Assignment: NSGCB 482 competency 1

Assignment: NSGCB 482 competency 1

Assignment: NSGCB 482 competency 1

Windshield Survey and Family-Level Narrative Template

Windshield Survey Data Overview

Data
Strengths
Weaknesses

Data Summary

Write a 350-word summary of the data for the windshield survey and for the family-level narrative.

Windshield Survey Narrative Summary

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Include the following information in your summary:

Write a data overview of all community components as identified in the Community Toolbox resource.

Describe the strengths of community as evidenced by the windshield survey.

Describe the weaknesses (gaps in service) as evidenced by the windshield survey.

Write your 350-word windshield survey narrative summary on a new line below.

Family-Level Narrative Summary

Include the following information in your summary:

The family prioritized problems (Diagnoses) from your windshield survey review with the family

The community resources you provided to the family

Your evaluation of the family’s understanding of how to access the community resources

Two family-level problems (also described as nursing diagnoses) with descriptions like the following examples:

One family-level problem that is affected by the lack of community resources. For example, a single parent cannot access affordable daycare in the community because the closest subsidized daycare in the county is located 25 miles away in the opposite direction from work, which would require the parent to leave the child unsupervised while they work or choose not to work. The problem (or diagnosis) might be written as, “Presence of a family stress point: lack of accessible, affordable childcare.”

One family-level problem based on the family assessment and identified by you and the parent/guardians that would benefit from strengthening or changing. For example, a grandparent who lives in the home has chronic cancer pain and is in palliative care. The grandparent has been prescribed fentanyl patches and has been discarding used patches in the family garbage can. You and the family decide that this is a safety issue. The problem (or diagnosis) might be stated as, “Presence of a health threat: potential for accidental opioid overdose.”

Write your 350-word family-level narrative summary on a new line below.

Part 1: Clinical Activities: Family Assessment and Intervention

Select a family within your community for this assignment. The family must have at least 3 members with 1 member under the age of 18 living within the home.

Prior to meeting the family, make sure to:

Review the key points of therapeutic conversation.

Visit the Centers for Disease Control and Prevention (CDC) website for parenting resources (e.g., prevention of child abuse and neglect resources).

Study the definitions of child abuse and neglect in your state regulations.

Watch the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) webinar on screening for child abuse and neglect.

Download and familiarize yourself with the ISPCAN Child Abuse Screening Tools (ICAST-P and ICAST-C). These tools will help you frame questions to screen for child abuse and neglect in a safe, empathetic, and therapeutic manner.

Meet with your preceptor, and together select3 key questions from the child and parent versions (3 from each for a total of 6) of the above screening tool to ask your chosen family.

Meet with the family and assess through discussion and observation critical information to understanding the family unit including:

Demographic data (i.e., age in years, self-identified race/ethnicity, languages spoken in the home, gender identification, health insurance status of all family members)

Developmental stage and history of family (e.g., Erikson’s developmental stages)

Environmental data (e.g., exposure to lead, house cleanliness)

Family structure (i.e., who makes up the family)

Family functions (i.e., roles, responsibilities, and occupations)

Family stress and coping (An example of family stress is a family with a child or children with developmental disabilities. Healthy coping strategies include joining a parental support group and/or having an ongoing professional relationship with a caring health care provider.)

Family composition (e.g., “Yours, mine, and ours;” caring for an extended family member)Parenting styles (i.e., authoritarian, permissive, authoritative, neglectful)

Identify any weaknesses, limitations, or vulnerabilities that might be interpreted as or place the family at risk for abuse and/or neglect.

Discuss with the parents or guardians ways they might strengthen their parenting skills and/or address the perceived vulnerabilities.

Part 2: Clinical Activities: Community Assessment and Intervention

Discuss your windshield survey findings with your chosen family. In collaboration with your chosen family:

Prioritize the problems you have identified based on a recognized gap in community resources that could contribute to one or more poor health outcomes (Planning).

