Population Based Health Assessment and Plan

The health of population aggregates play an important role in today's health care system. Nurses work closely with clients to promote the health of the population for individuals, small groups, clients with selected health conditions, populations in a community, and entire geographic communities. Population based nursing involves the collection and analysis of data on health related factors to identify health strengths and weaknesses, and to plan interventions to promote health and well being of the population.

The Population Based Health Care Clinical Laboratory challenge involves selection of a population of interest (to be approved by the lead teacher), assessment of health related factors, analysis of health needs, formulation of an nursing care plan for the population aggregate, and identification of criteria for evaluation. The written paper describing the nursing process applied to a population (typically 5-10 pages) will be submitted to the lead teacher and graded as pass or fail.

Overview of Population Assessment and Health Plan Paper

Select a target population for the project. Target populations may include geographic communities (such as counties or cities), age defined groups (children attending a specific school, employees of a certain locale or company, senior citizens in a given community), or those with specific health conditions (pregnant teens, persons with HIV) within a given community.
Submit a 1-2 paragraph description of the target population to the lead teacher for approval prior to proceeding.
Describe health characteristics of the population.
State and prioritize health strengths and weaknesses and identify a nursing diagnosis for aggregate health interventions.
Identify nursing interventions related to the nursing diagnosis for your population.
Describe a plan to evaluate the effectiveness and outcomes of the intervention (actual implementation is optional).

Detailed Guidelines:

Assessment: Population Description and Identification of Nursing Diagnoses
1. General characteristics
  1. Review existing sources of health related data to define and describe your population (include statistics relating to age, gender, and common health problems or needs, risk and protective factors). Research factual information and statistics about the health of your identified population (web sites, nursing journals, nursing books, CDC, & web resources such as those listed below). (Include reference citations for at least two sources).

http://www.kdhe.state.ks.us/hci/
http://www.cdc.gov/
http://www.khi.org
http://www.khf.org
http://www.who.int/
http://www.census.gov/
http://envirn.umaryland.edu/

Identify and list national health goals (at least two) that are relevant to the health of your population from the Healthy People 2010 Guidelines.

http://www.health.gov/healthypeople/

Specific characteristics (bulleted examples are provided as a guide for the student. Depending on the target population, selected examples may not apply and other factors may be more appropriate to assess).
1. Biophysical Considerations:
  - What are the leading causes of morbidity (diseases) among your target population? What physiologic conditions are prevalent in the population?
  - What are the causes of death of the target population?
  - How do morbidity and mortality rates of the target population compare with state and national rates?
  - What is the immunization status of the target & national population?
  - What is the extent of disability within the community?
2. Psychological Considerations:
  - What stressors are present in the community?
  - How cohesive is the community? How is the interaction of groups within the community (racial tension, etc.)?
  - How adequate are protective services in the community?
  - What are the formal communication channels in the community?
  - What are the rates of crime in the community, homicide & suicide rates?
  - What is the extent of mental illness in the community?
3. Environmental Considerations:
  - What type of community & where it is located? (urban/ rural). How large is the community (Size), and & what is the population density?
  - What topographical features could influence the health of the target population?
  - What are the types & conditions of housing? Are they adequate & affordable?
  - What is the source of water & is it safe for consumption? Is it adequate to meet needs?
  - How does community handle sewage and waste disposal? Does it have any safety hazards on the health of the target population?
  - Is there a nuisance factor present in the community? (Climate, plants, insects, noise, etc.).
  - Is there evidence of environmental pollution that may affect health? (Chemical, air, water, waste from restaurants, etc.).
  - Is there potential for disaster in the community & what kind? What is the extent of community disaster preparation?
4. Socio-cultural Considerations:
  1. Governance and Leadership:
    - How are decisions made? Who makes them?
  2. Culture and Religion:
    - What cultural & spiritual groups are represented in the community?
    - What language(s) is/are spoken by the target population?
    - What religious affiliations are represented in the community? What effect do they have on community life & health? (Programs, & Services).
  3. Socioeconomic Status:
    - What is the rate of unemployment in the community?
    - What is the education level of community members?
    - What is the income level and distribution within the community?
  4. Other factors:
    - What is the type of transportation in the community? How accessible is it in the community?
    - What is the marital status of community members?
    - What is the typical family structure in the community?
    - How accessible are goods and services to community members?
5. Behavioral Considerations:
  1. Consumption Patterns:
    - What are the usual food preferences and consumption patterns in the community?
    - What is the nutritional level in the community? What percentage of the population is overweight? Underweight?
    - What is the extent of alcohol sales in the community?
    - What is the extent of drug abuse in the community? What drugs are abused? How easy is it to obtain drugs?
    - What is the extent of smoking in the community?
  2. Exercise and Leisure:
    - What exercise opportunities are available to the target population? To what extent are they utilized?
    - What opportunities for leisure activity are present in the community?
    - Do typical community leisure activities pose any health or safety hazards?
  3. Sexual Practices:
    - What is the attitude of the community to sexual activity?
    - What is the extent of contraceptive use in the community?
    - What is the prevalence of unsafe sexual patterns in the community?
  4. Other Behaviors:
    - Safety practices (e.g., seat belt use)?
6. Health System Considerations:
  - What types of primary (e.g., exercise & health promotion programs), secondary (e.g., screening), tertiary (e.g., avoid complications), preventive services are available in the community?
  - How accessible are these services to the community members?
  - Are the types of services available adequate to meet community health needs?
  - Are available services culturally relevant to members of the population?
  - To what extent are available health care services utilized? What barriers to service utilization exist in the community?
  - Are there folk or alternative health services available in the community?
  - How are health care services financed? What proportion has health insurance?
  - What are community attitudes toward health care services and providers?
Analyses:
Based on the data you have collected and presented, identify five health related strengths of your population and five health related weaknesses.

Identify one Population Focused Nursing Diagnosis for your selected population.
Nursing Care Plan:
1. Planned interventions:
  1. Develop plans of intervention for promoting the health of the population.
  2. Provide rationale and references for your interventions.
2. Implementation (OPTIONAL): Briefly describe your implementation of the planned population focused nursing interventions.
Evaluation and Recommendations:

Identify measurable outcome criteria for evaluating your interventions.

Grading Criteria: A grade of Pass or Fail will be assigned to the paper. The following criteria must be met to achieve a passing grade:

The population is clearly identified and described and rationale for selecting the population is included.

Data relevant to the health of the population (with citations) are provided within each area of consideration (general, biophysical, psychological, environmental, socio-cultural, behavioral, and health systems).

Two Healthy People 2010 objectives related to the population are identified.

Strengths and weaknesses related to population health are based on assessment data.

The nursing diagnosis is based on assessment data and strengths and weaknesses.

A comprehensive intervention plan is described (including references). Interventions focus on the aggregate population, not just individual clients.

Population focused outcome criteria are reasonable and measurable.

The Report Considerations are adapted from Community Health Nursing: Advocacy for Population Health, chapter 15, by Clark, J., M. (2008). Fifth Edition. Prentice Hall. Upper Saddle River, New Jersey.

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