Community assessment Community Health Nursing 5e Mary Jo

Community assessment Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Assessment Definition The process of collecting data (from primary and secondary sources) and information regarding demographics, health status, and the infrastructure of a defined community. Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Health Assessment Guide categories A. Community 1. Place 2. People 3. Function B. Community Health 1. Status 2. Structure 3. Process Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community/Place • Geopolitical boundaries of community • Local or folk name for community • Size in square miles/areas/blocks • Transportation avenues • Physical environment Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community/People • Number and density of population • Demographic structure of populations • Informal groups • Formal groups • Linking structure Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community/Function • Production-distribution –consumption of goods and services • Socialization of new members • Maintenance of social control • Adapting to ongoing and unexpected change • Provision of mutual aid Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Health/Status • Vital statistics – Fetal death, abortion, birth, death, marriage, divorce to calculate demographics e. g. fertility rate • Disease incidence and prevalence for leading cause of mortality and morbidity • Health risk profiles • Functional ability levels Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Health/Structure • Health Facilities • Health-related planning groups • Health manpower • Health resource utilization patterns Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Health/Process • Commitment • Self-other awareness and clarity of situational definitions • Effective communication • Conflict containment and accommodation • Participation • Management of relations with larger society • Machinery for facilitating participant interaction and decision making. Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Another Category of Community Assessment 1. 2. 3. 4. 5. 6. 7. 8. Health & social services Communication Economics Recreation Physical environment Education Safety and transportation Politics & government Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Assessment Wheel Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Ten essential Services in Community Health Nursing Practice 1. Monitor health status to identify health problems – E. g. community health assessment with vital statistics and risk profiles 2. Diagnose and investigate health problems and health hazards in the community – E. g. Surveillance system Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Ten essential Services in Community Health Nursing Practice 3. Inform, educate and empower people about health issues 4. Mobilize community partnerships and actions to identify and solve health problems – Convening and facilitating community groups to promote health Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Ten essential Services in Community Health Nursing Practice 5. Develop policies and plans that support individual and community health problems – Leadership and development 6. Enforce laws and regulations that protect and ensure safety – Enforcement of sanitary codes Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Ten essential Services in Community Health Nursing Practice 7. Link people to needed personal health services and ensure the provision of health care when otherwise unavailable 8. Ensure a competent public health and personal health care workforce. Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Ten essential Services in Community Health Nursing Practice 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. 10. Research for new insights and innovative solutions to health problems. Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Factors affecting the selection of community assessment method 1. The purpose of assessment 2. Financial resources 3. Time limitations 4. Effort 5. Accuracy of required information Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Factors affecting the selection of community assessment method 6. Feasibility of conducting the assessment 7. Acceptance of the defined community to assessment process 8. The expertise of the person conducting the assessment Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Purposes of community Assessment 1. To determine the health status of a community or a target group – E. g. determine the health needs of elderly 2. Provide understanding about a problem and contributing factors – Reasons of premature death Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Purposes of community Assessment 3. Identify health related resources 4. Increase awareness of policy makers of both health and non health issues of concern to community members. Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Data Collection Methods 1. 2. 3. 4. 5. 6. 7. 8. Epidemiologic Approach System Approach Observational approach Key informants Approach Rates- under treatment approach Community forum approach Social indicators approach Survey Approach Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Epidemiologic Approach • Based on three elements: 1. Agent 2. Host 3. Environment Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

System Approach • The community is divided into subsystems and data collected separately about each system. – – – – Health system Environmental system Communication system Transportation system Recreational system Social system Economic system Educational system Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

System Approach cont • Easy method for data collection and analysis Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Observational approach • Used as initial approach for data collection • Use five senses to collect data • Make a tour in the community wearing compatible dress • Adv: Correct, quick • Disadv: personal bias Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Key informants Approach • Interview persons in leadership positions that have sensitive information – E. g. The director of health care center • Adv: Quick, does not need effort or financial resources • Disadv: bias because the health needs perspectives differ between leaders and customers of health care services Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Rates- under treatment approach • Interview the people visiting the health care center • Adv: better identification of health care needs, correct, easy, and quick • Disadv: bias because this group may not be representative to the whole community Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community forum approach • Invite community members to meet in certain time and place. • Adv: mix of leaders and common people • Disadv: not representative to whole community because some people may not able to come & have significant information Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Social indicators approach • Collect data from reports in the department of statistics or health care center • Adv: correct • Disadv: risk for missing some data due to loss of document or selecting data for certain purposes according to the purpose of the institution Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Survey Approach • The best approach overcome the disadvantages of the other approaches • Select random sample from the community to represent the community • Adv: not biased, representative • disadv: need time and financial resources Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Assessment Community assessment information can be classified under three categories: 1. information about community management. 2. information about the population 3. information about health Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

information about community management. • Internal and external policies • First step Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

information about the population • • • Geographical location population Density environment education Social and economic level Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

information about the population • • • Culture and customs communication transportation Safety hazards Security and safty Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

information about the population • Recreation • General services Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

information about health It includes: 1. Health status 2. Health services Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Health status 1. Mortality rates 2. Birth rates 3. Morbidity rates Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Mortality rates • • Crude Mortality rates according to gender Mortality rates according to age Mortality rates according to cause Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Morbidity rates • Prevalence rate • Incidence rate • The most common diseases according to season • The most common diseases according to gender and age groups Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Health services 1. Size of health care services 2. Quality of health care services Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Size of health care services • Number and size of hospitals and the services provided by them. • Number of health care centers • Number of pharmacies • Number of labs. Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Quality of health care services 1. Scientific qualifications of the health team 2. The ways of communication between health care providers and customers of health services. 3. Availability of equipments 4. The use of services by health customers Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Setting Priorities after community Assessment • The CHN should consider the following aspects to priorities community health needs: 1. The size of the problem 2. The strength of the problem( fatality) Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Setting Priorities after community Assessment 3. How long does it take to solve the problem 4. If solving the problem will solve other problems spontaneously 5. The ability to solve the problem 6. The availability of financial and human resources. Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Assessment Guide 1. 2. 3. 4. 5. 6. 7. Name of the Community: Location: History of the Community: Population: Environment: Housing Services( electricity, water, security, drain) Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Assessment Guide 8. Economic and social status 9. Communication system 10. Education system 11. Governmental leadership 12. Transportation 13. Welfare agencies 14. Recreation Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Assessment Guide 15. Religious places 16. Health and health services • • Available Health services Quality of services Chronic diseases Most common diseases Communicable diseases Main cause of death (by age, sex, cause) Any other problem Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.

Community Assessment Guide 17. List of health problems according to priorities 18. Plan of solving the health problems Community Health Nursing, 5/e Mary Jo Clark Copyright © 2008 by Pearson Education, Inc.