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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