Nursing Process – Plan, Implement, and Evaluate, and Funding

Nursing Process – Plan, Implement, and Evaluate, and Funding

Community Assessment

The selected community is geographically located in Wellsburg town in North Central Ohio, with a population of 75000. The community includes a village made up of 350 two-bedroom house apartments. Significantly high numbers of single parents and victims of teenage pregnancy were noted. The community comprises 63% Caucasian, 26% African-American, and 11% Latino. The community is faced with socioeconomic challenges where many families live below the poverty line, resulting in high dependence on assistance from the Department of Jobs and Family Services. In addition to the socioeconomic challenges, the residents are faced with other social challenges such as teenage pregnancy, high levels of family break-ups evidenced by single parenting, and high levels of illiteracy. The notable health issues revolve around reproductive health and substance abuse. The health issues include reduced prenatal care, high prevalence of childhood obesity, increased complications from the chronic illnesses attributed to poor nutrition and lack of physical activity as well as poor management of chronic disease and limited healthcare access. There are reduced childhood immunization rates and increased incidence of alcohol and drug abuse among teens and adults.

The Funding Streams

            A web search on the funding streams has revealed sources of funding stemming from federal grants, state funds, local taxes, service fees, and private donations (Rechel, 2018).

Public health offers essential and critical health services to the members of the public, which has a significant positive influence on the entire healthcare system. Inconsistency in the provision of these services to the public compromises the health and well-being of the entire population through a negative impact on all aspects of community health. To begin with, the impact on chronic disease management where inconsistent public health services led to irregular treatment and monitoring, which potentiates the risk for complications and increased hospitalization, as well as poor health outcomes due to poor follow-up. Secondly, inconsistency in public health affects preventive care such as early screening and vaccination, hence increasing the risk for outbreaks and late-stage diagnoses, leading to increased morbidity and mortality. Thirdly, the inconsistency in public health services impacts maternal and child health,h which increases the risk of childbearing complications and jeopardizes child health. Fourthly, the inconsistency in public health services leads to reduced mental health services and support to the mentally ill among society, hence reducing the quality of life led by these members of the community. The fifth impact of inconsistent public health services is increased health disparity, es where residents in the village may be unable to access the health care services that are mainly provided to them by the public health therefore having health inequalities. Also, the interruption of health services may reduce the confidence levels of the members of the public regarding the healthcare systems and consequently may opt to decline seeking medical interventions. The sixth impact of inconsistent public health services is delayed identification of health issues and inadequate data collection by the public health, and this increases the risk of outbreaks and poor planning secondary to insufficient data. Lastly, inconsistent public health services result in reduced health education and low participation in health programs, which leads to non-informed decisions and ineffectiveness of health interventions (Althouse et al., 2020).

SMART Goal

The term SMART means that the set goal is S-scientific, M-measurable, A-achievable, R-relevant, and T-time-bound (SAMHSA, 2019).

Goal: My set goal from the case study provided is to increase the percentage of youths participating in programs to prevent alcoholism and substance abuse from the current 20% to 50% by 31st December 2024.

Nursing diagnosis: Poor community coping related to inadequate prevention strategies against alcoholism and substance abuse as evidenced by high incidences of drug and alcohol abuse among teens and young adults, truancy among teenagers, and inadequate support system reported by the community.

Nursing process

Assessment

The community has many public health issues, including increased drug abuse and alcoholism among teens and adults.

Diagnosis

Poor community coping related to inadequate prevention strategies against alcoholism and substance abuse is evidenced by high incidences of drug and alcohol abuse among teens and young adults, truancy among teenagers, and an inadequate support system reported by the community.

Outcome Objective

Reduce the incidence of drug abuse and alcoholism among teens and youths by 25% by 31st December 2024.

Population-Focused Intervention

Implementation of Education Programs

Action: design substance abuse education sessions at the community center led by trained healthcare professionals and peer educators weekly.

Rationale: Education programs increase awareness of the risks associated with drug abuse, inform about the prevention strategies, and elucidate the available resources.

Create a Peer Support Network

Action: Mobilize a team comprised of teens and mentors who have overcome the menace of drugs and alcoholism to provide regular support on counseling, meetings, and activities to promote a healthy lifestyle.

Rationale: Peer support provides emotional support, and creates relatable role models and a supportive community, hence reducing stigma and encouraging positive behavior changes among teens and adults.

Evaluation

This will be done by 31^st December 2024 through community surveys, health department records, and alcohol reports. A reduction of 25% will mark the achievement of the set objective.  In addition, the attendance records will assess the engagement with the program.

