Direct Care Project part 1 (ANSWERED)

QUESTION

Purpose

The purpose of this direct care project is for learners to apply the nursing process to a community health problem determined by their observations and data collected of vulnerable populations in their community. This is Part 1 of 4 in the Direct Care Project.

Direct Care Project Overview

There are four parts to the Direct Care Project.
There will be graded Project Check-ins that correlate to each part.
The topic selected in Part 1 will be the same one used in Parts 2 through 4. Your choice is either Air Quality OR Substance Use.
Review the table below for overview and due dates with each topic.
Carefully review the instructions, tutorials, templates, and rubrics for each of the four parts as you begin this Direct Care Project.
Contact your instructor with questions.

Overview	Points	Due Date	Projects
Overview	Points	Due Date	Air Quality	Substance Use
Part 1: Assessment: Check-In	10	Wednesday of Week 2	Required, graded check-in on progress of assessing your community
Part 1: Assessment and Diagnosis	170	Sunday end of Week 2	Assess your community and collect data on air quality	Assess your community and collect data on substance use
Part 2: Planning: Check-In	10	Wednesday of Week 4	Required, graded check-in on progress of assessing your community
Part 2: Planning the Presentation	150	Sunday end of Week 4	Create a PowerPoint presentation on the use of the Air Quality Flag Program. You will present to at least 1 organization leader.	Create a presentation on the use of Screening, Brief Intervention, and Referral to Treatment (SBIRT). You will present to at least 3 practicing RN’s.
Part 3: Implementing the Presentation	Required	Schedule presentation Saturday of Week 5 through Saturday Week 6	Present to a local organization that serves the identified vulnerable population and could implement the Air Quality Flag Program. There should be at least one organizational leader present. Includes participant(s) completing a Pre- and Post-survey	Present to at least 3 practicing RN’s that serve the identified vulnerable population and could implement SBIRT; Includes participants completing a Pre- and Post-survey
Part 3: Implementation: Check-In	10	Wednesday of Week 5	Required, graded check-in on progress of implementing your presentation
Part 4: Evaluation: Check-In	10	Wednesday of Week 6	Required, graded check-in on progress of evaluation of your presentation and project
Part 4: Evaluating the Project	140	Sunday end of Week 6	Evaluate learning and reflect on project.	Evaluate learning and reflect on project.

Course Outcomes

This direct care project enables the student to meet the following course outcomes:

CO2 Assess the health of populations, aggregates, and communities (PO4)
CO3 Apply the nursing process to vulnerable populations with professional clinical judgment and evidence-based practice (PO4 & 8)
CO5 Utilize a collaborative approach to address factors that influence population health (PO2)
CO6 Examine collaborative trends in community health nursing (PO2)

Part 1 enables the student to meet the following course outcomes:

CO2 Assess the health of populations, aggregates, and communities (PO4)
CO3 Apply the nursing process to vulnerable populations with professional clinical judgment and evidence-based practice (PO4 & 8)

Directions for Part 1

Review the Direct Care Project Overview above. Select topic (Air Quality OR Substance Use) from the table. This will be the topic of your entire course project.
View the Direct Care Project Part 1 TutorialLinks to an external site..
Download the corresponding Assessment and Diagnosis template under Templates below. For example, if you have selected Air Quality as your topic, download the Air Quality Assessment and Diagnosis Template.
Collect the data outlined in the template. There are two parts:
- Online data collection – gather data from the weblinks provided on the template
  - Please note, if you live in Washington D.C. it may be listed as a state or county. You may list the Washington D.C. data as state and county, then compare to the U.S. data.
- Modified windshield survey data collection – gather local community data by physically looking at your community
  - If possible, plan on asking someone to drive during your survey so that you can take notes.
  - Your community should be the area where you live or the area surrounding your work. The community must include a residential area and be a large enough area to answer the survey questions. If you live in a large area, you may choose a suburb.
  - Note: It is helpful to conduct this portion of the assessment at least two different times: during the day or evening, on a weekday, and/or on the weekend.
Identify a nursing problem (nursing diagnosis) based on data and observations
- You must select a problem caused by your topic
- Important: the problem you identify will be utilized in Parts 2, 3, and 4 of the project.
Identify the vulnerable population that the problem affects. This will also determine who you will present to in Part 3.
Write the nursing diagnosis (See template and chapter 6 in Nies & McEwen textbook for more information)
Submit template through the submit assignment button on this page.

ANSWER

Air Quality Assessment and Diagnosis Template

Directions: Collect the data outlined in this template. Fill in the blanks in the tables provided. There are two parts – online data collection and a modified windshield survey data collection. You will then identify a nursing problem in a vulnerable population and write a nursing diagnosis. See the assignment directions and tutorial for suggestions and best practices. All information in a category must be completed. Air quality will be the topic of your Assessment and Nursing Diagnosis Template and also Parts 2 through 4 of your course project.

