Name: Identified Problem Bloodborn infections in the older population (cdiff, vre, mrsa, surgical wounds, decubitus wounds, sepsis Purpose Analysis based on data collection from windshield survey Identification of one community health nursing problem - Home Health Nurse Specific nursing intervention relating it to the public health intervention wheel Disease and health event investigation Target Population Older adults Place where the intervention is taking place Patients Number of times intervention takes place - home Multiple Methodology to reach out to the target population - individualized teaching Methodology of getting the target population involved Identification of trends with the adoption of analytical tools Engagement with effective education and teaching Adoption of the effective teaching methods CH nurse's role in this intervention Home health nurse Collaboration Physician's office Level of prevention addressed in intervention Tertiary prevention Aid in ongoing illness Justification of the problem The current problem pertains to the mismanagement Justification of nursing intervention considered to be a priority Issue observed in the past Repercussions being too complex as it affects the treatment, care and the prevention Reasons for effectiveness of interventions Putting an end to the problems existing in environment of nursing The effective measures that are well considered The scope of development programs for adequate training The benefit of humanity with the identified problem Workforce exhibiting greater dynamics Degree's of innovation involved in the care Leads to better outcomes for patients (Cummings et al. 2010a) Requirement of Optimization Dealt well with the analysis (Rutz, W., Knorring, L. v. and Wlinder, J. 1992) Adoption for obtaining the necessary approvals Aspect of getting the various advantages associated with the support to the elders in care Risk in the adopted strategy met with the planned course The methodology to assess the risk concerned The promote health and prevent illnesses Responsibility linked Educate population Correlation between the nurse and the outcomes in relevance to patients Greater quality and improvised solution Strategies based on enhanced quality care for the elderly leads to reductions in the infections suffered by patients Linked to the identified problem Justification of the problem The project failures in the past with involvement of risk The planned course of action The effective measures that are well considered The proposed intervention with the role of CH nurse The Methodology of getting the target population Adoption of the relevant tools to identify trends Systematic Plan Rutz, W., Knorring, L. v. and Wlinder, J. (1992), Long-term effects of an educational program for general practitioners given by the Swedish Committee for the Prevention and Treatment of Depression. Acta Psychiatrica Scandinavica, 85: 83-88. doi: 10.1111/j.1600-0447.1992.tb01448.x Cummings, G.G., T. MacGregor, M. Davey, H.P. Lee, C. Wong, E. Lo, M. Muise and E. Stafford. 2010a. "Leadership Styles and Outcome Patterns for the Nursing Workforce and Work Environments: A Systematic Review." International Journal of Nursing Studies 47: 363-85. Chamberlain College of Nursing NR443 Community Health Nursing Caring for Populations Milestone 3: Intervention and Evaluation PowerPoint Guidelines and Grading Rubric PURPOSE The purpose of this PowerPoint presentation is to provide an opportunity to develop a community health nursing intervention and evaluation plan for a community health problem that you identified in your community (described in Milestone 2: Vulnerable Population Assessment). You will apply the components of the nursing process to assist this vulnerable population and develop a proposal that could be presented to community leaders. COURSE OUTCOMES This assignment enables the student to meet the following course outcomes. CO1: Apply principles of nursing theory to the public health system by analyzing determinants of health and the public health intervention wheel. (PO 1) CO3: Plan prevention and population-focused interventions for vulnerable populations using professional clinical judgment and evidence-based practice. (PO 4, 8) CO4: Evaluate the delivery of care for individuals, families, aggregates, and communities based on theories and principles of nursing and related disciplines. (PO 1) DUE DATE Submit your assignment to the appropriate basket in the Dropbox by 11:59 p.m. MT Sunday of Week 6. POINTS This assignment is worth a total of 225 points. SCENARIO You are a community public health nurse (C/PHN) working with the vulnerable population you identified in Milestone 2. You will choose a specific community health role that would serve this population. You have analyzed the data collected from your windshield survey and vulnerable population assignments (the first two milestones) and identified one community health problem that a nurse can impact. Now, review the scholarly literature or scholarly websites listed below and identify one specific evidence-based nursing intervention that has the potential to improve the health of this group. Then develop a proposal to implement this intervention and a plan to evaluate the outcomes of this intervention. Create a PowerPoint that you could use to present to an organization in your community to request approval for funding and support for this intervention. (You are not required to implement the