Community Health Nursing

Direct Care Project Part 1
Substance Use Assessment and Diagnosis Template
 
Maria I Perez Garcia
RN Community Health Nursing
 
 
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: Date: May 16, 2021
 
Online Data Collection
 
1. Community Information
 

Your Community Data
Name of city or town and state Miami, Florida.
Population 454, 279 in Miami.
Nature of this community (rural, suburban, urban) Urban.
Describe your community in 2-3 sentences The community is cosmopolitan, comprising of all races, social, and political classes. The community flourishes in terms of business. However, t suffers significant challenges including high levels of poverty and substance abuse.

 
 
2. Community Demographics
a. Go to https://www.census.gov/quickfacts/fact/table/US/PST045218
i. The US data should automatically populate
ii. Input your zip code or county/township name
iii. Then input your state for comparison data
iv. Enter the data into the table below
v. Compare the county, state, and US data
 

County Data(Miami Dade) State Data(Florida) U.S. Data
Population total 2,716, 940 21,477,737 328,239,523
Male (subtract female % from 100) 48.6 48.9 49.2
Female 51.4 51.1 50.8
Persons under 5 5.8 5.3 6.0%
Persons over 65 16.7 20.9 16.5%
Race and origin data
County Data State Data U.S. Data
White alone 79.0% 77.3% 76.3%
Black or African American alone 17.7% 16.9% 13.4%
American Indian and Alaska Native alone 0.3% 0.5% 1.3%
Asian alone 1.6% 3.0% 5.9%
Native Hawaiian and other Pacific Islander alone 0.0% 0.1% 0.2%
Two or more races 1.3% 2.2% 2.8%
Hispanic or Latino 69.4% 26.4% 18.5%
White alone, not Hispanic or Latino 12.9% 53.2% 60.1%
Significant population characteristics
County Data State Data U.S. Data
Veterans 48, 104 1,440, 338 18,230,322
Foreign born persons 53.7% 20.7% 13.6%
Housing overview
County Data State Data U.S. Data
Housing units 1,040,666 9,673, 682. 139,684,244
Owner-occupied housing unit rate 51.2% 65.4% 64.0%
Median selected monthly owner costs with a mortgage $1, 825 $1, 503. $ 1,595
Median selected monthly owner costs without a mortgage $ 627 $ 505 $ 500
Median value of owner-occupied housing units $289, 600 $ 215, 300 $ 217, 500
Median gross rent $1, 328 $ 1,062
Family and living arrangements
County Data State Data U.S. Data
Households 883, 372 120, 756, 048 120, 756, 048.
Persons per household 3.00 2.65 2.62
Living in same house 1 year ago 88.0% 84.5% 85.8%
Language other than English spoken at home 74.9% 29.4% 21.6%
Computer and Internet Use
County Data State Data U.S. Data
Households with a computer 89.9% 91.5% 90.3 %
Households with broadband internet subscription 76.9% 83.0% 82.7%
Education
County Data State Data U.S. Data
High school graduate or higher 81.4% 88.2% 88.0%
Bachelor’s degree or higher 29.8% 29.9% 32.1%
Health
County Data State Data U.S. Data
With a disability under age 65 years 5.8 % 8.6% 8.6%
Persons without health insurance under age 65 years 19.5 % 16.3% 9.5%
Economy
County Data State Data U.S. Data
Civilian labor workforce ages 16+ 62.6% 58.5% 63.0%
Transportation-mean travel time to work (minutes) 32.8 27.8 26.9
Income and poverty
County Data State Data U.S. Data
Median household income $51, 347 $55, 660 $ 62,843
Persons in poverty 15.7 12.7% 10.5 %

 
 
3. Community Epidemiological Data
a. Go to: https://www.countyhealthrankings.org/
b. Click on your state
i. Start with Overall Rankings in Health Outcomes
ii. Then choose your county
 
**you will need to use the “+” to see all of the data**
 

County Data State Data
Health Outcome Rank Healthiest N/A
Length of life rank 50% N/A
Premature death 5,200 per 100,000 7200 per 100,000
Low birth weight 8% 9%
Adult smoking 16% 15%
Adult obesity 22% 27%
Physical inactivity 23% 26%
Excessive drinking 19% 20%
Alcohol impaired deaths 22% 22%
STIs 486.8 per 100,000 499.2 per 100,000
Teen births 15 per 1,000 20 per 1,000
Drug overdose deaths 10.9 25.5%
Uninsured 20% 16%
Unemployment 2.4% 3.1%
Children in poverty 21% 18%
Violent crime 602 484
Air pollution 7.7% 7.7%
Drinker water violations No No
Long commutes 57% 42%

