Deck 7: Community Health Planning, Implementation, and Evaluation

Question 1

José Mendez, a bilingual community health nursing student, worked with the school system in a community that had a large Portuguese subsystem. His primary responsibility was for students enrolled in the town's bilingual program. His contacts included the school nurse and the program teachers.
Assessment
José included the specific group of students, the members of the school system's organizational level, and the population group of the town's Portuguese-speaking residents in his assessment of the aggregate's health needs. José identified the subsystem's lack of primary disease prevention, specifically related to hygiene, dental care, nutrition, and lifestyle choices, by observing the children, interviewing teachers and community residents, and reviewing the literature. José's continued assessment and prioritization revealed that the problem was related to a lack of knowledge and not a lack of concern.
Diagnosis
Individual
• Inadequate preparation at home regarding basic hygiene, dental care, nutrition, and healthy lifestyles
Family
• Developing strengths toward self-care regarding basic hygiene, dental care, nutrition, and healthy lifestyles
Community
• Inadequate resources for communicating basics of hygiene, dental care, nutrition, and healthy lifestyles to the Portuguese community
Planning
The teachers and staff of the bilingual program helped contract and set goals, which reinforced the need for mutuality at this step in the process. A variety of alternative interventions were necessary to accomplish the following goals:
Individual
Long-Term Goal
• Students will regularly practice good hygiene, preventive dental care, good nutrition, exercise, and adequate sleep habits.
Short-Term Goal
• Students will learn the basics of good hygiene, preventive dental care, good nutrition, exercise, and adequate sleep habits.
Family
Long-Term Goal
• Families will regularly practice and teach their children good hygiene, preventive dental care, good nutrition, exercise, and adequate sleep habits.
Short-Term Goal
• Families will learn the basics of good hygiene, preventive dental care, good nutrition, exercise, and adequate sleep habits.
Community
Long-Term Goal
• Systematic programs will provide families and their children with education and information regarding the basics of good hygiene, preventive dental care, good nutrition, exercise, and adequate sleep habits.
Short-Term Goal
• Bilingual personnel will translate information into Portuguese, and program teachers will distribute it to families. This information will cover the basics of good hygiene, preventive dental care, good nutrition, exercise, and adequate sleep habits.
Intervention
• Sometimes nursing students' projects are more limited than the planning stage's ideal; in this case, interventions assessed only one grade level.
Individual
• The student nurse taught children many healthy lifestyle basics, including nutrition, hygiene, and dental care. Classes presented information in Portuguese and English.
Family
• All parents received a summary of the class content in both languages and in pictures.
Community
• The local teachers communicated the student nurse's activities to their state-level coordinators, and the coordinators incorporated the student nurse's materials into the bilingual program throughout the state.
Evaluation
Individual, Family, Community
This community health planning project had an impact on the individuals in the specific aggregate and had broader implications for the family systems and the community suprasystem. The outcomes, or product, were hugely successful. Mutually identified goals and objectives influenced the development of the process and incorporated input from a variety of sources. The student nurse believed the resources and support for the bilingual program were adequate. Although the student nurse addressed only primary prevention, the continuing nature of the project will allow the teachers, the school nurse, and the families to assess problems related to the program's content. Future implementation may address secondary and tertiary prevention.
Questions
1. How would you evaluate this project
2. How would you determine process and product evaluation
3. What would you do differently

Answer 1

The community health planning project has a massive impact on the level of individual in the form of specific aggregate. It had broader implication on the level of family systems and also community suprasystem.
This project had positive outcomes and was very successful. The process was influenced by the mutual goals and objectives. It also incorporated inputs from various sources. The student nurse believed in the adequacy of resources and the support for the bilingual program.
The project has a continuing effect despite it being addressed only towards primary prevention. This continuing nature of the project will allow teachers and school nurses along with their families in assessing problems related to the program's content. This project can be further implemented and addressed for secondary and tertiary prevention.

Question 2

Review the Affordable Care Act and your state's plans for action.

Answer 2

NO ANSWER

Question 3

Describe the concept "community as client."

Answer 3

The health nurse for the community is required to identify the environmental factors that influence the health of a community. These factors could then be used for planning of health interventions. This is usually done by assessment of the entire community or aggregate.
The concept or idea of community as a client was exemplified by Lillian Wald at the settlement of Henry Street in the city of New York. Many nurses worked in collaboration for taking care of immigrants that were extremely poor. The focus on the practice of community based nursing yields higher emphasis when the aggregate is treated as a care unit or a client.
The health nurse of the community, however, is also required to take care at the individual or family level. The information provided by the community could be utilized by the nurse in understanding and improvement of the health of the individual and the family. The nurse is required to possess knowledge and be comfortable with the idea of community as a client for participation in planning of healthcare.

Question 4

You are working with U.S. Veterans who have served in Iraq/Afghanistan. Refer to the U.S. Department of Veteran's Affairs website (http://www.va.gov/health/) to review some health issues you should consider in your assessment.

Question 5

Apply the nursing process to the larger aggregate within a system's framework.

Question 6

Select one of the following community diagnoses from your community: Increased rates of violence, asthma, lead poisoning, STIs, pediculosis, infected tattoos/piercings, childhood obesity, hunger and food insufficiency, homelessness. Write a plan on how to address that diagnosis, including goals and objectives. What resources will be needed

Question 7

Describe the steps in the Health Planning Model.

Question 8

Attend a state or local health planning meeting. Observe the number of health care providers and consumers in attendance. Compare the meeting's issues with the goals of improving care quality and reducing health care costs.

Question 9

Identify the appropriate prevention level and system level for nursing interventions in families, groups, aggregates, and communities.

Question 10

Review the American Planning Association's Planning and Community Health Research Center Plan. Discuss which plans and policies and plans improve the built environment in your community.

Question 11

Recognize major health planning legislation.

Question 12

Analyze factors that have contributed to the failure of health planning legislation to control health care costs.

Question 13

Describe the community health nurse's role in health planning, implementation, and evaluation.