intervention or present your PowerPoint, though you may want to consider implementing your project in the future). DIRECTIONS NR443 Milestone 3 Intervention Evaluation Guidelines updated 9/23/16 LS 1 Chamberlain College of Nursing NR443 Community Health Nursing Watch the Milestone 3 tutorial by clicking this url: http://www.brainshark.com/devry/Milestone3_2016. This tutorial is also available on Course Project page under Course Home as well as Week 6 Assignments page. A. Introduction: (average of 2-3 slides) Describe the identified problem o Include at least two important findings that demonstrate that this is a problem in your community. Describe your specific community health role: Some examples of roles are school nurse, parish nurse, home health nurse, occupational nurse, health department nurse etc. Identify the purpose of the presentation which is related to proposing a community health intervention and and evaluation plan. B. Identify an evidence based intervention: (average of 2-3 slides). Find an evidence-based nursing intervention from a peer-reviewed journal article OR one of the following databases. These databases evaluate research evidence about community health interventions. Be sure that your intervention is one that is recommended. Cite your source on the slide. o Use at least one of the following to identify an evidence based intervention: A peer reviewed journal article demonstrating that your intervention has been successful The Community Guide (http://www.thecommunityguide.org/) The CDC Community Health Improvement Navigator (http://wwwn.cdc.gov/chidatabase) Healthy People 2020 evidence-based interventions. Find a relevant topic area at (http://www.healthypeople.gov/2020/topics-objectives), click on that topic area and then click on the \"Interventions and Resources\" tab to see the evidence-based interventions list for that topic area Provide a brief overview of your intervention. Discuss why this intervention is a good fit for your community (why you expect it to be effective in your community). C. Intervention Implementation: (average of 3-4 slides). Describe how you would implement your community health nursing intervention in your community Discuss the actions will you take as the community health nurse to accomplish this intervention. o Relate your actions to the public health intervention wheel (Nies & McEwen, 2015, p. 14, Figure 1-3) Identify your target population. Describe how you will reach out to your target population. o Include strategies to engage your target population. Describe where the intervention will take place. Identify when your intervention will take place o Will it take place once or multiple times? Identify those in the community that you will collaborate with (e.g., physician's office, church, local resources, etc.). NR443 Milestone 3 Intervention Evaluation Guidelines updated 9/23/16 LS 2 Chamberlain College of Nursing NR443 Community Health Nursing Explain what level(s) of prevention is your intervention addressing (primary, secondary, or tertiary prevention)? D. Proposed Evaluation Methods: (average of 2-3 slides) Your presentation must include at least one proposed quantitative or qualitative evaluation method that you would use to determine whether your intervention is effective. Outcome measurement is a crucial piece when implementing interventions. Describe the method you would use to evaluate whether your intervention was effective. (There is a helpful tool found in Doc Sharing to assist you with understanding qualitative and quantitative methods of evaluation). Identify the outcomes you would track to show whether your intervention works (eg. BMI would be one outcome you could track for a weight loss intervention). When would you measure these outcomes? Describe the short-term and long-term impact on your community if the intervention is successful. E. Summary: (average 1 slide) The summary should reiterate the main points of the presentation and conclude with what you are asking to be accomplished; for example, \"Based on ABC, it is imperative our community has XYZ. Can we count on your support? Thank you for your consideration.\" F. In addition to the slides described above, your presentation should include a title slide with your name and role and a reference slide. Cite all sources used with (Author, year) on the PowerPoint slide. G. The slides should include the most important points in short bullet pointed phrases. Do not include full sentences or paragraphs on the PowerPoint slides. You may add additional comments in the notes section to clarify information for your instructor. H. The slides should be visually appealing and not overcrowded. Use an interesting template and include some clipart or graphics for interest. GUIDELINES Application: Use Microsoft PowerPoint 2010 (or later). Length: The PowerPoint slide show is expected to be no more than 20 slides in length (not including the title slide and reference list slide). Submission: Submit your files via the basket in the Dropbox: Milestone 3 Intervention and Evaluation by 11:59 p.m. Sunday of Week 6. Save the assignment with your last name in the file title: example: \"Smith Intervention and Evaluation.\" Late Submission: See the course policy on late submissions. Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/trainingFX101782702.aspx The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found under the Special Courses list in eCollege. BEST PRACTICES IN PREPARING POWERPOINT The following are best practices in preparing this presentation. Be creative. Incorporate graphics, clip art, or photographs to increase interest. NR443 Milestone 3 Intervention Evaluation Guidelines updated 9/23/16 LS 3 Chamberlain College of Nursing NR443 Community Health Nursing Make easy to read with short bullet points and large font. Review directions thoroughly. Cite all sources within the slides with (author, year) as well as on the Reference slide. Proofread prior to final submission. Spell check for spelling and grammar errors prior to final submission. Abide by the Chamberlain academic integrity policy . NR443 Milestone 3 Intervention Evaluation Guidelines updated 9/23/16 LS 4 Chamberlain College of Nursing NR443 Community Health Nursing Grading Rubric: Caring for Populations: Intervention and Evaluation (225 points) Criteria Problem identification 25 points Evidencebased Intervention and scholarly support 45 points Intervention implementation details 50 points Evaluation 45 points A (92-100%) Outstanding or highest level of performance B (84-91%) Very good or high level of performance C (76-83%) Competent or satisfactory level of performance Presentation includes at least one slide that introduces the problem and includes: Two important findings in the community Nurses' role, and Purpose. (23 - 25 points) One community health nursing intervention is described with: Support from at least one source listed in Guidelines and Discussion of why intervention fits your community. (41 - 45 points) Intervention specifics included: Actions related to Public Health Intervention Wheel Target population identified Outreach and engagement methods described. Intervention location described. Timing of intervention (number of sessions) included. Collaborating with other disciplines discussed Level(s) of prevention described (primary, secondary, and/or tertiary). (46 - 50 points) Presentation includes at least one proposed evaluation method and Problem is introduced but is missing one of items listed in \"A\" column. (21 - 22 points) Problem is introduced but is missing two or three items listed in \"A\" column (19 - 20 points) One intervention is described but is missing one item from \"A\" column. (38 - 40 points) One intervention is described but is missing two items from \"A\" column. (34 - 37 points) Intervention is not described or supported. (0 points) /45 Intervention is missing one or two specific details from \"A\" column. (42 - 45 points) Intervention is missing three or four specific details from \"A\" column. (38 - 41 points) Intervention is missing more than four details from \"A\" column. (0 - 37 points) /50 At least one evaluation method Long and short term impact on community Presentation lacks discussion of /45 NR443 Milestone 3 Intervention Evaluation Guidelines updated 9/23/16 F (0-75%) Poor or failing or unsatisfacto ry level of performance Problem is not introduced. (0 points) LS Pts /25 5 Chamberlain College of Nursing NR443 Community Health Nursing desired outcomes. Longterm and short-term impact on your community if the intervention is \"successful\" discussed. (41 - 45 points) Summary 20 points Overall presentation 20 points Mechanics 20 points Includes at least one summary slide that reiterates the problem and purpose of the presentation. (18 - 20 points) Presentation is presented in a clear and logical manner. PowerPoint is appealing to the eye and includes creativity. Bullet points with short phrases used instead of paragraphs. Font is easy to read. (18 - 20 points) Excellent mechanics with no more than two errors of the following: Title slide with title and student name Correct grammar and spelling All sources cited in the text of slide All references listed on the reference slide and in APA format (hanging indent not needed for PowerPoint). (18 - 20 points) adequately described but lacks discussion on long- and short-term impact on community. (38 - 40 points) Summary reiterate the problem but is missing the purpose. (16 - 17 points) Presentation is clear and organized but lacks creativity or slides are too busy. (16 - 17 points) discussed, but evaluation method unclear. (34 - 37 points) evaluation plan and future impact. (0 points) Lacks reiteration of problem and purpose. (15 points) Summary slide not present. (0 points) /20 Presentation is somewhat disorganized and lacks creativity. (15 points) Presentation is disorganized and difficult to understand. (0-14 points) /20 Three errors of elements listed in \"A\" column. (16 - 17 points) Four errors of elements listed in \"A\" column. (15 points) More than four errors of elements listed in \"A\" column. (0-14 points) /20 Total points: NR443 Milestone 3 Intervention Evaluation Guidelines /225 updated 9/23/16 LS 6 Chamberlain College of Nursing NR443 Community Health Nursing QUALITATIVE AND QUANTITATIVE EVALUATION METHODS For the final assignment in NR 443: Community Health Nursing, you will need to utilize a qualitative or quantitative evaluation method to evaluate your proposed intervention. Qualitative evaluation techniques generally are subjective data and can include methods such as: observation methods interviews focus groups other non-statistical data Example: If your proposed intervention is related to childhood obesity, you may want to interview the children pre and post intervention to see if their attitude about food and health has changed. This would be a qualitative evaluation