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Health Project Paper II

Health Project Presentation II


NURS 473 - Nursing Community Interactions II

Purpose of Assignment
The purpose of the assignment was to utilize the Health Planning Model to improve
aggregate health and to apply the nursing process to the larger aggregate within a systems
framework.

Student Approach to Assignment


To approach the assignment, we utilized a door to door community survey, educated
diabetic clients about managing their nutrition, blood pressure, and blood sugar levels through
vegetable cards and hemoglobin A1c testing at food pantries, and assessed the environmental
barriers in the Cradock neighborhoods that prevented those community members from
participating in physical activity.

Reason for Inclusion of the Assignment in the Portfolio


This assignment is included in the portfolio as it shows the progress made throughout the
year in our aggregate. This demonstrates my ability to identify and prioritize a community
diagnosis and develop a plan to address it. It also showcases my ability to work with other
students and community leaders.

 Nursing Practice
 Applies appropriate knowledge of major health problems to guide nursing practice
 Example: Nursing students of Old Dominion University partnered with Eastern
Virginia Medical School (EVMS) to help the members of the Portsmouth community.
The most significant health problems identified were uncontrolled diabetes and
hypertension. 12.4% of the Portsmouth population has diabetes compared to the
entire state of Virginia which is only 9.3% (City-Data, 2018). Members of the
community had ineffective health maintenance related to uncontrolled diabetes and
hypertension as evidenced by high blood pressure readings, high blood sugar and
verbalization of a knowledge deficit. Additional health problems included knowledge
deficit, imbalanced nutrition, and risk for injury.
 Implements traditional nursing care practices as appropriate to provide holistic health
care to diverse populations across the life span.
 Example: Some of the traditional nursing practices we used while in the community
were assessing members vital signs, such as blood pressure, heart rate, and
respirations. We also asked about the types of medication they were prescribed, such
as if they were on blood pressure medication, asked if they took their blood pressure
medication today and inquired into their regular medication regimen. If members
seemed to lack an understanding of their blood pressure medication requirements, we
educated them on proper use and also directed them to see their health-care provider
or helped them make an appointment with the local free clinic.
 Establishes and/or utilizes outcome measures to evaluate the effectiveness of care
 Example: Effectiveness of care in the community was evaluated by comparing
participants blood pressure and blood glucose readings before and after educational
intervention.

 Communication
 Uses therapeutic communication within the nurse-patient relationship
 Example: In conducting our community health II project we wanted to develop trust
with the community before implementing blood pressure screening and hemoglobin
A1c testing at food pantries located in Cradock. To develop rapport, we hosted the
neighborhood’s National Night Out, a partnership event between the neighborhood
and the Portsmouth Police Department and shared information, food, and recipes with
the community members. For the food pantries, individuals lined up early in the
morning to ensure a spot in line for food. When asked to come and get screening and
testing done, the community members did not want to lose their spot in line and miss
out on getting their food. To overcome this barrier, we approached individuals and
informed them that we were ODU nursing students providing free and quick blood
pressure and diabetes screening and pointed to out station that was set up at the end of
the receiving line. When members came to the tent, we talked to them about their
health and if they faced any barriers to receiving medication and treatment and then
provided them with information about free options nearby.
 Adapts communication methods to patients with special needs - visual or hearing
impaired
 Example: During the Craddock Community Outreach, one of the community
members that requested a screening was legally blind and used a walking stick. He
was unable to see the digital readings of the blood pressure or the HA1c machines nor
read the informational card. To ensure he was aware of the procedure, we provided
detailed instruction and asked which arm he wanted to use for the BP and which
finger he wanted to use for the blood glucose reading. To help communicate his
medical data, we provided detailed explanation to him, such as sitting directly in front
of him while reading his BP to him and informed him that his BP reading was within
range for his age group.
 Expresses oneself and communicates effectively with diverse groups and disciplines using
a variety of media.
 Example: Utilized media such as surveys to collect health status of the community,
particularly during Santa event at local Lion's Club where community members were
asked to fill out a questionnaire about their health management and at the local Senior
Center where senior citizens were asked how they used garden vegetables in their
daily routine. Additionally, approached community members about new vegetable
cards with information about incorporation of food pantry vegetables into regular
meals and provided presentation to senior citizens about the health benefits of eating
specific vegetables.
 Demonstrates skills in using technology, informatics, and communication devices that
support safe nursing practice.
 Example: To effectively accomplish our nursing community outreach, my group used
research websites such as MEDLINE to find research applicable to the diabetes health
concern and the demographics of the community. We shared documents such as
articles, pictures, and calendar schedules with each other via Google Docs to
coordinate our efforts in the community and provide safe nursing practice.
 Accesses and utilizes data and information from a wide range of sources to enhance
patient and professional communication
 Example: In our initial presentation, data from a variety of resources was used to find
information about the Cradock community population. Information was gathered
from City Data (2018), Data USA: Portsmouth, VA (2018), the Virginia Diabetes
Burden Report, Healthy Portsmouth (2013), and the Greater Hampton Roads
Community Dashboard (2018).

