The purpose of this direct care project is for learners to apply the nursing process to a community health problem determined by their observations and data collection of vulnerable populations in their community.

The purpose of this direct care project is for learners to apply the nursing process to a community health problem determined by their observations and data collected of vulnerable populations in their community.

This is Part 2 of 4 in the Direct Care Project. Direct Care

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Project Overview

1. There are four parts to the Direct Care Project.

2. There will be graded Project Check-ins that correlate to each part.

3. The topic selected in Part 1 will be the same one used in Parts 2 through 4.

4. Review the table below for overview and due dates with each topic.

5. Carefully review the instructions, templates, tutorials, and rubrics for each part.

6. Contact your instructor with questions.

Substance Use •

o SBIRT: Planning the Presentation Instructions (Links to an external site.)

3. Download the template below and create a PowerPoint presentation for your selected group.

4. Create speaker notes for the PowerPoint presentation. These will assist you as you present and will be part of your assignment submission.

5. Utilize your own words and paraphrasing for all presentation content.

6. The presentation should be no fewer than 8 and no more than 15 slides. This does not include the introduction and reference slides.

7. Submit presentation in PDF for instructor approval. See Submitting PowerPoint Notes Pages in PDF format (Links to an external site.).

Best Practices

• Please use your browser’s File setting to save or print this page.

• Include your name and date on the title slide.

• Check for spelling and grammar errors prior to final submission.

• Use bullet points instead of long sentences or paragraphs

• Include graphics, photographs, colors, and themes.

• Use the rubric as a final check prior to submission to ensure all content is clearly addressed.

• Scholarly Sources and Citations

• Minimum of 3 references. See Presentation Instructions for references needed.

• Cite all resources in APA format on the slide where content occurs. Cite in lower corner/footer as prompted on template. • Reference slide is in template. Hanging indent is not required.

Direct Care Project Part 1

Substance Use Assessment and Diagnosis Template

Directions: Collect the data outlined in this template. Fill in the blanks in the tables provided. There are two parts – online data collection and a modified windshield survey data collection. You will then identify a nursing problem in a vulnerable population and write a nursing diagnosis. See the assignment directions for suggestions and best practices. For full credit, all information in a category must be completed. This will be the topic of your Assessment and Nursing Diagnosis Template and also Parts 2 through 4 of your course project.

Name:

Online Data Collection

  1. Community Information
 Your Community Data
Name of city or town and stateBrooklyn, NY
Population2,504,700
Nature of this community (rural, suburban, urban)Urban
Describe your community in 2-3 sentencesKings county is very diverse neighborhood. The community has a variety of different cultures that interact to create a perfect melting pot.
 County DataState DataU.S. Data
Population total2,736,07420,201,249331,449,281
Male (subtract female % from 100)47.4%48.6%49.2%
Female52.6%51.4%50.8%
Persons under 55.8%7.1%6.0%
Persons over 6514.4%16.9%16.5%
Race and origin data
 County DataState DataU.S. Data
White alone49.8%69.6%76.3%
Black or African American alone33.8%17.6%13.4%
American Indian and Alaska Native alone0.9%1.0%1.3%
Asian alone12.7%9.0%5.9%
Native Hawaiian and other Pacific Islander alone0.1%0.1%0.2%
Two or more races2.7%2.7%2.8%
Hispanic or Latino18.9%19.3%18.5%
White alone, not Hispanic or Latino36.8%55.3%60.1%
Significant population characteristics
 County DataState DataU.S. Data
Veterans37,191705,92418,230,322
Foreign born persons36.1%22.6%13.6%
Housing overview
 County DataState DataU.S. Data
Housing units1,065,3998,404,381139,684,244
Owner-occupied housing unit rate30.1%53.9%64.0%
Median selected monthly owner costs with a mortgage$ 2,903$ 2,155$ 1,595
Median selected monthly owner costs without a mortgage$ 909$ 772$ 500
Median value of owner-occupied housing units$ 706,000$ 313, 700$ 217,500
Median gross rent$ 1,426$ 1,280$ 1, 062
Family and living arrangements
 County DataState DataU.S. Data
Households958,5677, 343,234120,756, 048
Persons per household2.662.592.62
Living in same house 1 year ago90.5%89.5%85.8%
Language other than English spoken at home45%30.5%21.6%
Computer and Internet Use
 County DataState DataU.S. Data
Households with a computer87.5%89.6%90.3%
Households with broadband internet subscription80.0%82.8%82.7%
Education
 County DataState DataU.S. Data
High school graduate or higher82.4%86.8%88.0%
Bachelor’s degree or higher37.5%366%32.1%
Health
 County DataState DataU.S. Data
With a disability under age 65 years5.8%7.6%8.6%
Persons without health insurance under age 65 years7.2%6.1%10.2%
Economy
 County DataState DataU.S. Data
Civilian labor workforce ages 16+63.6%63.0%63.0%
Transportation-mean travel time to work (minutes)43.0mins33.6mins26.9mins
Income and poverty
 County DataState DataU.S. Data
Median household income$ 60,231$ 68, 486$62, 843
Persons in poverty17.8%12.7%11.4%

