Reference no: EM133663115

Homework: Nursing Care of Communities and Populations- Clinical Care Plan- Community Assessment and Analysis

Purpose and Background Information

Nurses must be able to knowledgeably plan services for individuals, families and the community. In order to effectively plan, it is essential to assess the current health status of the community and its resources. Evidence collected during a formal community assessment forms the basis for planning to improve the health status of the community, which impacts individual health downstream.

For this course and homework, each clinical group will assess a chosen community that is approved by their clinical instructor, and complete many of the steps outlined above. Assessment will include the following strategies: a windshield survey or walking survey of the community where the community is observed and photos taken; mining of health data bases (see link provided in the instructions below); and more formal quantitative and qualitative research investigations involving community members and other stakeholders (research articles, interviews, attending a community event, local newspapers, online forums, or news from coalitions or other stakeholders in the community).

A "windshield survey" is a type of observation technique that is conducted from a car and provides a visual overview of a community; this survey may also be done as a walking survey. While conducting the survey, conditions and trends that could affect the health of the population, i.e. social determinants of health, are noted. Most surveys of this type must be validated and expanded by data mining of available online and other databases of demographic and health-related statistics. Therefore, each clinical group is required to complete data collection via a windshield or walking survey, and collect data from other sources (as described below) in order to prioritize a health issue for the community and describe an actual or potential community health intervention.

Objectives:

At the end of this activity, the student will be able to:

A. Identify social determinants of health present in assigned community (socioeconomic status, education, neighborhood and physical environment, employment, social support networks, etc.).

B. Analyze the actual health of the assigned community by utilizing resources to gather vital statistics such as morbidity and mortality rates of health issues present in the community.

C. Identify healthcare resources that are available in the community.

D. Analyze the community data as a clinical group.

E. Create a list of strengths and weaknesses of the community.

F. Prioritize one weakness to identify the highest priority need of the community.

G. Select 2 community health nursing diagnoses for your community based on your findings.

H. Identify community resources (actual, available resources or proposed resources) to address the highest priority problem. I.e., how does the community currently intervene to address the problem, or how does your group suggest the community should intervene?

I. Share community assessment and analysis in a formal, group presentation using a PowerPoint presentation or other method approved by your clinical instructor.

J. Complete a self and peer evaluation for each group member to rate each student's performance while completing the group project.

Course Learning Outcomes

This activity aligns with several of the course learning outcomes as stated below:

A. Utilize the nursing process to apply theories of nursing, public health, social and behavioral sciences to implement population-focused nursing care for the individual, family and community.

B. Utilize an interprofessional approach and apply concept of social determinants of health to create strategies to improve health outcomes and eliminate health disparities in diverse and vulnerable populations.

C. Utilize informatics to gather, examine, analyze and interpret epidemiologic and population-level data about systems, policies, and resources that impact population-focused nursing care at the global, national, state, and local levels.

D. Examine professional nursing concepts of social justice, advocacy, autonomy, human dignity, integrity, and ethics related to the health of vulnerable communities, groups, and populations and elimination of health disparities in a multicultural environment.

General Instructions

This homework is divided into 5 sections: Assessment, Analysis, Diagnosis/Planning, Presentation, Evaluation. Follow the steps listed in each section below to earn all potential points. In addition, all weekly "Check-Ins" must be completed by the due dates listed in the course calendar.

Windshield Survey Check-Ins

A. Each student to submit the community chosen by group and the group's plan to divide the work; include the date chosen to take photos and survey the community

B. Each student to submit the group's started PowerPoint presentation, and any data collected thus far

C. Each member to submit their contributions to the shared document/PPT

D. Clinical group to coordinate regarding the final analysis of data and finalize the presentation; submit outstanding tasks and who will complete them

Part 1: Assessment

A. Your clinical group will choose a neighborhood to survey by the end of Week 1 of the course.

B. Review the Week 3 PowerPoint in Brightspace that reviews the components of a Windshield Survey and the Community Assessment process.