 Teaching
 Provides teaching to patients and/or professionals about health care procedures and
technologies in preparation for and following nursing or medical interventions.
 Example: Prior to conducting health outreach to the Cradock community, ODU
students were instructed on the use of an H1Ac blood glucose testing machine. We
then used the machine during outreach events to test community members' H1Ac
levels. We informed the participants about the meaning of H1Ac levels and how they
measured blood glucose levels over a period of months and helped in screening for
prediabetes and diabetes.
 Uses information technologies and other appropriate methods to communicate health
promotion, risk reduction, and disease prevention across the life span.
 Example: Used PhotoVoice research methods - pictures of health hazards in the
Cradock community with stories; i. e. we took pictures of large potholes in the road
that prevent community members from using that road to get to their medical
appointments, garbage, shopping carts, and empty alcohol bottles along sidewalks
depicting a community that may have inebriated or homeless persons roaming the
streets, and fire hydrants covered with bushes showing the lack of fire prevention
maintenance. These examples demonstrate environmental barriers to health that are
prevalent in the community.
 Evaluates the efficacy of health promotion and education modalities for use in a variety
of settings with diverse populations.
 Example: We canvassed the Craddock community and met with community
members, particularly at the Craddock Branch Library to discuss viable options for
health promotion. Our initial idea was to promote the community garden and
encourage community members to eat healthier by consuming more vegetables. We
conducted an informational outreach to the local seniors, assessed community
knowledge about diabetes and healthy diets via survey, and then shared food made
with local vegetables. The reception was positive, and the seniors expressed a need
for similar outreach designs in the future. Their verbal confirmation was used to
evaluate the effectiveness of our interventions.
 Uses information technologies and other appropriate methods to enhance one's own
knowledge base.
 Example: Prior to providing health outreach to the Cradock community, we partnered
with EVMS for training. We learned to use the H1Ac testing machine by watching an
instructional video and then demonstrated to the EVMS research leader that we knew
how to use it. We also learned to do PhotoVoice via an oral PowerPoint presentation,
given by EVMS research leaders and then walked through the community with our
cameras and phones to take pictures of environmental hazards. Afterwards, we
journaled on our pictures and shared our research with the group of students and
instructors.

 Research
 Applies research-based knowledge from the arts, humanities, and sciences to complement
nursing practice. - used science
 Example: Our community outreach aimed at providing community members with
health awareness and diabetes management through nurse-led HA1c scoring. Using
an experimental research study that analyzed the effectiveness of a nursing team on
the management of diabetes within a specific community, results found at 6, 12, and
24 months after the initiation of the interventions HbA1c level, ankle brachial index,
and waist circumference were significantly improved with the participants in the
nurse-led group while the other measures did not show significant change. The study
concludes that interventions that are both nurse-led and focused may be more
effective in improving self-management of diabetes than other standard interventions.
 Shares research findings with colleagues.
 Example: In our community presentation, we shared research findings on diabetes
management with other nursing students. The research discussed how the
incorporation of lifestyle changes such as exercising, and DASH diet could reduce
HA1c levels.

 Leadership
 Assumes a leadership role within one's scope of practice as a designer, manager, and
coordinator of health care to meet the special needs of populations.
 Example: Prior to our health outreach efforts, we identified the Cradock community
as having a knowledge deficit r/t diabetes awareness and management as evidenced
by high prevalence of pre-diabetes and diabetes in aggregate. To help the community
become healthier, we planned outreach and education by setting up a tent in the
community during the open food bank when a large population of the community was
present. In the tent, we screened patients for prediabetes and diabetes and
hypertension and provided education on disease prevention and management.
 Initiates community partnerships to establish health promotion goals and implements
strategies to meet those goals
 Example: We coordinated with the Cradock community local church, food bank, and
Lion's club, as well as EVMS physician and researcher to participate in health
outreach in the Cradock community. Participated in gathering survey data during
Lion's club breakfast with Santa as part of research study about Cradock members
diabetes knowledge and management.
 Organizes, manages, and evaluates the development of strategies to promote healthy
communities
 Example: In evaluating ODU's outreach in the Cradock community, we found that
social events such as National Night Out and the breakfast with Santa were events
that garnered higher participation in health outreach efforts and research surveying.
Therefore, we recommend for the future, ODU students host classes for community
members with discussion about nutritious, low-fat, healthy eating and DASH diet;
coordinate exercise groups for overweight adults and methods to lose 7% of body
weight; host events at local schools, Senior Station; Lions Club where nursing
students can assess community members’ risk for diabetes such as checking A1c and
blood pressure and provide resources to local health clinics; and conduct outreach
events that focus on creation of self-care plans, such as recognition of baseline
ABC’s, diet and exercise plan, scheduling yearly eye and foot appointments.

 Culture
 Considers the impact of research outcomes and, the effects of health and social policies
on persons from diverse backgrounds
 Example: My community health II group participated in a research study by EVMS to
gather current and accurate data about diabetes management and awareness in the
Cradock community. This research will be used to create research-based interventions
by local health institutions such as EVMS.
 Maintains an awareness of global environmental factors that may influence the delivery
of health care services.
 Example: My paper compared the prevalence of diabetes in the Cradock Community
compared to state, national, and global statistics and found that Cradock had a
comparably high level of diabetes. Specifically, our paper found that the 2017-2018
diabetes prevalence in Portsmouth was 14%, the Virginia average was 9%, the
national average was 9.4%, and the 2014 global average was 8.5%. Diabetes is
growing at a faster rate in middle and low-income countries where food insecurity is a
concern. We found that the 2017-2018 food insecurity in Portsmouth was 19.6%,
Virginia was 10.6%, nationally was 12.9%, and globally at 10.9%.