The Community county that i choose for the assignment is “Blaine county Oklahoma”. You can research about the county to get information’s and data just be sure to city the source or sources. Community Assessment instruction and RubricInstructions: After reading about the implementation of the nursing process at the community level in Chapter 17, you will complete a community assessment and plan of care. This assignment is designed to give you an opportunity to participate in the assessment of a whole community. Data gathered will be used to determine the health status of the selected community and to formulate community health nursing diagnoses. You will propose (you will not actually be implementing these interventions) nursing interventions for primary, secondary, and tertiary levels of prevention to improve or maintain the health of the selected community. You will submit a paper with your data findings and plan of care for the community. The steps of a community assessment are:1. Data Collection2. Problem Clarification3. Analysis of Problem4. Resource Identification5. Resource Utilization6. Action Plan (Community Nursing Care Plan)Using the nursing process, the student will:1. Select appropriate data sources to assess a selected community.2. Identify factors that promote wellness and factors that are detrimental to the health of a community.3. Interpret data collected for the community assessment to determine the health status of a community.4. Formulate nursing diagnoses that reflect assets and liabilities of the community. 5. Identify the role of the community health nurse in improving the health status of the community.6. Communicate effectively with key people in the selected community to obtain required data.7. Demonstrate accountability for professional practice as a team member in conducting a community assessment.8. Formulate goals and nursing interventions that could improve the health of the selected community, using primary, secondary and tertiary levels of prevention.9. Evaluate outcomes based on goals and interventions.GENERAL TOOLS TO USE FOR DATA COLLECTION:1. Windshield Survey2. Existing data sources (national, state and local: see Sources for Data below) 3. Surveys – sample a specific population to get opinions4. Interviews – key informants and community members and/or leaders5. Community forums – get input from members of the communityWINDSHEILD SURVEY:The best initial step in assessing a community is to walk or drive around the community, looking at physical or environmental characteristics of the community. The next step is to conduct research regarding your chosen community (see Sources for Data Collection below). There will be a lot of information to cypher through; here are some suggested categories to help organize your data:· Physical/Environmental· Political· Social· Economic· HealthA partial listing of data that should be considered is as follows:· Income statistics/taxes· Transportation services· Churches, stores, recreational areas· Air quality· Waste disposal systems· Climate· Noise levels· Highways/streets/access· Crime statistics/police coverage/lighting· Morbidity and mortality statistics· Educational levels/resources· Accident rates· Health care facilities/practitioners· Presence of natural resources such as grass, trees, rivers· Housing· Demographic statistics· Observed health hazards· Factories/businesses· Meals on Wheels and other health care resources· Geography of the area· Water and air quality· Fire departments/emergency services· Government offices/type of government: mayor, city council, etc. ·History of the communitySOURCES OF DATA AND WHERE TO FIND THEMDATA SOURCESCensus data Local government planning office Chamber of CommerceOnlineMorbidity and mortality statistics State/Local Health Department OnlineVital records State Health Department Local government vital statisticsregistrarDemographic data Local government planning office Public LibraryChamber of CommerceHealth DepartmentInformation for special studies and projects Source of recipient of studyHospital admission and discharge statistics Hospital websiteDepartment of Health annualhospital reportDisease-specific data State/Local Health Departments;Disease-specific organizations suchas the Cancer Society, etc.Small population group data Community surveys, Household interviews, QuestionnairesFamily and individual client data Interviews, assessments and past medical recordsAir and water quality data State/Local Health Dept.COMMUNITY-ORIENTED NURSING DIAGNOSESThe development of the community-oriented nursing diagnosis helps to clarify the problem and is an important first step in planning. Community diagnoses clarify who receives the care, identifies problems faced by whoever is getting the care, as well as identifies factors that contribute to the problem.A three-part approach to the community-oriented nursing diagnosis is suggested:1. Identify the problem faced by the community and the members of the community (among/in)2. Identify factors that contribute to the problem (related to)3. Supporting data that document the problem (as evidenced by)EXAMPLES OF COMMUNITY PROBLEMS THAT COULD BE USED IN FORMULATING NURSING DIAGNOSES:· Inaccessible or unavailable services· Mortality and morbidity rates· Communicable disease rates· Specific populations at risk for physical or emotional problems· Health promotion needs for specific populations· Community dysfunction· Environmental hazardsEXAMPLES OF COMMUNITY-FOCUSED NURSING DIAGNOSES:1. Increased rates of infant mortality among young mothers in Enid related to a higher level of teenage pregnancies and a lack of prenatal care in this aggregate as evidenced by infant mortality rates above the national