C. Review this resource as a group prior to the survey: Community Tool Box (click on the link).

D. Use Google Maps (or other navigation software) to identify the boundaries of the assigned community.

E. Create a plan for how the group will collect all of the data described below.

F. Conduct the Windshield or walking survey with clinical group members.

1. Remember: SAFETY is always our priority! Please always travel in groups and during the day while collecting data for the community assessment. School uniform and ID is encouraged while collecting data in the community.

2. Support your assessment data with actual images/videos taken with your camera! This is a powerful tool to captivate your audience during the group presentation and provide real-life evidence to support your analysis and needed intervention.

G. Collect the other required data via data mining of state and local websites. This database provides a wealth of information:

UIC Research Guide for Demographic Data and Neighborhood plans.

Collect information on each of the following components of the community assessment:

A. Race and Ethnicity: Data and/or a description of the community demographics for the community. Be sure to identify any specific data that helps support the existence of your identified health problem or that may impact your health promotion project. Evaluate the racial identity of the community (e.g. is the area well integrated?) Consider the following questions: are there indices of ethnicity, various types of ethnic food stores, ethnic churches, private schools related to ethnicity, signs and information in a language other than English?

B. Health Status of the Community: Evaluate the vital health statistics for the area. For example, note what mortality rates are and the morbidity rates for chronic conditions in particular. Is there a specific health problem with a high incidence/prevalence rate in the community or a health problem within the community related to the environment (e.g., a problem of air pollution and high community rates of respiratory infection)? Is there a high risk of non-communicable disease (e.g., Lead exposure)? Are there high risks of communicable diseases (e.g., Tuberculosis; Covid-19)? What are the maternal and neonatal morbidity and mortality rates? What health issues most commonly affect the community?

C. Culture: Analyze the cultural data and assess the cultural dynamics within the community that influence the community's health beliefs or health status.

D. Religion: Include the various types of churches and places of worship. It would be beneficial to learn the number of available churches in the area, all of the different denominations and representation of differing religions, and the number of churches in a ratio comparison to the number of people in the community.

E. Politics: Determine if the community is very swayed politically or is predominantly of one-party affiliation. Identify evidence of political activism, such as campaign signs, political billboards, or other evidence of political influence.

F. Boundaries: Include the street boundaries for the community, as well as any physical demarcation that defines the community boundaries:

1. Is it a natural boundary such as a river or a lake?

2. Is it a man-made boundary such as train tracks?

3. Is there a noticeable difference in the socioeconomic level in comparison to neighboring communities? Do individual neighborhoods vary in socioeconomic status?

G. Housing and zoning: Evaluate the types of homes in the area, if they are typically single family, multi-family, alternative housing, assisted living, etc. A visual map showing the boundaries of the community is helpful. Make a note of whether or not the residences have a large number of real estate signs on them. Supportive data could also include:

1. Any specific areas (and the size of the area) in which houses were in disrepair,

2. How many homes were for sale

3. How many single-family homes in comparison to multi-family dwellings or senior living complexes,

4. Average home market price,

5. Any data regarding proportion of young families with children compared to retirees

6. Any changes in residency, recent trends in real estate (are the new construction homes built where previous existing homes were torn down? Or was there still available space in this established community?)

H. Open Space: Determine the open spaces throughout the community, including vacant lots, green spaces, undeveloped areas, nature areas, and parks. Supportive data could also include:

1. How many open spaces, parks, or green spaces are available?

2. Does the community appear to be focused on open space availability, parks, divided streets with trees or landscapes parkways?

3. Are there minimum lot sizes?

4. How many of these parks and green spaces are park district owned?

5. How many of these are City owned?

6. How many of these are State owned? Forest preserve district owned?

7. Are the people really utilizing the available spaces?

I. "Commons": Commons refers to areas or establishments in which people gather, socialize, spend leisure time, or use for recreation (e.g. walking, biking, and walking their dogs). What are the most popular neighborhood hangouts and what subgroup(s) of the population are drawn to those particular places to hang out? Supportive data may include:

1. The "closed" hang out places that may be unfriendly to strangers or newcomers?

2. Is there any gang activity?

3. Popular bars or nightlife?

4. Places that draw younger people (Jr. High, high school)?

J. Safety: Is the community safe? Environmental aspects or physical aspects that may compromise safety (e.g., community decay, traffic safety issues, road and sidewalk accessibility and quality, crime rates, lighting, safe drinking water, air quality). How do community safety issues impact your identified community problem or issue?