        **you will need to use the “+” to see all of the data**

 County DataState Data
Health Outcomes Percentile75-100%N/A
Health Factors Percentile25-50%N/A
Premature death5,1005,400
Low birth weight8%8%
Adult smoking15%13%
Adult obesity24%26%
Physical inactivity24%23%
Excessive drinking18%19%
Alcohol impaired deaths11%21%
STIs817.6602.4
Teen births1614
Drug overdose deaths1319
Uninsured8%6%
Unemployment4.1%4.0%
Children in poverty25%18%
Violent crime586379
Air pollution7.96.6
Drinker water violationsn/an/a
Long commutes61%39%
 State Average   Regional AverageNational Average
Tobacco use23.5%23.2%26.8%
Marijuana16.2%15.0%16.2%
Marijuana use disorder1.8%1.6%1.6%
Heroin use0.20%0.31%0.30%
Misuse of prescription pain reliever2.8%2.9%3.7%
Opioid use disorder0.5%0.6%0.7%
Illicit drug use disorder2.8%2.7%2.9%
Alcohol use disorder5.2%4.9%5.3%
Substance use disorder7.1%6.8%7.4%

Windshield Survey

It is recommended that you have someone drive you around your community at least 2 times, ideally at different times of day and weekend vs. weekday. 

Look at the people in your community.   Did you observe:NoYesIf Yes, provide number or state “many” “some” or “few”
*pregnant women xsome
*pregnant adolescents xfew
*infants (under the age of 1 year old) xmany
*young children (1-5 years old) xmany
*school-age children (6-18 years old) xmany
adults (18 – 60 years old) xmany
*older adults (over the age of 60 years old) xmany
people exercising xfew
people driving xmany
people walking xmany
people biking xfew
people congregating in groups on the street xmany
*people that had hygiene issues or were unkempt xsome
people that were appropriately dressed xmany
people that were physically fit xsome
people that were obese xmany
*people that were undernourished, thin xfew
people that appear healthy xmany
*people that have obvious physical disabilities, such as those using walkers or wheelchairs xsome
*people with apparent mental/emotional disabilities xsome
*people who appeared homeless or unemployed xsome

*Represents vulnerable populations

Social and Economic Conditions   Did you observe:NoYesIf Yes, provide number or state “many” “some” or “few”
 xfew
 xfew
 xfew
(subway, train, buses, taxis, etc) xmany
 xsome
 xfew
 xmany
 xfew
 xmany
 xmany
x  
 xmany
Health Resources   Did you observe:NoYesIf Yes, provide number or state “many” “some” or “few”
hospitals xmany
community clinics xmany
family planning clinics xfew
generalist doctors xmany
dentist offices xfew
pharmacies xmany
urgent care clinics xfew
skilled nursing facilities xfew
mental health or counselling clinics xfew
homeless or abuse shelters xfew
public health department office xfew
substance abuse treatment center xfew
alternative medicine practices, botanicals, or herbal medicine shops  few
  Answer the following question:

  If some of the above health resources were not observed, approximately how far away would a person need to travel to find these resources?      
Environmental Conditions   Did you observe:NoYesIf Yes, provide number or state “many” “some” or “few”
evidence of anything that might make you suspicious of ground, water, or air pollutants xfew
poor road conditions with potholes, or poor drainage xfew
adequate traffic lights, signs, sidewalks, and curbs xmany
railroad crossings fitted with warnings and barriersx  
streets and parking lots well lit xmany
handicapped access to buildings, sidewalks, and streets xfew
recreational facilities, playgrounds, and/or facilities like the YMCA xfew
children playing in the streets, alleys, yards, or parks xfew
evidence of nuisances such as ants, flies, mosquitoes, or rodents, or stray animals observed xmany

Problem

Identify a nursing problem based on your data and observations. The problem must be related to substance use. Example: Alcohol use

Problem Identification: _____Illicit Drug Usage (Marijuana)___________

Vulnerable Population

Identify the vulnerable population that is most impacted by this problem. Example: Adolescents

Vulnerable Population Identification: __Young adults_______________

Diagnosis

Write a nursing diagnosis based on your problem from above. Fill in the blanks below.