Name: Date:

Online Data Collection

Community Information

	Your Community Data
Name of city or town and state	Liberty County, Georgia
Population	65,711
Nature of this community (rural, suburban, urban)	Rural
Describe your community in 2-3 sentences	Liberty County is a rural area in coastal Georgia. The community is family-oriented, and Christianity is the dominant religion. The main employment sectors in the community are public administration, health & social assistance, tourism, retail trade, and manufacturing.

Community Demographics
1. Go to https://www.census.gov/quickfacts/fact/table/US/PST045218
  1. The US data should automatically populate
  2. Input your zip code or county/township name

Then input your state for comparison data

Enter the data into the table below
Compare the county, state, and US data

	County Data	State Data	U.S. Data
Population total	65,711	10,799,566	331,893,745
Male (subtract female % from 100)	50.8%	48.8%	49.5%
Female	49.2%	51.2%	50.5%
Persons under 5	10%	5.9%	5.7%
Persons over 65	10.2%	14.7%	16.8%
Race and origin data
	County Data	State Data	U.S. Data
White alone	46.3%	59.4%	75.8%
Black or African American alone	45.4%	33%	13.6%
American Indian and Alaska Native alone	0.7%	0.5%	1.3%
Asian alone	2.2%	4.6%	6.1%
Native Hawaiian and other Pacific Islander alone	0.6%	0.1%	0.3%
Two or more races	4.8%	2.4%	2.9%
Hispanic or Latino	12.6%	10.2%	18.9%
White alone, not Hispanic or Latino	37.2%	51%	59.3%
Significant population characteristics
	County Data	State Data	U.S. Data
Veterans	9,157	635,251	17, 835, 456
Foreign born persons	6.2%	10.2%	13.5%
Housing overview
	County Data	State Data	U.S. Data
Housing units	27, 171	4, 475, 274	142, 153, 010
Owner-occupied housing unit rate	46%	64%	64.4%
Median selected monthly owner costs with a mortgage	$1,177	$1,449	$1,621
Median selected monthly owner costs without a mortgage	$421	$435	$509
Median value of owner-occupied housing units	$133,700	$190, 200	$2229,800
Median gross rent	$1,064	$1, 042	$1.096
Family and living arrangements
	County Data	State Data	U.S. Data
Households	24,053	3, 830, 264	122, 354, 219
Persons per household	2.49	2.68	2.60
Living in same house 1 year ago	72.2%	85.5%	86.2%
Language other than English spoken at home	13.1%	14%	21.5%
Computer and Internet Use
	County Data	State Data	U.S. Data
Households with a computer	95.2%	92%	91.9%
Households with broadband internet subscription	89.7%	84.4%	85.2%
Education
	County Data	State Data	U.S. Data
High school graduate or higher	91.9%	87.9%	88.5%
Bachelor’s degree or higher	19.3%	32.2%	32.9%
Health
	County Data	State Data	U.S. Data
With a disability under age 65 years	11.9%	8.9%	8.7%
Persons without health insurance under age 65 years	2.2%	15.5%	0.2%
Economy
	County Data	State Data	U.S. Data
Civilian labor workforce ages 16+	54.3%	62.7%	63%
Transportation-mean travel time to work (minutes)	22.3%	28.7	26.9%
Income and poverty
	County Data	State Data	U.S. Data
Median household income	$50, 411	$61, 224	$64,994
Persons in poverty	4.7%	14%	1.4%

Community Epidemiological Data
1. Go to: https://www.countyhealthrankings.org/
2. Click on your state
  1. Start with Overall Rankings in Health Outcomes
  2. Then choose your county

**you will need to use the “+” to see all of the data**

	County Data	State Data
Health Outcomes Percentile	50-75%	N/A
Health Factors Percentile	50-75%	N/A
Premature death	10,000	8,000
Low birth weight	9%	10%
Adult smoking	22%	17%
Adult obesity	37%	33%
Physical inactivity	35%	27%
Excessive drinking	17%	18%
Alcohol impaired deaths	33%	21%
STIs	1, 209	637.8
Teen births	52	23
Drug overdose deaths	12	15
Uninsured	12%	16%
Unemployment	6.2%	6.5%
Children in poverty	23%	20%
Violent crime	478	388
Air pollution	8.3	8.6
Drinking water violations	No	N/A
Long commutes	31%	42%

Respiratory Conditions
1. Go to https://www.lung.org/research/trends-in-lung-disease/prevalence-incidence-lung-disease
  1. Input your state
  2. Then identify your county

**Please note these are estimated amounts of total diseases. Communities with a higher population will likely have more cases. Be sure it is clear in your presentation that these totals are estimates.**

	County Data	State Data
Pediatric asthma	1,715	244,252
Adult asthma	4,021	735,730
COPD	2,538	545, 078
Chronic lung disease	7,336	1,325,857
Lung cancer	35	6,166

Windshield Survey

It is recommended that you have someone drive you around your community at least 2 times, ideally at different times of day and weekend vs. weekday.