Signs of community decay: Identify any areas of the community in which there is evidence of decline of resources, or community decay?

1. Abandoned cars,

2. Visible trash in the street,

3. Levels of noticeable pollution,

4. Abandoned houses, businesses, and unfinished structures (boarded up buildings),

5. Increased numbers of homeless or panhandlers

K. Media: Identify the types of local media available for the community residents. Does the town have its own paper? Does the area have its own cable television station? What types of magazines and print materials are circulated? (These types of things you will usually find in front of cafes and stores). Are they bilingual to the needs of the community? Do you notice outdoor antennas or dishes?

L. Stores, Services and Service Centers: Evaluate the service industry in the area including various stores and businesses within the community, social service agencies, community outreach programs, recreation centers, e.g., a local YMCA, and other service industries. The community health nurse should analyze access to food, fitness, and health services availability.

1. What is your evaluation of the availability of resources/stores?

2. Are there many fast-food restaurants in comparison to healthier restaurants?

3. Is this considered a food desert?

4. Are there significantly more entertainment options (movie theaters, bowling alleys, etc.) than green space?

5. Are there a high number of fitness and exercise service centers?

6. What is your evaluation of the services available?

M. Schools: Describe the educational system for the community including public, private, and alternative schools. Supportive evidence is helpful for the community nurse to make assessments about the community. Remember schools range from pre-schools to colleges and universities. Supportive data may include:

1. How many schools are in the area and what level of students do they serve?

2. How many private school options are there in this community? What types of private institutions are represented (religious affiliation, Montessori, academic driven)?

3. What are the public schools rating/ranking?

4. What is the high school graduation rate? How does it compare to the state or national averages?

N. Transportation: Include photos of cars, buses, trains, ferries, trolleys, bicycles, and pedestrians. Photos of people utilizing the various types of transportation would be appropriate for your windshield survey. Noting the safety measures (bike lanes, safe crosswalks, etc.) is helpful. Which type(s) of transportation seems to be the most predominant in the community?

1. Is public transportation accessible and provide realistic transportation options for community residents?

2. Where is the closest/local airport?

3. What are the major highways that are close to the area?

O. Case Management: How is the community health presently being monitored? What current collaboration is taking place and what is required to provide continuity of care in the community treatment plan? What stakeholders can you identify? Include Federal, State, local, and private agencies that may be involved. Include the major hospitals and identified that medical/dental/vision/addiction services were readily available. Are there any collected statistics and data to show how readily available healthcare services are in the community? How are people with minimal or no insurance provided care or access to care?

Part II: Analysis of Assessment Data

A. Based on your data collection from the windshield survey and mining of databases, identify 3 strengths of the community.

B. List and prioritize 3 potential community risk factors (weaknesses).

Part III: Diagnosis and Planning

A. Describe the community weaknesses as a community health nursing diagnosis.

B. Identify community resources that may help address the highest priority weakness (either currently in existence or something you propose to help address this problem).

C. Describe an actual or potential community health intervention used to address the problem (hint: review the interventions listed on the Public Health Intervention Wheel).

Community Health Diagnoses:

1. Problems identified by community assessments are often stated as community health diagnoses.

2. Community nursing diagnoses incorporate information from the community assessment, general nursing knowledge, and epidemiological concepts (especially the concept of risk in a population).

3. Community nursing diagnoses often are written in the ‘risk of' format.

Examples:

Risk of [specific problem or risk in the community] among [the specific population that is affected by the problem or risk] related to [strengths and weaknesses in the community that influence the problem or risk].

Risk of low birth weight among adolescents who are pregnant in the downtown district related to low income, lack of availability of nutritious food, and tobacco use as evidenced by lack of secure housing, food bank use, increased rates of unemployment, and smoking among pregnant adolescents (ATI, 2019).

Part IV: Presentation

Create a presentation of your findings using the grading rubric on Brightspace to guide you. The presentation should be visually appealing and well delivered, utilizing technology and media to convey the material.

The presentation must include the findings of Parts I, II, and III, and an APA formatted reference list.