Review the information in your textbook about the following assessments - problem-oriented, community subsystem, and community assets. Write a 3-4 page paper that identifies the strengths and weakness
COMMUNITY ASSESSMENT PAPER 13
Community Assessment Paper
Public Health Nurses function outside of the clinical setting, primarily within the community. These nurses play a pivotal role in the response to public health emergencies and must be ethically prepared for any issues that may arise (Johnstone & Turale, 2014). An assessment of the community being served can be obtained by performing a windshield survey. The purpose of this paper is to discuss the importance of the community assessment in the Public Health Nurse’s quest to gain an overall snapshot of the community they serve.
Overview of the Community
The windshield survey of the community of Walls, Mississippi was quite enlightening. According to the United States Census, the community of Walls has 6,194 residents (United States Census Bureau, n.d.). The majority of Walls residents are age 35-44. Caucasian and African-American races make up the majority of the population. Smaller groups of Asians, Hispanics, and Iranians were also noted.
Walls is a small farm town located in the Northwestern corner of Mississippi. This community is bordered by the Mississippi River to the West and the Tennessee state line to the North. Homes in the community are of brick construction and an average of 15 years old. Many homes are in neighborhoods while others are on larger acreage.
The environmental hazard of power lines was noted in this community. There is a lot of open space in this community, most of which is covered with large towering power lines. The occupational hazard of fuel exposures was noted as well. Many local workers are exposed to fuel while operating large farm equipment.
This community is a well-kept area with much of the town covered in crops. There is no public transportation here, as the residents must rely on their personal autos to get to their destinations. There are no social service centers, no retail stores, and no health care outlets in Walls. Most of the residents of Walls depend on adjacent cities for entertainment, shopping, groceries, health care, and employment.
Vulnerable Populations
“Public health nurses are monitoring, investigating, and diagnosing public health problems, informing and empowering people to act, linking individuals and groups with resources, and evaluating the effectiveness of health policies and services” (Abrams, 2012, p. 479). It is these vital tasks that allow the Public Health Nurse to identify vulnerable populations within the community. The entire Walls community may be considered a vulnerable population. There is no access to health care or emergency services in Walls. There are no physician offices, hospitals, or pharmacy services in Walls. There is one volunteer fire department which is staffed by community volunteers. At this time, there are no plans for advancements in this area. Community residents depend on the services available in larger cities that are adjacent to the community.
The children of Walls are another vulnerable population due to high rates of childhood obesity. There are no social service centers or extracurricular physical education programs to promote physical activity. The elementary school in Walls does have a good physical education program to assist in children getting their daily activity. Other residents travel to nearby cities for social service centers and sports programs there.
The last vulnerable population in Walls is the Hispanic community. Although their population is small in number, a large volume of Hispanics in Walls are non-English speaking Hispanics. The library and the elementary school in Walls have free programs to assist both children and adults with learning the English language. These programs are mostly attended by working class Hispanics.
Southaven, Mississippi, and Memphis, Tennessee are large cities that are nearby the town of Walls. They are accessible via interstate and highway within 15-30 minutes. Both of these cities have a plethora of physician services, hospitals, and pharmacy services. Along with Southaven and Memphis, the nearby city of Horn Lake, Mississippi has a large sports program that offers year-round activities for Mississippi youth. Social services centers and entertainment can be obtained in Southaven and Memphis. These adjacent cities also have programs for Hispanics to learn English.
Impact on Nursing
“There is growing evidence of increasing inequalities in access to health care and health outcomes among populations in local, national, and global contexts. There is a need to advocate for vulnerable populations to lessen the impact of social inequalities on their health” (Douglas et al., 2014). The absence of health care and emergency services in Walls makes this community very vulnerable. This issue presents itself as a significant problem for the Public Health Nurse(PHN). As the nurse is out in the community, there are no facilities or services to refer or direct patients to. The PHN must reach out to neighboring communities for care options for patients.
The absence of social services centers and extracurricular activity creates an environment that leaves children leading sedentary lifestyles. This issue also presents itself as a significant problem for the PHN. The PHN is dependent on social service centers and activity centers to provide outlets for activity for both children and young adults to keep them out of trouble. The absence of these centers leads to boredom amongst youth; boredom is associated with mischief and violence.
