Primary roles of a community health nurse

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Introduction:

More emphasis is being placed on healthier communities as changes are occurring in the fields of healthcare financing, policy, and focus. One of the primary roles of a community health nurse is to assess the community or population in order to determine its health status in relation to its assets and needs.

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Requirements:

A. Identify an appropriate community for which there is published data available (county, state, or national data) that will support the diagnosis.

Note from customer

**** Community selected: Roosevelt or Hempstead N.Y. is preferred for this paper.******

B. Assess the health needs and risks of the identified community by utilizing the following tools:

Note: The collection of this data should include a variety of data sources, such as focus groups with older adults and/or youth, epidemiological data from the health department or department of vital statistics, investigations of community resources from stakeholders or faith-based organizations, and/or surveys. You do not have to answer every question listed in the assessment tools. Each of these tools can be found either in the web links section or as an attachment to this task.

• Population Economic Status Assessment

• Neighborhood/Community Safety Inventory

• Cultural Assessment Tool

• Disaster Assessment and Planning Guide

• Windshield Survey

• Population Health Scavenger Hunt

Note: The name of each of the six tools should be identified in the needs assessment summary, along with a brief summary of how each of the six tools was used in the needs assessment.

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1. Interpret the collected data using concepts of epidemiology and health determinants (e.g., birth rate, death rate, rates of disease, morbidity).

C. Formulate an appropriate community diagnosis for the selected community by doing the following (suggested length of 4–6 pages):

1. Identify the top three problems for the selected community based on the Healthy People 2020 goals.

a. Discuss the problems in relation to the Healthy People 2020 goals.

2. Select one of the problems identified in part C1 that you would like to investigate further, and do the following:

a. Discuss community resources (e.g., Public Health Department, American Red Cross, American Heart) that are available to address this problem.

3. Formulate a primary prevention topic based on the problem you identified in part C2.

Note: See the attached “Approved Topic List” for guidance in formulating your topic.

D. Include all in-text citations and references in APA format.

Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.

Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.

Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly.

(1) Approved Topic List: Choosing Your Field Project Topic with a Primary Prevention Focus

Note: You may not log any work on your field project until you are enrolled in Community Health and Population-Focused Nursing Field Experience/Community Health and Population-Focused Nursing Clinical and have selected your topic.

What is a Primary Prevention?

The Community Health Nursing practicum requires a field project. The project focuses on primary prevention. Primary prevention is the prevention of disease, injury, disability or premature death before they occur.

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First Steps in Choosing a Field Project Topic

First, consider what might be an issue of public health concern in your own community. The pertinent questions to consider are:

• What is the biggest contributor to disease (morbidity) and premature death (mortality) in your community?

• What are the controversial community health concerns discussed in your local newspaper?

• What do you believe people in your community are most concerned about related to health?

• What is generating the most visits to the emergency room or hospital admission in your community?

• What do you believe is reducing the quality of life in your community?

Possible Topic Areas to Choose for Field Project

Access to Healthcare

• access to mental health services

• access to dental health services

• access to health services

Alcohol and Drug Use

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• responsible alcohol consumption

• prevention of drug abuse, including

– IV drug use

– prescription drug use

Child Health

• prevention of neonatal mortality

• prevention of unintentional childhood injuries, including:

– sudden unexpected infant death (SUID)

– poisoning

– drowning

– motor vehicle related (child safety seat and seat belt use)

– sports related

– pedestrian related

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• prevention of child abuse

• promotion of vaccination

Disabled

• promotion of health and well-being, including

– access to disability related services and devices,

– limit barriers to participating in home, work, school, or community activities

Disaster Preparedness

• prevention of adverse health consequences caused by natural and human caused disasters

HIV/AIDS

• prevention of HIV/AIDS, including

– sexual transmission

– prenatal transmission

– IV drug use transmission

Oral Health

• prevention of dental caries

Overweight and Obesity

• prevention of overweight and obesity through healthy nutrition and physical activity

