The Problem Description
- Little Haiti in Miami has many health problems that are caused mostly by the lack of knowledge in people and the deficit of competent specialists in local hospitals.
- One of the most prominent health problems is hypertension.
- The most vulnerable groups that need support are elderly Hispanics and Haitian immigrants, as they have many chronic diseases including hypertension (Zevalios, Wilcox, Naomie, & Acuña, 2016).
Findings that demonstrate the relevance of the problem
- People in the community have many chronic diseases.
- The influence of poverty and the lack of knowledge.
- The lack of large hospitals in the community.
- The lack of qualified healthcare specialists.
- A high cost of health insurance (Zevalios et al., 2016).
The Community Health Role
I have chosen the role of a health department nurse at one of the local hospitals because this position gives me the opportunity to:
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- advocate for more affordable medicine in the community.
- influence medical education.
- be closer to sick people.
The Purpose of the Assignment
The primary goals of the assignment are to:
- choose a position that will help influence the medical situation in the community.
- propose the community health intervention to decrease hypertension morbidity.
- provide the evaluation methods.
- evaluate the outcomes.
- propose further intervention in case of success.
As a source of information about the strategies of evidence-based nursing intervention, I have chosen an article found in Google Scholar entitled:
- “The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure in older hypertensive patients in the community” written by Cheng et al. (2014).
The Article Overview
- The purpose of the article is to analyze the effects of continuous nursing intervention in order to provide comprehensive care to elderly people with hypertension.
- Ninety patients were divided into two groups, namely the control group and intervention group.
- One year after the beginning of the study, people in the intervention group were measured blood pressure twenty-four hours a day for several weeks.
- The results showed the chronotherapy and behavioral intervention based on the ambulatory pressure monitoring is able to provide better control over blood pressure (Cheng, et al., 2014).
The Benefits of the Article for the Chosen Community
- It provides effective ways of dealing with hypertension in elderly people.
- It uses chronotherapy as one of principal means of treatment hypertension which fits the chosen community.
- Interviewing patients.
- Measuring their blood pressure.
- Providing them with knowledge and giving them specific recommendations on how to treat hypertension including the refusal from alcohol and smoking.
- Making sure that patients follow the recommendations.
- Checking the changes in the patients’ blood pressure.
- Taking a final interview.
- Analyzing the results.
- Developing a plan for future implementation of the intervention is successful, or terminating it if the intervention fails (“Developing an intervention,” 2017).
- Elderly people having hypertension.
- Hispanics and Haitian immigrants.
Means of reaching the target population
- through personal contacts;
- at the hospital;
- at patients’ homes;
- in various community forums.
Time and Place
- The place of intervention is Little Haiti Health Center.
- The time of intervention is next year.
- The duration of the intervention is one year.
Will the intervention be repeated?
- If it proves to be successful, it will be implemented multiple times.
- In case of failure, it will be terminated.
In order to provide successful implementation of the intervention, it is essential to collaborate with:
- local authorities;
- others who can help provide additional support (“Developing an intervention,” 2017).
Level of Intervention
As the problem of hypertension is common and it is difficult to get rid of it, all levels of intervention may be necessary for its successful implementation:
- The primary level will address the general community problems concerning hypertension.
- The secondary level will address small groups of people with similar types of this disease.
- The tertiary level will address separate individuals with specific needs (“Developing an intervention,” 2017).
Proposed Evaluation Methods
Description of Evaluation Methods
In the provided intervention, qualitative evaluation methods are most appropriate.
- Interviews will be conducted where patients will be asked whether the state of their health ameliorated and to what degree.
- Observation methods will be implemented to see whether the patients follow the provided recommendations.
Identification of the Outcomes
- Measuring the blood pressure will demonstrate the effectiveness of the intervention.
- The blood pressure will be measured for two weeks before the intervention and for two weeks after it.
Short- and Long-Term Impact
- The short-term impact on the community is the alleviation of hypertension symptoms.
- The long-term impact is the permanent improvement of the state of health of people in the community (“Developing an intervention,” 2017).
Thus, one of the most important health problems in Little Haiti in Miami is hypertension in elderly people. Working as a health department nurse gives an opportunity to influence this problem. In the process of intervention, it is important to cooperate with doctors and different government institutions, and also, it is crucial to make sure that patients follow all the recommendations. The duration of the intervention is one year. The evaluation of the results including the blood pressure measurement and a final interview following the implementation shows whether it has been successful or not. In the case of success, it will be repeated, while in the case of failure it will be terminated.
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Cheng, M., Cheng, S. L., Zhang, Q., Jiang, H., Cong, J. Y., Zang, X. Y., & Zhao, Y. (2014). The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community. Journal of Clinical Nursing, 23(15-16), 2247-2255.
Developing an intervention. (2017). Web.
Zevalios, J. C., Wilcox, M. L., Naomie, J., & Acuña, J. M. (2016). Profile of the older population living in Miami-Dade County, Florida. Medicine (Baltimore), 95(20), e3630.