Chapter 6: Community Assessment Flashcards
When going through the communities still using nursing process -
still start at assessment; doing it more broad way: whether shoe leather where walking/windshield survey - driving; businesses, healthcare access, access to grocery stores, population look like: driving/walking
Intro
Primary concern of community health nurses is to improve the health of the community to address this concern community health nurses use all principles and skills of nursing and pub health prac; process involves using demographic and epidemiologic methods to assess the community’s health and diagnosis its health needs
Community is the client
First step is to Define the community and describe its characteristics
Next nurses Work collaboratively with the community using the steps of the nursing process
Probs are identified and solutions are developed to improve the community’s health
Goal pub health: primary prevention to protect health and prevent disease development
When providing community care think community as whole as clients
Major features of a community
First major feature is an
Second major feature:
Third major feature:
First major feature is an (Major features of a community)
Aggregate (community composed of people who have common characteristics - members of community may share residence in same city, sim demographic characteristics, membership in same religious organization; Parents of disabled infants or people at risk of second MI may also consider themselves a community) of people: the “who”: personal characteristics/traits; who talking about; describing who people are; getting characteristics and traits
Second major feature: (Major features of a community)
Location in space and time: The “where” and “when” - regardless shared features geographic/phys location may define communities of people; phys location is frequently delineated by boundaries and influenced by passage of time; laying out borders; geographic area: giving location; time: month and season
Third major feature: (Major features of a community)
Social system: The “why” and “how” - relationships community members form with one another; community members fulfill the essential actions of community by interacting in groups; these funcs provide socialization, role fulfillment, goal achievement, and member support; get to that as interviewing, not know until talk to people
Healthy communities
According to national study Determinants of a healthy community include:
Movements such as Healthy Cities and Healthy Places:
Developing community competence – building a community’s capacity to address future problems
According to national study Determinants of a healthy community include: (Healthy communities)
Low crime rate - big one; track and consistently put stats up number murders in KC; talk about how lower crime rate in KC which is a big deal - want lower because determines health in overall community
Good place to bring up children - if is/not; feeds into crime rate - parents afraid to let kids go out/anywhere
Good schools - if is/not; feeds into crime rate
Strong family life
Good environmental quality
Healthy economy
All impact each other
Ensure safe and healthy environments that allow for healthy lifestyles
Movements such as Healthy Cities and Healthy Places: (Healthy communities)
Urge community members to bring about positive health changes in their local environments
Stress interconnectedness among people and the public and private sectors essential to address the causes of poor health and make changes
Each community will have a unique perspective on critical health qualities
Communities ability to respond effectively to changing dynamics and meet needs member indicates productive functioning
Developing community competence – building a community’s capacity to address future problems (Healthy communities)
building community’s capacity to address future problems is called developing community competence; nurse should assess the community’s commitment to a healthy future, the ability to foster open communication, the ability to elicit broad participation in problem-identification resolution, active involvement in structures of health: health departments that can assist the community with health issues, and extent to which members have successfully worked together in past on probs - provides nurse with indic of community’s strength and potential for developing long-term solutions to identified probs
Diagram of assessment parameters
Help nurse develop complaint list of critical community funcs
Nurse can then prioritize funcs from particular community’s perspective
Assessing the community: sources of data
Analysis of demographic info and statistical data provides descriptive info about pop; community health nurse can use demographic and epidemiological data to assess the community; know where get data
Census data – every 10 years
Vital statistics
Other sources of health data
Community health nurse should become familiar with the community and understand its nature by traveling through the area
Shoe leather epidemiology
Windshield survey –
Census data – every 10 years (Assessing the community: sources of data)
Census Beuaru
Tabulates many demographic values (including population size and the distribution of age, sex, race, and ethnicity); avg age, race breakdown in community - Census data for info; get other sources info because want compare local stats to national stats; labor and housing - Census Beuru for national stats to compare to community
American Community Survey (conducted annually), reports social data such as/includes income, poverty, occupational factors
Vital statistics (Assessing the community: sources of data)
Info Includes Births, deaths, marriages, divorces, and adoptions
Records the causes of death, which is useful in determining morbidity and mortality trends also included
Other sources of health data (Assessing the community: sources of data)
U.S Census Bureau – has a subcidiary that provides information on crime, housing, and labor
National Center for Health Statistics (NCHS) survey data – describes health trends and provides information on disability, illnesses, and other health-related variables
Local, regional, and state government reports - provide information about the health of the community and Locally generated data collection
Shoe leather epidemiology (Assessing the community: sources of data)
Down to earth approach to community assessment
Nurse travels through the area to Establish hypotheses about the community’s health, strengths, and potential health problems by traveling through the area
Windshield survey – (Assessing the community: sources of data)
direct observational method
Another assessment approach
Performed by Driving or walking through an area and making organized observations - set of questions looking to answer while doing it; get idea layout, kinds people there, interaction with eachother, resources have; observing people in their role
Helps nurse Gain an understanding of environmental layout, including geographic features and the location of agencies, services, businesses, and industries
Also help nurse Locate possible areas of environmental concern through “sight, sense, and sound”
Gives nurse the opportunity to Observe people and their role in the community
Box 6-2, page 98 provides questions to guide community observations during a windshield survey (this will be utilized to complete the Windshield Survey portion of the Group Community Assessment Project) - nurse must then substantiate these initial assessments and impressions with more concrete and defined data before formulating community diagnosis and plan; some cannot answer and that is fine
Windshield survey topics
Community vitality
Indicators of social and economic conditions
Health resources
Environmental conditions related to health
Social functioning
Attitude toward health and health care
Give overall feeling of community
Steps of the nursing process
Assessment Diagnosis Planning Implementation/Intervention Evaluation
Community needs assessment
The nurse must understand the community’s perspective on health status, the services it uses or requires, and its concerns
102; 6.4 - full needs assessment
Group Community Assessment Project is a modified process for conducting a needs assessment
Windshield survey first assessment and second is talking to community members and community leaders; whole point is know climate, issues perceive having and why having issues - need to address those issues
Approaches to gathering data - other ways to gather data
Approaches to gathering data - other ways to gather data (Community needs assessment)
Interview key informants – may be knowledgeable residents, elected officials, or health care providers; administrators, social workers, nurses, HCPs, clients; knowledgable about agency or community serve
Hold a community forum to discuss selected questions
Hold Focus groups
Consideration categories for group community assessment project
Review and analyze statistical data for community; considerations used as guide for assessment criteria - 5 categories below: basic determinants of health and all factors influence health status
Biology Considerations –
Behaviors Considerations –
Social Environment Considerations –
Physical Environment Considerations –
Access to High Quality Health System Considerations –
Refer to the Group Community Assessment Project guidelines for specific questions on the above categories
Biology Considerations – (Consideration categories for group community assessment project)
age, racial composition, gender, morbidity, mortality; Census Beurau
Behaviors Considerations – (Consideration categories for group community assessment project)
stressors, community cohesion, protective services, crime rates, nutrition, drug and alcohol abuse, exercise, recreation, safety - interviewing to get more info about whatever group assigned to do
