Application of Community Health & Population-Focused Nursing
Community health and population-focused nursing is an aspect of the public health nursing which places its activities in a specific community. In this case, the nurse tasked with the duty of working with the community members and the concerned agencies in promoting the health of the individuals while also preventing the eruption of diseases. Before engaging in the real community settings, the community health nurses can undergo virtual training to equip them with knowledge and skills concerning the community of interest (Davis, 2016).
This article entails the use of an immersive educational environment in the Sentinel City to conduct assessment and the health needs of the residents. From the simulation, various results are determined besides the learning of multiple strategies in handling community health nursing in real communities. The paper consists of multiple activities within Sentinel City, the health needs from the assessments, health determinants of the residents, the problems identified, the community resources useful in solving its issues as well as the application of the strategies in assessing communities in other settings.
Need assessment- health needs and risks of the community
Demographics
The Sentinel City consists of a population of 663,862 from the four towns. The demographics of each town is unique concerning the population, ethnicity, and income. The population of Nightingale Square is 103,974 with a median household income of $269,550. Regarding ethnicity, the town consists of 81.3% of whites and 3.7% Hispanic or Latino. The population of Acer Tech Center is 168,390 with a median household income of about $168,390. Concerning ethnicity, the city has 70.2% of its population as whites and 13.7% as Hispanic or Latino. The population of Casper Park District is 352,643 with a median household income of $80,134. Regarding ethnicity, the town has 63% of its population as whites with Hispanic or Latino constituting of about 24%. Finally, the industrial Heights have a median household income of $24,672. Concerning ethnicity, 46.8% of the town population consists of Hispanic or Latino with the African Americans constituting 13.3%.
Amongst the four towns, Industrial Heights that appears to be the most impoverished neighborhood have the black Americans as residents. There seems to be discrimination concerning categorization as per median household income and ethnicity which indicates the predominantly white neighborhoods to be having higher incomes compared to the neighborhoods that are mainly occupied by the African Americans and the Hispanics. The median household income level within the Sentinel City also has an association with the overall income, cleanliness, disability as well as the crime rate.
Neighborhood/Safety Assessment
While going round the various towns of the Sentinel City, each of them has occasional trash having rats and other stray animals though this changes as one move from higher income areas to lower income areas. In Industrial Heights with lowest income levels, the buildings are in worse conditions. The town has more boarded-up buildings with trash and graffiti when compared to Nightingale Square which has the highest median income level. Industrial Heights neighborhood is characterized by trash with rodents, stray animals, a fire truck and a car fire with police.
In terms of crime reports, no breakdown was made per town by indicated as general occurrences of crime within the entire Sentinel City. The crimes reported within the city entailed the following: drunk and disorderly conduct, property damage, bicycle theft and shoplifting. While rating the crime index for the towns, office Rodney Cooper industrial Heights a 42/100, Acer Tech Center 89/100, Casper Park District 57/100 and Nightingale Square 93/100 with score 100 representing the safest level.
In terms of the non-insured residents of the Sentinel city, 0.7% of the Nightingale population, 1.5% in Acer Tech Center, 22.7% of the Casper Park District and 37.5% of the population in Industrial Heights has no cover. These figures translate to the affordability and use of healthcare services within the city.
Population Scavenger Hunt
Within Sentinel City, there exist six community resources with each providing different programs to the community members. Parks and Recreation offer a variety of educational programs ranging from gardening, swimming, nutrition, kids swimming programs, afterschool programs as well as well as adult fitness programs. In spite of the existences of these services, complaints by the residents still existed pertaining the location and cleanliness of the park, drugs, crime, stray animals as well as homeless population.
The community also enjoys the elderly services that are available in their healthcare system. These services encompass having medical care advocates to represent their interests, senior transportation that see them move about to various areas and also meals on the wheels. Social services are also offered at the City Hall through various programs. The services entail adult and child protective services, adoption assistance, healthcare services and WIC (women, infant, and children) as well as SNAP (supplemental assistance program).