method. Example: For the same intervention, you want to have a focus group with pre and post intervention with parents to see if their children's attitudes about food have changed. This would be a qualitative evaluation method. Quantitative evaluation techniques generally are objective data and can include methods such as: surveys/questionnaires pre/posttests physiologic data statistical analysis Example: Your proposed intervention is the same as the example above, but instead of an interview, you would like to measure the children's weight pre and post your intervention. This would be a quantitative evaluation method. Example: Another example of a quantitative evaluation method would be having a pre and posttest on healthy foods and importance of exercise. You would compare the pre intervention test results with the post to measure if your intervention was effective. NR443 Qualitative and Quantitative Evaluation Methods 9/27/12 mm 1 Running Head: MILESTONE 2 VULNERABLE POPULATION ASSESSMENT Milestone 2: vulnerable population assessment Name Uchechi Elekwachi Course NR 443, Community health Nursing Date 11/19/2016 1 MILESTONE 2 VULNERABLE POPULATION ASSESSMENT 2 Introduction This paper critically explores on women of color as a vulnerable group with respect to access to healthcare in North Carolina. It focuses on the challenges faced by women of color in Raleigh City in North Carolina. According to the NC. Department of Health and Human Services record, the state's 2014 infant mortality rate was 7.1deaths of babies in their first year for every, 1,000 live births. In all, 860 infants died in North Carolina before their first birthday. The situation is particularly dire for women of color (African American) whose babies death rate babies is 2.2 times higher than for White babies. Pregnancy outcome most times are influenced by a woman's health and differ by factors such as race, ethnicity, age, location, healthcare access, education and income all which are determinants to an affordable health care. This invariably represent a double tragedy for women of color, the vulnerable group who may not get the right medical attention .and services required during pregnancy and afterwards. Hoban, R (2016).mentioned that \"When we look at poverty, it goes hand in hand with infant mortality\". She goes further to mention that is disparity in infant mortality outcome in counties where there are large population of low -income African -American women, such as Durham and Wake Counties in which Raleigh is one of the cities. According to the 2009 North Carolina BRFSS, African American are more likely to be obese, have diabetics ,be physically inactive and have a disability \"This paper therefore seeks to explore the health needs of women of color in Raleigh to identify their health risks and seek for a better approach to address the situation. Vulnerable population overview The vulnerable populations in Raleigh community are those experiencing homelessness and people with low income. According to data 40% of women in Raleigh has never been married with 32% of the women between the age of 18-24years .These group of population are most times seen in street going about their day to day activities and with the good bus system, you will find most families at the bus station using bus as an affordable means of transportation. You will see mothers with their children strolling to their nearby public school as well as after school .Most of the road systems in Raleigh are grid streets providing a convenient access to the various neighborhoods and other part of the city. A trip at night in most streets shows sufficient light and there is no worry of being mugged. Although in some neighborhood, you find the illegal dumping of waste which can cause a health problem to the community as the illegal dumping pollutes the environment. Most Pregnant women of color and their fetuses and infants are vulnerable to environmental hazards being influenced by their household income and assets, the quality of housing and basic services and environmental health risks within the workplace. Life stresses combined with the lack of resources to remediate them make these women of color ill with greater frequency than other women. MILESTONE 2 VULNERABLE POPULATION ASSESSMENT 3 Strengths, risk factors, and/or barriers Among strength for accessibility of healthcare for women of color in Raleigh includes government policies such as the affordable healthcare act. This policy eliminates barriers posed by high cost of medical care in the region and the country at large. Introduction of this policy has caused a 30 percent decrease number of women of color who cannot access healthcare. Health insurance ensures that challenges raising funds for medical care are factored. Medicaid and Medicare are other policies that represent strength for accessibility of healthcare to women of color but then the argument still goes even when insured, black women frequently encounter barriers, such as finding and accessing the offices of providers who accept their insurance coveragea common occurrence for persons enrolled in the Medicaid program. The lack of culturally respectful engagement with some medical professionals and living in communities without place-based supports to facilitate disease prevention (such as a healthy environment and access to fresh foods) also threatens the health of African-American women. Other array of factors contributing to disparities in health care among people of color is illiteracy, differences in healthy behaviors (e.g. diet, smoking, and exercise), socioeconomic differences, and other environmental factors. According to Leigh, W. (2012). \"A complex set of historical and contemporary factors (such as racism, poverty and segregation) shape the life experiences, and health outcomes of African American women. Their place in society and literally the places where they live both determine their health.