Identify at least 1 area where parents/guardians might benefit from additional assistance or resources to strengthen their parenting skills (Diagnose).

Provide support and resources to minimize any health risk factors to your family. Resources should include other professionals from the community to work with the family and the public health nurses as part of an interprofessional health care team (e.g., social services, psychiatric/mental health resources, teachers, religious leaders) (Intervene).

Evaluate the family members’ understanding of the information provided. You might accomplish this evaluation by asking the family which of the resources they might consider using. Ask them to tell you how they would access these resources (Evaluate).

Compile your windshield survey data using the Windshield Survey and Family-Level Narrative Template to include:

Data overview of all community components as identified in the Community Toolbox resource

Strengths of community as evidenced by the windshield survey

Weaknesses (gaps in service) as evidenced by the windshield survey

Using the space provided at the end of the Windshield Survey and Family-Level Narrative Template, document the family prioritized problems (Diagnoses) from the windshield survey review, community resources provided, and your evaluation of the family’s understanding of how to access community resources.

List 2 family-level problems (also described as nursing diagnoses):

One family-level problem that is affected by the lack of community resources. For example, a single parent cannot access affordable daycare in the community because the closest subsidized daycare in the county is located 25 miles away in the opposite direction from work, which would require the parent to leave the child unsupervised while they work or choose not to work. The problem (or diagnosis) might be written as, “Presence of a family stress point: lack of accessible, affordable childcare.”

One family-level problem based on the family assessment and identified by you and the parent/guardians that would benefit from strengthening or changing. For example, a grandparent who lives in the home has chronic cancer pain and is in palliative care. The grandparent has been prescribed fentanyl patches and has been discarding used patches in the family garbage can. You and the family decide that this is a safety issue. The problem (or diagnosis) might be stated as, “Presence of a health threat: potential for accidental opioid overdose.”

Submit your completed Windshield Survey and Family-Level Narrative Template that includes 2 family prioritized problems (nursing diagnoses), community resources provided, and an evaluation of the family’s understanding of how to access community resources.

Parent interview questions:

Father (we will call Matthew SR for privacy) Your child was not taken care of when s/he was sick or injured?

Answer: when the father and mother were going through a divorce, the mother had custody and father had visitation. The child ( we will call Matthew Jr) would show up for visitation with severe diaper rash and prescribed medications would not be open. Matthew Sr started to take pictures for documentation. Shortly thereafter the mother was found deceased and Senior received full custody. Matthew jr has no memory of this.

Your child was not always provided a safe place to live?

Answer: No. When the Matthew jrs mother left the family home she was living with a known drug addict. Per Matthew Jr sister, they would be locked in the laundry room when the mother and her boyfriend was using. Matthew jr has no memory of this.

Locked him or her up or tied him/her to restrict movement?

Answer: Matthew Jr was locked in the laundry room to prevent him from coming into the living area where the mother was using drugs.

Child interview

Shouted, yelled, or screamed at you very loudly?

Answer, Yes, my father and mother. (aka) girlfriend. Approx. once a month

Explained to you why something you did was wrong?

Answer, Yes, my father and mother

Gave you a reward for behaving well?

Answer: yes, mother and father

Information on my family:

The house is a 3 bedroom 1 bath brick home. In the basement where the laundry room is there is an apartment. The house is in a quite subdivision in Westminster, Maryland. The house is centrally located. Both adults work within two blocks of the home. The home appeared clean but noticed the kitchen floor needs to be replaced along with the refrigerator. There is radiant heat that is controlled by everyroom individually. They do state that it is very expensive to heat the house.

English is the language of the family. There does appear to be some cognitive development from both adults.