Physical Environment

• promotion of healthy physical environment, including

– air quality

– land quality

– water quality

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Seniors

• prevention of falls

• prevention of social isolation

• promotion of vaccination

Social Environment

• safe, affordable, quality housing (prevention of homelessness)

Tobacco

• prevention of tobacco use

• prevention of smoking

Unintentional Injuries

• prevention of workplace injuries

• prevention of motor vehicle related death/injuries

– prevention of pedestrian injury and death (includes bicyclists)

Violence

• prevention of domestic violence/intimate partner violence

• prevention of dating violence

• prevention of gang violence

• prevention of bullying/cyber-bullying

• prevention of suicide/depression

Women’s and Maternal Health

• prevention of unintended pregnancies

• lack of breastfeeding/promotion of breastfeeding

• promotion of vaccination

Resources to Start Your Topic Choice Process

• Task Force on Community Preventive Services

• Healthy People 2020

Topics force on community Preventive services

• Adolescent Health

• Alcohol – Excessive Consumption

• Asthma

• Birth Defects

• Cancer

• Cardiovascular Disease

• Diabetes

• Emergency Preparedness

• Health Communication

• Health Equity

• HIV/AIDS, STIs, Pregnancy

• Mental Health

• Motor Vehicle Injury

• Nutrition

• Obesity

• Oral Health

• Physical Activity

• Social Environment

• Tobacco

• Vaccination

• Violence

• Worksite

The Guide to Community Preventive Services is a free resource to help you choose programs and policies to improve health and prevent disease in your community. Systematic reviews are used to answer these questions:

• Which program and policy interventions have been proven effective?

• Are there effective interventions that are right for my community?

• What might effective interventions cost; what is the likely return on investment?

Learn more about The Community Guide, collaborators involved in its development and dissemination, and methods used to conduct the systematic reviews

(2) Community and Population Health

Windshield Survey

Directions:

This assessment is a foundational exercise for you to learn about your environment and

explore where you live. Take some time to intentionally explore your county. Look at your

county as the home and the place of work for the county residents.

While driving through your community, stop for coffee or have lunch in a neighborhood.

Find a place to eat where you can sit down as part of the community. You may want to walk

around your community as well so that you can explore it from both a driving perspective

and a walking perspective.

Once you have observed the area, write about your impressions of the county in your notes.

Reflect on any surprises and whether the county looks different to you now after taking the

time to note the various elements. What would you like to learn more about related to your

topic and population of interest? You may want to sketch a map related to your topic area for future reference when writing your community description.

Take notes on the county using the following questions as a guide. These questions are only to provide guidance; you may discover other areas that you want to note. Include your findings in the community description section of your paper. You will use this information to complete task 1 for your “Community Health and Population-Focused Nursing” course.

Collecting this data will help you define your population of interest and prepare for your practicum experience. You may also want to reference these results in the resources and partners section of your paper.

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ELEMENT DESCRIPTION:

Housing and Commercial Buildings:

•?How old are the houses and buildings in the community?

•?What materials are the homes and buildings constructed from?

•?Are all the houses similar in age and architecture?

•?How would you characterize their differences?

•?Are the houses detached or connected to each other?

•?Are there solar panels? Windmills?

•?Do the houses have space in front or behind them?

•?What is the general condition of the houses and buildings?

•?Are there signs of disrepair (e.g., broken doors or windows, leaks, missing locks)?

•?Are there signs of neighborhood pride, such as well-tended yards?

•?Is there central heating, modern plumbing, air conditioning?

Open space:

•?Is the county primarily rural, suburban, urban, or a mix? How much open space is

there?

•?What is the quality of the space (i.e., lush green parks or rubble-filled lots)?

•?What is the lot size of the houses, lawns, and flower boxes?

•?Do you see trees on the streets or a green island in the center of the streets?

•?Is the open space public or private? Who uses this space?

Boundaries:

•?What signs are there of where neighborhoods begin and end?

•?Are the boundaries natural (a river, a different terrain); physical (a highway, a

railroad); or economic (differences in real estate or presence of industrial or

commercial units along with residential)?

