Chapter 6: Community Assessment

Question 1

When going through the communities still using nursing process -

Answer 1

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

Question 2

Intro

Answer 2

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

Question 3

Major features of a community

Answer 3

First major feature is an
Second major feature:
Third major feature:

Question 4

First major feature is an (Major features of a community)

Answer 4

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

Question 5

Second major feature: (Major features of a community)

Answer 5

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

Question 6

Third major feature: (Major features of a community)

Answer 6

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

Question 7

Healthy communities

Answer 7

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

Question 8

According to national study Determinants of a healthy community include: (Healthy communities)

Answer 8

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

Question 9

Movements such as Healthy Cities and Healthy Places: (Healthy communities)

Answer 9

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

Question 10

Developing community competence – building a community’s capacity to address future problems (Healthy communities)

Answer 10

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

Question 11

Diagram of assessment parameters

Answer 11

Help nurse develop complaint list of critical community funcs
Nurse can then prioritize funcs from particular community’s perspective

Question 12

Assessing the community: sources of data

Answer 12

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 –

Question 13

Census data – every 10 years (Assessing the community: sources of data)

Answer 13

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

Question 14

Vital statistics (Assessing the community: sources of data)

Answer 14

Info Includes Births, deaths, marriages, divorces, and adoptions
Records the causes of death, which is useful in determining morbidity and mortality trends also included

Question 15

Other sources of health data (Assessing the community: sources of data)

Answer 15

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

Question 16

Shoe leather epidemiology (Assessing the community: sources of data)

Answer 16

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

Question 17

Windshield survey – (Assessing the community: sources of data)

Answer 17

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

Question 18

Windshield survey topics

Answer 18

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

Question 19

Steps of the nursing process

Answer 19

Assessment
Diagnosis
Planning
Implementation/Intervention
Evaluation

Question 20

Community needs assessment

Answer 20

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

Question 21

Approaches to gathering data - other ways to gather data (Community needs assessment)

Answer 21

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

Question 22

Consideration categories for group community assessment project

Answer 22

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

Question 23

Biology Considerations – (Consideration categories for group community assessment project)

Answer 23

age, racial composition, gender, morbidity, mortality; Census Beurau

Question 24

Behaviors Considerations – (Consideration categories for group community assessment project)

Answer 24

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

Question 25

Social Environment Considerations – (Consideration categories for group community assessment project)

Answer 25

culture, spirituality, religious affiliation, income, employment, education - interviewing to get more info about whatever group assigned to do

Question 26

Physical Environment Considerations – (Consideration categories for group community assessment project)

Answer 26

population, geography, housing, water supply, pollution - interviewing to get more info about whatever group assigned to do

Question 27

Access to High Quality Health System Considerations – (Consideration categories for group community assessment project)

Answer 27

primary, secondary, tertiary services; accessibility, locations - interviewing to get more info about whatever group assigned to do

Question 28

Protective Factors

Answer 28

(strengths)
Conditions or attributes (like skills, strengths, resources, supports or coping strategies) in individuals, families, communities, or even the larger society that help people deal more effectively with stressful events and mitigate or eliminate risk in families and communities
Things in person’s environment that are +/supportive

Question 29

Predictive Factors

Answer 29

(actual and potential risks/problems)
Characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes (weaknesses)
Things in person’s environment that are -/predictive of - outcomes but might not necessarily have - impact

Question 30

Nursing process in community

Answer 30

After gathering data the Next step of the nursing process is synthesizing assessment data in which the nurse examines the data and creates a list of actual or potential problems and creating diagnosis
Want to Diagnos(ing) health problems (actual or potential) – these statements specify the nature and cause of an actual or potential community health problem and direct the community health nurses’ plans to resolve the/that problem - 4 components of nursing assessment
After diagnosing the prob the other steps in the nursing process include: Planning, Intervention, and Evaluation

Question 31

Want to Diagnos(ing) health problems (actual or potential) – these statements specify the nature and cause of an actual or potential community health problem and direct the community health nurses’ plans to resolve the/that problem - 4 components of nursing assessment (Nursing process in community)

Answer 31

See next slide for format

Diagnosis consists of four components:

Question 32

Diagnosis consists of four components: (Want to Diagnos(ing) health problems (actual or potential) – these statements specify the nature and cause of an actual or potential community health problem and direct the community health nurses’ plans to resolve the/that problem - 4 components of nursing assessment (Nursing process in community)

Answer 32

The identification of the health problem or risk
The affected aggregate or community The etiological or causal statement
The evidence or support for the diagnosis

Question 33

The identification of the health problem or risk –

Answer 33

which represents a synthesis of all assessment data; figure out health prob

Question 34

The affected aggregate or community –

Answer 34

this specifies the aggregate that will be the beneficiary of the nurse’s action plan and whose health is at risk; group people targeting within pop; whole community or specific people

Question 35

The etiological or causal statement –

Answer 35

which describes the cause of the health problem and directs the focus of the intervention; “what”; what is happening

Question 36

The evidence or support for the diagnosis –

Answer 36

which is the supporting data or evidence, drawn from the completed assessment; subjective data, stats, interviews

Question 37

Format for community health diagnosis

Answer 37

Increased risk of (disability, disease, etc. - identification of health problem/risk - represents synthesis of all data collection) among (Community/population - affected - whose health at risk) related to (etiological statement - describes cause of health prob) as demonstrated in (health indicators - evidence/support for diagnosis).