Community Assessment Lecture 2 2023 PDF

Community Assessment  Community Assessment The major goal of the community health practice is to apply methods and solutions to health problems making sure that most people receive the maximum benefit. Another central goal of community health practitioners is primary prevention, wh...

Community Assessment  Community Assessment The major goal of the community health practice is to apply methods and solutions to health problems making sure that most people receive the maximum benefit. Another central goal of community health practitioners is primary prevention, which protects the public’s health and prevents disease development, with intentions to reduce the pain, suffering, and huge expenditures that occur when major divisions of the population become diseased and require resources to resolve their health problems.  Community Assessment The community is not only the context or place where community health nursing occurs, but also the focus of community health nursing care. The community itself (not individuals) is the unit of service. A community is a complex social system, and its interacting members constitute various subsystems within the community. These subsystems are interrelated and interdependent  Community as Partner Anderson and McFarlane (1996) used the term “Community as Partner” instead of “community as client”. To demonstrate equality in the nursing relationship with the community. Community as Partner was based on the total-person approach (Neuman, 1972). Two major components compose the Community as Partner Community assessment wheel. Nursing process.  Community Assessment Wheel Two major components – The core The community residents who are described by demographics, values, beliefs and history – Eight surrounding subsystems. Physical environment Education Safety and transportation. Politics and government. Health and social services. Communication. Economics and recreation. Community residents are affected by and influence the eight community subsystems.  Community Assessment Wheel Surrounding the community is its normal line of defense (level of health obtained by the community) represented by the solid line. The broken line represents the flexible line of defense “a buffer zone”. Representing the dynamic level of health resulting from temporary response to stressors. Broken lines between the eight subsystems indicate that they both influence and are influenced by each other. Lines of resistance (strengths) or internal mechanisms within the community represented by circular broken lines, which defend against stressors  Community Assessment Wheel Stressors are tension-producing stimuli that may potentially produce disequilibrium in the system. Stressors (either from within or from outside of the community) penetrate the flexible and normal lines of defense causing disruption of the community. The amount of disruption or disequilibrium is known as “the degree of reaction” (Anderson & McFarlane, 2015).  Community Assessment A community health nurse must define a community and describe its characteristics before applying the nursing process. Comprehensive assessment data are essential to directing effective primary prevention interventions within a community. The nurse establishes partnership with community members to identify community problems and develop solutions to ultimately improve the community’s health.  Community Assessment A process by which community members gain an understanding of the health, concerns, and health care systems of the community by identifying, collecting, analyzing, disseminating information on community assets, strengths, resources, and needs. Objectives of Community Assessment Identify and set priorities based on the community need. Make decisions about how to improve the community based on needs and available resources Identify organizations or agencies that may help meet the needs or provide resources Understand the determinants of a health issue. Help decide how to best address a health issue. Provide a systematic basis for which decisions are made. Create an awareness of a community concern or problem.  Steps of community assessment 1. Data collection and interpretation Data gathering Obtaining existing, readily available data. Surveys. Census data Vital statistics. Data generation The process of developing data that do not already exist through interaction with community members or groups. Windshield surveys Participant observation Informant interviews Secondary analysis Composite data  Steps of community assessment 2. Problem analysis Seeks to clarify the nature of the problem Community oriented nursing diagnosis 3. Planning for community health a. Prioritizing needs, Priorities may be refined by applying a theoretical background such as Maslow’s Hierarchy of Needs, where lower-level needs have priority over higher-level needs. taking into consideration The aggregate’s preferences Number of individuals in the aggregate affected by the health problem Severity of the health need or problem Availability of potential solutions to the problem Practical considerations such as individual skills, time limitations, and available resources.  Steps of community assessment b. Establishing goals and objectives c. Identifying intervention activities 4. Implementing activities 5. Evaluating community intervention  Needs assessment Based on information about the prevalence and causes of health problems, the community health nurse can apply the nursing process, expanding assessment, diagnosis, planning, intervention, and evaluation from the individual client level to a targeted aggregate in the community. The nurse should determine which problems or needs require intervention in conjunction with the aggregate’s perception of its health problems and needs and on the basis of the outcomes of prioritization. Then the nurse must identify the desired outcome or ultimate goal of the intervention.  Community assessment Sources of data: Windshield survey; driving or walking. Direct observation Interviews (Key informants) Analysis of demographic information and statistical data. Surveys. Census data Vital statistics. Local and regional reports  Community assessment Data collection from aggregates may be more insightful and accurate than official data. Most official data do not contain information about community’s perspectives on health status, needs, the services used or required and concerns.  Community Needs Assessment A community needs assessment identifies the strengths and resources available in the community to meet the needs of the community. The assessment focuses on the capabilities of the community, including its citizens, agencies, and organizations. It provides a framework for developing and identifying services and solutions and building communities that support and nurture children and families.  Steps in Needs Assessment Process Identify aggregate for assessment. Identify required information. Select method of data gathering. Develop questionnaires or interview questions. Develop procedures for data collection. Train data collectors. Arrange for a sample representative of the aggregate. Conduct needs assessment. Tabulate and analyze data. Identify needs suggested by data. Develop an action plan.  Needs assessment Key community informants (knowledgeable residents, elected officials, Health care providers). Focus groups. Community forum. surveys.  Diagnosing health problems. Community diagnosis: Identification of the health problem or risk. (increased risk of_______) The affected aggregate or community (among____). The etiological or causal statement (related to_____). The evidence or support for the diagnosis (as demonstrated in_________).  Community Needs Community needs can be categorized as Perceived needs: Things that members of the public think they need, and may vary greatly from person to person. Expressed needs: These are the things that have been voiced, whether it be to a public official, on a Facebook group or at a community meeting. While they may not be universal, they are real needs. Absolute needs: The basics such as clean running water, power, food, safety. If any of these are lacking, they should be an absolute priority. Relative needs: These are the things that contribute to a more equitable society. It might be providing laptops for families without one, breakfast at schools for children who don’t eat at h home. General overview  Community map – Draw a map for your community.