Monday, 12 March 2018

Nursing Intervention


Nursing Intervention 
Health Professions and Related Clinical Sciences/Nursing (RN) assignment help
Using book Public Health Nursing by Marcia Stanhope and Jeanette Lancaster

Care of Vulnerable Populations
COMMUNITY ASSESSMENT, ANALYSIS, and NURSING INTERVENTION
Modules Assignment Template

Use of the Three-Part Course Template

  The use of the three-part template to submit Major Course Paper Assignments goes as follows:
 Week 1:  Windshield Survey and Key Informant Interviews. Complete the  First Section of the  course template and submit. (Keep this section attached to Weeks 2 and 3 assignments.)
Week 2:  Statistical  Analysis of Community Health Problem. Complete the Second Section of the course template and submit.  (Keep this section attached to Weeks 1 and 3 assignments.)
Week 3:  Community Health Nursing Intervention. Complete the Third Section of the course template and submit.  By now, you should have Sections 1-3 as one whole document.  

● Each section of the course template is submitted on a WEEKLY basis, depending on which week you are working on.  DO NOT wait to submit all three sections at the end of the third week.
● Please note that students are not to make any changes to the content of the course template, for example, removal of questions or examples imbedded in the response box of the template.  

Removal of the questions or examples imbedded in the response box of the template is considered tampering with the content and will result in a 10-point grade deduction per assignment.

Should removal of the questions or examples imbedded in the response box of the template persist by the student, in addition to the 10-point deduction, the student will be referred to the Office of Student Conduct for final disposition.  You are strongly encouraged to be mindful of this course policy.


● The ONLY change students may make to the template is to enlarge the space to make their entries in the response boxes.

● Should you encounter any difficulties with any aspect of these assignments, please consult with your Academic Coach. We are glad to assist you!      

Analyze & integrate findings of  2 previous assignments at the beginning of the uploaded file.  include the informant interviews, data & Community Health Statistical Analysis. From the sources establish a community health nursing care plan.1. Introduction: State PURPOSE of paper. Provide brief synopsis of  community & present 2 CHN from  observations & statistical data from the previous 2 assignments. Include key supporting evidence for the 2 CHN diagnoses.
2. Select 1 Diagnosis/problem based on the (2) CHN Diagnoses developed in Week 2 OR a newly developed CHN diagnosis. Discuss rationale for selecting this problem/Diagnosis.
Provide supporting community & scientific evidence, for example, Healthy People 2020, Center for Disease Control (CDC), American Heart Association (AHA), & others for this diagnosis.
3. Develop a plan of nursing intervention. Explain the intervention time line. Be realistic when setting goals & the time line for the various intervention activities to take place.
Describe the Goals (minimum of 2) & objective (2-3 PER goal) of the CHN nursing intervention. Goals and objectives need to be realistic.
Explain the intervention objective time line. This time line needs to be realistic.
Include your plan of intervention activities & evaluation measures. The evaluation should measure the outcomes of your intervention. Be specific.
4. Summary & conclusions: Summarize your assessment findings, your proposed community health nursing intervention, & the community public health outcomes that you anticipate as a result of the intervention. This can be one or two brief paragraphs
5. References: Follow APA guidelines




Windshield Survey and Key Informant Interviews
Assignment #1
Student Name:  ___ Date: _March 3, 2018_ ________
Name of Community or Zip Code: _, 30680_ _______

