Chapter 5 Flashcards
Exam 2
What is one of the three core functions of community health nursing?
Community assessment
What must be done before an assessment?
Define community before assessment
Define community before assessment:
What is included:
People
Place
Function
Define community before assessment:
What is included: People
Community members or residents
Define community before assessment:
What is included: Place
Geographic and time dimensions
Define community before assessment:
What is included: Function
aims and activities of the community
Community Assessment: What does it include?
Community assessment includes examination of biologic, psychological, and sociocultural influences of the environment that surrounds a specific group of people.
Community Assessment: What process in involved? What are you identifying?
The process of critically thinking about the community – identifying community needs, clarifying problems, and identifying community strengths and resources
Community Assessment:
What approaches are used?
Systematic process that may use several approaches including key informant interviews, analysis of data on health status and health behavior indicators, observation, and community surveys.
Community Health
Community health has three common characteristics (or dimensions)
Status
Structure
Process
Community Health
Community health has three common characteristics (or dimensions)
Status:
Status: biological, emotional, and social components
Community Health
Community health has three common characteristics (or dimensions)
Status: biological, emotional, and social components
Such as what data?
Morbidity, mortality data
Community Health
Community health has three common characteristics (or dimensions)
Structure:
Services and resources
Community Health
Community health has three common characteristics (or dimensions)
Structure: Services and resources
Hospitals, community health clinic, population characteristics (SES, gender, age)
Community Health
Community health has three common characteristics (or dimensions)
Process:
Process: community functioning or problem solving; ability to function effectively
Community Health
Community health has three common characteristics (or dimensions)
Process: community functioning or problem solving; ability to function effectively
Like?
Conflict resolution,
active participation by members,
effective communication
Community Needs Assessment:
What is this?
Process of determining real or perceived needs of a defined community
Community Needs Assessment:
What are the types?
Windshield survey
Problem-oriented assessment
Comprehensive assessment
Community asset-based assessment
Community Needs Assessment:
Windshield survey:
(familiarization assessment)
Community Needs Assessment:
Comprehensive assessment:
(key informants)
Data Collection: What is it?
Gathering or compiling existing data and generating missing data
Data Gathering:
the process of obtaining existing, readily available data (Secondary Data)
Data Generation:
the process of developing data that do not already exist through interaction with community members or groups (Primary Data)
Data Gathering (Secondary Data):
What are you obtaining?
Obtaining existing, readily available data
Data Gathering (Secondary Data):
Who is it collected by? How?
Collected by others via structured interviews, questionnaires, or surveys and are available in published reports (incl. research)
Surveillance Data:
What are examples?
US Census (Census)
National Health Interview Survey (NHIS)
National Health and Nutrition Examination Survey (NHANES)
Behavioral Risk Factor Surveillance System (BRFSS)
Centers for Disease Control and Prevention (CDC)
Community Profiles (EpiQuery: NYC Interactive Health Data)
Data Generation (Primary Data): What is it?
- Generation of direct data
- Collection of reported data:
Data Generation (Primary Data):
Generation of direct data- How?
Informant interviews,
Focus groups,
Participant observation
Windshield surveys
Data Generation (Primary Data):
Collection of reported data: What does this mean?
Secondary analysis of data collected by someone else
Surveys
Data Generation (Primary Data):
Collection of reported data:
Secondary analysis of data collected by someone else- What are examples?
Ex, public documents, minutes from meetings, statistical data from health records
Data Generation (Primary Data):
Collection of reported data:
Surveys
Data from a sample of persons
Key Informants:
Who are they not always?
Key informants are not always people who have a formal title or position
Key Informants:
What kind of role do they often have?
Often have an informal role within the community
Key Informants:
Who are often informants? What do they know?
County health department nurses and church leaders are often key informants.
They also know many community members and can identify other key informants.
Windshield Surveys: What are they?
Motorized equivalent of simple observation
Windshield Surveys:
Motorized equivalent of simple observation: What does it provide?
Get a quick, initial sense of a community’s life and environment
Windshield Surveys:
Motorized equivalent of simple observation:
Elements like?
