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 collection 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 an overview and due dates for each topic.
Carefully review the instructions, tutorials, templates, and rubrics for each of the four parts as you begin this Direct Care 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)
Substance Use 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 for suggestions and best practices. For full credit, all information in a category must be completed. This 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 | |
| Population | |
| Nature of this community (rural, suburban, urban) | |
| Describe your community in 2-3 sentences |
- Community Demographics
- Go to https://www.census.gov/quickfacts/fact/table/US/PST045218
- The US data should automatically populate
- Input your zip code or county/township name
- Go to https://www.census.gov/quickfacts/fact/table/US/PST045218
- 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 | |||
| Male (subtract female % from 100) | |||
| Female | |||
| Persons under 5 | |||
| Persons over 65 | |||
| Race and origin data | |||
| County Data | State Data | U.S. Data | |
| White alone | |||
| Black or African Americans alone | |||
| American Indian and Alaska Natives alone | |||
| Asian alone | |||
| Native Hawaiian and Other Pacific Islanders alone | |||
| Two or more races | |||
| Hispanic or Latino | |||
| White alone, not Hispanic or Latino | |||
| Significant population characteristics | |||
| County Data | State Data | U.S. Data | |
| Veterans | |||
| Foreign born persons | |||
| Housing overview | |||
| County Data | State Data | U.S. Data | |
| Housing units | |||
| Owner-occupied housing unit rate | |||
| Median selected monthly owner costs with a mortgage | |||
| Median selected monthly owner costs without a mortgage | |||
| The median value of owner-occupied housing units | |||
| Median gross rent | |||
| Family and living arrangements | |||
| County Data | State Data | U.S. Data | |
| Households | |||
| Persons per household | |||
| Living in the same house 1 year ago | |||
| Language other than English spoken at home | |||
| Computer and Internet Use | |||
| County Data | State Data | U.S. Data | |
| Households with a computer | |||
| Households with a broadband internet subscription | |||
| Education | |||
| County Data | State Data | U.S. Data | |
| High school graduate or higher | |||
| Bachelor’s degree or higher | |||
| Health | |||
| County Data | State Data | U.S. Data | |
| With a disability under the age of 65 years | |||
| Persons without health insurance under the age of 65 years | |||
| Economy | |||
| County Data | State Data | U.S. Data | |
| Civilian labor workforce ages 16+ | |||
| Transportation-mean travel time to work (minutes) | |||
| Income and poverty | |||
| County Data | State Data | U.S. Data | |
| Median household income | |||
| Persons in poverty | |||
- Community Epidemiological Data
- Go to: https://www.countyhealthrankings.org/
- Click on your state
- Start with Overall Rankings in Health Outcomes
- Then choose your county
**you will need to use the “+” to see all of the data**
| County Data | State Data | |
| Health Outcomes Percentile | N/A | |
| Health Factors Percentile | N/A | |
| Premature death | ||
| Low birth weight | ||
| Adult smoking | ||
| Adult obesity | ||
| Physical inactivity | ||
| Excessive drinking | ||
| Alcohol-impaired deaths | ||
| STIs | ||
| Teen births | ||
| Drug overdose deaths | ||
| Uninsured | ||
| Unemployment | ||
| Children in poverty | ||
| Violent crime | ||
| Air pollution | ||
| Drinker water violations | ||
| Long commutes |
- Substance Use
- Go to: https://www.samhsa.gov/data/report/behavioral-health-barometer-state-barometers-volume-6?page=0
- Find your state and download the report.
- Review the report and document the following:
- Go to the Substance Use, Misuse, and Use disorders section. This will be the area that discusses those 12 and older (near end of the report).
- Go to: https://www.samhsa.gov/data/report/behavioral-health-barometer-state-barometers-volume-6?page=0
- Find the following percentages:
| State Average | Regional Average | National Average | |
| Tobacco use | |||
| Marijuana | |||
| Marijuana use disorder | |||
| Heroin use | |||
| Misuse of prescription pain reliever | |||
| Opioid use disorder | |||
| Illicit drug use disorder | |||
| Alcohol use disorder | |||
| Substance use disorder |
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 on weekends vs. weekdays.
| Look at the people in your community.
