Community Needs and Risk Assessment

Added on - 16 Oct 2019

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Running head: IMPROVE POPULATION HEALTH1Community Needs and Risk Assessment to Improve Population HealthAl DenteSchool of Nursing
IMPROVE POPULATION HEALTH2AbstractPoplarville, Mississippi is amidst a major construction boom due to a large casino corporationmoving in and building a resort/casino complex. Currently with the first 250 out of 1000 workersrelocated to the area, many dramatic community changes have been noted.The local criticalaccess hospital has already seen an increase in volumes in the emergency department due to amarked increase in construction accidents, teen pregnancies, alcohol related accidents, and anincrease in domestic violence accompanied by an overwhelming increase in the diversity ofpatients from different cultures.The local hospital has teamed up with the community to conductan assessment in order to address the needs of the growing and newly diverse communityincluding the potential for developing ethical and diversity issues, genetics and genomics, healthpromotion, disease processes, pharmacological issues, physical assessment needs of thepopulation, population and public health issues, and integrating advanced practice nursingmodels and theories into the existing healthcare services.Keywords:cultural diversity, critical access hospital, teen pregnancy, health promotion
IMPROVE POPULATION HEALTH3Community Needs and Risk Assessment to Improve Population HealthPoplarville, Mississippi is experiencing a major construction boom due to a large casinocorporation coming to town and building a resort/casino complex. So far 250 workers havearrived from South Africa and Eastern Europe with the expectation of up to 1000 workerseventually needed to train and staff the new facilities. The local hospital has teamed up with thecommunity to conduct an assessment in order to address the needs of the growing and newlydiverse community. This paper will discuss the potential for developing ethical and diversityissues, genetics and genomics, health promotion, disease processes, pharmacological issues,physical assessment needs of the population, population and public health issues, and integratingadvanced practice nursing models and theories into the existing healthcare services.Development of Ethical Issue with Four Principles of EthicsFor Poplarville, Mississippi, abrupt changes will bring a multitude of healthcarechallenges. Challenges brought forth by the growing community will bring with it ethical issues.The local critical access hospital has already noted an increase in volumes in the emergencydepartment due to a marked increase in construction accidents, alcohol related accidents, and anincrease in domestic violence that accompanied an overwhelming increase in a diversity ofpatients from different cultures. One issue of note is after a local women’s services contacted thenew chief nursing officer about a four-fold increase in teen pregnancies over the past twelvemonths. The women’s services staff claim the young girls are attracted to the new workers intown because of their accents and intriguing new cultures. Birth control has quickly become ahot button dilemma discussed around the community. Local parents are said to be in denial of therecent increase in sexual activity among teens so parents have been noted to be resistant to sexeducation and birth control. In turn, the teens are practicing unsafe sex, at risk for sexually
IMPROVE POPULATION HEALTH4transmitted infections (STIs) and unplanned pregnancies. Healthcare teams want to respectparent wishes, however, feel an ethical obligation to provide facts about teen pregnancy andresources regarding birth control and safe sex practices to the community.Beneficence, or doing what is good, is violated when healthcare providers feel restrictedto provide the proper education needed about safe sex practices to the community. Meetingresistance from long-time community members may require the healthcare providers to use morecreative tactics to provide the needed education. The call to do what is good may be at risk asunplanned pregnancies and STIs increase in Poplarville. However, parents may feel autonomy isdisrupted if healthcare providers go against wishes to provide sex education and birth controloptions to the youth in the community. The principle of autonomy is a theory allowing people tohave self-control over decision making. There exists a fine line between allowing a parent tomake autonomous decisions regarding their children’s health when the children become teensand choose to be sexually active. Is justice dishonored if healthcare providers choose to becreative and distribute consumer educational flyers on teen pregnancy and birth control? Onlyone quarter of the staff have been hired to work at the casino and already the teen pregnancynumbers have increased four-fold. The statistics will continue to rise dramatically and anintervention is clearly needed in order not to sully the principle of doing least harm.Development of Human Diversity IssuesPeople often think of diversity as race, nationality, culture, ethnicity, subculture, gender,class (or wealth/poverty), age (especially extreme youth or age), (dis)ability, sexual preference,religion, political party. Despite common perceptions, diversity most importantly is theunderstanding of specific cultural, language, social and economic nuances of particular peopleand families. There are two major events making cultural diversity issues important to
IMPROVE POPULATION HEALTH5understand. First is the civil rights movement that began in the 1950s, in which AfricanAmericans, women, gays and lesbians, people with disabilities and other minority groups alertedthe country to distinct identities and the need to understand different cultures. Second is thegrowing number of new immigrants to the United States, who bring with them unique cultural,language, religious, and political backgrounds of their heritage much like what has occurred inPoplarville, Mississippi. Some of these cultures have a history of displacement, torture, politicaloppression, and extreme poverty abound among the communities they know. Combining thesebackgrounds with history, experiences, and expectations of the people born in America createsboth challenges and opportunities for, nurses, doctors, lawyers, social workers, and all otherpeople of society. Healthcare professionals and society have come a long way yet have just as farto go in order to gain cultural competence. Fortunately, healthcare represents a group ofproviders with a long history of understanding and learning both people’s differences and theimpact of social injustices on their behalf, but it is still not close to understanding all needing tobe known. Many nursing schools, hospitals and other healthcare industries are adding culturalcompetence to the list of education needs to be met by associates. In developing a plan ofteaching for the hospital in Poplarville, the language of the Native Americans, and the worldlyviews of the population are the two main focuses of education for the hospital staff[ CITATIONNat12 \l 1033 ].In 2003, National Assessment of Adult Literacy (NAAL) assessed the English literacy ofpeople age 16 and older, in the United States. The NAAL provided information proficiency ofapproximately 18,000 adults living in households and 1,200 prison inmates. In the householdsample, 2,807 adults did not speak English before starting school. This same assessment reported31% of the workforce does not speak English as their native Language. Language differences
IMPROVE POPULATION HEALTH6affect both majority and minority populations. An example is the large number of NativeAmericans living in Poplarville unable to speak and communicate needs. If the Native Americanpopulation are unable to communicate needs, potential dangers develop resulting from the lackof understanding on behalf the healthcare team which then develop into an inability to access thehealthcare system. Nurses cross trained in culturally competent care connects this populationwith a range of services available to them. Healthcare staff trained to speak to this populationdecreases the risk of miscommunication, misdiagnoses, and leads to an increase of care,understanding, and education needs to this population[ CITATION Jin09 \l 1033 ].Development of Genetic and Genomic IssuesThe terms genetics and genomics, although sounding similar, have different meanings.Genetics refers to the study of a single gene and the impact it has on a single gene disorder,whereas genomics is the study of all the genes and interactions with one another, theenvironment, and the culture. Four key competencies nurses should demonstrate while buildingan understanding of genetics and genomics in healthcare are applying and or integrating geneticand genomic knowledge through nursing assessment, identification, referral actives, andprovision of education, care, and support (Corporate Panel, 2008).Through the nursing assessment much of the needed information about the patient can beobtained. On admission at the Poplarville hospital, assessments completed by nursing staffshould go back at least three generations of the patient family to obtain a more precise medical,environmental, and social history, including genetics and genomics. After the history is collectedthe information then should be analyzed by the nursing staff to recognize any risk factors to thepatient, then shared with the appropriate staff. After information is reviewed and analyzed, areview with the patient needs to be completed to see how much information the patient is aware
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