Matthew SR (father)

33 years old high school graduate and works full time at as an assistant manager at a pizza delivery chain. His father has been deceased since the age of 12 due to diabetes and kidney failure. His mother is alive and lives in tn currently. He is very close to his mother and lived with her for many years. She was a single mother but had support from his grandfather. His grandfather lived with him till 2020 when he passed away in the home. His ex wife and juniors mother left him when junior was 2 and she passed away 9 months later. The house consists of senior, junior, and his girlfriend Brittany (we will call her for privacy). Matthew Sr states he struggles financially. Housing in Maryland is expensive and with the raising price of groceries and fuel. He is socially withdrawn and does hang out with any friend. His girlfriend is very insecure but he is able to bowl once a week on league to allow him to socialize. He states that he has to leave Matthew jr home alone due to not being able to get help with childcare. He does not qualify for food stamps because he receives a social security check for Matthew jr in the amount of four hundred and fifty dollars. He states he is exhausted a lot because his girlfriend does not drive so he has to get up early to take her to work. He is struggling with needing dental work but can not afford it. He has health insurance through Medicaid but states when he gets a day off he is too tired to tend to his issues. He does all the cleaning and most of the cooking and the grocery shopping due to his girlfriends pain issues. He corrects Matthew Jr when he needs it and assigns chores for him.

Matthew Jr

This is a 10 year old child and going into the fifth grade. It appears that he is happy and loves to talk. He has 2 siblings he has not seen in 7 years since the death of his mother. He has little memory of his brother but states he really misses his sister. He did talk about the loss of his grandfather and his cat. He showed me his grandfathers bedroom that he now sleeps in. There was a motorized scooter in there that the child started beeping the horn stating that is how he knew his grandfather needed something. He also showed me the cats ashes. He currently has a cat but states its crazy. He states he calls his daddy’s girlfriend mommy. He states he takes care of her and reminds her to take her meds including her birth control pills. ( I was a little taken back by this). He states he stays home alone but daddy works two blocks from home. He states he doesn’t really have any friends to hang out with. He said he had one but he was mean to him so he stopped going over there. Child does belong to big brother program and one night a week he comes over. They play games and write in his journal. He also sees a counselor one day a week. He denies being hit every by his parents and is only yelled at once a month if he is bad. He states he feels safe at home.

Brittany

Brittany is 34 years old high school graduate. She recently started working in a Dr office as an Medical assistant. She was in nursing school but dropped out due to pain. She states she has Ankylosing spondylitis for which she takes multiple medications and injections for. There are multiple medications sitting around the house on the end tables. She states she is unable to do most everyday tasks due to pain. While conducting my interview she could not open the childs drink due to pain in her hands. She has a hard time financially due to missing large chunk of time at work due to her flair ups of pain. She also has a difficult time attending any physical therapy due to lack of transportation because she does not have a driver license. She states she is scared to drive. She states that she thinks by the time she is 40 she will be unable to work because of her condition.

Westminster, MD:

Westminster is a smaller older town community. It does consist of farmland. The city section of Westminster consists of approx. 10 blocks. There is small mall but most of the stores are empty. Transportation is limited. The local hospital is 7 miles away and appears to be a smaller hospital. By 8pm the streets had little traffic. The main economic activities are manufacturing and agriculture such as dairy, cattle, oat, and corn. The area is 449 square miles. Per redfin the median price of a home is $385K.

There are local parks but most are not maintained.

Resources found for the family:

Carroll county food bank

Tues, wed, thur 10-11:15am and 1-2:15 pm

Saturday 9-11:15

Silver run community food pantry @ St Marys Evangelical Lutheran church

Drive thru 1st and 3rd Wednesday of each month from 5-6

Assignment: NSGCB 482 competency 1 Sample

Healthcare professionals have various roles among individuals and populations at large. Therefore, they employ various strategies to improve health outcomes. One such approach is the use of a windshield survey, which entails a simple observation of a community. Through such an observation, an individual can collect data that can be used to assess the community, unveil particular trends, explore the community’s stability, and study various changes that can define the community’s health (Kiper & Geist, 2020). Therefore, the purpose of this assignment is to provide a summary of the windshield survey and a family-level narrative.

