Community’s biggest challenges

Objectives:

Assess, plan and provide care appropriate to clinical sites, level of knowledge and skill in compliance with clinical agency policy and procedure.
Effectively plan compassionate, comprehensive nursing care that reflects preferences and values of diverse populations.
Reflect on the impact of social determinants of health on diverse populations.
Demonstrate use of informatics and technology to analyze public health care delivery systems.
Analyze impact of quality improvement initiatives in healthcare policy, finance, and regulatory environments.
Identify areas for improvement in community agencies.
Demonstrate core professional values (caring, altruism, autonomy, integrity, human dignity, and social justice).
Discuss how psycho-social issues and the social determinants of health influence patient health outcomes
Examine community-based activities to promote ethical reasoning, advocacy, collaboration, and social justice
Instructions:

Section 1

Windshield Survey – read steps 1-7 before starting the assignment

Use the template provided in this document (p. 2-5) to conduct a windshield survey in your community. Do not just visit the areas you are familiar with, see the whole town. If your town does not have one of the items on the list, report it as NA. Items should be answered fully to receive full credit.
Enlist the help of a friend who will drive for you so you can take notes. If possible, use public transportation for at least part of the journey. Describe this experience by answering the questions in the template provided.
Take photos of sites that surprise or concern you about your community. Photos taken should be photos that come from your phone or camera while completing the windshield survey. Uploading pictures from a website online will not meet the requirements for photos.
Prepare a report using the windshield survey template, include at least 3 photos from the experience.
At the end of the report provide a 3-4 sentence response to each of the following questions.
What seem to be the community’s biggest challenges?
What disparities did you note?
What surprised you?
Were there any safety risks identified in your assessment? If so, how would a community health nurse need to intervene to address the safety risks?
How has your perspective about your community changed?
What would you want readers to know about your experience?
While completing the windshield survey, locate one social service agency to visit and schedule an appointment to interview a key informant for the next section of the assignment. In the following section, you will be learning how the social service agency utilizes the Nursing Process for Community as Client.
In section 3, you will be interviewing a health care consumer and a healthcare professional from another discipline.
Windshield Survey Tool

For Community Health Nurses to be able to knowledgeably plan services for a community, it is essential to know a specific community, identify health-related resources that may be helpful to members, and learn about gaps in services. A windshield survey is conducted from a car and provides a visual overview of a community. Conditions and trends in the community that could affect the health of the population are noted. This data provides background and context for working in the community or for conducting a community assessment.

Question

Answer
Introduction. In what community are you completing the Windshield Survey? How does the community look?

Boundaries. Are the boundaries geographical, political, or economic? How is this seen? Do neighborhoods have names? Are there sub-communities? How are these identified?

Land use. How much open space is there? How are residential, commercial, and industrial areas distributed? Do major roads or railroad tracks divide neighborhoods, or are they on the edges of the community?

Housing and Zoning. What is the age of the buildings? What are the construction materials? Are the residences single family or multifamily dwellings? What is the size and condition of the lots (repaired or damaged)?

Signs of Decay. Is the area well maintained or in disrepair? Is there garbage strewn? Are there trashed/abandoned cars, places for rodents or other wildlife to hide, vacant lots?

Parks and Recreational Areas. Are there play areas for children and adults? Are there sports facilities – basketball courts, soccer pitches, baseball fields, cricket pitches, etc.? Are they safe and maintained? Who uses them?

Common Areas. Where do people collect for social gatherings of all sorts; where do they “hang out”? Are they for particular groups or are they open to all? Is there diversity? Are there signs posted?

Stores. What stores (grocery, retail, drug, dry cleaning, etc.) are in the area? How do residents travel to them?

Transportation. How do most people get around the area? Is there public transportation? If so what kind and does it appear to be used? Who uses it? What is the condition of the streets, roads, highways? Are there differences in these conditions from one area of the community to another?

Environmental quality. How much usable green space is there, and is it scattered throughout the community? Is there smog or haze? Does the air smell of smoke, garbage, car exhaust, chemicals, industrial waste, etc.? Does the water in streams, ponds, lakes, etc. seem reasonably clear?

Communication. Is there evidence of local and national newspapers to other media? Are there informational posters on streets, busses, billboards, etc.?

Signs. What languages are business signs in? Are traffic signs informative? Are there signs directing people to various parts of the community (downtown, museums, highways, etc.)?

Service Centers. Where the services for the community are located – health care, social services, schools, employment offices etc.? How many hospitals and clinics are there in the community? Where are they located? How big are they? How easy are they to get to?

Higher education. Are there two- and four-year colleges and/or universities in the community? Where are they located? Do they seem open to the community, or do they seem self-contained and isolated?

People in the Community. Who is in the area during the day? How are they dressed? Are there animals (pets) with them or in the area? What evidence is there of particular “Classes” of people – upper, middle, working, lower?