\" Most women of color when pregnant are at risk for preterm birth, low birth weight, and their outcome with other hidden condition that will need medical screening before pregnancy, during and after pregnancy which if not detected will pose a threat to their babies. Community resources Among community resources for women of color in Raleigh is The Minority Women's Health Project, Inc. it is a non-profit organization that serves to enhance health of women of color by improving their education, policies and establishment of strategies that ensure their access to healthcare. Office of research on women's health is another resource in Raleigh that is utilized towards access to healthcare. This institution sponsors programs such as breast cancer, diabetes and heart diseases among this group. Other resources in the region are The North Carolina Healthy Start Foundation which is dedicated to eliminating preventable infant death and illness in North Carolina have developed pre-pregnancy, pregnancy, and post-pregnancy public education materials that teach women and families how to increase their chances of being healthy and having a healthy pregnancy, and how to reduce the risks of infant death and illness. Southeastern Regional Medical Center and the North Carolina Healthy Start Foundation (NCHSF) will partner to distribute onsides, nightlights and parent checklists with infant safe sleep and Sudden Infant Death Syndrome (SIDS) risk reduction messages in conjunction with National SIDS Awareness Month. MILESTONE 2 VULNERABLE POPULATION ASSESSMENT 4 Community health problem diagnosis Reducing the rate of infant death is an example of a problem that can be impacted by us as healthcare nurses. It is indeed a community problem facing women of color in Raleigh and should be addressed .Strategies to this end include provision of high quality of health care to women of color which should start before pregnancy, when pregnant and those who have recently given birth. Healthy people 2020 MICH 1.2 stated that the objective for this project will be \"Reduce the rate of fetal and infant deaths during prenatal period (28 weeks of gestation to 7 days after birth)\" Disparity in High infant mortality rate among women of color with the other women has been partly contributed by provision of poor healthcare by professionals due to discrimination against members of the group. Elimination of discrimination and other barriers to effective health will serve to reduced infant mortality issue in my community. Summary Women of color do face challenges in accessing health care in Raleigh. Such challenges creates gap between women of color and white women in the region with regard to accessibility to health care and should be addressed. Many barriers that affect accessibility of health care by women of color may be partial or impartial like discrimination, high illiteracy level, high poverty levels, differences in healthy behaviors (e.g. diet, smoking, and exercise), socioeconomic differences, and other environmental factors. Being aware that labor and immediate postnatal period as the most dangerous time for both newborn babies and their mother, and that both can survive health threats and thrive better if they had access to a simple and affordable interventions should at all time set our mind on the objective of this project which is to reduce infant mortality among women of color and their children .Eliminating these barriers will close up the gap and improve health care provision for the most vulnerable group in Raleigh and avoid deaths during prenatal period . Providing timely, accessible, quality care could prevent almost three quarters of infant deaths. The package of essential care includes antenatal care, obstetric care and postnatal care. Women, their families and communities also need education and information so they can care for themselves, recognize the risks and demand access to the care they need. We need to be in partnership with community resources to advocate strategically and improve policy and implementation of good and accessible health in Raleigh North Carolina. MILESTONE 2 VULNERABLE POPULATION ASSESSMENT 5 References. Hoban, R (2016) NC Infant Mortality Rate Remains Stubbornly High. Retrieved from: http://www.northcarolinahealthnews.org/2016/10/21/nc-infant-mortalityrate-remains-stubbornly-high/ https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-childHealth/objectives MICH 1.2 http://www.meetup.com/TheMinorityWomenHealthProject/member/14581321/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447111/ http://www.nchealthystart.org/mortality-in-north-carolina/ http://www.cdc.gov/brfss/state_info/brfss_use_examples.htm Leigh, W. (2012). The Affordable Care Act and Its Potential to Improve the Health of African American Women. Review of Black Political Economy, 39(4), 461-464. Doi: 10.1007/s12114-011-9 U.S. Census Bureau, (2015). State and County Quick Facts. Retrieved from http://quickfacts.census.gov/qfd/index.html