENTED NURSING DIAGNOSES

The development of the community-oriented nursing diagnosis helps to clarify the

problem and is an important first step in planning. Community diagnoses clarify who

receives the care, identifies problems faced by whoever is getting the care, as well as

identifies factors that contribute to the problem.

A three-part approach to the community-oriented nursing diagnosis is suggested:

1. Identify the problem faced by the community and the members of the community

(among/in)

2. Identify factors that contribute to the problem (related to)

3. Supporting data that document the problem (as evidenced by)

EXAMPLES OF COMMUNITY PROBLEMS THAT COULD BE USED IN FORMULATING NURSING DIAGNOSES:

· Inaccessible or unavailable services

· Mortality and morbidity rates

· Communicable disease rates

· Specific populations at risk for physical or emotional problems

· Health promotion needs for specific populations

· Community dysfunction

· Environmental hazards EXAMPLES OF COMMUNITY-FOCUSED NURSING DIAGNOSES:

1. Increased rates of infant mortality among young mothers in Enid related to a higher

level of teenage pregnancies and a lack of prenatal care in this aggregate as evidenced by

infant mortality rates above the national average.

2. Increased incidence of respiratory diseases among citizens in Buffalo related to

increased air pollution compared to national standards as evidenced by high rates of

asthma.

Grading Rubric: Use this rubric to help guide the development of your paper to receive

maximum points.

1. Introduction of the community _________/10

2. Assessment: Comprehensiveness of data collection/

Resources used (including at

least 1 informant interview) _________/25

3. Data analysis/problem list (Minimum of 2)

Use of Healthy People 2020 objectives

(One objective linked to each problem) _________/20

4. Nursing diagnoses (Minimum of 2)

_________/25

5. Planning: Establish and prioritize goals to

address the 2 priority nursing diagnoses

(One goal for each diagnosis) _________/20

6. Implementation: Identify/Prioritize interventions

designed to meet above listed goals _________/20 (Must include at least one

primary, secondary and

tertiary level of prevention for each goal)

7. Evaluation: Plan for each nursing diagnoses developed _________/15 (One

evaluation for each goal)

8. Reference List __________/5

9. APA Format/Grammar __________/10

TOTAL POINTS POSSIBLE _________/150 GRADER