The community also benefits from the programs by the Community Health Center. It offers a range of programs including computer classes, English language learning, parenting classes and alcoholics anonymous. The Soup Kitchen that works with the Interfaith Church provided meals to those individuals who are homeless and from low-income families. Besides, they also offer other food programs including USDA Commodity program, Commodity Supplemental food program, Food Assistance and Emergency food program. Through the Affordable Housing Project, the Sentinel City can get reports and data concerning the property crimes, occupancy, and the vacant units in the area, tenant complaints as well as the average income according to the tenant types.
Windshield Survey
The Windshield survey provides a general overview of the Sentinel City. Most of the buildings in the city appear to be either brick or cement block. The appearance and upkeep of building differ from town to town. Nightingale Square is the most beautiful city which can be related to the high median income among the residents of the city in comparison to other cities. It has less trash and graffiti as well as more families. While moving towards the Industrial Heights, the amount of trash and graffiti increases which contributes to the attraction of rats and stray animals.
Sentinel City is an urban city with no lawns, very few trees and flowers. In the entire city, there is only one playground which is within a school compound with no other outdoor park. The transport services within the city entail public transportation, motorcycles, bicycles, privately owned vehicles and walking. The city also has few restaurants, convenience stores, donut shops and one grocery store.
Data Analysis- Concepts of Epidemiology and Health Determinants
Epidemiology entails the study of determinants of health as well as their distribution in specified populations and application of an assessment to curb the health concerns of the determined population. Sentinel City has many epidemiological concerns that are key to the health of the entire population that it serves.
Health determinants
They refer to the factors that lead to the occurrence of diseases as well as other health-related events. The occurrences of illness and other health-related events are assumed not to occur randomly in various populations but from the accumulation of various determinants and risk factors within a setting or in an individual (Baum, 2016). The various health determinants of health within the city of Sentinel are grouped as follows:
Demographic characteristics
From the demographic data the individuals under the age of 65 years who were not insured in the neighbor in the four towns varying from 0,7%, 1.5%, 22.7% and 37.55 for Nightingale square, Acer Tech Center, Casper Park District and Industrial Heights respectively. This composition translates to the affordability and even access to preventive care services which differs among the populations. The differences indicate exposure of advance effects of illness among residents from Casper Park District and Industrial Heights due to the affordability of healthcare which they are likely to be forced to pay directly from their pockets.
At the same time, with the varying household incomes, the residents from the low-income towns are predisposed to health care risks. The risks can be associated with the low incomes that may not afford healthcare services, fitness centers as well as healthy food. This predisposed the residents of Casper Park District and Industrial Heights who have lower median household incomes compared to residents from the Nightingale Square and Acer Tech Center.
Racial Diversity
Sentinel city is inhabited by three ethnic groups including the whiles, Hispanics, and the black Americans. The diversity predisposes each racial group to various conditions depending on the genetic compositions as well as the differences in terms of culture which predisposes the groups concerning their practices and behaviors.
Environmental Exposures
The existence of trash especially in the towns inhabited by low-income residents such as the Industrial Heights predisposes them to communicable diseases. Especially in the instances where the garbage overflows, it causes air pollution. The garbage buildup predisposes the residents of the low-income towns to stomachache, skin diseases, respiratory allergies, gastroenteritis, diarrhea, and vomiting.
With the trash attracting rodents and stray animals, the residents of the residents primarily from Industrial Heights are predisposed to conflicts and injuries by the stray animals. They are also predisposed to plagues that are transmitted by rodents. The data from the windshield survey that also indicates the increment of trash as one moves from Nightingale Square to Industrial Heights can be associated with variation in the harboring and promotion of bacterial growth in the low-income areas hence can easily be affected compared to the towns with high-income households.
In curbing this environmental exposure, the community health nurse is critical to facilitate education and health promotion strategies surrounding the removal of garbage on time to reduce the buildup. Besides, through education, the community members can keep the surrounding clean to keep them off the risk of contracting the disease from the trash as well as encountering conflict with the stray animals.