A large number of non-English speaking Hispanics are vulnerable due to their inability to safely communicate within a primarily English speaking community. This issue presents as a problem for the PHN as it creates a breakdown in communication among community members. Hispanics remain vulnerable to malice until they learn to speak fluent English as effective communication is essential in any relationship.
Summary
It is suggested that the public health nurse’s interaction among the domains of nursing results in revealing of nursing problems and solutions (Abrams, 2012). There are no easy or immediate solutions to the problems identified for the rural Walls community. The evidence-based practice of Telemedicine could be a possible solution to the absence of healthcare in Walls. “Telemedicine-based collaborative care involves an off-site team of health specialists collaborating with on-site primary care providers, from a centralized location, using telephones, videoconferencing, and electronic health records” (Fortney et al., 2013). This would provide citizens of the Walls community with some access to healthcare without having to travel long distances to facilities in other cities or states. The addition of social service centers and activity programs are likely to occur as the community grows economically. Lastly, language assistance programs in Walls could be expanded to reach all members of Hispanic households to include non-working family members.
The PHN performs an assessment of their working community via a windshield survey. This survey yields significant data that is very useful to the PHN. Community assessment helps the PHN identify any vulnerable populations, environmental hazards, or occupational hazards. It is important to identify these items before any patient care tasks. “A feet on the ground approach will yield rich data and visiting the community and interacting with its members is essential” (Stanhope & Lancaster, 2016, p. 408).
References
Abrams, S. E. (2012). Persistent Problems and Collective ‘Response-Ability’. Public Health
Nursing, 29(6), 479–480. doi:10.1111/phn.12011.
Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M.,
Lauderdale, J., & … Purnell, L. (2014). Guidelines for Implementing Culturally Competent Nursing Care. Journal of Transcultural Nursing, 25(2), 109–121. doi:10.1177/1043659614520998. Retrieved from the Walden Library databases.
Fortney, J. C., Pyne, J. M., Mouden, S. B., Mittal, D., Hudson, T. J., Schroeder, G. W., ... &
Rost, K. M. (2013). Practice-based versus telemedicine-based collaborative care for depression in rural federally qualified health centers: a pragmatic randomized comparative effectiveness trial. American Journal of Psychiatry.
Johnstone, M., & Turale, S. (2014). Nurses’ experiences of ethical preparedness for public health
emergencies and healthcare disasters: A systematic review of qualitative evidence. Nursing & Health Sciences, 16(1), 67–77. doi:10.1111/nhs.12130. Retrieved from the Walden Library databases.
Stanhope, M., & Lancaster, J. (2016). Public Health Nursing: Population-Centered Health Care in the Community (9th ed.). St. Louis: Elsevier.
United States Census Bureau. (n.d.). American FactFinder - Community Facts. Retrieved August
11, 2016, from http://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml
Windshield Survey
Community Assessment
Walls, Mississippi
| Survey Guidelines Boundaries What defines the boundary? Roads, water, railroads? Does the area have a name? A nickname? Housing and Zoning What is the age of the houses? What kind of materials are used in the construction? Describe the housing including space between them, general appearance and condition, and presence of central heating, air condition, and modern plumbing. Open Space Describe the amount, condition, use of open space. How is the space used? Is it safe? Attractive? Commons Where do people in the neighborhood hand out? Who hangs out there and what hours during the day? Transportation Where do people get from one place to another? If they use public transportation, what kind and how effective is it: How timely? Personal autos? Bikes, etc.? are there pedestrians? Does the area appear to be safe? Social Service Centers Do you see evidence of recreation centers, parks, social services, offices of doctors, dentists, pharmacies? Stores Where do residents shop? How do they get to the shops? Do they have groceries or sources of fresh produce? Is this a “food desert”? Street People and Animals Who do you see on the streets during the day? Besides the people, do you see animals? Are they loose or contained? Condition of the Area Is the area well-kept or is there evidence of trash, abandoned cars or houses? What kind of information is provided on the signs in the area? Race and Ethnicity What is the race of the people you see? Religion What indications do you see about the types of religion residents practice? Health Indicators Do you see evidence of clinics, hospitals, mental illness, and/or substance abuse? Politics What indicators do you see about politics? Posters, headquarters? Media Do you see indicators of what people read? If they watch television? Listen to the radio? Business and Industry What type of business climate exists? Manufactures? Light or