Elements: housing and zoning, open space, boundaries, “commons”, transportation, social service centers, stores, street people and animals, condition of the area, race and ethnicity, religion, health indicators, politics, media , and business & industry.
Approaches to Community Assessment
Include:
Functional health status approach
Developmental approaches
Epidemiologic approach
Geographic information systems
Community as partner framework
Community asset-based approach
Collaborative model
Approaches to Community Assessment
Functional health status approach:
Functional health status approach evaluates health patterns in the community.
Approaches to Community Assessment
Developmental approaches:
Developmental approaches use a retrospective historical approach to understand cultural changes over time to inform future initiatives.
Approaches to Community Assessment
Epidemiologic approach: What does it describe/determine?
Describing the disease or disability
Determining relationships that can predict health status
Approaches to Community Assessment
Geographic information systems: What is it?
Developing and testing interventions
Approaches to Community Assessment
Community as partner framework
uses a systems approach with a focus on partnerships to effect change.
Approaches to Community Assessment
Community asset-based approach
Community asset-based approach identifies community resources and strengths along with community needs
Approaches to Community Assessment
Collaborative model
involves assessment by an interdisciplinary team and members of the community.
Problem Analysis: What are they for?
To clarify the nature of the problem
Problem Analysis:
To clarify the nature of the problem such as?
Direct and indirect factors that contribute to the problem and to the outcomes of the problem
Community Nursing Diagnosis:
What must it describe?
Must describe at the aggregate level
The comparison of local data with state, regional, or national data, as rates and across multiple years, is important to identify community-level problems as well as patterns and trends.
Community Nursing Diagnosis:
What must be used?
Community-level data must be used
Community Nursing Diagnosis:
Community-level data must be used- like what?
Ex. Epidemiologic data or community survey
Nursing Diagnosis Format
What is included?
“Risk of”–
“Among” –
“Related to” –
Nursing Diagnosis Format
“Risk of” - ?
Identifies a specific problem or health risk faced by the community
Nursing Diagnosis Format
“Risk of”– Identifies a specific problem or health risk faced by the community
Example?
) infant malnutrition
Nursing Diagnosis Format
“Among”
“Among” – Identifies the specific community client
Nursing Diagnosis Format
“Among” – Identifies the specific community client
Example?
ex) families in Jefferson County
Nursing Diagnosis Format
“Related to” – ?
“Related to” – Describes characteristics of the community, including motivation, knowledge, and skills of the community and its environment
Nursing Diagnosis Format
“Related to” – Describes characteristics of the community, including motivation, knowledge, and skills of the community and its environment
Example?
ex) high rate of teenage pregnancy; lack of regular developmental screening; high rate of malnutrition among new mothers
Define Population
Target population: What is it?
those who you plan to serve (=who you are targeting for your services)
Define Population
Accessible population: What is it?
a subset of the target population that reflects specific characteristics with respect to age, gender, diagnosis, etc., and who are accessible for study
those who you have readily available to “access”.
Establishing Goals/Objectives
Goals: include
Generally broad statements of desired outcomes;
general direction of logical response to a demonstrated need
What you ultimately aim to achieve by your nursing intervention (long range)
Establishing Goals/Objectives
Objectives: What are they?
The precise statements of the desired outcomes
The interim steps to reach goals;
realistic and attainable means to meet the goal (short term)
Criteria for a Good Objective (SMART)
includes?
Specific
Measurable
Achieveable
Relevant
Time Specific
Criteria for a Good Objective (SMART):
Specific
What exactly are we going to do and to/with whom?
Criteria for a Good Objective (SMART):
Measurable
Is it measurable and can we measure it?
Criteria for a Good Objective (SMART):
Achievable
Can we get it done in the proposed timeframe, using the proposed activities, for this amount of money?
Criteria for a Good Objective (SMART):
Relevant
Will this objective lead to the desired results (or goal)? Does it support the outcomes of the agency’s or funder’s long-range plan?