Example: Increased risk for alcohol use among adolescents related to lack of sufficient knowledge about the long and short-term impacts demonstrated in increased county data compared to state/national averages.

*See chapter 6 in the Nies and McEwen (2019) textbook for more examples of composing a community health nursing diagnosis.

Nursing Diagnosis:

Increased risk of Marijuana used among young adults who work civilian labor workforce related to lack of higher education in addition to low paying jobs as demonstrated by lower higher education rates and below state/ U.S household income.

References

Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Behavioral health barometer, volume 6. https://www.samhsa.gov/data/report/behavioral-health-barometer-state-barometers-volume-6?page=0

County Health Rankings and Roadmaps. (2018). Explore rankingshttp://www.countyhealthrankings.org/

U.S. Census Bureau. (2018). State and county QuickFacts.  https://www.census.gov/quickfacts/

Direct Care Project Part 2

Screening, BriefIntervention, and Referral to Treatment (SBIRT): Planning the Presentation Instructions

Directions: Create a PowerPoint presentation teaching about the use of Screening, Brief Intervention, and Referral to Treatment (SBIRT). See the assignment directions and tutorial for suggestions and best practices. Review the week’s readings prior to starting on your presentation, understand SBIRT, and its use related to the problem you identified in Part 1: Assessment and Diagnosis assignment.

  1. Identify at least 3 practicing registered nurses who will volunteer for a session to learn about the SBIRT process that is used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs.
    1. You can present to all at the same time or individually. Set a date and time(s) for your presentation during Saturday of Week 5 and Saturday of Week 6to allow ample time to complete the Week 6 Part 4 Evaluation assignment.
  2. Review local data related to the specific problem or addiction identified in the Community Health Assessment and Diagnosis assignment. Maintain privacy and only include data that is available to the public. Include citation(s) on the slide when resources are used. Include all resources used on reference slide.
  3. Download the PowerPoint Presentation Template PowerPoint.(Once your presentation is complete, follow the job aid located in the Canvas Week 4 module Part 2 directions on how to convert the PowerPoint to PDF format with speaker notes displayed).
  • Create a PowerPoint presentation with speaker notes (8-15 slides not including introduction or references) for fellow healthcare professionals that includes:
  • Community description
    • Basic demographic data (i.e. population, size, education, poverty levels, etc.)
    • Relevant epidemiological data from Community Assessment and Diagnosis assignment.
  • Problem description
    • Comprehensive overview of the substance and problem
      • Overview of the problem and relevant data
      • Give an overview of contributing factors specific to your community (supported by data/ scholarly evidence) (i.e. target marketing, lack of employment opportunities, few treatment providers, lack of transportation, availability, etc.)
  • SBIRT description
    • Elements
      • Description of SBIRT abbreviation and process
        • Include an overview of each part of SBIRT
        • Identify the steps that are used with each part
    • Use
      • How SBIRT is used specific to identified problem
        • i.e. how to incorporate into an assessment
    • Example
      • How to use SBIRT in nursing practice with vulnerable populations
        • This may include a role play, script for a nurse to use in their assessment, example of an existing tool, etc.
    • Outcomes
      • How SBIRT impacts the problem?
        • i.e. enhances awareness, motivates change, health improvement, cost reduction, etc.
  • Community Resource
    • Describe one community resource that may assist with the substance use concern.
      • (For example, a local substance abuse clinic).
    • Include how to reach this resource
      • Phone, referral form, etc.
    • Assess 4 A’s: affordability, accessibility, acceptability, availability for each resource (see the Week 4 lesson)
  • Implications for practice
    • Provide a comprehensive overview of the impact of substance useto the audience.What does this data mean to them?How does the data impact them as healthcare professionals?
    • How could the implementation of SBIRT intervention into their practice impact patienthealth outcomes?
    • Use at least one scholarly reference as support
  • Conclusion
    • Includes brief overview of:
      1. Community demographic and epidemiological data;
      2. Problem;
      3. SBIRT description;
      4. Resources;
      5. Implications for practice;
      6. Importance to improving population health outcomes
  • Q&A slide
    • Give your audience an opportunity to ask questions they may have.
  • Reference slide
    • Minimum of 3 references. Should include references for SBIRT overview, community data, and at least one scholarly source. Utilize more references as needed.
  • See rubric, submission details, and best practices in Canvas.

