Community Notes for Midterm 9/24 Notes Community Analysis and Nursing Diagnosis/ Chapter 10 8 questions

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I. Data Analysis-Why? A. To study and examine data collected A. Synthesis of data B. Identify community strengths C. Identify community health needs D. Determine need for further data collection: 1. find if research has been done. 2. Data gaps: determine need for further data collection. Make sure you can support data gaps with information from assessment. E. Look for trends/patterns; how often do you see a recurrent theme? F. Discovery of causative relationships: the R/T portion. II. Basic Steps of Data Analysis(4) A. Categorize-e.g. by demographics, commonalities. E.g. intra/extra community for health and social services A. Summarize B. Compare C. Inference/Interpretation III.Categorize Data D. There are many ways to sort and categorize data e.g. demographically by age groups, by problem type E. Geographic approaches may be used F. Use of model; we are using the wheel from Neumans model. G. Look for data convergence when categorizing-e.g. how many times do we see data converging in different categories? H. Look for commonalties, health resources that are available. SEC, age, etc. IV. Data Summary I. Summary statements-summarize each table. J. Summary statistics-put data into percentages and rates so that different areas/communities can be compared. Raw numbers will not work to compare different areas. K. Graphic methods of data summary:

Community Notes for Midterm 9/24 Notes Community Analysis and Nursing Diagnosis/ Chapter 10 8 questions

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2. Remember that tables need concise summary data. P. 222, can put population statistics in graph. 3. Dependency Ratio: how many people in your community who can support the dependents. Calcuation on page 225. Should do for both census tracts. A. Data summarization facilitates ease of reading and spotting trends/patterns in data V. Summary Statistics B. Rates-vital statistics C. Percentages-population characteristics D. Ratios-sex, dependency, etc. E. Rank order listing-top ten causes of death VI. Examples of Summary Statements F. When comparing community strengths and needs, it is observed.. G. Community strengths established include. H. Through visual inspection as well as interviews of residents, it was found I. Public health services in the community include. VII. Other Data Summary Methods J. Tables K. Graphs L. Charts M. Mapping summarizing boundaries N. Pictures-can be put into appendix and does not count towards page count of final community assessment paper. O. Photographs P. Population pyramid-see page 222 in text for example. VIII. Data Comparison Q. Facilitates identification of data gaps, omissions, inaccuracies R. Determine if a trend or pattern exists, especially if data are collected from past to present S. Data comparison gold standard or benchmark IX. Data Comparison Standards T. Select standard similar to community

Community Notes for Midterm 9/24 Notes Community Analysis and Nursing Diagnosis/ Chapter 10 8 questions

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U. Use of higher level than study community, e. g. city, state, or national levels V. May compare different areas or regions of city, county, state, e. g. North side compared to South side W. Schools to same type of school, other districts or district as whole X. Aggregates may be compared to different groups or similar groups elsewhere: Example, seniors who express a desire to have better access to healthcare or teens attitudes towards drug use in one area as compared with teen attitudes towards drug use in another area. Y. Previous studies may be used for problems, diseases Z. Norms for developmental stages, ages, ethnic groups may be used AA. National Health Objectives statistics; Healthy People 2010 statistics are available to compare data to. Use this with intervention. X. Inference & Interpretation chapter 10, table 10.1 & 10.5 BB. CC. data DD. Cite comparison standards e.g. rates, ratios and/or percentages EE.Formulate lists of strengths and needs FF. Distinguish between fact and opinion GG. Validity of source Formulate conclusions with interpretative statements Justify conclusions use references such as interview quotes or statistical

XI. Community Nursing Diagnosis: from inferences and summary statements. HH. Need to depart from NANDA as it is more individual focused II. Appropriate for primary, secondary, and tertiary levels of prevention JJ. Implies that the community/aggregate is target of intervention KK. Compare strengths to community needs in table format. Take the two needs you find to be most significant. List should be longer than two. LL. From inferences and summary statements, make a final summary statement. MM. Encompasses (what the nursing diagnosis could be)

4. health risks 5. vulnerable groups

Community Notes for Midterm 9/24 Notes Community Analysis and Nursing Diagnosis/ Chapter 10 8 questions

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6. health problems 7. lack of services 8. health promotion 9. potential risks XII. Framing the Community Nursing Dx community B. Identification of factors etiologically related-causes C. AEB -Signs and symptoms that characterize the problem/concern; they may come from other subsystems. D. Nursing diagnosis is the final, summary statement: E.g. Increased fear of crime related to young kids on crime sprees as evidenced by.supporting data. XIII. Validating the Comm. Nsg. Dx D. Collection of more data E. Surveys fast-good way to validate by opinion. E.g. Eight out of ten people surveyed agree thatblah blah blah F. Interview of residents, business owners, service providers G. Analysis of other studies of the community; does not have to be r/t this particular community. Secondary Data. A. Examples of Community Nursing Diagnoses H. Description of problem, response, state (have problem and degree of reaction) 10. High rate of dental caries (e.g. problem = caries; deg. of rxn = high rate) 11. Potential for mugging and criminal victimization 12. Inadequate family planning services 13. Incomplete immunization status of preschool children A. Factors etiologically related A. Description of the problem, response, or state-come from the inferences of

14. lack of fluoride in drinking water; no dental hygiene education; limited income to pay for dental care 15. few self protective measure; episodes of thefts and burglaries 16. clinic days twice a month and no PM hours

Community Notes for Midterm 9/24 Notes Community Analysis and Nursing Diagnosis/ Chapter 10 8 questions

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17. limited access to immunization clinics; lack of knowledge of importance of early immunizations A. Signs and symptoms, manifestations, evidence 18. 62% have caries on inspection 19. Police report 30 % of calls; personal report of citizens 20. crude birth rate 50% higher than city; published clinic hours 21. immunization completion rate of 37% based on survey data XIV. Nursing Diagnoses A. Potential for disability and loss of productive years of life among the residents of CT 333 related to lack of access to area medical resources, inadequate financial resources for needed medicines, and lack of knowledge regarding disease etiology as evidenced by higher adult and infant mortality rates. When compared to the City of Houston, complaints of local residents that waits for medical care are too long, the elderly are unable to afford needed medicines, and school nurses report they are treating more children with diabetes and blood pressure problems. B. Potential for CV disease in the ethnic population related to the mortality of ethnic statistics (Health of Houston, 1995) as evidenced by high sales of alcohol and tobacco, a median income of $30-35,000, the inadequacy of nutritional status and fitness facilities, and a lack of programs that offer educational materials about the disease. C. Potential for accidents as children travel to and from school related to a lack of sidewalks in the neighborhood and inadequate fencing around construction site as evidenced by a lack of after school programs, latch key kids, and open bayou construction.