NR 443 Week 2 Direct Care Project Part 1
Student Name
Chamberlain University
NR-443 RN Community Health Nursing
Prof. Name
Date
Direct Care Project Part 1
Substance Use Assessment and Diagnosis Template
Directions
This project involves collecting both online data and information gathered through a modified windshield survey. The goal is to identify a nursing problem affecting a vulnerable population, develop a corresponding nursing diagnosis, and set the foundation for the subsequent stages of the course project. Two primary data collection methods are used: (1) gathering secondary data from official online resources, and (2) observational assessment of the community environment and population characteristics.
Online Data Collection
1. Community Information
Your Community Data
The community selected for this assessment is Miami City, located in Miami-Dade County, Florida. Miami is a major urban hub, serving as the economic, cultural, and financial center of the state. It is well-known for its diverse population, thriving tourism industry, and significant international influence. However, recent community health reports indicate increasing mental health challenges among adolescents, particularly linked to alcohol abuse and other forms of substance use.
| Attribute | Data |
|---|---|
| Name of city or town | Miami City |
| Population | 2,761,581 |
| Nature of community | Urban |
| Description | Miami is the economic and cultural epicenter of Florida, housing diverse communities and serving as a central hub for trade, tourism, and international relations. However, substance use and related mental health issues, particularly among youth, have emerged as pressing health concerns. |
2. Community Demographics
The demographic data for Miami-Dade County was obtained from the U.S. Census Bureau. This data provides a snapshot of population size, distribution by age and gender, racial and ethnic composition, education levels, housing, and economic conditions.
| Demographic Indicator | County Data | State Data | U.S. Data |
|---|---|---|---|
| Population total | 2,761,581 | 21,299,325 | 328,239,523 |
| Male (%) | 48.5% | 48.9% | 49.2% |
| Female (%) | 51.5% | 51.1% | 50.8% |
| Persons under 5 years | 5.8% | N/A | 6.1% |
| Persons over 65 years | 16.2% | 20.5% | — |
| White alone, not Hispanic or Latino | 10.7% | 60.4% | — |
| Hispanic/Latino | 72.5% | 18.3% | — |
| Veterans | 7,032 | — | — |
| Foreign-born persons (%) | 58.2% | 13.5% | — |
| Owner-occupied housing rate | 29.8% | 63.8% | — |
| Median value of owner-occupied housing | $292,900 | $204,900 | — |
| Median household income | $36,638 | $60,293 | — |
| Persons in poverty (%) | 24.3% | 11.8% | — |
Notable Observations:
- Miami-Dade has a significantly higher proportion of foreign-born residents compared to the state and national averages, indicating a highly diverse, immigrant-rich community.
- The median household income is substantially lower than both the state and national figures, suggesting economic disparities that could influence health access and outcomes.
- The homeownership rate is considerably low, reflecting a high prevalence of rental housing, potentially linked to the transient nature of some populations.
3. Community Epidemiological Data
The County Health Rankings resource was used to evaluate Miami-Dade County’s health indicators compared with statewide data.
| Health Indicator | County Data | State Data |
|---|---|---|
| Premature death (per 100,000) | 5,300 | 7,300 |
| Low birth weight (%) | 9% | 9% |
| Adult smoking (%) | 16% | 16% |
| Adult obesity (%) | 22% | 27% |
| Excessive drinking (%) | 16% | 17% |
| Alcohol-impaired driving deaths (%) | 12% | 23% |
| Drug overdose deaths (%) | 16% | 17% |
| Uninsured (%) | 20% | 6% |
| Children in poverty (%) | 23% | 20% |
| Violent crime rate (per 100,000) | 602 | 484 |
Key Insights:
- Miami-Dade fares better than the state average in premature death rates but experiences notably higher rates of uninsured residents.
- The violent crime rate in Miami-Dade is significantly higher than the state average, which may contribute to stress and substance use patterns in vulnerable groups.
- Alcohol-impaired driving deaths are lower than the state average, but drug overdose rates remain high.
4. Substance Use Data
Data from the Behavioral Health Barometer (SAMHSA) report offers a detailed perspective on substance use patterns in Florida compared to national averages.
| Substance Use Measure | State Average | National Average |
|---|---|---|
| Tobacco use | 37.5% | 42.6% |
| Marijuana use | 34.3% | 33.0% |
| Marijuana use disorder | 4.9% | 5.1% |
| Heroin use | 0.28% | 0.33% |
| Misuse of prescription pain relievers | 4.2% | 4.3% |
| Opioid use disorder | 1.1% | 1.3% |
| Illicit drug use disorder | 7.1% | 7.2% |
| Alcohol use disorder | 9.9% | 11.0% |
| Substance use disorder | 14.4% | 15.1% |
Windshield Survey
The windshield survey was conducted across Miami City to visually assess the community’s population characteristics, environmental conditions, and available resources. Observations were made during different times of the day and on both weekdays and weekends to capture a comprehensive overview.