Criteria for a Good Objective (SMART):
Time Specific
By when will we accomplish this objective?
Identifying Interventions:
What are they?
Strategies used to meet the objectives/goals
Identifying Interventions:
Strategies used to meet the objectives/goals
include
Selecting the best set of activities
Evidence-based practice
Identifying Interventions:
Strategies used to meet the objectives/goals
include- Selecting the best set of activities:
What exists? What must be identified?
Alternative intervention activities do exist, and they must be identified and evaluated
Identifying Interventions:
Evidence-based practice:
Review previous research to determine what approaches have been used in other places with similar problems and with what success
Synthesizing the evidence and translating it into practice
What can be learned from the experience of others in similar circumstances?
Considerations: Planning
What questions to ask?
Which factors are changeable?
What intervention can be most effective?
What can be done in the community?
How much change is desired over what period of time?
Who can most effectively affect the outcome of the plan?
What is the role of community health nurse in the action plan
Considerations: Implementation
What questions to ask?
What is the role of community health nurse in the action phase?
Which strategies can facilitate healthy change in the community?
Action Plans: What are they?
Detailed description of intervention activities
Action Plans:
Detailed description of intervention activities
include
Who
What
How
Where
Material resources used for intervention (equipment, handouts)
Action Plans:
Detailed description of intervention activities
include
Who
Who planned and delivered the intervention (identify supporting personnel involved in planning, implementing, authorizing)
Action Plans:
Detailed description of intervention activities
include
What
What was the content of the intervention
Action Plans:
Detailed description of intervention activities
include
How
How was the intervention delivered (format, time frame)
Action Plans:
Detailed description of intervention activities
include
Where
Where the intervention took place (location, facility)
Action Plans:
Detailed description of intervention activities
include
Material resources
Material resources used for intervention (equipment, handouts)
Evaluation: How long is it?
An ongoing process from the beginning of the planning phase until the program ends.
Evaluation: What are goals of evaluation?
The major goals of program evaluation are to determine the relevance, progress, efficiency, effectiveness, and impact of program activities.
Why should we conduct an evaluation?
Improve program design and implementation
Demonstrate program impact
- more info on slide 32
How do I conduct an evaluation:
What are you identifying?
Identify and engage stakeholders
Identify program elements to monitor
How do I conduct an evaluation:
What are you determining?
Determine how the information will be gathered
How do I conduct an evaluation:
What are you selecting?
Select the key evaluation questions
How do I conduct an evaluation:
What are you developing?
Develop a data analysis and reporting plan
Ensure use and share lessons learned
Evaluation: Formative
Evaluation for the purpose of assessing whether objectives are met, or planned activities are completed (= Examine process)
Evaluation: Summative
Outcome evaluation
Evaluation to assess program outcomes or as a follow-up of the results of the program activities
Evaluation: Summative
What are the types of goals?
Immediate effects of program (short-term)
Incidence/prevalence of risk factors (=effectiveness of program, long-term)
Aspects of Evaluation include
Relevance (F)
Adequacy
Progress (F)
Efficiency (F/S)
Effectiveness (S)
Impact (S)
Sustainability
Aspects of Evaluation include
Relevance:
Was the program necessary?
Aspects of Evaluation include
Adequacy:
large enough to make a positive difference in the problem?
Aspects of Evaluation include
Progress (F):
Tracking of program activities to meet program objectives
Aspects of Evaluation include
Efficiency (F/S):
Relationship b/w program outcomes and the resources spent
Aspects of Evaluation include
Effectiveness (S)
Meet program objectives and goals
Aspects of Evaluation include
Impact (S)
Long-term changes in health status
Aspects of Evaluation include
Sustainability
Enough resources to continue the program
Health Planning
Organized and systematic process in which problems are identified, priorities selected, and objectives set for the development of community health programs based on the findings of community health assessments and health surveillance data.
Common Themes of current national and international health plans include:
Common themes of current national and international health plans include providing health promotion and disease prevention at the population level, addressing social determinants of health, and achieving health equity
Levels of Health Planning
Global
National and state levels