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. 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 blocks on the template by continuing to type within each section.  Use as much space as necessary to provide your answers.
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?
The community selected for the windshield survey was the area of Winder, Georgia within the zip code of 30680. The zip code is a large area with several small towns included in it. Decision was made to focus on Winder as it is in the center of the zip code area. This is a small rural town that does not have city blocks, therefore, the identified roads will be the boundaries. The focal point is the location of the historic courthouse that appears to be in the center of town sitting at the intersection of Broad and West Athens street.  
The historic courthouse is located on Broad street that runs through the middle of town. To obtain the northern border a person would need to take Broad street toward Rockwell Church road which, actually, circles the city on the eastern and western sides also. Once you turn on to Rockwell Church Road you can circle the city until you reach the southern border which is identified as Highway 316. The city seems to be only about 10 miles in diameter when driving the outer edges of it. However, there are several small roads within the city that seem to all connect to either Rockwell Church Road or Highway 316. There is a railway that goes through the middle of the town that resulted in a witnessed traffic jam as there is only one underpass to get across town when there is a train.
There are signs posted that the town was known as Jug Tavern when it was first settled many years ago.
   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?
The houses in the Winder area near the historic courthouse seem to be from the early 1900’s as there are signs posted that they are in the historic district. The homes in this area seem to be well kept as the houses appear to have fresh paint on them and the yards are manicured. These houses are mostly made of wood and give the appearance of being older homes. As you travel through other parts of the city you see older sections of town dating around the mid to late 1900’s that have not been as well preserved but are still in good condition. These homes are brick homes that are single family dwellings but have not been maintained as well as the historic section. This is evidenced by the paint chipping, gutters handing from the homes and yards overrun with weeds and debris.
As area of lower income levels was identified based on the homes types, wood falling off the homes, windows broken, no lawn care performed, and no pride displayed in this section. This area elicited a feeling of uneasiness as this might not be a safe area. Only a few miles from this area are new subdivisions that are single family homes made of brick and wood that seem to be on the upper level as far as price. There is also an assisted living community and an over 50 living community located near the center of the city. Duplexes for multi-family dwellings were very hard to locate and the ones found were older models in need of repair and located in areas of unsafe neighborhoods.
   Common Meeting Places
Where do people in the neighborhood hang out? Who hangs out there and what hours of the day?
Driving through the area the only areas that seemed to have people hanging out were the baseball fields at the recreation department and Dixie Youth. The school age children were noted to be here after school and on weekends. The recreation fields seem to attract more children after school as there are apartments located across the street. The children noted at these locations were of the middle school age and teenagers without adult supervision. As subdivisions were observed the children did seem to play with each other in some of the cul-de-sacs but no organized hang out area.
There were no hangouts noted at night for adults or children in this area.  There are no entertainment venues for the neighborhood to gather to socialize noted in the windshield survey.
In the lower income section there is a store that seems to be the hang out for that part of the city. The main people noted at this hang out were African American men in the mid -twenties to late thirties. People were noted during the day and even more at the evening hours. The main people no matter the time of day were African American men, poorly dressed and with rough exterior appearance. During the evening hours there was a mixture of middle aged men as well as, teenager or younger boys. Feeling that this would not be a safe place to be especially at night.
   ● 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?
This community seems to look “run down” as it is an older town that is in need of repairs to its buildings and landscape. Several buildings are vacated showing signs that businesses are moving from this community. As you move from the center of town it is noted that there are three shopping areas identified that have some new businesses located there. Several fast food restaurants are noted near the center of town, along with several Mexican restaurants. Several properties outside the center of town had “for sale” signs for vacant land and buildings. There were areas that appeared to be recently upgraded with new benches for sitting and sod areas but majority of town still gives run down appearance.
No sign of new businesses or industries were noted in this area. There were signs of shopping centers that were now left abandoned with close signs noted in the windows. On- going construction of new subdivisions was observed in several areas of the town.
The streets are in need of repair as there are holes that are being dodged when driving especially when outside the center point. The streets are well labeled so that you are able to find your way around.  They seem to be working on developing small walking areas with sidewalks as identified with signs posting of up coming areas that you may walk. There are no sidewalks except in the center of town and those are breaking apart. A street sweeper was identified so the main street was clean but once outside the center of town the streets were littered with trash. There are no signs of graffiti noted in the center of the area but in the lower income areas some graffiti is noted but only sporadically. This is noted mainly in the few public areas in this area.
For a “run -down” community with few new businesses noted the town is clean and shows signs of attempting to improve its appearance.
   Employment Opportunities
What places for employment are there is this area? Name the businesses and industries in this area.
The employment opportunities for this area seem to be related to service type businesses or governmental with some retail and manufacturing. Seems that this area offers work opportunities at the: local hospital, City Hall, Police and Fire, Courthouse, schools, fast food, Wal-Mart, grocery stores, nursing home, restaurants, physician offices and chemical plants.
   Transportation
How to people get from one place to another?  Is public transportation available?  How timely is it? Personal autos? Bikes?  Walking?
The only form of transportation in this area is the use of personal vehicles. There are no signs of public transportation identified. No people were seen biking or walking during the windshield survey for either a weekday or weekend day. A major highway is identified that may led to the possibility of public transportation in the future. During the windshield survey it was noted that the roads are all two- lane roads and traffic is extremely heavy making it difficult to maneuver through the area. There were no cabs noted in the area and most cars only had one person in them so no focus on car-pooling noted. Other than private vehicles the only other transportation noted were school buses that seemed to have full loads of children.