Population Observations
During the survey, a diverse age range and demographic mix were observed. While adults made up the majority of individuals in public spaces, there was a noticeable presence of children, adolescents, and older adults. The health status of individuals varied, with some appearing physically fit and others displaying signs of obesity or undernourishment.
| Observation | No | Yes | If Yes, Description |
|---|---|---|---|
| Pregnant women | ✓ | Some observed | |
| Pregnant adolescents | ✓ | Few observed | |
| Infants (<1 year) | ✓ | Some observed | |
| Young children (1–5 years) | ✓ | Some observed | |
| School-age children (6–18 years) | ✓ | Some observed | |
| Adults (18–60 years) | ✓ | Many observed | |
| Older adults (>60 years) | ✓ | Some observed | |
| People exercising | ✓ | Few observed | |
| People driving | ✓ | Many observed | |
| People walking | ✓ | Many observed | |
| People biking | ✓ | Some observed | |
| People appropriately dressed | ✓ | Many observed | |
| People obese | ✓ | Many observed | |
| People undernourished | ✓ | Few observed | |
| People with visible disabilities | ✓ | Few observed | |
| People with apparent mental/emotional disabilities | ✓ | Few observed | |
| People homeless or unemployed | ✓ | Few observed |
Social and Economic Conditions
The community showed a mix of well-maintained and lower-income areas. Public housing units were present in several neighborhoods, and renewal efforts were visible in certain districts. Access to public transportation was common, and local restaurants and community health advertisements were observed.
| Observation | No | Yes | If Yes, Description |
|---|---|---|---|
| Run-down housing | ✓ | — | |
| Areas under renewal | ✓ | Some observed | |
| Public housing | ✓ | Many observed | |
| Public transit | ✓ | Many observed | |
| Transportation to healthcare | ✓ | Some available | |
| Health education signs | ✓ | Many observed | |
| Community health improvement efforts | ✓ | Some observed | |
| Religious institutions | ✓ | Some observed |
Health Resources
Miami has a range of healthcare facilities, though distribution varies by neighborhood. While some areas have immediate access to hospitals, urgent care, and pharmacies, others require traveling several miles for specialized care such as mental health clinics or substance abuse treatment centers.
| Resource | No | Yes | If Yes, Description |
|---|---|---|---|
| Hospitals | ✓ | Some present | |
| Community clinics | ✓ | Many present | |
| Family planning clinics | ✓ | Some present | |
| Generalist doctors | ✓ | Some present | |
| Dentist offices | ✓ | Some present | |
| Pharmacies | ✓ | Some present | |
| Urgent care clinics | ✓ | Some present | |
| Skilled nursing facilities | ✓ | Many present | |
| Mental health/counseling clinics | ✓ | Few present | |
| Homeless or abuse shelters | ✓ | Few present | |
| Substance abuse treatment centers | ✓ | Few present |
Environmental Conditions
The physical environment in Miami varied by district, with some areas well-kept and others facing environmental concerns such as visible air pollution sources. Most public spaces had proper lighting, sidewalks, and traffic signals.
NR 443 Week 2 Direct Care Project Part 1
| Observation | No | Yes | If Yes, Description |
|---|---|---|---|
| Potential ground/water/air pollutants | ✓ | Some observed | |
| Adequate traffic signs/lights/sidewalks | ✓ | Many present | |
| Railroad crossing safety features | ✓ | Some present | |
| Recreational facilities/playgrounds | ✓ | Some present | |
| Children playing outdoors | ✓ | Many observed |
Problem Identification
Identified Nursing Problem:
Based on the collected data, alcohol use among adolescents emerged as a significant public health concern. This is supported by the observed presence of vulnerable youth populations, local substance use statistics, and epidemiological trends indicating increased rates of mental health challenges related to alcohol misuse.
Vulnerable Population Identification
Primary Vulnerable Group:
Adolescents (ages 13–18) are the most affected population segment, given their increased exposure to risk factors such as peer pressure, limited access to mental health education, and higher rates of reported alcohol experimentation compared to other groups.
Nursing Diagnosis
Diagnosis Statement:
Increased risk of mental health disorders among adolescents related to alcohol consumption, as evidenced by community-level data indicating elevated depression and suicidal ideation rates associated with substance use.
References
Substance Abuse and Mental Health Services Administration. (2019). Behavioral health barometer, volume 5. https://store.samhsa.gov/product/Behavioral-Health-Barometer-Volume-5/sma19-Baro-17-US
County Health Rankings and Roadmaps. (2018). Explore rankings. http://www.countyhealthrankings.org/
NR 443 Week 2 Direct Care Project Part 1
U.S. Census Bureau. (2018). State and county QuickFacts. https://www.census.gov/quickfacts