Rubric

Direct Care Project Part 2: Planning the Presentation
CriteriaRatingsPts
This criterion is linked to a Learning OutcomeCommunity Description 1. Relevant demographic data
2. Relevant epidemiological data
15 pts Community description includes all relevant demographic and epidemiological data. 13 pts Community description includes most of the relevant demographic and epidemiological data. 12 pts Community description includes some relevant demographic and epidemiological data. 6 pts Community description includes minimal relevant demographic and epidemiological data. 0 pts Provides no community description15 pts
This criterion is linked to a Learning OutcomeProblem Description 1. Problem overview
2. Contributing factors
25 pts Problem description includes a comprehensive overview and contributing factors. 22 pts Problem description includes an adequate overview and contributing factors. 20 pts Problem description includes a minimal overview and contributing factors. 10 pts Either problem overview OR contributing factors are missing. 0 pts Provides no problem description25 pts
This criterion is linked to a Learning OutcomeSBIRT OR Air Flag Program description 1. Elements; 2. Use; 3. Example; 4. Outcomes40 pts Comprehensively provides all four criteria 1. Elements; 2. Use; 3. Example; 4. Outcomes 35 pts Adequately provides all criteria 1. Elements; 2. Use; 3. Example; 4. Outcomes 32 pts Minimally provides all criteria OR one criterion is missing. 1. Elements; 2. Use; 3. Example; 4. Outcomes 15 pts Missing two to three criteria 1. Elements; 2. Use; 3. Example; 4. Outcomes 0 pts Provides no criteria 1. Elements; 2. Use; 3. Example; 4. Outcomes40 pts
This criterion is linked to a Learning OutcomeCommunity Resource 1. Describes one community resource that can assist with identified problem.
2. Assesses the 4 A’s
(Affordability, Acceptability, Accessibility,
Availability)
25 pts One community resource described; Assesses the four A’s 22 pts One community resource described but one of the four A’s missing 20 pts One community resource described but two of the four A’s are missing 10 pts One community resource described but three of the four A’s are missing 0 pts Provides no resources OR all the four A’s are missing25 pts
This criterion is linked to a Learning OutcomeImplications 1. Provides comprehensive overview;
2. Explains how the implementation could impact outcomes;
3. Utilizes at least one scholarly reference as support.
15 pts Provides comprehensive overview of the impact to audience, how the implementation could impact outcomes, and utilizes one scholarly reference. 13 pts Provides adequate overview of the impact to audience, how the implementation could impact outcomes, and utilizes one scholarly reference. 12 pts Overview and explanation are minimal OR missing one criterion 6 pts Missing two criteria 0 pts Provides no criteria15 pts
This criterion is linked to a Learning OutcomeConclusion Includes brief overview of:
1. Community demographic and epidemiological data;
2. Problem;
3. Program/tool description;
4. Resources;
5. Implications;
6. Importance to improving population health outcomes
15 pts Provides all six criteria. Includes brief overview of: 1. Community demographic and epidemiological data; 2. Problem; 3. Program/tool description; 4. Resources; 5. Implications; 6. Importance to improving population health outcomes 13 pts Missing one criterion 12 pts Missing two to three criteria 6 pts Missing four to five criteria 0 pts Missing four or more criteria15 pts
This criterion is linked to a Learning OutcomeWriting and Design: 1. Writing contains no spelling or grammatical errors;
2. Bullet points used instead of long sentences or paragraphs;
3. Notes section is utilized;
4. Slides are visually appealing incorporating graphics, photographs, colors, and themes
5 pts Provides all four criteria 1. Writing contains no spelling or grammatical errors; 2. Bullet points used instead of long sentences or paragraphs; 3. Notes section is utilized; 4. Slides are visually appealing incorporating graphics, photographs, colors, and themes 4 pts Missing one criterion 3 pts Missing two criteria 2 pts Missing three criteria 0 pts Provides no criteria5 pts
This criterion is linked to a Learning OutcomeProfessionalism 1. Reference and title slide present; title slide includes name;
2. Assignment is 8 -15 slides (not including the title and reference slide);
3. Assignment submitted as PDF;
4. A minimum of three sources are used and cited in APA on slide where content occurs in lower corner/footer.
10 pts Provides all four criteria 1. Reference and title slide present, title slide includes name; 2. Assignment is 8 -15 slides (not including the title and reference slide); 3. Assignment submitted as PDF; 4. A minimum of three sources are used and cited in APA on slide where content occurs in lower corner/footer. 9 pts Missing one criterion 8 pts Missing two criteria 4 pts Missing three criteria 0 pts Provides no criteria10 pts
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