average.2. Increased incidence of respiratory diseases among citizens in Buffalo related to increased air pollution compared to national standards as evidenced by high rates of asthma.Grading Rubric: Use this rubric to help guide the development of your paper to receive maximum points.1. Introduction of the community _________/102. Assessment: Comprehensiveness of data collection/Resources used (including atleast 1 informant interview) _________/253. Data analysis/problem list (Minimum of 2)Use of Healthy People 2020 objectives(One objective linked to each problem) _________/204. Nursing diagnoses (Minimum of 2)_________/255. Planning: Establish and prioritize goals toaddress the 2 priority nursing diagnoses(One goal for each diagnosis) _________/206. Implementation: Identify/Prioritize interventionsdesigned to meet above listed goals _________/20 (Must include at least one primary, secondary andtertiary level of prevention for each goal)7. Evaluation: Plan for each nursing diagnoses developed _________/15 (One evaluation for each goal)8. Reference List __________/59. APA Format/Grammar __________/10TOTAL POINTS POSSIBLE _________/150 GRADER Community Assessment sample paperWellston, Oklahoma
Introduction of the Community
If you hop onto Route 66 headed east of Edmond, Oklahoma, and drive for about 30 minutes, you will come to the small, quiet town of Wellston, Oklahoma. Located in Lincoln County, it is north of the Turner Turnpike and about 40 miles northeast of Oklahoma City. The population as of 2014 was 787. This represents a 4.6% population change since 2000. Wellston was first established as a trading post in 1880. The trading post officially became a town in 1895 and was laid out by a pharmacist named J.L. Ross, who also served as the town clerk. Around the turn of the century, the town included a school, three churches, general stores, two lumber yards, two hotels, cotton gins, a bank, and a brickyard. The town grew steadily until reaching its peak population of 912 in 1990. Since the turn of the 21st century, the population has steadily declined.
Assessment
Physical/Environmental: Due to its small size, Wellston has little noise or air pollution and the air quality index score is 79.3. The climate is moderate, with an average low temperature in January of 28 degrees Fahrenheit and an average high temperature in July of 93 degrees Fahrenheit. There are an average of 243 sunny days per year. Yearly, Wellston gets about 38 inches of rain and 4 inches of snow. This moisture is enough to support many trees both in and out of town, as well as some small ponds and lakes in the area. Historically, Wellston’s tornado activity is 243% higher than the U.S. average. This rate is only slightly higher than the rate for Oklahoma, though. Wellston’s average earthquake activity rate is about the same as that of Oklahoma. This is about 70% smaller than the U.S. average. Wellston is located just off of Route 66 and the Turner Turnpike. There is no form of public transportation in Wellston, and many residents use their own vehicles to commute to the Oklahoma City metro area for work. Political: In addition to a Town Hall in Wellston, the Wellston Chamber of Commerce is led by president and Wellston resident Gloria Goggin. The mayor of Wellston is Paul Whitnah. Social: The windshield survey revealed that Wellston has 8 churches, 1 town park, 4 restaurants, 1 gas station, and 1 Dollar General. Police coverage in Wellston is maintained by the Wellston Police Department and the Oklahoma State Patrol. The crime rate in Wellston is similar to the average crime rate of Oklahoma and slightly lower than the crime rate of the Oklahoma City metro area. There are 20 registered sex offenders in the town of Wellston. The Wellston Fire Department is run completely by volunteers. Wellston residents are predominantly white, with 85% of the population being white. The next largest group is American Indians with 5% of the population. 11% of Wellston residents live at or below the poverty line. This is significantly lower than the state average. 89% of residents hold a high school diploma and 15% have a Bachelor’s degree. As previously mentioned, many Wellston residents commute to the Oklahoma City metro for work, with a mean travel time to work of 30 minutes. Wellston has an elementary, middle, and high school. The nearest university is about 30 minutes away. Economic: The average household income in Wellston is $28,553. The most common occupations of Wellston residents are in construction and extraction, management, office and administrative support, material moving, production, transportation, and sales. The average home value in Wellston is $85,714. Health: The top 10 causes of death in Lincoln County are heart disease, cancer, bronchitis/emphysema/asthma, unintentional injury, stroke, diabetes mellitus, Alzheimer’s disease, influenza, pneumonia, liver disease, and suicide. Like much of Oklahoma, the population of Wellston struggles with obesity. In Wellston, 41.5% of the population is overweight or obese. Some observed health hazards include agricultural waste and accidents. Health services are limited in Wellston, but there is one clinic called The Clinic at Wellston. The county health department is located in Chandler, OK, which is about 17 minutes away. The nearest large hospital is about 30 minutes away, in the Oklahoma City metro. The closest Meals on Wheels program is in Harrah, OK, which is about 15 miles away. We interviewed Wellston resident Sandy Canada about what exercise and healthy lifestyle resources are available in Wellston. She said that to her knowledge, there are no gyms, exercise programs, healthy eating programs, or walking trails available.
