The Role of Community/Public Health Nursing
Community and public health nursing is an effective power in promoting health and human dignity (Muntean, Tomita, & Ungureanu, 2013). Thus, community nurses can be helpful in the case of the analyzed family community. Due to the lack of access to quality health care, all of the family members have chronic health problems, both physical and mental. Therefore, nurses who can visit the family at home can provide recommendations about lifestyle changes, management of chronic conditions and stimulate the family members to visit a physician.
The Influence of Social Determinants of Health
In the case of the family’s community, social determinants are decisive for health. The family of B. and S. live in an area with high crime prevalence. Such neighborhoods are traditionally low-income with poor access to resources. With both parents unemployed, the family is not able to provide their children and themselves with all necessary resources, including healthy food or medical assistance. Another possible reason for the family’s condition is the lack of cultural identity. The family is Caucasian, living in the prevalently Caucasian community. Still, they do not have any religious preferences and are not members of an ethnic community. Consequently, they do not have any support from the outside to help them cope with their complicated life situation.
Comparison of Epidemiological Data
Phoenix, the city where the community from the case is located, is the most populous city in Arizona. The analysis of some epidemiological data proves that the epidemiological situation in Phoenix is slightly different from that in the state as a whole. For example, the incidence of deaths from HIV disease was higher in Phoenix than in Arizona (2,5 compared to 1,5 correspondently) (“Health status report,” 2012). At the same time, the rate of deaths from tuberculosis was almost the same, with 0,3 in Phoenix and 0,2 in Arizona. The most frequent communicable disease in Phoenix was coccidioidomycosis, with 2,406 cases in 2011, which makes the rate of 163.7 while in Arizona, this rate was 175.9. Cardiovascular diseases make up a primary cause of death in the state as a whole and in the community. Thus, the rate in Arizona was 199.5 compared to 140.2 in Phoenix (“Health status report,” 2012). Also, cardiovascular problems as primary discharge diagnoses are more prevalent in Arizona than in Phoenix, with the rate of 1,112.0 and 1,435.3 correspondently.
Community Nursing Diagnosis
The community nursing diagnosis for the case under analysis can be formulated as follows: actual poor access to high-quality health care and resources due to the low income resulting in unsatisfactory health conditions among adults and children. Thus, high crime rates and unemployment lead to negative health outcomes for the community members.
Leading Health Indicator
There are some leading health indicators (LHIs) related to the community of the family in the case study under analysis. For example, such LHIs as access to health services (persons with medical insurance); nutrition, physical activity, and obesity (obesity among adults); and substance abuse (binge drinking in the past month – adults) are applicable to the case under consideration (“2020 LHI topics,” 2018). Therefore, nursing interventions are necessary to address these LHIs and improve the general health condition of the community. First of all, to improve the access of the community members to healthcare services, the community nurses can organize home visits and administer patients with serious or dangerous conditions to the nearest hospital. To address the problem of poor nutrition, lack of physical activity, and obesity among adults, the community nurses can provide “healthy days,” inviting the community members to meetings dedicated to healthy lifestyles or active weekends, thus promoting healthier living. Finally, to improve the situation with substance abuse among adults, nursing interventions can be focused on spreading information about the negative impact of alcohol on individuals and their families as well as promoting therapies to reduce and prevent this abuse.
Community Health Plan
Goals
- To improve the health literacy of the community population
- To address the healthcare needs of the community members
Planned Action
To complete the first goal, the community nurses should plan patient education interventions applicable during home visits. For example, these can be informing the community members about peculiarities of their chronic diseases and their management. Particular attention should be given to promoting high-quality healthcare for children. To address the healthcare needs of the citizens, community nurses should organize home visits. As a part of health care quality improvement in the area, nurses can initiate a project of creating a new healthcare facility with basic equipment and physicians to provide the local low-income population with access to the necessary care.
Needed Resources
The resources necessary for the plan implementation include professional community nurses, accommodation for the nurses, including the office, printed materials, basic portable equipment for patient examination. In case the initiative of creating a new facility is supported by the local government, additional resources will be needed.
Timeframe for Evaluation
The estimated time for evaluating the effectiveness of the plan is six months. This period is expected to be enough to reveal the advantages and disadvantages of the plan and show the first results.
References
Health status report for cities and towns in Maricopa County 2009-2011. (2012). Web.
Muntean, A., Tomita, M., & Ungureanu, R. (2013). The role of the community nurse in promoting health and human dignity – Narrative review article. Iranian Journal of Public Health, 42(10), 1077-1084.
2020 LHI topics. (2018). Web.