heavy industry? Large employers? Small business owners? Retail? Hospitality industry? Military installation? Do people have to seek employment elsewhere? | Findings Boundaries The Northern boundary of the city is the MS/TN state line. This is boundary is also marked by a road named Stateline Road. The large city of Memphis, TN is just North of the city. The Western boundary of the city is the marked by Highway 61 and a railroad. The Eastern boundary of the city consists of roads. This boundary also meets adjacent cities of Southaven and Horn Lake. The Southern boundary of the city is also marked by roads and meets adjacent cities of Lake Cormorant and Horn Lake. The area is called Walls, MS. It is also referred to as the Swamp or the Delta due to its close proximity to the MS river. Housing and Zoning The average home in Walls is around 12 to 15 years old. Most of the homes are constructed with brick. There are some older homes made with wood. There are also several modular homes in Walls. The homes are about 10ft apart on average. Some homes with more acreage are further apart. These lots are about 5 acres on average. Most homes are neat and clean in appearance, have central heating and hair, and modern plumbing. Open Space Acres and acres of open space can be found in Walls. A portion of Walls lies within the delta which contains old river beds. These old river beds make for great farming. Much of the open space is planted year round. The crops are attractive especially when the cotton blooms. The other areas that are not farmed are covered in kudzu. This parasitic vine covers the landscape creating bright green sculptures throughout the city. Overall there are no safety issues. Commons There are no hang outs in Walls. There is a skating rink in an adjacent city where many children and teens gather during evening and weekend hours. Transportation People in Walls get from place to place primarily via personal vehicles. There is no public transportation here. The personal autos consist of trucks and cars. Children can be seen on bikes within neighborhoods. No pedestrians noted. The area appears to be safe. Social Service Centers The town of Walls has very few social service centers. Small parks are located within neighborhoods but no large parks were noted. There are no physician offices or dentists in the area. There is one pharmacy located on the outskirts of town. Most physician offices, dentists, and pharmacies are located in adjacent cities of Southaven, Horn Lake, and Memphis. Stores The only stores in Walls are the CVS Pharmacy and two gas stations. Most citizens use their personal vehicles to get to the store. Few can be seen walking or biking due to the long distance to stores. This town can be considered a food desert as there are no outlets for groceries here. Most residents travel to adjacent cities Horn Lake, Southaven, and Memphis for household needs and groceries. Street People and Animals People in Walls can been seen on the streets in their personal vehicles traveling to and from their destinations. Besides the people, livestock such as horses and cattle can be seen contained on area farms. Deer, coyote, rabbit, opossum, and other wildlife can be see regularly in the open areas of the community. Condition of the Area The area of Walls is clean and well- kept. No abandoned vehicles or homes were noted. Signs in the area post speed limits, signage for gas stations, mileage to other towns, and billboards for nearby casinos. Race and Ethnicity Caucasian, African-American, Asian, Hispanic, and Iranian races can be seen in Walls. There are no indices of ethnicity that lean more toward one race than the other. There are multiple churches that multiple races attend here. The food stores are basically gas stations that serve hot food. They are all ran by an Iranian family. There is one restaurant in Walls, which is a Mexican restaurant. All signage in Walls is in English. Religion There are five churches in Walls: three Baptist, one Methodist, and one non-denominational. There is a large Baptist presence here and in nearby cities. Health Indicators There is no evidence of any clinics, hospitals, mental illness, and/or substance abuse facilities. All health care needs are obtained in nearby cities. Politics There are no political headquarters in Walls. The library in the town is also the polling place for all official elections. During election times, political signage can be seen there. Media There is a small library in Walls. Librarian states there is a lot of readers’ school age and seniors. Many citizens watch television in their homes, and listen to the radio while driving. Business and Industry The major industry here is mostly farming. There is very little business climate here. No manufactures or light/heavy industry present. There are no large employers. Small business owners are present with gas stations and a car repair garage. There is no retail here. There is no hospitality industry or military installation here. Many citizens of Walls seek employment in surrounding cities or other states such as Tennessee. |
Adapted and modified from p.410: Stanhope, M., & Lancaster, J. (2016). Public Health Nursing: Population-Centered Health Care in the Community (9th ed.). St. Louis: Elsevier.