Data Analysis
There were several points of concern related to the physiologic health conditions in the Wellston community. The two most prevalent physiologic conditions in Wellston are obesity and diabetes. In Wellston, 41.5% of the population is overweight. This is significantly higher than Oklahoma’s rate of 33.1%. This statistic is even more concerning when looking at the bigger picture, which displays Oklahoma as the eighth most obese state in the U.S. It was also reported that the Diabetic rate for Wellston is 11.3%, which is the same as that of the highest diabetic state in the United States, Mississippi. These statistics reveal a need for attention to the issues of obesity and diabetes. After observing Wellston, several elements are apparent that contribute to the present health of its residents. First is the access to food. There is no grocery store located in Wellston. There is a Dollar General and a gas station where residents can purchase non-perishables or frozen food, but there is no fresh produce available to be purchased in Wellston. There are also no public resources for residents to exercise. There is no recreational building, weight room, walking trails. There is only one playground. At this time, Wellston does not provide an environment that promotes health. There are currently no resources available to combat the problems of obesity and diabetes. Healthy People 2020 has a goal to create an environment to promote better health for all. Some ways to help the community of Wellston achieve this goal would be the addition of a grocery store and public facilities that encourage physical activity. If Wellston can improve their overall health, then it is likely that the community will also accomplish another goal of Healthy People 2020. This goal is for people to have higher quality, longer lives, be free of preventable diseases, and have a decrease in premature death.
Nursing Diagnoses
• Risk of imbalanced nutrition among diabetic residents in Wellston related to limited access to nutrient-dense foods that align with a diabetic diet and lack of communitybased support for diabetics as evidenced by a diabetic rate of 11.3% of the Wellston adult population. • The increased rate of activity intolerance among Wellston residents related to inadequate public resources for exercise as evidenced by a rate of 41.8% of the population being overweight in Wellston.
Planning
Risk for imbalanced nutrition: Goal: Diabetics living in Wellston will have a basic understanding of healthy eating and be able to describe a “healthy plate” by the end of 12 months. Risk for activity intolerance: Goal: The residents of Wellston will have access to at least two free resources for physical activity by the end of 12 months.
Implementation
Risk for imbalanced nutrition 1. Primary prevention – nutrition and cooking classes will be taught in the schools to promote better lifestyle choices hopefully preventing diabetes 2. Secondary prevention – community health screenings will be held 4 times a year to identify those at risk for developing diabetes or those who maybe undiagnosed 3. Tertiary prevention – patients who have diabetes will be offered education classes on how to manage diabetes with diet and medication Risk for activity intolerance 1. Primary prevention – education will be provided in the schools about the importance of exercise to prevent obesity and they will provided with free resources in the community for physical activity (walking trails, community center) 2. Secondary prevention – community screenings will be held 4 times a year to identify those who are at risk for obesity or already overweight 3. Tertiary prevention – education will be provided to those who are identified as obese as to what resources are free to them in the community for physical activity (walking trails, community center)
Evaluation
At the end of the 12 months, we would send out surveys to those who participated in each class. For diagnoses number one we would ask the diabetic participants to describe a healthy plate. For diagnosis number two we’d survey a group of Wellston residents and ask them to identify at least two resources in the community where they could get some exercise for free. This would tell us if our plan was successful or if we needed to do a better job of communicating with our target groups.
Reference List
About Healthy People. (2014). Retrieved November 28, 2017, from https://www.healthypeople.gov/2020/About-Healthy-People GET STARTED TODAY. (2017). Retrieved November 28, 2017, from https://www.mealsonwheelsamerica.org/signup/aboutmealsonwheels/findprograms?filter=74881# Greenfield, G. S. (2009). WELLSTON. The Encyclopedia of Oklahoma History and Culture. Retrieved November 28, 2017, from http://www.okhistory.org/publications/enc/entry.php?entry=WE011 List of Water Systems in SDWIS. (2017, October 23). Retrieved November 28, 2017, from https://oaspub.epa.gov/enviro/sdw_query_v3.get_list?wsys_name=&fac_search=fac_begi nning&pop_serv=&sys_status=active&wsys_id=&last_fac_name=&page=1&query_resu lts=&total_rows_found=&fac_county=Lincoln&fac_state=OK Sandy Canada, personal communication, November 17, 2017 Wellston, OK Profile: Facts, Map & Data. (2017, July 1). Retrieved November 28, 2017, from https://oklahoma.hometownlocator.com/ok/lincoln/wellston.cfm Wellston, Oklahoma . (2017). Retrieved November 28, 2017, from http://www.bestplaces.net/climate/city/oklahoma/wellston Wellston, Oklahoma. (2017). Retrieved November 28, 2017, from http://www.citydata.com/city/Wellston-Oklahoma.html Windshield survey