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?
The main racial group that was noted in the area were Caucasians and the main ethnic group is American. Observation of the areas seems to have a greater female population than male in the areas that were observed. Within the center of the city there seems to be more of an elderly population possibly contributed to the assisted living facility, nursing home and senior living community located near the center of town. On the outer borders is more of the middle-aged population of mainly single families. There were no generational families identified in the observation.
While the main ethnic group is American there is a strong presence of the Hispanic, Hmong and African-American population, especially in the lower income area of the city. Numerous authentic Mexican restaurants are observed and stores that are operated and owned by Mexicans.  The African-American community seems to be concentrated in several areas of the City.
   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?
The town is a southern town with cultures of the past evident as people smile and wave even if they don’t know you. Other cultures are dispersed such as the Hispanic culture. Languages note in the area were English, Mexican and some Hmong.  Although, different languages were noted the only language that signs are posted in was English. The area has several “Mexican” restaurants noted with no other ethnic restaurants noted. The closest ethnic restaurant other than Mexican is Chinese located 15 miles from the focal point a couple of towns over.  There were no signs of culturally-based celebrations at the time of this observation.  
   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?
Observation of healthy lifestyles was limited in this community. There are no walking paths or bike paths noted. Very few people were noted to be walking on the few sidewalks that were identified. There are two gyms noted but each had very few cars outside to indicate a low volume of people utilizing the gym. There were no children noted to be outside riding bikes or running and playing in the center of town. The lower income section did have children outside and playing with each other so this section seemed to be more social and involved in outside activities.
Review of people in the cars showed that there was compliance with the use of seat belts. The streets are clean and trash cans are noted at the intersections with little trash noted in the center of the community. The majority of restaurants are fast food chains and no organic/natural stores noted, so no healthy options available.
  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.
Unhealthy lifestyles were observed with the one bar that draws a rough looking crowd and people are noted standing outside drinking. This is a scary situation as it is located on one of the main highways only a few yards from the road.  Numerous people were noted to be smoking outside the buildings and in the cars especially in the lower income section.
There were no signs of violence, fighting or gang activity noted during the observation period. Crime appears to not be an issue as stores and businesses do not have outward appearance of bars or barriers, when properties are closed or vacated. The one store located in the lower income section was noted to have bars on its windows and doors. There were no signs of drug activity during the observation period.  A few of the newer homes have security signs in the yards but most did not. Based on the observation of the population and lack of physical activity noted in the area, 80% of the people observed appeared to be overweight especially the children and middle-aged group.
A concern was the number of children that were observed in the lower income section playing without any adult supervision. Watching the interactions that took place most of the population seemed to know each other and speak to each other.
Very few homeless people were noted in the area and the ones that were noted seemed to be well known. As they are walking the streets not stopping in one place for to long the other people around them speak to them as if they know them. There was no area identified that they congregated in. The ones identified were all middle-aged Caucasian men.
  Poverty Indications
Do you see any signs of homelessness?  Street people? Describe gender, age, and race/ethnicity of persons observed.
Only a few homeless people were noted on the streets and they were generally walking and would only stop long enough to look at something that had been thrown out. There were no homeless villages or areas identified. The ones that were noted were men of the middle-aged category and all were Caucasian. No homeless shelter was identified during the tour of the area.
The area has three areas that have clearly identifiable subsidized housing complexes.  The areas are maintained, but do have older vehicles, clothes lines, and play areas that are not maintained. The people noted in this area were mainly African -Americans around the 20’s or the elderly of mid 70’s to 80’s age range. These areas seem to have many people living in them as it gives the appearance of being a crowded area.
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.
The area has what appears to be a relatively new recreation area with a gym, small play-ground, tennis courts and baseball/softball fields that is located across from low income housing. Another baseball field is located on the other side of the city and appears to be older and in need of repair. The newer field seems to have the more well-off children playing there while the lower economy children are playing at the old ball fields.
The area can be proud that it has one of the state parks in its territory Fort Yargo. It is easily accessible, appears well kept and numerous campers noted to be using it. It is a wooded area with a lake. This is the only park that is noted in the area and it charges for entry.
There were no signs of areas for entertainment for the area. Unable to locate movie theater within the limits, however, the nearest one is only a few miles from the focal point so is readily accessible. There are no skating rinks, skate parks, outdoor basketball goals, swimming pools or play grounds noted. The nearest ones are within a 20 mile radius of the focal point.
Social Services are located near the center of the City and close to the low income areas of the City.  DFAC, Health Department, Senior Centers, Head Start and Service Center for the Mentally Challenged were identified for the community.
● 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?
The area has one small hospital noted that is toward the outer border of the town. The sign identifies that doctors’ offices are located in the hospital, as well as at least five identified around the area. The area also seems to have several orthodontist and dentist in the area. A health department is located near the center of town which appears to be a small section of an older building. One building advertised mental health care for the area. Three chiropractors were noted in the various corners of the area.
This area seemed to have several massage therapists in the area that all had signs advertising basically the same types of massages. The area does not offer much in the form of alternative services for the population. The area is situated near a college town approximately 20 miles from the focal point that has access to herbalist, herbal store, palm readers and acupuncturist.
● Fire and Police Services
Do you see any fire and police services/equipment/officers? Where are the closest fire and/or police stations?
The city has one fire station that is only a few feet from the focal point in the center of town. This City also has a police department and is located in the heart of the town. Another fire station is located toward the northern end of the border and is able to respond quickly to that section of the town. The south side does not have a station located within the area but the one in the center can arrive in a timely manner from the observation of the area. Police presence was very notable during the observation period, not only of the area police but also the county officers. The county has a jail that is outside the city limits but their officers are seen continuously during the windshield survey. The rescue trucks of the fire station were seen driving through the city non-emergently during the survey.
● Educational Resources
Where is the nearest public library?  Discuss the Schools and Universities/Community colleges?
A public library is located about 2 miles from the focal point. It is in a brick building that seems to be outdated and small with a small parking lot with few cars noted
. The area gives the impression of growing as two new schools were noted on the eastern border, an elementary and middle school. A high school that is an older school in appearance with multiple layers and a large parking lot. Three elementary schools and two middle schools noted. There are no colleges identified in the area but 15 miles from the focal point is a community college and 20 miles in the other direction is a large university.
Religions





What signs of religion do you see? Discuss the types of churches, mosques, temples?  What services are offered by these churches, for example, Day Care, Mother’s Day Out, Summer Camps, Languages Classes, Citizenship Classes, Food Banks, Clothing, other.
The area has several large and small churches/temples boasting a variety of religions. Two of the biggest churches noted that are located close to each other are the First Methodist and First Baptist churches. The Baptist church appears to be new and has a huge parking area and several services posted. The Methodist appears to be an older church that is outgrowing its location as evidenced by the number of cars that are not in the parking areas but lining the driveway. Also, identified a Catholic, Hmong, Episcopal, Church of God, seven Baptist, three Christian, two Presbyterian churches in the area. Due to the number of churches in this area it appears that religion is important to this area.
There was no posting of activities such as language classes, citizenship classes or camps noted being offered by the churches. A clothes closet was noted for those in need and stated that it was funded by the local churches. The food bank found advertises that it is managed by the pastoral association. These are difficult to locate and seem to be in run down locations that are not easily identifiable.
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.
The area has four large grocery stores noted in different areas of the city not near each other such as Ingles, Wal-Mart, Publix and Quality Food. A number of gas stations were found totaling ten with various prices. The only department store identified was Wal-Mart. The nearest other department store being Target and Belk is only about three miles from the focal point. Within the immediate area being observed the business climate seems to be cold with not much activity noted. The businesses seem to be moving outside the borders near the main highway that can be accessed from the area. A section of chemical industries is noted but not any others to speak of in this area. The largest employer appears to be the hospital, Wal-Mart, chemical industry and the government entities of police, fire and courthouse. Several small locally owned businesses are noted in the area that seems to be in the process of renovating. Wal-Mart is the only retail store noted. There is no hospitality industry identified or in the neighboring communities.  The appearance is that there are not a lot of job opportunities in the area and people are having to go outside the area for employment. Winder is a bedroom community as it seems to be fading from attracting businesses but due to the number of news homes and subdivisions noted people are moving into the area to live.

