Community Health Project Paper

Nurs 492
Community Health Nursing

Purpose of Assignment
The purpose of the project is to examine a community health problem for a specific aggregate.
The project is to be able to apply the nursing process to a vulnerable population with in your
community. In addition the purpose of this assignment is to utilize the Health Planning Model to
improve aggregate health and to apply the nursing process to the larger aggregate within a
systems framework.
Student Approach to Assignment
The aggregate I chose was a long-term & skilled rehabilitation center. This aggregate was chosen
because of the goal listed from Advancing Healthy People 2030 to improve the health and well-
being for older adults. Older adults are in a higher risk level for health diseases such as diabetes,
osteoporosis, and Alzheimer’s and more likely to be hospitalized for infectious disease such as
pneumonia. Also, with COVID restricting visitation to these patients I was able to work towards
another Healthy People 2030 Goal of “improving Mental Health.” According to Health People
2030, mental health disorders such as depression and/or anxiety can affect a person’s ability to
participate in healthy behaviors such as physical exercise.
I gained access to the facility by attending a meeting with the Director of Nursing and explaining
the purpose of the assignment and how I felt I could work towards those Healthy People 2030
Goals. We came to an agreement with the understanding I would have to submit to COVID
testing at the facility and provide hands on and face to face patient activities.
Reason for Inclusion of this Assignment in the Portfolio
I feel it is important for me to include this in my portfolio because it shows volunteer work I
have provided during my time at ODU and the importance of awareness to elderly patients’
physical and mental health. During COVID many elderly patients suffered mentally due to
visitors being completely restricted and being separated from their families. In this project I
demonstrate not only community service but also successfully providing interventions towards
the Healthy People 2030 goals after thoroughly researching goals that could relate to the elderly
patients in a nursing facility in my community.
It represents me as a nurse because it demonstrates the empathy I have for elderly patients and
how I believe interventions need to take place for our elderly patients in these long term &
skilled rehabilitation centers. The first six years of my Nursing career took place at a similar
facility, so I understand the downfalls of these facilities and the changes that need to be made for
the quality of care provided to this patient group. It also demonstrates my ability to work within
an interdisciplinary team while I worked with not only nursing staff but also physical therapy
and the activities department to provide the best quality care to the patients.
Research
• Evaluates research that focuses on the efficacy and effectiveness of nursing interventions
o After assessing a study that was completed that concluded that the selected group of
elderly patients viewed aging as an inevitable aspect of life but did not understand the
benefits and risks of exercise when questioned about physical activity I determined
that interventions needed to be put in place to not only promote exercise but to
educate the elderly on the risks and benefits of exercising or not exercising.
o A study was also conducted that determined that the use of video chat applications
helped to address the hopelessness feelings and reduce depression symptoms by 50%.
This is a realistic intervention that could take place to reach the Healthy People 2030
to increase socialization to these patients for the mental well-being.
Professionalism
•Advocates for professional standards of practice using organizational and political
processes
 I also advocated for the patients by promoting a change in activities, suggesting a care
plan that would improve the socialization of patients and assisting them throughout
their physical activity to promote safety by increasing muscle strength to reduce the
chance of falls
Nursing Practice
•Applies appropriate knowledge of major health problems to guide nursing practice
Residents in this age group are at risk for falls related to immobility, weakness, and
hazards in their homes. Being alone increases the risk of injury from falls. By increasing
mobility and strength, fall risk decreases. They also suffer Adult Failure to Thrive.
Decreased nutritional intake results in weakness which decreases immobility. This leads
to the perfect storm for a resident to fail to thrive. I not only discuss interventions to
increase mobility and strength but also participate in therapy for the patients directly to
improve their strength.

Social Isolation leads to Depression which also increases Failure to Thrive. These
residents become ill simply from lack of care related to social isolation. The desire to
continue self-care decreases as the resident has no reason to go out and interact with other
adults. During this project, as the paper will reflect, I spent a lot of time socializing with
the patients and promoting mental health.