Potential Risks
According to Windshield survey, there are noticeable poor houses as one move from the Nightingale Square to the Industrial Heights. This information indicates potential risks that individuals with poor houses are predisposed to. The individuals in both Casper Park District and Industrial Heights having poor housing are predisposed to adverse health defects such as respiratory and cardiovascular conditions that usually come about with poor indoor air quality and communicable diseases such as tuberculosis from the poor living conditions. They are also at risk of home injuries due to the peeling and falling of the construction materials as well as illness and death that can originate from the extreme temperatures that usually comes with poor sheltering during the cold and hot periods.
Health-Related States
With the entire Sentinel city having only one playground that is ownership of school with no other outdoor park, the residents of the city are predisposed to limited activity. This ranges from the children and the adults dwelling in the city. The lack of adequate playgrounds limits the engagement of the residents into physical and sporting activities. The results of this setting are unfit individuals who are predisposed to lifestyle conditions such as obesity, hypertension, and diabetes. The absence of outdoor packs translates to children spending time indoor hence likely to concentrate on television watching which can predispose them to conditions such as attention deficit disorders. This disorder emerges when the children spend more time on television watching and at early ages.
Having the Park and Recreation Center only in Nightingale Square also translates to denial of other city residents’ easy access to such services. Such residents are predisposed to various health condition related to recreation as they may opt to ignore such services due to the distance to be covered to access the center.
Discussion addressing top three problems of Sentinel city and supported by the healthy people 2020 goals
The first problem I identify in Sentinel City disparity among the communities inhabiting various communities residing in towns within the Sentinel City. According to healthy people 2020, there is need to achieve health equity, do away with disparities and improve the health of all the groups that are living within specific settings (Bolin et al., 2015). This goal calls for the determination of the differences within communities and bridging them to improve their lives.
The disparities within the Sentinel City are pointed out in the neighborhood and safety assessment which determines the states of the housing to differ within the city. The buildings appear to be in worse conditions in Industrial Heights where residents have lower income compared to Nightingale Square which is having a building made of bricks and cement blocks. The demographics also show the racial disparities with the majority of the whites inhabiting nightingale square with the black Americans staying in the industrial Heights.
Another problem within the Sentinel City is the teen pregnancy which is higher than the national levels, and this is part of the goals of the Healthy People 2020. The program aims at promoting quality of life and healthy development which in this case is curbed by the cases of pregnancies that are alarming(Bolin et al., 2015). According to the data from the assessment of Sentinel City, there were 475 pregnancies, 179abortions and 296 births among the teenagers. This situation can be averted by giving attention to the crisis and intervening through education to the teenagers about sexuality and prevention of pregnancies which can help in the reduction of the teen pregnancies.
The crucial third problem that the Sentinel city had was the increased cases of sexually transmitted infections. The leading conditions were HIV at 96% and Hepatitis B at 92%. Others sexually transmitted infections with high incidence and prevalence rate within the city included Trachoma and Syphilis. The prevention of the sexuality transmitted infections in line with the goals of the Healthy people. This strategy aims at ceasing all the preventable condition before they are transmitted from one person to the other. In preventing this condition, there is a need for health education on the transmission of various infections that can prompt safe sex as well as being cautious in one’s sexual life. At the same time, vaccinations against hepatitis B are also vital in the process of preventing the transmission of the illness.
Community Resources Relevant to Addressing the Problems
From the data, Better Health Clinic exists within the city and provides vaccination services that are vital in the prevention of development and transmission of infections such as hepatitis B. The health personnel can also provide education to various audiences concerning sexuality and prevention of sexually transmitted infections. This will see the community benefiting from their services.The city also has media stations composing of television channels and radio stations such as Radio Buzz 96.5 FM which can be used as a media to pass health information concerning the prevention of the sexually transmitted infections and general sexuality.
Various points such as the restaurants and bars within the Sentinel city also provide critical avenues through which various parties can be targeted in the prevention of sexuality transmitted infections. At these settings, various posters and communication strategies can be implemented to facilitate the use of barrier methods during intercourse which will then prevent the number of individuals contracting the sexuality transmitted infections. Condom dispensers can be placed in such settings to enhance their use.
