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N4465 Care of Vulnerable Populations

COMMUNITY ASSESSMENT, ANALYSIS, and NURSING INTERVENTION

Clinical Experience: Windshield Survey and Key Informant Interviews

Student Name: _______________________________Dates: _________________

Name of Community or Zip Code: _____________________

Module One (Week One): Part One Windshield Survey and Key Informant Interviews

Please complete the following information on this template about the community you have selected.

Elements	Descriptors
Physical Environment	Make sure you address fully what you observed and NOTE if something was not found within your community area.
● Boundaries	What defines the boundaries? Roads, water, railroads. Is the area known for a particular name? What area is this community located in?
● Housing and Zoning	What is the age of the houses? Describe type of construction material, appearance, and general condition. Do you see single family housing?  Multi-family housing?
● Common Meeting Places	Where do people in the neighborhood hang out? Who hangs out there and what hours of the day?
● Indicators of Growth or Decline	Is this a “thriving” community or does it look “run down?”  Is there new or ongoing construction?  Businesses and Industries coming to the area? Are buildings, roadways, and public areas clean and well-kept. Do you see dirt, trash, or graffiti?
● Employment Opportunities	What places for employment are there is this area? Name the businesses and industries in this area.
● Transportation	How to people get from one place to another?  Is public transportation available?  How timely is it? Personal autos? Bikes?  Walking?
People	Make sure you address fully what you observed and NOTE if something was not found within your community area.
● Race and Ethnicity	What is the majority racial group represented? What is the majority ethnic group represented? Describe the distribution of gender, approximate ages, single families, multiple families, generational families?
● Cultural Characteristics	What cultural similarities or differences do you observe? Languages spoken?  Clothing?  Ethnic eating places?  Culturally-based celebrations? Signs in languages other than English?
●Lifestyle Healthy Behaviors	What healthy lifestyle behaviors do you observe? Do you see people exercising, wearing helmets when biking, seat belt usage, using trash cans for garbage disposal, healthy eating practices?
● Lifestyle Risk Behaviors	What unhealthy lifestyle behaviors do you observe? Do you see people practicing risky lifestyle behaviors such as drinking alcoholic beverages, smoking, fighting? Do you see signs of violence, gang activity, drug use, criminal activity, and bars on doors and/or windows?  Do you see overweight/underweight persons? Do you see children unattended playing out in the streets? Do you see any signs of homelessness?  Street people? Describe gender, age, and race/ethnicity of persons observed.
● Poverty Indications	Do you see any signs of homelessness?  Street people? Describe gender, age, and race/ethnicity of persons observed.
Services in the Community	Make sure you address fully what you observed and NOTE if something was not found within your community area, how far away it is and how people will access it.
● Social Services	Do you see evidence of recreation centers, parks, and social services? For services that are not available, how far must persons travel to access these services?   Describe each.
● Health Services	Do you see evidence of health (Hospitals, Dr’s Offices, Clinics) and mental health services?  Describe each. Are there any signs of alternative services in the area, such as healers (curanderos), herbalists, herbal stores, palm readers, acupunctures, chiropractors. For services that are not available, how far must persons travel to access these services?
● Fire and Police Services	Do you see any fire and police services/equipment/officers? Where are the closest fire and/or police stations?
● Educational Resources	Where is the nearest public library?  Discuss the Schools and Universities/Community colleges?
● Religions	What signs of religion do you see? Discuss the types of churches, mosques, temples?  What services are offered by these churches, e.g., Day Care, Mother’s Day Out, Summer Camps, Languages Classes, Citizenship Classes, Food Banks, Clothing, other.
Business & Industry	Describe stores and shops available in the community, e.g., grocery stores, gas stations, department stores. What type of business climate exists?  Manufactures? Light or heavy industry?  Large employers?  Small business owners?  Retail? Hospitality industry?  Do people have to seek employment elsewhere?  Is this considered a “bedroom community”- where people work outside this community but live here? Make sure you address fully what you observed and NOTE if something was not found within your community area.
Politics	What indicators do you see about politics? Posters? Headquarters? Make sure you address fully what you observed and NOTE if something was not found within your community area.
Media	Do you see indicators of what people read? Listen to the radio?  Watch TV? Are there any signs of media language other than English? Make sure you address fully what you observed and NOTE if something was not found within your community area.
Key Informants	Interview a fireman or police office. Also interview a librarian, school teacher, school nurse or administrator. Ask each person interviewed to share their perceptions of the following and cite personal communication as appropriate: Interview with fireman or police officer       ˃ Community’s Health issues       ˃ Community’s Safety issues       ˃ Strengths of the Community   Interview with librarian, school teacher, school nurse or administrator           ˃ Community’s Health issues       ˃ Community’s Safety issues       ˃ Strengths of the Community Enter the information about your interviews with Key Informants in this space in your template. You will not receive credit if the Key Informant interviews are inserted elsewhere on this template.
Analysis of Windshield Survey	Analyze and summarize your observations and the input from key informants. Write a 3-paragraph summary of community health (2) and safety (1) issues for this community and strengthens of the community. Remember to cite personal communication as appropriate:

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Reference
Module 2 (Week 2) Part Two: Statistical Analysis of Community Health Problem

Please complete the following information on this template. If you do not use this template there will be a 10-point grade penalty per assignment, and you will be required to resubmit within 48 hrs. You may increase the size of the block by continuing to type. Use as much space as necessary to provide your answers

Name of Community or Zip Code:

Instructions:  Enter your response in each category marked below.  Provide objective, statistical support for your subjective findings. 

● Include all the data listed in the Objective Data Criteria listed below.  

● Add supplemental data as needed for your community.

● All statistical data must be reported in NARRATIVE form only. Tables and graphs will not be accepted. 

● Compare objective data for your community with local (city), state, and national data.

You may increase the size of the block by continuing to type.  Use as much space as necessary to provide your answers

General Objective Data Criteria for the Community-at-Large

1. Demographics:  Total population; age distribution; gender distribution; family characteristics (single parent, multi-family, etc.). Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

2. Racial/Ethnic Characteristics: Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

3. Economy: poverty rate, unemployment rates, median income. Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

• Education: High school completion rates; higher education statistics. Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.                                                                                                                                                                                                                                                                                                                                                                                                                                                    

• Identify two Morbidity and Mortality/Risk Problems: (Based on your observations from Week 1 subjective assignment, windshield survey and key informants provide Morbidity, Mortality (M&M) and risk data for your community… Example 1: if you observed obesity in your community then present obesity rates and health conditions associated with obesity [i.e. CVD, HD, Depression, etc.). Example 2: smoking/drinking rates and health conditions associated with smoking [i.e. Lung Cancer, COPD, etc]. These variables may include the following: gender (who does this problem affect the most, men or women); age distribution; ethnicity or racial group(s) mostly-affected; morbidity and mortality rates; any data related to life-expectancy in light of the health issues; is there a geographic area where the health problems mainly exist; is there a relationship between the health issue(s) and environmental health hazards; are these life-threatening health issues? Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

• Other data as needed (air, water quality, crimes rates). Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

Analysis of Data

1. Based on your subjective and objective review of your findings, what conclusions have you arrived at? Remember to cite sources as appropriate.
2. What impressions from your subjective observations were unfounded/invalid?

• Given the objective data, what impressions were validated/substantiated?

• What cause-and-effect relationships did you discover/identify?

• Problem Analysis for Community/Zip Code:

Problem: List two (2) problems within your community (for example, Infant Malnutrition, CVD, Lung Cancer, Obesity, Alcoholism, Violence) NOTE: These problems need to be something the Community Health Nurse can impact  (for example, a CHN cannot build a sidewalk, repair a street, implement a new bus route, etc.). Remember to cite sources as appropriate.

1. ____________________________________________
2. ____________________________________________

    Select one of these problems and complete the Problem Analysis chart

Problem Correlates*	Relationship of Correlate to Problem	Data Supportive of Relationship +
Ex. Inadequate diet	Ex. Diets lacking in required nutrients contribute to malnutrition	Ex. All infants and children seen at the local Public Health Clinic are referred to the nutritionist because of poor diets (X.Y. personal communication, date). Of infants measured, 60% were in the lower percent for their weight/height (X report, date).