● 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.
There were no political indicators noted during this observation time. No posters or headquarters identified in the area. Observation is not performed during an election time. 
● 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.
The Barrow Journal is located in the area and within stores it can be found along side of the Atlanta Journal Constitution and the USA Today. Another magazine that seems to be read is the Bad and Busted that shows pictures of those that have been arrested during the month. Witnessed several of these being purchased during the survey. The marque sign located on one of the main roads indicated there is a local AM station; however, TV advertisement was not noted. There were no media signs noted in any language other than English.
● 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:
1.      Interview with fireman or police officer
      ˃  Community’s Health issues
    MB who has been a long- time fireman/paramedic for the community was interviewed regarding his perceptions of the community. According to MB, “obesity is on the rise in this area especially with the children” (personal communication, February 28, 2018). His perception mirrors my observations that there is not much physical activity noted in the community and this can be related to lack of sidewalks, walking paths or affordable recreation. The area is not friendly for those that want to walk early in the mornings or evenings due to no sidewalks and poor visibility in certain areas.  
     Another health concern that MB is seeing on his calls is the increase in persons not taking their prescribed medications because they cannot afford it and do not understand the dangers of not taking it. MB states, “people do not understand the harm they are doing to their body when they do not take the medicine for their blood pressure or diabetes.” (personal communication, February 28, 2018) More calls are related to the elderly not being able to afford the medications due to the increase in healthcare and having to support themselves with low social security checks. More of the elderly populations seems to be living in poverty and choosing not to purchase their medications and pay their rent or food bills. Feel that more options need to be available for them and education on the needs.
      ˃  Community’s Safety issues
MB was quick to say that the illegal drug activity in the community is a huge concern for him as his family lives here.(personal communication, February 28, 2018). MB shared that, “we are seeing more and more calls related to drug overdoses and drug activity than in the past.” The police and firemen are having to be more cautious on calls due to the potential drug deals and violence that is involved with them at times. As the drug activities increase so does the danger for the community. The community is growing as Atlanta is pushing more people in this direction which brings more crime such as drugs into the community that was not a problem a few years ago.
      ˃  Strengths of the Community
One strength of the community that is identified by MB is that it is a small town and not spread out so are able to respond to everyone in the area in a timely manner. MB states, “small towns are easier to cover than the large cities that I have worked. As things are more local and tight knit it is easier to service everyone quickly.”( personal communication, February 28, 2018). Being in a small area means that most people know or have seen each other and usually are willing to help in a crisis This does not occur when the towns are spread out and no one knows anyone and not as quick to help each other out. 
Another strength of the community is the fact that it is near several larger towns and is easily accessible. You can go in any direction and be in a major city with 30 minutes either way. MB says that people are moving to our rural area as they are tired of the city life but want easy access to it when they want it. (personal communication, February 28, 2018). This can be seen in the number of new subdivisions being built in the community but still no live entertainment or amusement being developed as it is readily available in any of the neighboring towns.
2.      Interview with librarian, school teacher, school nurse or administrator    
      ˃  Community’s Health issues
AM is a school teacher that lives in the area and has many opinions on what is happening in the city and school system. According to AM, a health issue that she has identified is the number of students that are obese due to inactivity. (personal communication, March 1, 2018). Students and the community are not active except during certain seasons of school sponsored sports such as football and basketball. There is no community encouragement for people to be active as there are no walking parks, outdoor activity centers that are well lit or groups that promote activity for the community.
Another health concern is related to the amount of drugs that she hears about from her students. AM states, “you would be surprised at the number of students that know of someone using illegal drugs that you would not expect to be using.” (personal communication, March 1, 2018). The schools and resource officers are working to try and educate the students on the dangers and legal consequences. However, the drugs are so readily available that it is difficult to gain any movement toward eradicating the dangers of them. The world is becoming a scary place with the variety of drugs and easy access that they have to obtain them.
      ˃  Community’s Safety issues
When looking at the area you do not see anything that jumps out to you that says this is not a safe area but the number of drugs that are being sold on the streets is scary according to the informants that I spoke with. According to AM, if you are observant and know what you are looking for you will see drugs being sold right under your nose” (personal communication, March 1, 2018). The drug dealers have tricks that seem like everyday activities if you do not know what you are looking for. This sleepy little town seems to have some hidden secrets that are not found on a tour of the town.
      ˃  Strengths of the Community
The community is small but readily accessible to other major cities within a few miles. Per AM, “ I like the small town feel and that it is not a big city with the hustle and bustle even though it is growing by leaps and bounds.” (personal communication, March 1, 2018).  People are moving to the area to get away from the big city life but not so far away that they can not drive within an hour and receive a nice meal or entertainment.
Another strength of the community is the involvement of the police with educating the public when things are occurring in the area so that they are not surprised. According to AM,“ the police presence is ensuring that they are watching and doing their best to keep us informed and stop things before they happen.” (personal communication. March 1, 2018). The police are involved with educating the public and working to keep the area safe and seem to have a good relationship with the children in the area.
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:
The windshield survey of the Winder area identified areas of concern as well as strengths for the area. The area seems to struggle with attracting businesses to the area, encouraging community activities especially for a healthy lifestyle such as healthy eating options or accessible walking paths. This is identified by the vacant store fronts in the main section of town, while outside the borders of the city growth is evident of new businesses forming. The lack of opportunities for healthy living is evident by the lack of sidewalks for walking, no bike or skateboard paths, no walking paths, no hang out locations and no community encouragement for activities of its members. Related to the decline in the businesses locating to the town this is reflective in the decrease in the job opportunities that are available. Construction is evident with the number of new subdivisions being built to attract people to the community but they are having to drive outside the community to locate work. There seems to be a definite divide between the middle/upper class and the lower income class. The lower poverty sections seem to have fewer affordable homes, recreational opportunities, stronger presence of potential crime and definite segregation from the center of town. Although, there is a strong Mexican presence in the town that is not noted in street signs or cultural awareness in the town as all signs are only in English. As community concerns are noted these can be related to health and safety concerns also.
The community has health and safety concerns that were identified during the survey. Per AM, a health concern that she has for the community is,” the number of students that are obese due to inactivity”. (personal communication, March 1, 2018). Children are not seen being active in the community other during certain sports season this is not enough to keep the in shape. In the past children were outside and active and now they are more than likely inside on computers. This may be due to the lack of recreational opportunities available and lack of walking or play areas in the community that were unable to be located during the survey. Another health concern identified by the informant that was not identified during the survey was the amount of illegal drug activity in the community. AM states, “you would be surprised at the number of students that know of someone using illegal drugs that you would not expect to be using.” (personal communication, March 1, 2018). This is well hid when touring the town and not recognizable especially in the center of town. In the lower poverty section when people were gathered there might be the inclination to think something illegal was occurring but not witnessed. The illegal drug activity can also be a safety concern for the community. Per MB,” we are seeing more and more calls related to drug overdoses and drug activity than in the past.” (personal communication, February 28, 2018). The fact that there is a drug problem identified by those in the community but not readily noticeable is a safety concern especially for the police and firemen that are responding to these calls. These calls can be dangerous if they are answering calls to drug deals that have resulted in violence and could turn around on them for trying to help. This is becoming a real concern for the responders now that the drugs are becoming more readily available. The strength of the community that was identified on the survey and by the informants was the city easy access to the larger cities for entertainment and fine dining. It has a main highway that grants access to several man cities and a college town that opens up doors to several types of entertainment. Another strength stated by MB  “small towns are easier to cover than the large cities that I have worked. As things are more local and tight knit it is easier to service everyone quickly. Our response time is around 12 minutes anywhere in the city”( personal communication, February 28, 2018). This is a good response time for someone in a emergency not only in the city but in the county. The community has its weaknesses but it has strengths that will help to stabilize it.
The community weaknesses consist of inability to attract new businesses, lack of recreational opportunities, lack of healthy food options, increase in drug activity and segregation of income levels are only a few of the items identified. These weaknesses can relate to the health concerns identified such a obesity and drug activity that were identified by the informants and witnessed on the survey rounds. If the weaknesses could be addressed and opportunities offered the health concerns may take a decrease as the community would become more active and eat healthier. The health concerns of drug abuse results in safety concerns also for the community. As illegal drug activity occurs this places people in harms way especially our first responders and police and the public if they happen to be in the wrong place at the wrong time. The community does not seem to readily accept the minority populations as they are segregated to other areas and not housed in the main part of the town. There are also no signs of the cultures working together as one as the only signs posted are in English. This small rural town has some challenges to assist it’s community members to have a productive healthy lifestyle.








