comm1CommunityAnalysisandNursingDiagnosisChapter10

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Community Notes for Midterm Page 1 of 59/24 Notes Community Analysis and NursingDiagnosis/ Chapter 10 8 questions

T. Lyons & L. Jones

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 SummaryI. 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:


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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, inaccuraciesR. 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


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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. Formulate conclusions with interpretative statements

CC. Justify conclusions use references such as interview quotes or statistical

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

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


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6. health problems

7. lack of services

8. health promotion

9. potential risks

XII. Framing the Community Nursing Dx

A. Description of the problem, response, or state-come from the inferences of

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 crimerelated 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

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


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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.

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