NR 442 Case Study 04-Community Assessment Part 1
Student Name
Chamberlain University
NR-442 Community Health Nursing
Prof. Name
Date
Community Assessment Part 1
Case Study Synopsis
In this scenario, a public health nurse is tasked with conducting a comprehensive community assessment to support the development of an updated six-year strategic plan for future growth and development in a nearby community. This process presents a valuable opportunity to evaluate the strengths and weaknesses of the area, identify public health concerns, and provide evidence-based recommendations to improve the overall health and wellness of the population.
Concepts Covered
- Health promotion
- Health policy
Public Health Nursing Interventions Addressed
- Disease and health event investigation
- Consultation
- Policy development and enforcement
Suggested Readings
- Edelman, C. L., & Kudzma, E. C. Health Promotion Throughout the Life Span (Chapter 8: Health Promotion and the Community)
- Nies, M. A., & McEwen, M. Community/Public Health Nursing (Chapter 6: Community Assessment)
- Stanhope, M., & Lancaster, J. Foundations for Population Health in Community/Public Health Nursing (Chapter 12: Community Assessment and Evaluation)
- Stanhope, M., & Lancaster, J. Public Health Nursing (Chapter 17: Community as Client: Assessment and Analysis)
Estimated Completion Time
| Task | Time Estimate |
|---|---|
| Case study only | 2 hours |
| Review questions | + 30 minutes |
| Discussion questions | + 1 hour |
| Total | 3.5 hours |
Case Study Objectives
- Identify appropriate data and information sources for understanding the community.
- Gather demographic, geographic, governmental, health care, cultural, and socioeconomic data.
- Conduct a preliminary analysis of windshield survey data to determine community strengths and weaknesses.
- Propose recommendations for a strategic plan based on the assessment findings.
Introduction
The city manager has approached the public health nurse to conduct a community assessment as part of the city council’s updated six-year strategic plan. Recognizing this as an opportunity to highlight community assets and areas for improvement, the nurse initiates the process with preliminary online research to gather baseline data on the population, infrastructure, resources, and public health indicators.
Community Profile
Population Demographics
| Category | Percentage/Value |
|---|---|
| Total population | 22,791 |
| Female | 52.2% |
| Male | 47.8% |
| Under 18 years | 34.8% |
| 19–64 years | 61.2% |
| Over 65 years | 4% |
| Caucasian | 56.8% |
| Black or African-American | 9% |
| Hispanic or Latino | 23.4% |
| Other races | 10.8% |
Location and Environment
The community boasts a livability score of 86, characterized by a low crime rate, affordable cost of living, and a temperate climate with warm summers and mild winters. The presence of local amenities enhances its appeal.
Primary Industries
| Manufacturing | Non-Manufacturing |
|---|---|
| Computer technology | Public education |
| Systems & hardware | Government services |
| Software | Health care |
| Farming & ranching |
Economic Overview
- Per capita income: $73,977
- Poverty rate: 7.4%
- Unemployment rate: 3.4%
- Home ownership rate: 65.1%
Education System
The education infrastructure includes one public high school, two middle schools, six elementary schools, and a Higher Education Center offering workforce readiness programs. There are five private universities, two public universities, and two public colleges. Educational attainment shows 59.6% of residents with a high school diploma and 41.4% with a college degree.
Recreation and Cultural Activities
Recreational options range from high school football and outdoor activities (hunting, fishing, hiking, biking) to community events like the Crawfish Festival and Old Tyme Festival. Public facilities include two community parks, a YMCA, and a Parks and Recreation Department.
Health Care Facilities
| Facility/Service | Availability |
|---|---|
| Head Start Program | Yes |
| Urgent Care (24/7) | Yes |
| Pediatric Clinic | Yes |
| Regional Primary Care Clinic | Yes |
| Rehabilitation & Skilled Nursing | Yes |
| EMS & Fire Department | Yes |
| Alzheimer’s/Respite Day Care | Yes |
Religious Institutions and Cemeteries
Baptist, Methodist, Lutheran, Catholic congregations, and Pilgrims’ Rest Cemetery serve the community.
Environmental Indicators
- Air Quality: 70/100
- Water Quality: 79/100
Transportation and Media
Public transportation includes a railroad terminal, taxi service, and bus service. Local media consists of a weekly newspaper, a radio station, and a public library.
Critical Thinking Questions and Answers
Describe the role of a community health nurse.