According to the Scavenger Hunt, the Sentinel community has the Community Health Center which offers various programs to the public. This center can be useful in the creation and operation of a youth-friendly center that deals with the sexually transmitted infections in terms of teaching, testing as well as their management in conjunction with the Sentinel healthcare and the Better Healthcare Clinic.
Primary Prevention Topic
My primary prevention topic is Sexually Transmitted Diseases. According to the information obtained from the survey, the communities within the Sentinel City experience high rates of infection including, Hepatitis, HIV/AIDS, Syphilis, and Trichomonas. In conjunction with these diseases, the number of teen pregnancy is also high. This prevention is in line with the goal of Healthy people 2020 that aims at curbing preventable health conditions.
The prevention takes the form of education on sexuality and prevention of transmission of the sexually transmitted infections. These can include the use of protective barriers during intercourse such as condoms to ensure safe sex. Sexual education can also be introduced to the curriculum in schools to target the teenagers in preventing both the transmission of the sexually related infection as well as the teen pregnancies.
Reflection- Application of the Learned Assessment Strategies from Simulation to the Community
Through the simulation environments, I have learned that the critical analysis of the data from the community can be useful in the determination of the problem experienced by the community members. The simulation also provided various tools for the assessment of the community which included the Windshield survey, population health Scavenger Hunt, Neighborhood/Community Safety Inventory and Demographic assessment tools. From the method of data collection, I learned the need to use various aspects and method to collect data as it adds to the validity and reliability of the information obtained. This development evident since information concerning various issues can be obtained via different aspects. In consideration of the Windshield Survey, it was evident that the city has only one playground with the Health Scavenger Hunt determining the presence of a recreational and park center in the Nightingale square hence summarizing the presence of few areas of recreation and physical activity that is open to the public.
The simulation environment taught me of being keen and objective to capture all the activities and issues that exist within the community (Davis, 2016). This is demonstrated by the determination of various aspects of health that the assessment could determine such as the presence of rodents and stray animals that were brought about by the trash, the existence of few stores and restaurants as well as issues such as living status. I will apply this scrutiny while making a diagnosis to my community. This can be attained via considering all the matters that surround the residents hence impacting their lives. The center of focus will be then placed on the health determinants and needs of the community of concern.
I also learned that comprehensive assessment of the community is essential not only in making a diagnosis but also determining various needs and health concerns of the community. I will apply this by exhausting all the determinants of health of the concerned community that I am caring for. This application entails the consideration of the physical, financial, spiritual, cultural and environmental factors. With this in mind, the problems that a community faces are determined as a whole and planned for to improve their lives. This aspect is evident from the assessment by the tools in the simulation environment which surveyed on the religious practices, communication, demographics of the town, income levels of the households, common conditions, environmental issues and recreational activities amongst others which eventually depicted the entire activities that the Sentinel residents engage in.
Conclusion
Community health and population-focused nursing revolve around the community health nurse working in conjunction with the community members as well as other parties interested in the health of the community to prevent diseases and manage conditions in a specific community. The nurse ought to be aware of the demographics of the population as well as their resources that can be used in promoting their lives. The nurse plays various roles such as assessing the needs of the community and taking preventive, promotive and curative actions depending on the outcome of the assessment to curb the situation at hand. The virtual simulator environment as in the case of Sentinel City provides an ample setting for one to learn the assessment and management of various community needs. Through this learning process, an individual can determine the problems of a community as well as learn strategies such as critical analysis of data, comprehensive assessment of community needs, objective analysis as well as the use of multiple approaches in identifying the needs in the community. These strategies are applicable in the real-life situation in the management of various communities and effective community nursing.
References
Baum, F. (2016). The new public health (No. Ed. 4). Oxford University Press.
Bolin, J. N., Bellamy, G. R., Ferdinand, A. O., Vuong, A. M., Kash, B. A., Schulze, A., &
Helduser, J. W. (2015). Rural healthy people 2020: new decade, same challenges. The
Journal of Rural Health, 31(3), 326-333.
Davis, J. E. (2016). The use of simulation in causal analysis of sentinel events in healthcare.
University of Pennsylvania.