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 blocks on the template by continuing to type within each section.  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.
Population
The city of Winder has a population of 15,777 per the most recent data of July 2016.  ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). This is a small part of the overall population of the state of Georgia of 10,310,371 people or the national population of 323,127, 513 ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).  Barrow county, of which the city is located in, has a population of 77,126. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).  In comparison with the county, state and national populations, Winder seems to be a small city in every aspect related to population.
Age Distribution
The age distribution of Winder compared against the county, state and national averages show that it has a higher percentage of children under the age of five. Percentage of children under five for the town of Winder was 8.4% compared with county of 7.1%, state 6.4% and United States (US) of 6.5%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). The percentage of children under 18 for Winder at 27.8% is slightly higher than the state rate of 25.7% and the national rate of 24% but lower than the county rate of 28.2%.%.  ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). The percentage of adults 65 or older was the same at 13% for Winder and US but higher than the country rate of 9.3% and state rate of 10.7%.  ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).  This leads us to conclude that an average of 50% of Winders population is between the ages 18 to 65. According to City-Data,” the average age of persons in Winder is 37.5 compared to the average age in Georgia of 36.5 years.”
Gender Distribution
Females are the dominate gender for the town of Winder at 53.3%. %. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). This is higher than the county, state and national rates. Respectfully, the county rate for females is 50.7%, state 51.2% and US rate of 50.8%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). Seems females are the dominant gender throughout the country but especially so in Winder.
Family Characteristics
The city has 5,150 households of the 24,000 in the county and 3,611,706 of the state. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2018). Winder has a higher person per household rate than the state and US.  There are 2.89 persons per household in Winder, compared to 2.72 in the state and 2.64 in the U.S, the county has a higher percentage at 3.05 persons per household. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).   The city has the lowest owner - occupied housing rate compared to the county, state or US. Winder only has 53.3% of owner occupied homes compared to the county of 72.8%, state 62.8% and US 63.6%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017) The city’s population density as of the year 2010 was 1,135.7 people per mile squared, compared to county of 432.7, state 168.4 and US 87.4. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).
Winder has 952 veterans living in it’s boundaries compared to the 4,557 living in the county, 662,333 in the state and 19,535,341 living in the US. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). The population of Winder has a lower percentage of foreign born persons than the state and US. Winder only has 7.2% foreign born persons compared to state average of 9.8% and US rate of 13.2%, the county is lower however, at 6.9%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). Seems that not only does Winder have a smaller percentage of foreign born persons but the entire state of Georgia has a low percentage rate.
Although, it might not have many foreign born persons living in its boundaries it does have the highest rate of persons with disabilities under the age of 65. Winder has a rate of 12% compared to county 8.8%, state 10% and US 8.6%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).