•?Do the neighborhoods have an identity or a name? Do you see them displayed? Are

there unofficial names?

“Commons”:

•?What are the neighborhood hangouts (e.g., schoolyard, convenience store, bar,

restaurant, park, 24-hour drugstore)?

•?What groups of people tend to gather at these hangouts?

•?At what time do they typically meet?

•?Does the commons area have a sense of territoriality, or is it open to everyone?

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Transportation:

•?How do people get in and out of the neighborhoods (e.g., car, bus, bike, walking)?

•?Are the streets and roads conducive to good transportation and bicycle use and also

to community life?

•?Are there major highways running through the county? Who do these highways

serve?

•?How frequently is public transportation available?

•?Are gas stations available?

•?Are there train stations or light rail stations?

Service centers:

•?Do you see social agencies, clients, recreation centers, signs of activity at the

schools?

•?Are there offices of doctors, dentists, and other such services?

•?Are there parks? Are these parks in use?

Stores:

•?Where do residents shop (e.g., shopping centers, neighborhood stores, outdoor

markets)?

•?How do they travel?

People out and about:

•?If you are traveling during the day, who do you see on the street (e.g., an occasional

passerby, a father with a baby)?

•?Do you see anyone you would not expect?

•?Can you spot the purpose of those that you see, such as a door-to-door salesperson

or a postal worker?

•?Is the dress of those you see representative or unexpected?

•?What animals do you see (e.g., stray cats, pedigreed pets, watchdogs, birds, wild

life)?

Signs of community vibrancy:

•?Is this neighborhood on the way up or down?

•?Is it alive?

•?How would you decide?

•?Do you see any of the following: street vendors, trash, abandoned cars, political

posters, neighborhood-meeting posters, real estate signs, abandoned houses, mixed

zoning usage, people tending their yards, sidewalks in good repair?

Race:

•?Are the residents primarily Caucasian, African-American, Asian, of another group, or

is the area integrated?

Ethnicity:

•?Are there indications of ethnicity (e.g., food stores, churches, private schools,

information or signs in a language other than English)?

Religion:

•?Of what religion are the residents?

•?Do you see evidence of heterogeneity or homogeneity?

•?What denominations are the churches, temples, and mosques?

•?Do you see evidence of these religious facilities being used other than on days of

worship?

Health:

•?Do you see evidence of acute or of chronic diseases or conditions?

•?Do you see evidence of accidents, communicable morbidity diseases, alcoholism,

drug addiction, mental illness, etc.?

•?How far it is to the nearest hospital? To the nearest clinic?

Politics:

•?Do you see any political campaign posters?

•?Is there a headquarters present?

•?Do you see evidence of a predominant party affiliation?

Media:

•?Do you see indications of television use such as satellite dishes?

•?What magazines and newspapers do residents read?

•?What media do you see being sold in the stores?

•?What form of media seems most important to the residents (e.g., radio, television,

print, online)?

•?What languages are represented in the various forms of media?

Physical Environment:

•?Are there indications of an excess of certain types of activities, such as stores that

sell alcohol or fast food restaurants?

•?What sorts of billboards are displayed and what do they indicate?

•?Are there many cell phone towers or is cell phone access limited?

Adapted from Anderson, E.T., & McFarlane J.M. (1988). Community as client: Application of

the nursing process. Philadelphia, PA: L

(3) Community and Population Health Scavenger Hunt

Explore your community and choose six of the following facilities (within your

city/county or just outside of your county):

Women, Infants, and Children office (WIC)

Health department

Food pantry

Meals on wheels

Department of human/social services

Fire department

Police department

Substance abuse facility

YMCA

Senior Center

Community center

Domestic Violence center/shelter

Crisis child center

Homeless shelter

Emergency Management Director

Mental Health associations (e.g., NAMI: National Alliance on Mental Illness)

Boys and girls club

Planned Parenthood

Chamber of Commerce

Consider the following questions while interacting with these service providers in your

community:

1. What is the organization’s target population?

2. How does the organization advertise its services to the community or target population?

3. Are there any barriers to service?

4. What written information do they have available (e.g., pamphlets, brochures)?

5. What is the appearance, both internal and external, of the facility?

6. How do staff members present themselves (e.g., appearance, attitude, knowledge of

services, diversity)?

