Introduction
The purpose of this essay was to develop a care plan for Kendall Lakes Windshield Community based on the public health issue of Chlamydia. A public health nurse approach has been selected for the care plan. Community health nursing focuses on care provided to patients outside healthcare facilities, but nurses must adopt creative strategies to deliver care. Strong clinical skills are required with thorough knowledge of the community receiving care. Nurses require self-reliance, adaptability, analysis, and critical thinking to cope with certain unique healthcare needs (Gerber, 2012). The community nurse must develop an effective relationship to handle notable cases of Chlamydia, which is the most prevalent communicable disease in the Windshield Community. The relationship must be a partnership and significantly differs from other approaches used in healthcare settings. Within the community setting, patients may have more control relative to hospital settings. For instance, Chlamydia is a sexually sensitive issue among the public, and therefore patients may not feel free to discuss their conditions and may opt to or not to follow medication schedules, healthy sexual practices, and other treatment regimens recommended (Rubin et al., 2011).
Community nurse, therefore, has the responsibility of assisting the public to internalize the relevance of healthy sexual behaviors by teaching and reviewing the care plan to meet the needs of specific individuals or an individual.
One advantage is that community health nursing provides more holistic care with a wide focus on clients. For instance, the care plan will target all members of the Windshield Community, including families, youth, individuals, and even seniors who are still sexually active. Thus, nurses must understand various attributes of a given community and adapt a care plan to work in such environments. A nonjudgmental strategy is recommended to enhance effective communication between nurses and their patients (Gerber, 2012).
For nurses who work in healthcare settings, they must also consider services outside such environments to focus on communicable disease management in communities (Gerber, 2012). This is public health nursing. While Windshield Community is large and experiences a wide range of communicable diseases, Chlamydia is the most appropriate for nurse intervention because it is the most reported in the community relative to others. Nevertheless, nurses can still screen for other conditions, manage family planning and evaluate for chronic conditions such as hepatitis, HIV/AIDS, hypertension, and obesity among others. Thus, management and control of communicable diseases are a priority for the nurse. Apart from providing care at the site, nurses may also visit patients at their homes, especially individuals identified to be at high risks for communicable diseases (Stanhope & Lancaster, 2008). Public health nurses can therefore address the challenge of widespread Chlamydia in the Windshield Community. They can offer mass education to all members of the community.
Community Assessment
During the community assessment, Chlamydia was identified as the most common communicable disease in Windshield Community. Community assessment requires the nurse to possess strong interviewing and listening skills. Nurses will have to collect relevant information about patients, as well as their cultural, physical, psychological, daily life events and environments (Gerber, 2012). The nurse must establish a rapport with members of the community because they will share sensitive information about their sexual activities, partners, and other data related to Chlamydia and communicable diseases like gonorrhea.
For communities who will visit the onsite care center, nurses will interview them. Clients will have to provide exhaustive information about their medical and sexual history, sexual intercourse, partners, frequency of urination, other STIs, medication status, menstruation, and sexual orientation among others. The nurse must listen and collect information about the sexual concerns of clients. Studies show that “clinicians must be able to make risk assessments on their patients who may have an asymptomatic disease” (Whelan, 1988, p. 877). In most cases, Chlamydia is not diagnosed and therefore infected individuals may continue to spread the disease to other sexual partners and their neonates (Whelan, 1988). In addition, physical examination is also necessary to reveal the effects of the disease. The nurse must encourage patients to bring their partners for assessment too. Further, nurses should encourage community members to test for other sexually transmitted diseases, especially community members who have tested positive for Chlamydia and gonorrhea.
A baseline study has determined that youth had a high burden related to STIs, but clinicians did not screen females consistently and rarely screen male youth (Rubin et al., 2011). Nurses therefore must focus on both male and female screening consistently.
Community Nursing Diagnoses
Nurses will focus on social challenges to understand communicable diseases in Windshield Community. For instance, a focus will shift to changes in community health nursing diagnosis to highlight sexual behaviors and patterns. Individuals with multiple sexual partners should learn from public education about the risks associated with such practices. In addition, nurses must explore knowledge deficits on sexual behaviors among community members to address cases of reported communicable diseases.