  1. Racial/Ethnic Characteristics: Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.
Racial/Ethnic
Winder is comparable with the county, state and US by being made up of primarily whites, African Americans and Hispanics. Statistics have shown that white people make up the majority of the United States population. Whites alone make up 66.5% of the Winder population, with blacks next at 17.7% and Hispanics 10.8% per City-Data (2016). Whites are the dominant race for the county at 81.7%, state 61.2% and US 76.9%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). In Winder (17.7%), Barrow county (11.8%) and Georgia (32%), the African Americans are second highest population. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). However, this is not the case for the US. The US has Hispanics or Latino next at 17.8% and African Americans third at 13.3%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).
The population of Winder has a lower percentage of foreign born persons than the state and US. Winder only has 7.2% foreign born persons compared to state average of 9.8% and US rate of 13.2%, the county is lower however, at 6.9%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). The city of Winder has a smaller Asian population compared to the other sections. Winder has 1.8%, county 3.7%, state 4.1% and US 5.7%. Seems Winder is a small racial/ethnic congregation of mostly whites, African Americans and Hispanics.

  1. 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.
Poverty
Winder, although small, has a higher than average percentage of persons in poverty. Per census bureau (2016), “Winder has poverty rate of 20.8% compared to county 12.9%, state 16% and US 12.7%.” As Winder during the observation had a high rate of elderly these numbers could be related to the location of the nursing home, assisted living facility for seniors and the senior citizens community located in the city.
Unemployment Rate
Unemployment seems to be an issue for Winder and Barrow county as both are at 5% compared to state rate of 5.8% in 2015. (City-Data, 2016). This is also, higher than the US rate of 4.1% (“Bureau of Labor Statistics: Unemployment rate.” 2017).
Median Income
Not only is the unemployment rate up for Winder but the median income is lower than the other sections. The median income for a household in Winder for 2016 was $44, 276, compared to county of $43,133, state $51,037 and US of $55,322. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).
Winder specializes in wholesale trade, retail trade and construction by employing 17,154 people. (Data USA: Winder, Ga, 2015). The largest industries are retail, manufacturing, accommodation and food services with the highest paying being transportation, warehouses, educational and utilities. (Data USA: Winder, Ga, 2015).

4.      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.                                                                                                                                                                                                                                                                                                                                                                                                                                                    
High School Completion Rate
The city of Winder has a high school graduation rate of 80.1% which is lower than the other sections under review. Barrow county has completion rate of 82%, Georgia 85.8% and the US 87%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). This is surprising due to the number of schools that were seen during the windshield survey.
Higher Education
The city is lagging behind in higher education rates compared to their county, state and the national average. Winder only has a higher education rate for bachelor’s degree of higher of 16.4% in comparison to county 16.8%, state 29.4% and US of 30.3%. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017). The city has 7.5% of population with a Masters degree compared to 8.3% for the state and only 1.4% have a professional degree compared to 2.1% for the state. (City-Data, 2016).

5.      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, other]. 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.
Obesity is a morbidity and mortality risk problem for the city of Winder. The windshield survey showed a large number of citizens appearing to be obese. According to AM, she sees that the obesity rate in the city is increasing for not only the adults but the children also due to lack of activity in both populations. (personal communication, March 1, 2018). MB when questioned about his thoughts on obesity for the city states that he is seeing more obesity to the point that the EMT’s are required to call for backup to assist with moving the patient to the ambulance. (personal communication, February 28, 2018). Unable to locate data specific to the city of Winder in regards to obesity but the data from the Centers for Disease Control and Prevention (CDC) base shows that the county has a high rate of obesity at 34.6% compared to the state rate of 31.4% and national rate of 30.1%. (2016).  For this area obesity is rated as affecting men more than women respectfully at 16.8% compared to 10.8%. (CDC,2016). Obesity also is seen to affect African Americans 16.8% and Hispanics 16.4% compared to whites at 12.4%. (CDC, 2016). The high obesity rates can lead to increase in diabetes, high cholesterol and hypertension. These conditions can result in heart disease which has a death rate of 180.2 in the state of Georgia. (CDC,2016).  Obesity does not only affect the adults but also the children, especially the low income preschool level.  According to City-Data, “the rate of obesity in low income preschool is 15.1% for the county compared to 14.6% for the state.” The obesity rate for the county has steadily risen since 2001 from 21.1% to 30.1% in 2016. (CDC,2016).  There are several factors which increase the overall risk of becoming obese in this city that were identified during the windshield survey.
Only 47.2% of people in Winder eat a healthy diet compared to 48% for the state. City – Data).  This could be related to the number of fast food restaurants in the area and no healthy options available. No health food stores were identified.  The average BMI for Winder was 28.8 compared to 29 for the states. (City-Data). While the average BMI is not greater than 30 the percentage of overweight people in the area is high. Percentage of people in Winder overweight is 32.7% and the state is 33.6%. (City-Data). This can be attributed to the lack of options for activity in the city. According to CDC, only 50.8% of adult population is Georgia is active and there was no data available for youth activity rate. There are few sidewalks, no walking paths, few playground areas and no visible options for safe activity to occur. The area is not friendly for those that want to walk early in the mornings or evenings due to no sidewalks and poor visibility in certain areas. 
There is a state park but it charges for admission. Lack of activity, poor food choice options can result in obesity which can result in health concerns that eventually lead to death if not addressed. The life expectancy rate for Barrow county for females is 79.0 and 73.7 for men per Health Data (2014). This compares to the state average of 79.7 for females and 75 for men, nationally for women 81.5 and males 76.7. (Health Data, 2014)
Another risk factor for the city relates to death related to drug poisoning. This was mentioned by the informants and identified in the data reviewed. AM states, “you would be surprised at the number of students that know of someone using illegal drugs that you would not expect to be using.” (personal communication, March 1, 2018). The illegal drug activity can also be a safety concern for the community. Per MB,” we are seeing more and more calls related to drug overdoses and drug activity than in the past.” (personal communication, February 28, 2018). The fact that there is a drug problem identified by those in the community but not readily noticeable is a safety concern especially for the police and firemen that are responding to these calls. Per Data USA (2016), the death rate for Georgia related to drug overdose is 13.3% which is up from 12.7% in 2015.  This is lower than the national average of 16.3% for drug poisoning mortality rates. (CDC, 2016). Unable to identify death rate per city or county for this topic. The increase in drug poisoning could be related to the lack of opportunities for any type of recreational activity, lack of adult supervision, lack of affordable entertainment in the area.