7. What language capabilities do staff members have?

8. Does the organization have a referral process or does it operate on self-referrals?

9. Are there fees for the services provided? Are payment options available?

10. Does the organization have a presence on the Internet?

11. Is the organization’s facility accessible from various types of transportation (e.g., bus,

train)?

12. What specific services does the organization provide?

13. (Your Choice)

Below is the grading system:

Evaluation Method

value: 0.00 value: 1.00 value: 2.00 value: 3.00 value: 4.00 Score/Level

Articulation of Response (clarity, organization, mechanics) The candidate provides unsatisfactory articulation of response. The candidate provides weak articulation of response. The candidate provides limited articulation of response. The candidate provides adequate articulation of response. The candidate provides substantial articulation of response.

A. Identification of Community The candidate does not accurately identify a community for which there is published data available that will support the diagnosis. Not applicable. Not applicable. Not applicable. The candidate accurately identifies a community for which there is published data available that will support the diagnosis.

B. Assessment of Needs and Risks The candidate does not provide an assessment of how each of the tools listed was used in the assessment of the identified community. The candidate provides an assessment, with no detail, of how 1–5 of the tools listed was used in the assessment of the identified community. The candidate provides an assessment, with limited detail, of how each of the 6 tools listed was used in the assessment of the identified community. The candidate provides an assessment, with adequate detail, of how each of the 6 tools listed was used in the assessment of the identified community. The candidate provides an assessment, with substantial detail, of how each of the 6 tools listed was used in the assessment of the identified community.

B1. Interpretation of Collected Data The candidate does not provide a logical interpretation of the collected data using concepts of epidemiology. The candidate provides a logical interpretation, with no detail, of the collected data using concepts of epidemiology. The candidate provides a logical interpretation, with limited detail, of the collected data using concepts of epidemiology. The candidate provides a logical interpretation, with adequate detail, of the collected data using concepts of epidemiology. The candidate provides a logical interpretation, with substantial detail, of the collected data using concepts of epidemiology.

C1. Problems in the Selected Community

The candidate does not identify any problems based on the Healthy People 2020 goals for the selected community. Not applicable. The candidate identifies 1–2 top problems based on the Healthy People 2020 goals for the selected community. Not applicable. The candidate identifies 3 top problems based on the Healthy People 2020 goals for the selected community.

C1a. Problem in Relation to Goals

The candidate does not provide a logical discussion of the problems in relation to the Healthy People 2020 goals. The candidate provides a logical discussion, with no detail, of the problems in relation to the Healthy People 2020 goals. The candidate provides a logical discussion, with limited detail, of the problems in relation to the Healthy People 2020 goals. The candidate provides a logical discussion, with adequate detail, of the problems in relation to the Healthy People 2020 goals. The candidate provides a logical discussion, with substantial detail, of the problems in relation to the Healthy People 2020 goals.

C2a. Availability of Community Resources

The candidate does not provide a logical discussion of community resources that are available to address the selected problem. The candidate provides a logical discussion, with no detail, of community resources that are available to address the selected problem. The candidate provides a logical discussion, with limited detail, of community resources that are available to address the selected problem. The candidate provides a logical discussion, with adequate detail, of community resources that are available to address the selected problem. The candidate provides a logical discussion, with substantial detail, of community resources that are available to address the selected problem.

C3. Primary Prevention Topic

The candidate does not formulate a logical primary prevention topic based on the problem identified in part C2. Not applicable. Not applicable. Not applicable. The candidate formulates a logical primary prevention topic based on the problem identified in part C2.

D. Sources The candidate does not provide in-text citations and references. The candidate provides only some in-text citations and references. The candidate provides appropriate in-text citations and references with major deviations from APA style. The candidate provides appropriate in-text citations and references with minor deviations from APA style. The candidate provides appropriate in-text citations and references with no readily detectable deviations

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