Communication
•Uses therapeutic communication within the nurse-patient relationship
 While I volunteered at this facility, I spent a lot of time socializing and providing
therapeutic communication to not only groups of patients but also one-on-one time with
patients. During this time period of this assignment due to COVID the risk for depression
had increased due to the visitation restrictions put in place for their physical safety. I
learned it was not only important to assess for signs and symptoms of depression but also
to provide therapeutic communication and in this case, specific interventions to increase
communication with their family members, to these patients to promote mental well-
being.

•Adapts communication methods to patients with special needs

Because this facility also had patients that were non-verbal, I was also able to use
different communication methods such as their picture chart with letters they could point
to and notepads where the patient was able to write what they wanted to express to me,
therefore I was still able to provide a nurse-patient therapeutic line of communication
with these resources.
Teaching
•Provides teaching to patients and/or professionals about health care procedures and
technologies in preparation for and following nursing or medical interventions
When determining a plan of action, I suggested offering more social based programs for the
aged community and planning ways to get more residents involved increases a home's overall
geriatric health. Encouraging visits between patients and families encourages socialization.
Even in times of pandemic concerns, plexiglass booths can be utilized to allow visualization
of family members and friends, decreasing the feelings of isolation and depression which is
something this facility did utilize but only once or twice a week. This is especially important
in residents who suffer dementia since they cannot understand the constrictions a pandemic
response places on the facility to keep residents safe. I also recommended a push for more
community programs to aid in socialization and keeping patients physically active.
Professionalism
 Differentiates between general, institutional, and specialty-specific standards of
practice to guide nursing care
o I adhered to the CDC guidelines that were related to healthcare professionals
by consenting to covid swab testing before coming into contact with the
patients for the physical safety of the patients. Due to COVID there were also
several other guidelines I needed to follow regarding how close patients could
be to each other and making sure I was not going to COVID positive rooms
and then back to non-positive rooms. COVID positive patients were on a
specific unit in an attempt to slow the spread.
Leadership
o Initiates community partnerships to establish health promotion goals and
implements strategies to meet those goals
After selecting a goal listed from Advancing Healthy People 2030 to
improve the health and well-being for older adults because they are more
at risk for health diseases such as diabetes, osteoporosis, Alzheimer’s, and
more likely to be hospitalized for infectious diseases, such as pneumonia.
Another goal I decided to focus on from Healthy People 2030: “Improving
Mental Health”. I developed several interventions that I also assisted the
staff with interventions related to these goals at the long-term skilled
rehabilitation center I was volunteering at. Research studies determined
that there would be an increase in psychological distress and suicide in
geriatric-aged patients during and after COVID 19 but the use of video
chat applications helped to address the hopelessness feelings and reduce
depression symptoms by 50%. I proceeded to assist patients with group
activities, one-on-one social interaction with patients and even assist with
virtual calls to their loved ones so they could see their families’ faces. I
also suggested offering more social based programs for the aged
community and planning ways to get more residents involved increases a
home's overall geriatric health. Encouraging visits between patients and
families encourages socialization. Even in times of pandemic concerns,
plexiglass booths can be utilized to allow visualization of family members
and friends, decreasing the feelings of isolation and depression.
o Organizes, manages, and evaluates the development of strategies to promote
healthy communities
o I identified two of the needs I would be committed to during this project as
Risk of injury related to falls and social isolation that leads to depression
which increases failure to thrive. I assessed for potential interventions and
identified actions such as community programs aiding in increased
socialization and keeping resident more active. They also encourage
residents to eat in groups which increases nutritional intake. Exercise
programs reduce muscle atrophy and increase overall strength, reducing
risk of falls. I identified that offering more social based programs for the
aged community and planning ways to get more residents involved
increases a home’s overall geriatric health. Awareness to elderly patient’s
physical and mental health is extremely important and many times
correlate together. As a nurse and anyone in the healthcare industry it is
not only important to assess for mental health distress and lack of physical
activity, but to also educate and promote mental health methods and
appropriate physical activity to maintain good health and even potentially
lessen risk factors for disease processes. I evaluated strategies the facility
used to avoid isolation and to increase overall physical activity to their
residents and assisted in providing interventions to the patients to promote
a healthy community.