Further, the diagnosis must also evaluate pain associated with infection of Chlamydia and other STIs. Community members must also be diagnosed with anxiety related to fear of having Chlamydia and other unknown infections. Nurses should also assess situational self-esteem associated with guilt and shame of infections and infecting others with Chlamydia and potential STIs. Diagnoses must also address poor sexual habits and behaviors, specifically cases that lead to re-infection.
Planning/Interventions
Generally, a care plan for the community is normally wider in scope and more complex relative to plans for patients in healthcare facilities. As the numbers of involved nurses and community members increase, the care plan becomes expensive but leads to a stronger patient-nurse relationship.
Nurses must ensure that interventions for Chlamydia are flexible and are developed to meet the specific needs of community members and individuals. It must account for lifestyles, sexual behaviors, and social activities, as well as economic factors. The care plan must contain sexual health education, counseling, and referral services for community members who may require further nursing care (Stanhope & Lancaster, 2008).
The care plan must contain expected outcomes. For instance, outcomes after interventions may include reduced rates of infections and few reported cases while individuals may indicate increased self-esteem, quick reporting of new cases once symptoms have appeared, and shifts to safe sexual practices.
A care plan must be planned and implemented. Therefore, nurses will have to screen and teach patients about Chlamydia and other STIs. In addition, they must ensure that patients use correct dosage, observe medication time, and must insist on full dosage even if patients no longer feel symptoms of the disease. Further, any dietary recommendations must be observed, including restrictions. Therefore, nurses must emphasize the need for patients to adhere to medications, discuss their feelings and concerns regarding the diagnosis of Chlamydia. It is imperative to demonstrate that diagnosis should not impair the self-esteem and self-worth of community members. In addition, nurses must educate the community about engaging in safe sex, talking with other sexual partners, and teaching children about STIs.
Evaluation
The care plan evaluation is necessary to determine its effectiveness. For nurses who will serve a large population of Windshield Community, evaluation could be more difficult. In such cases, patient progress could be slow while several other variables are also involved. Evaluation is usually simple in a case where only a few patients are involved. In addition, community outcomes may not be readily apparent, and they could take several weeks, months, or years. Community nurses must therefore plan for a long-term evaluation care plan.
Constant follow-up visits are necessary to get patients’ status and medication adherence. It would help nurses to understand if patients have changed their behaviors and risky habits.
Nurses will utilize feedback obtained from the evaluation process to improve future community care plans for the same population.
A study conducted in California for Chlamydia care practices established that many primary care providers did not adhere to current clinical guidelines strictly (Guerry, et al., 2005). Therefore, nurses should use their feedback to improve care plan practices.
Conclusion
The purpose of this essay was to develop a care plan for Kendall Lakes Windshield Community based on the public health issue of Chlamydia. A public health nurse approach was adopted for the care plan. Chlamydia was selected because it was the most reported case in the community and it is known for asymptomatic tendencies.
The care plan will meet the specific needs of the community and address specific risk factors associated with Chlamydia and other STIs. All the required steps that incorporate assessment, diagnoses, planning/intervention, implementation, and evaluation have been included in the care plan. Nurses can use results to improve future public health nursing activities.
References
Gerber, L. (2012). Community health nursing: A partnership of care. Nursing Career Directory, 42(1), 19-20.
Guerry, S. L., Bauer, H. M., Packel, L., Samuel, M., Chow, J., Rhew, M., & Bolan, G. (2005). Chlamydia Screening and Management Practices of Primary Care Physicians and Nurse Practitioners in California. Journal of General Internal Medicine, 20(12), 1102–1107.
Rubin, S. E., Alderman, E. M., Fletcher, J., Campos, G., O’Sullivan, L. F., & McKee, M. D. (2011). Testing Adolescents for Sexually Transmitted Infections in Urban Primary Care Practices: Results from a Baseline Study. Journal of Primary Care & Community Health, 2(3), 209–212.
Stanhope, M., & Lancaster, J. (2008). Public Health Nursing: Population-Centered Health Care in the Community (7th ed.). St. Louis, MO: Mosby.
Whelan, M. (1988). Nursing management of the patient with Chlamydia trachomatis infection. Nursing Clinics of North America, 23(4), 877-83.