Industries. What are the major industries? What types of occupations are evident?

Protective Services. Where are fire and police stations located? Is there evidence of police and fire protection in the area? Is it more in one region than another?

Ethnicity. Who lives in the community? Are there identifiable racial and ethnic groups? Do particular groups seem to live in particular areas? According to Census reports (Links to an external site.) what is the ethnic what is the predominant ethnic group? Are there residents from a variety of ethnic backgrounds or is the community mostly one group? Which one? Are there stores, restaurants, churches, schools, or languages that indicate a particular ethnic group(s)?

Religion. What kinds of religious institutions are there? Do the institutions of one particular religion or sect dominate? Are there separate houses of worship for people of different ethnicities or races, even if they share the same faith? What churches and church-run schools are in the area? How many are there?

Health and Morbidity. Is there evidence of any health problems such as drug abuse, communicable diseases, chronic diseases, mental illnesses etc.? Per the county report (Links to an external site.), what are the top 3 health related issues in the county where your community is located?

Politics. Is there evidence of any political activity? Are there any signs that indicate predominant political parties and political concerns?

Perceptions and Observations. What do residents indicate about their community and what are your observations and perceptions based upon your own personal observations?

The residents:

Your Perceptions:

The residents:

Your Perceptions:

Reflections about findings (each question should be answered with at least 3-4 sentences of well-thought out perspectives).

a) What seem to be the community’s biggest challenges?

b) What disparities did you note?

c) What surprised you?

d) Were there any safety risks identified in your assessment? If so, how would a community health nurse need to intervene to address the safety risks?

e) How has your perspective about your community changed?

f) What would you want readers to know about your experience?

  1. What seem to be the community’s biggest challenges?
  2. What disparities did you note?
  3. What surprised you?
  4. Were there any safety risks identified in your assessment? If so, how would a community health nurse need to intervene to address the safety risks?
  5. How has your perspective about your community changed?
  6. What would you want readers to know about your experience?

Include 3 photos of the experience below or attach separately when submitted the assignment via Canvas.

Section 2

Social Service Informant Interview Questions: The following questions should be answered by the informant and you as the interviewer as appropriate:

Questions to be answered

Answer

Partnership:

a) Who do you “partner with”/collaborate with at this agency? (Leadership/staff/ beneficiaries/all of the above?)

b) Who does your agency partner with in the community?

a)

b)

Assessment:

a) What is the name of the agency?

b) Brief background and history on the organization: What is the mission and or vision of your organization? What geographic areas does it cover?

c) Describe the population(s) served and describe how you advocate for this population. Are they well known? How do they market to the community? How do they get funded?

a)

b)

c)

Diagnosis/Planning:

a) Are they community oriented or community based? (This should be answered by you as a student-see Chapter 1 and lecture for explanation of difference) Explain.

b) What health promotion programs do they offer? (Any billboards/posters/educational information available?)

c) Do they have any upcoming community events planned?

d) Do they have plans for expanding their program or services offered to their clients?

a)

b)

c)

d)

Implementation:

a) How effective is the agency in achieving their goals/mission?

b) How does this benefit the community?

a)

b)

Evaluation:

a) What additional resources are needed for the agency to be successful?

b) What do you feel they can they do differently?

a)

b)

Student Reflection:

a) What did you learn during your time at this agency?

b) How could you use the nursing process for community as client (partnership, assessment, diagnosis, etc.) in your future if you see a need in your community?

a)

b)

As you move on to section 3, consider what you learned in section 2 while completing the health care consumer and the interprofessional interview.

Section 3

Health Care Consumer Interview Questions:

Questions to be answered

Answer

Locate and interview one health care consumer that meets the following criteria: a) A person older than 65 years of age; b) A young mother (younger than 25 years of age); c) A single man or woman (about 35-40 years of age). Include their first name and their most recent health care consumer experience. Be brief and maintain confidentiality.

Criteria met (a,b,or c):

First name:

Most recent health care consumer experience:

What has been their overall experience with the health care system?

How does this person define health?

What is their opinion about the role of public and community health nursing?

How do they pay for major health care (Medicare, Medicaid, private insurance, direct individual payment, etc.)?

What are three suggestions they have for how health care costs can be cut?

1.

2.

3.

Interprofessional Interview Questions:

Locate and interview one health care professional from another discipline (OT, PT, RT, Dietitian, SLP, Pharmacist, MD, Social Worker) Include name, credentials, position, and level of education in your summary.

Name:

Credentials:

Position:

Level of education:

What services does this professional provide?

What role do they play in patient care?

How does this professional define health?

What are three suggestions you have for how health care costs can be cut?

1.

2.

3.

Personal Reflection Questions:

Questions to be answered

Answer

What is your definition of health?

How is your definition of health the same or different than the people you interviewed?

What is one thing you learned in your interview with the health care consumer?

What is one thing you learned in your interprofessional interview?

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