Look at the people in your community. Did you observe:	No	Yes	If Yes, provide number or state “many” “some” or “few”
· *pregnant women		✔	Some
· *pregnant adolescents		✔	Few
· *infants (under age of 1 year old)		✔	Some
· *young children (1-5 years old)		✔	Few
· *school-age children (6-18 years old)		✔	Many
· adults (18 – 60 years old)		✔	Many
· *older adults (over the age of 60 years old)		✔	Many
· people exercising		✔	Few
· people driving		✔	Many
· people walking		✔	Some
· people biking		✔	Few
· people congregating in groups on the street		✔	Few
· *people that had hygiene issues or were unkempt		✔	Few
· people that were appropriately dressed		✔	Many
· people that were physically fit		✔	Some
· people that were obese		✔	Some
· *people that were undernourished, thin		✔	Few
· people that appear healthy		✔	Many
· *people that have obvious physical disabilities, such as those using walkers or wheelchairs		✔	Few
· *people with apparent mental/emotional disabilities		✔	Few
· *people who appeared homeless or unemployed		✔	Some

*Represents vulnerable populations

Social and Economic Conditions Did you observe:	No	Yes	If Yes, provide number or state “many” “some” or “few”
· housing that was run down or dilapidated		✔	Few
· areas undergoing renewal	✔
· public housing		✔	Many
· Public transit (subway, train, buses, taxis, etc.)		✔	Some
· transportation to health care resources		✔	Some
· landfills		✔	Some
· restaurants		✔	Many
· any political signs		✔	Some
· any evidence of health education on billboards, advertisements, or signs		✔	Few
· any efforts to improve the neighborhood’s health such as advertisements for health-related events, health fairs, clinics, or lectures		✔	Few
· any group efforts in the neighborhood to improve the living conditions or the neighborhood	✔
· churches, synagogues, mosques, and other places of worship		✔	Many

Health Resources Did you observe:	No	Yes	If Yes, provide number or state “many” “some” or “few”
· hospitals		✔	2
· community clinics		✔	Many
· family planning clinics		✔	Few
· generalist doctors		✔	Some
· dentist offices		✔	Some
· pharmacies		✔	Many
· urgent care clinics		✔	Few
· skilled nursing facilities		✔	Few
· mental health or counselling clinics		✔	Some
· homeless or abuse shelters		✔	Some
· public health department office		✔	2
· substance abuse treatment center		✔	Some
· alternative medicine practices, botanicals, or herbal medicine shops		✔	Few

Answer the following question:

If some of the above health resources were not observed, approximately how far away would a person need to travel to find these resources?

Hinesville is the County’s seat and has all the above resources. Residents from the marginalized or impoverished areas will have to travel to Hinesville to receive services absent in their communities. The Liberty Transit System transports residents through the most populous areas in the County. The Transit’s system longest route is three-hours-long.

Environmental Conditions Did you observe:	No	Yes	If Yes, provide number or state “many” “some” or “few”
· evidence of anything that might make you suspicious of ground, water, or air pollutants		✔	Some
· poor road conditions with potholes, or poor drainage		✔	Some
· adequate traffic lights, signs, sidewalks, and curbs		✔	Few
· railroad crossings fitted with warnings and barriers		✔	Many
· streets and parking lots well lit		✔	Few
· handicapped access to buildings, sidewalks, and streets		✔	Few
· recreational facilities, playgrounds, and/or facilities like the YMCA		✔	Some
· children playing in the streets, alleys, yards, or parks		✔	Many
· evidence of nuisances such as ants, flies, mosquitoes, or rodents, or stray animals observed		✔	Some

Problem

Identify a nursing problem based on your data and observations. The problem must be related to air quality. Example: Childhood asthma

Problem Identification: COPD

Vulnerable Population

Identify the vulnerable population that is most impacted by this problem. Example: Children

Vulnerable Population Identification: The elderly.

I discovered that some nursing homes in the community are located in in highly industrialized areas. This positioning places the elderly an increased risk of COPD, considering the industrial emissions and air pollution.

Diagnosis

Write a nursing diagnosis based on your problem from above. Fill in the blanks below.

Example: Increased risk of asthma among children related to local air pollution demonstrated in county childhood asthma rates.

*See chapter 6 in the Nies and McEwen (2019) textbook for more examples of composing a community health nursing diagnosis.

Nursing Diagnosis: Increased risk of COPD among the elderly related to poor air quality demonstrated in county COPD rates.

References

American Lung Association. (2020). Estimated prevalence and incidence of lung disease. https://www.lung.org/research/trends-in-lung-disease/prevalence-incidence-lung-disease

County Health Rankings and Roadmaps. (2018). Explore rankings. http://www.countyhealthrankings.org/

U.S. Census Bureau. (2021). State and county QuickFacts. https://www.census.gov/quickfacts/