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Windshield Survey Data Overview

Data	Strengths	Weakness
Community housing: condition, nature, and age	Most of the houses are well-maintained	The site is a few blocks away from low-income neighborhoods as well as poorly maintained facilities and buildings.
Infrastructure	The sidewalks, streetlights, and surrounding public roads are well-maintained.	There are other parts with damaged sidewalks and roads, which makes it complicated to navigate those parts.
Industrial facility and functioning business	The area has numerous upcoming businesses that show potential for growth	There are also dilapidates buildings in the business area which attract homeless people
Public spaces: Usage and condition	The place has numerous public spaces; while some are free, others can be available on lease or rent.	People shy away due to continual activities experienced
Activities experienced in the street	Activities are limited, especially during winter. On the other hand, summer and spring are associated with increased street activities.	Criminal activities are experienced during increased activities
Noise levels	Noise is mainly experienced during the day, with the intensity reducing significantly at 2130 hours. Places with heavy traffic have higher levels of noise, especially during the summer, as compared to the colder parts of the year.	The high and constant levels of noise during the summer enhance crime, which makes families move away and drive away potential investors.
Traffic	Traffic is mainly experienced in the morning and evening when people are going to and coming from school and work.	Heavy traffic sometimes causes accidents.
Public buildings: condition and location	The important public buildings such as city hall are accessible and within walking distance. Therefore, individuals can easily go when in need.	The closeness sometimes makes the people around experience congestion due to human traffic. The high number of people at times increases crime incidences.
The Walkability	The area has sufficient biking and walking paths. The authorities have also put in place appropriate safety measures for the paths.	Sometimes, congestion is experienced on the paths, especially during the warmer months.
Accessibility of community resource	Most community resources are near and accessible. Some are within walking distance.	Individuals avoid accessing the resources on foot, especially during winter, which reduces their levels of physical activity.
Public transportation: cost and availability	Public transport is readily available, and they are accessible and cost-friendly. The transport system has taken the disabled into consideration.	Public transport is not accessible for individuals without resources
Availability of community public spaces and centers recreation centers, community centers, churches, parks, public libraries, social service centers	There are two community social services, a public library and public parks are numerous. There are numerous churches as well as a number of recreation facilities	The specific opening and closing hours for most of the facilities limit activity, especially for those who want to use them after hours.
Availability of healthcare facilities and resources: Hospitals and clinics	There are three hospitals which serve the population. There are also several clinics in the area which operate seven days a week	There are individuals from low-income areas who may lack the insurance needed to access healthcare services offered in these facilities.
Food options and nutrition	The region has grocery stores that sell healthy foods	Healthy foods are more expensive and hence cannot be afforded by many people
Characteristics of deserts and food	The stocked foods are frozen before being transported to the region. They have to be used before their expiry date.	Wastages when foods remain past their expiry dates
Availability of grocery stores	There are several grocery stores, with stores located within meters of each other.	Individuals with no stable income and resources find it difficult to purchase from these stores.
The presence of the homeless population	There is a handful of homeless population, which increases during the summer.	Heavy drug and alcohol abuse is experienced among homeless people. They also experience a decline in health during the winter.
Availability of homeless services	There are various shelter services for homeless individuals	The services are not sufficient; the services are also only available at specific times of the day
Fire/police presence	There are various fire rescue points and around four police posts	Sometimes, it takes time before a fire response is made

Windshield Survey Summary

This section focuses on summarizing the windshield survey narrative. Various data were used in the community assessment to obtain the relevant information needed. One of the data used is community housing, which was majorly concerned with the age, nature, and condition of the houses. This was done to explore the living conditions of the individuals in terms of housing. Infrastructure was also explored, and it majorly focused on the condition of public roads and sidewalks. The other aspects were industrial facilities and functioning businesses, which looked at various business establishments, both new and old businesses. The other data aspects were public spaces, how they are used, and their condition, whether maintained or not; this was explored in connection with the activities experienced in the streets. Another aspect was noise levels, which were explored to find out how conducive the environment was. Traffic flow is another data point that was explored to describe the nature of the traffic experienced.

