Community Analysis and Nursing Diagnosis



Data Analysis-Why?

A. To study and examine data collected

1 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.

I. Basic Steps of Data Analysis(4)

2 Categorize-e.g. by demographics, commonalities. E.g. intra/extra community for health and social services

3 Summarize

4 Compare

5 Inference/Interpretation

II. Categorize Data

6 There are many ways to sort and categorize data e.g. demographically by age groups, by problem type

7 Geographic approaches may be used

8 Use of model; we are using the wheel from Neuman’s model.

9 Look for data convergence when categorizing-e.g. how many times do we see data converging in different categories?

10 Look for commonalties, health resources that are available. SEC, age, etc.

III. Data Summary

11 Summary statements-summarize each table.

12 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.

13 Graphic methods of data summary:

14 Remember that tables need concise summary data. P. 222, can put population statistics in graph.

15 Dependency Ratio: how many people in your community who can support the dependents. Calcuation on page 225. Should do for both census tracts.

16 Data summarization facilitates ease of reading and spotting trends/patterns in data

IV. Summary Statistics

17 Rates-vital statistics

18 Percentages-population characteristics

19 Ratios-sex, dependency, etc.

20 Rank order listing-top ten causes of death

V. Examples of Summary Statements

21 When comparing community strengths and needs, it is observed…..

22 Community strengths established include….

23 Through visual inspection as well as interviews of residents, it was found…

24 Public health services in the community include….

VI. Other Data Summary Methods

25 Tables

26 Graphs

27 Charts

28 Mapping – summarizing boundaries

29 Pictures-can be put into appendix and does not count towards page count of final community assessment paper.

30 Photographs

31 Population pyramid-see page 222 in text for example.

VII. Data Comparison

32 Facilitates identification of data gaps, omissions, inaccuracies

33 Determine if a trend or pattern exists, especially if data are collected from past to present

34 Data comparison “gold standard” or benchmark

VIII. Data Comparison Standards

35 Select standard similar to community

36 Use of higher level than study community, e. g. city, state, or national levels

37 May compare different areas or regions of city, county, state, e. g. North side compared to South side

38 Schools to same type of school, other districts or district as whole

39 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.

40 Previous studies may be used for problems, diseases

41 Norms for developmental stages, ages, ethnic groups may be used

42 National Health Objectives statistics; Healthy People 2010 statistics are available to compare data to. Use this with intervention.

IX. Inference & Interpretation – chapter 10, table 10.1 & 10.5

43 Formulate conclusions with interpretative statements

44 Justify conclusions – use references such as interview quotes or statistical data

45 Cite comparison standards e.g. rates, ratios and/or percentages

46 Formulate lists of strengths and needs

47 Distinguish between fact and opinion

48 Validity of source

X. Community Nursing Diagnosis: from inferences and summary statements.

49 Need to depart from NANDA as it is more individual focused

50 Appropriate for primary, secondary, and tertiary levels of prevention

51 Implies that the community/aggregate is target of intervention

52 Compare strengths to community needs in table format. Take the two needs you find to be most significant. List should be longer than two.

53 From inferences and summary statements, make a final summary statement.

54 Encompasses (what the nursing diagnosis could be)

55 health risks

56 vulnerable groups

57 health problems

58 lack of services

59 health promotion

60 potential risks

XI. Framing the Community Nursing Dx

61 Description of the problem, response, or state-come from the inferences of community

62 Identification of factors etiologically related-causes

63 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 crime related to young kids on crime sprees as evidenced by….supporting data.

XII. Validating the Comm. Nsg. Dx

64 Collection of more data

65 Surveys – fast-good way to validate by opinion. E.g. Eight out of ten people surveyed agree that…blah blah blah

66 Interview of residents, business owners, service providers

67 Analysis of other studies of the community; does not have to be r/t this particular community. Secondary Data.

Examples of Community Nursing Diagnoses

1 Description of problem, response, state (have problem and degree of reaction)

2 High rate of dental caries (e.g. problem = caries; deg. of rxn = high rate)

3 Potential for mugging and criminal victimization

4 Inadequate family planning services

5 Incomplete immunization status of preschool children

6 Factors etiologically related

7 lack of fluoride in drinking water; no dental hygiene education; limited income to pay for dental care

8 few self protective measure; episodes of thefts and burglaries

9 clinic days twice a month and no PM hours

10 limited access to immunization clinics; lack of knowledge of importance of early immunizations

11 Signs and symptoms, manifestations, evidence

12 62% have caries on inspection

13 Police report 30 % of calls; personal report of citizens

14 crude birth rate 50% higher than city; published clinic hours

15 immunization completion rate of 37% based on survey data

XIII. Nursing Diagnoses

16 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.

17 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.

18 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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