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clugger
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5 methods to investigate people, location, social system ...of a commuinity
- 1. Windshield survey
- 2. Informant interviews
- 3. Participant observations
- 4. Analysis of existing data
- 5. Constructed surveys
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What are the components of community assessment?/
- People,
- place
- Social systems
- social determinants of health
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Who should be asked if you do an informant interview?
- Key informants: residents in position of power or influence in the community,
- Community residents who are members of the general public: random phone calls, person on street interview,
- Typically unstructured to collect general
- information
- May be used by nurses in acute care by asking family members, client,...
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Participant observation
- Observing of formal and informal community activities-> determine significant events and occurrences-> conclusion about what is happening, values, norms, priorities, how are decisions made, who has power...
- Formal gatherings: city council, school board,...
- E.g. nurse observes patient interacting with family members (values, behavior), context of family and community
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Existing data
- Records, documents, vital statistics (birthrates, death rates by age, gender, morbidity...), census data, reportable diseases
- Can be used to asses people, place or social systems
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Constructed surveys
- To get info about communities-> time consuming and expensive-> data analyzed for patterns and trends
- Tool for nurse with graduate degree working in community based setting (any nurse can still do a simple survey)
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Population based community care
- Occurs through partnership among constituents
- Relationship character should be full of trust, respect, genuineness, commitment and build upon assets and strengths,
- Important: ongoing dialogue within the reciprocal relationship
- Starting the community assessment can also be based upon recommendations from Robert Wood Johnson Foundation Commission to build a healthier America (or like just learned by observing people, place, social system)
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Robert Wood Johnson Foundation Commission for a healthier America
- 1 Ensure all children have high-quality early development
- 2 Food stamps for hungry families
- 3 create public-private partnerships to open full service grocery stores in communities without access to healthy food
- 4 only healthy food in schools
- 5 school should include time for physical activity each day
- 6 Become smoke free nation
- 7 create healthy community demonstrations, plan, implement and show effect of project
- 8 health impact rating for housing and infrastructure projects + incentives
- 9 integrate safety and wellness into every aspect of community life
- 10 ensure decision makers of all sectors have evidence to build health into public and private policies
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Common nursing diagnosis for community care
- ineffective community coping
- Readiness for enhanced community coping
- Community contamination/ risk for it
- Ineffective community self health management. It is important to document the data that support the problem + processes used for identification (in real world might be stated as a problem statement)
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Planning/goals and outcomes
- Planning follows the nursing diagnosis for the community
- Robert Wood Johnson ... can be used also for "smaller" communities
- Prioritizing needs-> goals->determine action plan
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Nursing interventions in population based care
(6)
- 1 community organizing
- 2 collaboration
- 3 Advocacy
- 4 Social marketing
- 5 Policy development and enforcement
- 6 Coalition building
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Some questions regarding evaluation of population based community assessment
- Were all key stakeholders satisfied with program, why/why not
- What additional data do we need
- Did problem statement focus on most important problems
- What strengths were not used
- Was the diagnosis/statement, intervention and outcome realistic, why/why not
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Suggested steps to facilitate community building
- Map existing capacity + assets, focus on strengths-> that can be used for participation
- Build and strengthen existing partnership for problem solving
- Mobilize community's assets for information sharing and economic development
- convene a broad representative group to craft vision and plan
- Leverage activities, investments, resources from outside the community to support local development
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Public policy
How can a nurse influence
- Calling or sending letter to city
- Testifying at a public hearing
- Public education + public marketing + advocacy -> influence public opinion
- Nurse's responsibility = stay current on health care issues and share that expertise with community members
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What is holistic assessment directed to ?
- Individual clients across the life span, families, communities
- Physical, psychosocial, cultural, functional, nutritional, environmental, spiritual aspects are considered
- Community assessment helps to discover existing problems
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