The next data considered was public building, their location, their condition, and the walkability of the region. Accessibility to various community resources was also explored to find out how easily the community members could access these facilities. The nature, cost, and availability of public transport were also explored. The availability of community public spaces, centers, recreation centers, community centers, and churches was another data point. The availability of healthcare facilities and resources was also explored to find out how well the community can access them as it determines the patient’s health outcomes (Chen et al.,2020). Food options, nutrition, and availability of grocery stores were other aspects. The survey also focused on the presence of the homeless population and the availability of services to support them.

The survey revealed various strengths, including well-maintained houses, sidewalks, and some public roads. There were also numerous public spaces and recreation spaces for individuals to keep fit. Noise levels significantly reduce at night, which is important for health. The important public buildings are accessible and within walking distance; hence, individuals can easily access them. There are also sufficient hospitals and clinics within the region and easy accessibility. On the other hand, there are various areas of weakness or gaps in service. For example, there are higher incidences of alcohol and drug abuse among homeless individuals, which is a threat to the larger community. Healthy foods are also expensive.

Family Level Narrative Summary

The assessed family is a family of three: father (Mathew Sr), his son, who was two years old when his wife died, and his girlfriend, who he started relating with after his wife’s death. From the windshield survey review with the family, various family problems were identified. One of them is financial struggles. Mathew Senior struggles financially. Things have not been made easier due to the fact that housing in Maryland is expensive, while there have also been cases of rising costs of grocery and fuel. However, the family does not qualify for food stamps since they get four hundred and fifty dollars for junior. He can also afford dental care, which he needs due to financial struggles. Junior also has to see a counselor every week, pointing to mental health struggles. The girlfriend also experiences pain due to ankylosing spondylitis. She also has financial struggles, and she has a lot of worries that her condition will make her stop working by the time she is forty.

            Various community resources were provided to the family. One of them is the recreational facility within the community to help them keep fit and healthy. The child needs counseling at least once a week; therefore, another community resource provided is the community counseling center and psychiatric or mental health service where counselors can easily be accessed to offer the services (Rosen et al.,2020). The social hall, where individuals can meet for various purposes such as hanging out, was also offered since they feel lonely due to various reasons. The family demonstrated a substantial understanding of how to access community resources. For example, the father explained that he has an idea of the location of all the community resources, and it only requires an effort from them to adequately access the resources. They also indicated that they are aware that some of the resources have specific operation times, hence a need to visit them when they are open.

            One family-level problem is affected by financial constraints. For example, due to financial struggles, the family cannot access adequate medical care. They are also not in a position to consistently buy adequate groceries due to the increasing costs of groceries. The other family-level problem is caused by the chronic pain experienced by the girlfriend due to ankylosing spondylitis. Lack of adequate transport can be a barrier in case of emergencies as she does not have a driving license and she fears driving.

Conclusion

            This assignment has focused on a windshield survey, which has revealed various aspects of the community that represent care gaps. Various family problems were also identified, including health complications. The other aspects identified include financial struggles and mental health complications.

References

Chen, S., Zhang, Z., Yang, J., Wang, J., Zhai, X., Bärnighausen, T., & Wang, C. (2020). Fangcang shelter hospitals: A novel concept for responding to public health emergencies. The Lancet, 395(10232), 1305-1314. https://doi.org/10.1016/S0140-6736(20)30744-3

Kiper, V., & Geist, R. (2020). Nurses on the frontline: Improving community health. Nursing made Incredibly Easy, 18(3), 22-26. Doi: 10.1097/01.NME.0000658188.17482.9a

Rosen, A., Gill, N. S., & Salvador-Carulla, L. (2020). The future of community psychiatry and community mental health services. Current Opinion In Psychiatry, 33(4), 375-390. Doi: 10.1097/YCO.0000000000000620