*These are factors that contribute to problem and outcomes.

+ Refer to appropriate sections of the database and relevant research of the findings in current literature.  Data in the third column could be local, state, or national statistics.

• Community Health Nursing Diagnoses:

Based on your subjective and objective assessment findings above for both Weeks 1 and 2, write TWO priority community health nursing diagnoses.

You must use this format for correctly writing a CH nursing diagnosis (do NOT use NANDA): *RISK OF   AMONG    RELATED TO

Health *Risk/problem of (specific injury, illness, or potential of, complication of, etc) Among (specific population) Related to (supporting evidence from your assessment findings). 

• Your CHN Diagnoses MUST be something that a community/public health nurse can do something about. See example below.
• Note: Poverty is NOT a CHN diagnosis.
• Remember do NOT use NANDA Nursing Diagnoses.

For example: Risk of asthma complications among children in SE Dallas County related to observations of overcrowded living conditions, lack of public transportation (may result in inability to access health care), high number of animals observed living in homes, poverty indications (may result in lack of access to medications).

Community Health Nursing Diagnosis #1

Community Health Nursing Diagnosis #2

Reference

Module 3 (Week 3) Part Three: Community Health Nursing Intervention

Directions: Please complete the following information on this template. If you do not use this template there will be a 10- point grade penalty per assignment, and you will be required to resubmit within 48 hrs.You may increase the size of the block by continuing to type.  Use as much space as necessary to provide your answers

Introduction: Purpose of the paper, synopsis of community, two CHN diagnoses with supporting evidence, for example, observations, reports from Key Informants and Statistical data.  Remember to cite sources as appropriate.

Based on the 2 CHN Diagnoses you developed in Assignment 2 or modified, select ONE problem and develop a CH Nursing intervention. Remember to cite sources as appropriate.

1. CHN Diagnosis/Problem you selected: 

• Why did you select this problem? Provide your rational for selecting this problem in 1-2 comprehensive paragraphs (Consider the problem priority criterion on page 417 Box 18-5). Provide supporting community and scientific/authoritative evidence, for example, Healthy People 2020, CDC, AHA, other.  Remember to cite sources as appropriate.

•  Identify two (2) Goals. For example, goals indicate where you want to go.

Then, identify two to three (2-3) objectives per goal. For example, objectives should indicate how you plan to get there, or how you plan to accomplish the goal(s).

Goal 1:   Objective:   Objective:        3.  Objective:     Goal 2:   Objective:   Objective:   Objective:

• Intervention Objectives Timeline

Under Interventions you should have an intervention for EACH objective you list (if you have 4 objectives then you should list 4 interventions;  if you have 6 objectives (3 for each goal), then 6 interventions).  You can insert rows into that table to accommodate if needed. If one intervention addressed more than one objective, you must make it clear in your paper. See the example in the table.

Present Date	Objective( Number and Statement)	Anticipated Completion Date
Enter Date	Ex.  Eighty-percent (80%) of infants seen by health department, neighborhood health center, and private physicians will have developmental levels assessed.	Enter Date

Refer to textbook for additional examples.

• Plan of Intervention and Evaluation

Date	Intervention Activities	Responsible  Agency/Person	Evaluation Measures	Target Date of Completion
Enter start date.	Ex. Community Health Nurse identifies and trains lay advisors in community as case finders	Ex. Community Health Nurse (CHN)	Ex. • Lay advisors will be able to verbally describe case-finding methods to CHN • Number of new WIC cases will be tracked by CHN on monthly basis for 1 year to determine if goal of 80% has been met	Ex. Lay advisor training completed by enter date of estimated completion.

Summary/Conclusion: Summarize your assessment findings, your proposed community health nursing intervention, and the community public health outcomes that you anticipate as a result of the intervention.  This can be one or two brief paragraphs. Remember to cite sources as appropriate.

Reference