References

Althouse, B. M., Wallace, B., Case, B., Scarpino, S. V., Allard, A., Berdahl, A., White, E. R., & Laurent Hébert-Dufresne. (2020). The unintended consequences of inconsistent pandemic control policies. https://doi.org/10.1101/2020.08.21.20179473

Rechel, B. (2018). Financing of public health services. Www.ncbi.nlm.nih.gov; European Observatory on Health Systems and Policies. https://www.ncbi.nlm.nih.gov/books/NBK535726/#:~:text=Reported%20sources%20of%20public%20finance

SAMHSA. (2019). Setting goals and developing Specific, Measurable, Achievable, Relevant, and Time-bound objectives. In SAMHSA. https://www.samhsa.gov/sites/default/files/nc-smart-goals-fact-sheet.pdf

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One of the biggest challenges faced in population health is the funding; where it comes from, how you get an increase in it, and its use. Many people believe that all the money that runs the public health departments comes from the government. They would be surprised to find out how creative the public health departments are in raising money for their communities. Many public health nurses have learned the skill of writing grant proposals to secure the funds needed to keep their communities/departments operating. In this workshop, you will evaluate your community in terms of funding. You will research your local public health department for the money allocated to your community from numerous places, including the federal government, community taxes, personal donations, and grants, to name a few. You will report back with this amount.

Plan, Implement, and Evaluate, and Funding

The nursing process is a foundational element in professional practice. As a practicing professional, you may have used the nursing process to assess, diagnose, plan, implement, and evaluate care for individual clients in various settings. In Workshops One through Four, you learned about the assessment and nursing diagnosis of an aggregate as a recipient of care. This community assessment is an ongoing effort that will culminate in the development of a strategic plan to address a weakness in your community that affects your at-risk population. This weakness will be addressed by ONE of your community diagnoses. This strategic plan will be submitted in Workshop Seven.

Upon successful completion of the course material, you will be able to:

Apply the nursing process to an at-risk recipient of care within the community context.
Discuss the impact of funding streams and emerging healthcare reform on population-focused health practice.

Resources
Textbook: Public Health Nursing: Population-centered Health Care in the Community
OCLS PDF: Chapter 11 in Community as Partner: Theory and Practice in Nursing.
E-book: Nursing Diagnosis Handbook
Website: Public Health Leading Indicators(new tab)
Website: Public Health in the Age of Healthcare Reform
Optional Resources

Article: Public Health in the Age of Healthcare Reform
Background Information
Case Study: The Village

You have been tasked with writing a Strategic Plan to support a population-focused initiative for the community described below. The foundation awarding funds has a strategic plan available for up to $5000 earmarked specifically for a population-focused health promotional project. Based on your analysis of the situation, you are to develop a population-focused program plan and proposal for funding using the instructions that follow:

You are a public health nurse practicing in Wellsburg, a town of 75,000 in North Central Ohio. The health department where you work provides services at a satellite clinic located in the community center at The Village, located in the downtown area. You are visiting the housing development to assess the health status of this community and to get an idea of the health needs of its residents.

The Village is a public housing development consisting of 350 two-bedroom townhouse apartments. Due to its downtown location, several busy streets border the neighborhood. The units are small and situated closely together, but appear to be in good repair. Near the apartments is a small playground area; however, there are no significant grassy areas in the development. There are five central dumpsters, and you notice that they are overflowing with trash and abandoned debris. The Village has a small community center and commons area, where items of interest can be posted on bulletin boards. Residents’ mailboxes are located here, as well as a bus stop for the public transportation system. There is an elementary school five blocks from The Village, however, any shopping or grocery stores (other than corner convenience stores) are located three miles away. The community hospital and most physicians’ offices are ten miles away, on the other side of town. This fall, the Head Start Program will be offering services at the community center for qualifying children ages 3 – 5.

For your first visit to The Village, you meet with the director from the public housing authority. He shares with you that The Village has a large number of single parents and pregnant teens. He also tells you that most families who qualify to live in the development fall significantly below the poverty line and receive assistance from the Department of Jobs and Family Services. Many of the residents have no high school diploma, and there is increasing truancy among the teenagers. Those residents who are fortunate enough to be employed work at very low-paying jobs, and there are a fair number of disabled and elderly residents living on a fixed income.

A recent study conducted by the local university, health department, and hospital found that the ethnic composition of The Village is 63% Caucasian, 26% African-American, and 11% Latino. Approximately 12% of all births are premature, and only 28% of pregnant women receive early prenatal care in the first trimester. There is a growing problem with childhood obesity, and the rate of childhood immunizations is much lower than the state average. Recent concerns also include increased incidence of alcohol and drug use among both teens and adults.

Upon driving through the neighborhood, you notice several young women visiting while they watch their small children at the playground. You also notice a fair number of elderly residents sitting out on their porches, and some visiting together in the commons area near the community center.