Did you observe: |
No | Yes | If Yes, provide a number of states “many” “some” or “few” |
| · *pregnant women | |||
| · *pregnant adolescents | |||
| · *infants (under the age of 1 year old) | |||
| · *young children (1-5 years old) | |||
| · *school-age children (6-18 years old) | |||
| · adults (18 – 60 years old) | |||
| · *older adults (over the age of 60 years old) | |||
| · people exercising | |||
| · people driving | |||
| · people walking | |||
| · people biking | |||
| · people congregating in groups on the street | |||
| · *people that had hygiene issues or were unkempt | |||
| · people that were appropriately dressed | |||
| · people that were physically fit | |||
| · people that were obese | |||
| · *people that were undernourished, thin | |||
| · people that appear healthy | |||
| · *people that have obvious physical disabilities, such as those using walkers or wheelchairs | |||
| · *people with apparent mental/emotional disabilities | |||
| · *people who appeared homeless or unemployed |
*Represents vulnerable populations
| Social and Economic Conditions
Did you observe: |
No | Yes | If Yes, provide a number of state “many” “some” or “few” |
| · housing that was run down or dilapidated | |||
| · areas undergoing renewal | |||
| · public housing | |||
| · public transit (subway, train, buses, taxis, etc) | |||
| · transportation to health care resources | |||
| · landfills | |||
| · restaurants | |||
| · any political signs | |||
| · any evidence of health education on billboards, advertisements, or signs | |||
| · any efforts to improve the neighborhood’s health such as advertisements for health-related events, health fares, clinics, or lectures | |||
| · any group efforts in the neighborhood to improve the living conditions or the neighborhood | |||
| · churches, synagogues, and other places of worship |
| Health Resources
Did you observe: |
No | Yes | If Yes, provide a number of states “many” “some” or “few” |
| · hospitals | |||
| · community clinics | |||
| · family planning clinics | |||
| · generalist doctors | |||
| · dentist offices | |||
| · pharmacies | |||
| · urgent care clinics | |||
| · skilled nursing facilities | |||
| · mental health or counseling clinics | |||
| · homeless or abuse shelters | |||
| · public health department office | |||
| · substance abuse treatment center | |||
| · alternative medicine practices, botanicals, or herbal medicine shops |
|
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?
|
| Environmental Conditions
Did you observe: |
No | Yes | If Yes, provide a number of states “many” “some” or “few” |
| · evidence of anything that might make you suspicious of ground, water, or air pollutants | |||
| · poor road conditions with potholes, or poor drainage | |||
| · adequate traffic lights, signs, sidewalks, and curbs | |||
| · railroad crossings fitted with warnings and barriers | |||
| · streets and parking lots well lit | |||
| · handicapped access to buildings, sidewalks, and streets | |||
| · recreational facilities, playgrounds, and/or facilities like the YMCA | |||
| · children playing in the streets, alleys, yards, or parks | |||
| · evidence of nuisances such as ants, flies, mosquitoes, rodents, or stray animals observed |
Problem
Identify a nursing problem based on your data and observations. The problem must be related to substance use. Example: Alcohol use
Problem Identification: _________________
Vulnerable Population
Identify the vulnerable population that is most impacted by this problem. Example: Adolescents
Vulnerable Population Identification: _________________
Diagnosis
Write a nursing diagnosis based on your problem from above. Fill in the blanks below.
Example: Increased risk for alcohol use among adolescents related to lack of sufficient knowledge about the long and short-term impacts demonstrated in increased county data compared to state/national averages.
*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____________(problem from above) among ____________ (vulnerable population from above) related to ___________(etiological statement) as demonstrated in _______(health indicators/community data from above)
If you need a similar but plagiarism-free “assessment and diagnosis”, then feel free to contact us!