6.      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.
The city of Winder has a low crime rate for violent crimes. Per the UCR (2018), Winder only had a total of 41 violent crimes with 10 being robberies and 31 aggravated assaults. This is lower than the county and national levels mentioned below. The City violent crime rate is 277 compared to the national violent crime rate of 386.3 offenses per 100,000 inhabitants Per UCR (2017).  The city does have a higher incidence of property crime than violent crimes. Per UCR (2018), Winder total of 609 property crimes with larceny theft the greatest at 470 followed by burglary at 94. There were no murders or rapes reported for the city for calendar year 2014. County crime rate for homicides is low at a total of 3 for collection year 2009-2015 down from 3.7 for collection years 2007 - 2013. (Data USA, 2017). The county has a high rate of violent crimes with report of 480.5 offenses per 100,000 inhabitants, for collection years 2012-2014. (Data USA, 2017). This is down from 482.2 for year 2016 report for years 2010 -2012. (Data USA, 2016).   The state of Georgia had a total of violent crimes of 38,097 (rate of 377.3) with aggravated assault being 22,052 (rate of 218.4) and robbery being the second highest at 12,417 (rate of 123) with most recent data being for calendar year 2014. (UCR, 2018). Property crime rates for Georgia was 331,316 (rate of 3,281.2) with larceny theft highest at 228,034 (rate of 2,258.4) followed by burglary at 76,428(rate of 756.9).  (UCR, 2018).
Air quality index for Winder is 59.8 which is lower than the national rate of 74.7. (City-Data). Winder has a good index of 64.5% and moderate of 35.5%. (EPA 2015). Review of the data shows that the air quality for the city has been steadily increasing since 2012. According to the EPA, the rivers and creeks that supply the city of Winder with water are all in good status with the main source being Bear Creek. Georgia Impaired streams are in the 50 to 60 percentile range, and Barrow County is 14.15 percent and the national rate is 11 percent.
Only one percent of homes in Barrow county are units with a high risk of lead hazards, which places Barrow County in the lower 10% of the indicator.  compared to national rate of between 20% - 30%, state rate of between 10% to 20%. (Scorecard, 2011).   The highest states were indicated as New York, Texas and California (Scorecard 2011).

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.
·         What impressions from your subjective observations were unfounded/invalid?
Based on the subjective finding of the windshield survey the population seemed to be obese. The observations were also supported by discussion with informants.  According to AM, she sees that the obesity rate in the city is increasing for not only the adults but the children also due to lack of activity in both populations. (personal communication, March 1, 2018). MB when questioned about his thoughts on obesity for the city states that he is seeing more obesity to the point that the EMT’s are required to call for backup to assist with moving the patient to the ambulance. (personal communication, February 28, 2018). This was supported with the data reviewed.  Unable to locate data specific to the city of Winder in regards to obesity but the data from the data base shows that the county has a high rate of obesity at 34.6% compared to the state rate of 31.4% and national rate of 30.1%. (CDC-Sortable Risk Factors 2016).  The lack of opportunities for healthy living is evident by the lack of sidewalks for walking, no bike or skateboard paths, no walking paths, no hang out locations and no community encouragement for activities of its members
Another area identified by the informants but was not identified on the windshield survey was the use of drugs in the community. Per MB,” we are seeing more and more calls related to drug overdoses and drug activity than in the past.” (personal communication, February 28, 2018). The fact that there is a drug problem identified by those in the community but not readily noticeable is a safety concern. While unable to locate drug usage specific to the city, per Data USA (2016), the death rate for Georgia related to drug overdose is 13.3% which is up from 12.7% in 2015.  This is lower than the national average of 16.3% for drug poisoning mortality rates. (CDC-Sortable Risk Factors 2016). During the survey in the lower income housing there seemed to be people gathered that gave the impression that drug activity could be occurring but nothing that was easily identifiable when driving through the area other than they gave the impression of not wanting someone they did not know in their area.
A strong Mexican presence was noted during the windshield survey which was validated by the Hispanics making up 10.8% of the Winder population per City-Data (2016). They were the third largest population outside of whites and African Americans. Although, there is a strong Mexican presence in the town that is not noted in street signs or cultural awareness in the town as all signs are only in English.
There were several areas of low income noted during the windshield survey. This was validated with the rate of unemployment rate and median household income for the city. 