A community health nurse delivers preventive, promotive, and restorative care to entire populations, focusing on addressing social determinants of health, reducing health disparities, and promoting community-wide wellness.
What is the purpose of conducting a community health assessment?
The primary purpose is to systematically identify the health needs, strengths, and resources of the community, enabling data-driven interventions that enhance population health.
Windshield Survey Observations
During the windshield survey, the nurse notes agricultural landscapes, flat terrain, a river, and temperate weather. Observations include the use of crop dusters, which raises concerns about pesticide exposure and potential health risks to residents.
What questions will guide the public health nurse as he/she conducts the windshield survey?
Questions may include:
- What is the predominant racial/ethnic composition?
- Are residential properties well-maintained?
- Is there evidence of homelessness?
- Is public space clean or littered?
- Are parks and recreational facilities available?
- Is there proximity to railroad tracks or industrial zones?
Provisions under the Food Quality Protection Act… What considerations are important?
The nurse must consider potential short- and long-term health effects of pesticide exposure, such as respiratory problems, dermatologic reactions, neurological effects, and risks to vulnerable populations, especially children.
Town Center Observations
In the town center, the nurse documents locations of essential services, including the library, restaurants, churches, retail stores, and a health clinic. Attention is given to infrastructure, pedestrian safety, and environmental quality.
When conducting a community assessment, what characteristics should be considered?
Factors include demographic profiles, location and accessibility of services, environmental health indicators, socioeconomic conditions, and availability of health resources.
School Nurse Interview Findings
The school nurse reports high rates of breast cancer, farm-related accidents, and obesity in both children and adults. This prompts further investigation into potential environmental and behavioral causes.
What additional data may be collected?
The nurse could gather statistics on cholesterol levels, injury prevention measures for farm workers, and environmental factors linked to cancer prevalence.
Social Determinants of Health (SDOH)
A review of the Culture of Health and MeasureUp resources highlights factors such as education quality, economic stability, health care access, social support, and environmental safety.
When considering community factors, what determinants of health should be included?
Determinants include social and economic factors, availability and quality of health services, individual health behaviors, and genetic/biological influences.
NR 442 Case Study 04-Community Assessment Part 1
Emergency Access Concerns
Proximity to the railroad presents a barrier to timely EMS access. This is particularly concerning during school hours when train traffic can delay response times.
What implications must be considered for community members?
Emergency services must be equally accessible to all, requiring infrastructure solutions to bypass rail blockages and ensure timely response to life-threatening situations.
Recommendations for Improving Emergency Response
The nurse suggests reducing rail blockage times, installing crossing barriers and signals, and considering a secondary health facility on the opposite side of the tracks.
What level of practice defines consultation between the public health nurse and the city manager?
This is systems-focused practice, as it addresses infrastructure, policy, and community-wide service delivery.
Health Policy Considerations
Proposed policies include regulations to improve air and water quality, restrictions on prolonged rail blockages, and requirements for healthy food availability in public venues.
What health policy concerns will need to be considered?
Stakeholders must evaluate economic feasibility, political will, and community support when implementing policies related to environmental safety and public health promotion.
Wrap-Up and Benchmarks
The nurse concludes data collection, confirming stakeholder engagement and financial backing for proposed initiatives. Benchmarks for acceptable EMS access times will be determined by local and state guidelines, referencing research such as Cui et al. (2019).
What activities is a public health nurse likely to include in a community assessment?
Activities include systematic data collection, analysis of health indicators, identification of priority concerns, and formulation of an actionable plan for health improvement.
References
Cui, E. R., Beja-Glasser, A., Fernandez, A. R., Grover, J. M., Mann, N. C., & Patel, M. D. (2019). Emergency medical services time intervals for acute chest pain in the United States, 2015–2016. Prehospital Emergency Care, 24(4), 557–565. https://doi.org/10.1080/10903127.2019.1676346
Robert Wood Johnson Foundation. (n.d.). A culture of health. https://www.cultureofhealth.org/
Centers for Disease Control and Prevention. (2011). Vaccine-preventable diseases, immunizations, and MMWR. https://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a9.htm
NR 442 Case Study 04-Community Assessment Part 1
Asthma and Allergy Foundation of America. (n.d.). Asthma triggers and causes. http://www.aafa.org/page/asthma-triggers-causes.aspx
Juvenile Diabetes Research Foundation. (n.d.). What is type 1 diabetes?. http://www.jdrf.org/about/what-is-t1d/facts/