·         Given the objective data, what impressions were validated/substantiated?
Reviewing life expectancy the county seems to be in line although slightly lower than the state and national level. The life expectancy rate for Barrow county for females is 79.0 and 73.7 for men per Health Data (2014). This compares to the state average of 79.7 for females and 75 for men, nationally for women 81.5 and males 76.7. (Health Data, 2014). Unable to locate the life expectancy for the city.  The expectancy rate may improve if more opportunities were available for recreational activities to improve on decreasing the rate of obesity in the area.
Obesity was also validated as one of the observations and data collection. Unable to locate data specific to the city of Winder in regards to obesity but the data shows that the county has a high rate of obesity at 34.6% compared to the state rate of 31.4% and national rate of 30.1%. (CDC-Sortable Risk Factors 2016).
The median income for a household in Winder for 2016 was $44, 276, compared to county of $43,133, state $51,037 and US of $55,322. ("U.S. Census Bureau QuickFacts: Winder city, Georgia", 2017).  This can be validated by the number of lower income and middle income homes that were identified in the area.


·         What cause-and-effect relationships did you discover/identify?
The cause and effect relationship that was identified is that the lack of recreational and outdoor activities, lower education attainment, and limited health eating options may lead to obesity which relates to poor health and higher mortality rates. If the area offered more affordable activities such as community events, walking paths or parks the community could become more active and healthier. Additionally, the community should consider education opportunities to be a high priority.

2.      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.      Obesity
2.      Drug Usage
    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).
·         Obesity
-       Lack of healthy food choices evident in high number of fast food choices available of high fat levels in food.
-        
-       High rate of obesity at county level of 34.6% compared to the state rate of 31.4% and national rate of 30.1%. (CDC-Sortable Risk Factors 2016). 
-       High levels of fat in food make individuals have high fat content in their bodies. As a result, they become overweight and this condition may lead to the blockage of some of the blood vessels in the patients’ bodies (Skinner et al., 2016).
-        
Drug poisoning death rate
Lack of education of potential dangers of drugs leading  to increase overdoses and lack of recreational opportunities to keep busy.
While unable to locate drug usage specific to the city, per Data USA (2016), the death rate for Georgia related to drug overdose is 13.3% which is up from 12.7% in 2015.  This is lower than the national average of 16.3% for drug poisoning mortality rates. (CDC-Sortable Risk Factors 2016).
Staff scientists are considering the possibility that exercise—including active play, outdoor adventure, team sports, martial arts, and dance—not only boosts energy and keeps weight in check but also helps prevent substance abuse. (Volkow, 2011).










*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.
3.      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.
 NOT use NANDA.  Use the following format for the community health nursing diagnoses:
          Risk of (State the health problem or risk.)
        Among (Identify the population group affected.)
       Related to ( State factor(s) contributing to the health problem or associated risk.)
Health Risk/problem of (specific injury, illness, or potential of, complication of, etc) among (specific population) related to (supporting evidence from your assessment findings).  Reference: Shuster, George F., (2014). Community as Client: Assessment and Analysis. In Stanhope,
                                               Marcia and Lancaster, Jeanette, Public Health Nursing (8th ed., pg. 413). Saint Louis,
                                               MO: Elsevier.

.Your CHN Diagnoses MUST be something that a community/public health nurse can do something about. See example below.
Ø  Note: Poverty is NOT a CHN diagnosis.
Ø  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 financial resources to purchase medications.)
Community Health Nursing Diagnosis #1
Risk of obesity among members of the Winder community related to the high consumption of fatty foods (may results in high cholesterol), lack of outdoor activity areas (may lead to inactivity), poverty indicators (may result inability to afford recreational activities or healthy foods).

Community Health Nursing Diagnosis #2
Risk of drug usage among members of the Winder community related to lack of outdoor activities (may lead to idleness and curiosity), lack of adult supervision (may lead to outside influences to try drugs), poverty indicators ( may lead to involvement of gang or drug activity).

References
Bureau of Labor Statistics: Unemployment rate. (2017). Labor force. Retrieved 8 March 2018, from https://data.bls.gov/timeseries/LNS14000000
Centers for Disease Control and Prevention. (2016).  Sortable risk factors and health indications. (2016). Retrieved from https://sortablestats.cdc.gov/#/detail
 City – Data: Winder, Georgia (2018). Public record. Retrieved 8 March 2018 from http://www.city-data.com/city/Winder-Georgia.html
Data USA: Winder, Ga, (2015). Economy. Retrieved 8 March 2018 from https://datausa.io/profile/geo/winder-ga/
Environmental Protection Agency Retrieved 7 March 2018 from http://www.epa.gov 
Health Data: County Profile: Barrow County/Georgia. Retrieved 9 March 2018 from http://www.healthdata.org/sites/default/files/files/county_profiles/US/2015/County_Rep
Scorecard: The Pollution Information Site: Retrieved 7 March 2018 from  www.Scorecard.com
Skinner, A. C., Perrin, E. M., & Skelton, J. A. (2016). Prevalence of obesity and severe obesity in US children, 19992014. Obesity24(5), 1116-1123.
U.S. Census Bureau QuickFacts: Winder city, Georgia. (2017). Census.gov. Retrieved from https://www.census.gov/quickfacts/windercitygeorgia
Volkow, N. D. (2011). National Institute on Drug Abuse: Physical activity may prevent substance abuse. Retrieved 8 March 2018 from www.drugabuse.gov/news





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 blocks on the template by continuing to type within each section.  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: 
  








2.      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.





3.       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:

1.      Objective:

2.      Objective:

     3.  Objective:


Goal 2:

1.      Objective:

2.      Objective:

3.      Objective:






4.      Intervention Objectives Timeline
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











5.      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.













No comments:

Post a Comment

Balsa Glider Project Assignment

Balsa Glider Project Assignment #2 An APA paper must be submitted which includes the following sections (with headings): Prototype...