 
 
4. Substance Use
a. Go to: https://www.samhsa.gov/data/report/behavioral-health-barometer-state-barometers-volume-6?page=0
i. Find your state and download the report.
ii. Review the report and document the following:
1. Go to Substance Use, Misuse, and Use disorders section. This will be the area that discusses those 12 and older (near end of report).
iii. Find the following percentages:

State Average Regional Average National Average
Tobacco use 24.6% 29.0% 26.8%
Marijuana 14.6% 14.0% 16.2%
Marijuana use disorder 1.3% 1.3% 1.6%
Heroin use 0.28% 0.25% 0.30%
Misuse of prescription pain reliever 4.1% 3.9% 3.7%
Opioid use disorder 0.9% 0.8% 0.7%
Illicit drug use disorder 2.7% 2.7% 2.9%
Alcohol use disorder 4.2% 4.5% 5.3%
Substance use disorder 6.3% 6.4% 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:
No Yes If Yes, provide number or state “many” “some” or “few”
· *pregnant women yes Few
· *pregnant adolescents No
· *infants (under the age of 1 year old) yes some
· *young children (1-5 years old) yes many
· *school-age children (6-18 years old) yes many
· adults (18 – 60 years old) yes many
· *older adults (over the age of 60 years old) yes many
· people exercising yes some
· people driving yes many
· people walking yes many
· people biking yes some
· people congregating in groups on the street yes few
· *people that had hygiene issues or were unkempt yes few
· people that were appropriately dressed yes many
· people that were physically fit yes some
· people that were obese yes some
· *people that were undernourished, thin yes Some
· people that appear healthy yes Many
· *people that have obvious physical disabilities, such as those using walkers or wheelchairs yes Few
· *people with apparent mental/emotional disabilities yes some
· *people who appeared homeless or unemployed yes few

*Represents vulnerable populations

Social and Economic Conditions
 
Did you observe:
No Yes If Yes, provide number or state “many” “some” or “few”
· housing that was run down or dilapidated yes Few
· areas undergoing renewal yes few
· public housing yes some
· public transit (subway, train, buses, taxis, etc) yes many
· transportation to health care resources yes many
· landfills yes few
· restaurants yes man
· any political signs yes many
· any evidence of health education on billboards, advertisements, or signs yes many
· any efforts to improve the neighborhood’s health such as advertisements for health-related events, health fares, clinics, or lectures yes some
· any group efforts in the neighborhood to improve the living conditions or the neighborhood yes few
· churches, synagogues, and other places of worship yes many

 
 
 

Health Resources
 
Did you observe:
No Yes If Yes, provide number or state “many” “some” or “few”
· hospitals yes many
· community clinics yes some
· family planning clinics yes About three
· generalist doctors yes some
· dentist offices yes some
· pharmacies yes many
· urgent care clinics yes About 2
· skilled nursing facilities yes some
· mental health or counselling clinics yes some
· homeless or abuse shelters Yes some
· public health department office yes some
· substance abuse treatment center yes some
· alternative medicine practices, botanicals, or herbal medicine shops No
 
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:
No Yes If Yes, provide number or state “many” “some” or “few”
· evidence of anything that might make you suspicious of ground, water, or air pollutants Yes Few
· poor road conditions with potholes, or poor drainage No
· adequate traffic lights, signs, sidewalks, and curbs Yes Many
· railroad crossings fitted with warnings and barriers Yes Many
· streets and parking lots well lit Yes Many
· handicapped access to buildings, sidewalks, and streets Yes Some
· recreational facilities, playgrounds, and/or facilities like the YMCA Yes Many
· children playing in the streets, alleys, yards, or parks Yes Many
· evidence of nuisances such as ants, flies, mosquitoes, or rodents, or stray animals observed No

 
 
Problem
Identify a nursing problem based on your data and observations. The problem must be related to substance use. Example: Alcohol use
 
 
Problem Identification: Tobacco use.
 
Vulnerable Population
Identify the vulnerable population that is most impacted by this problem. Example: Adolescents
 
 
Vulnerable Population Identification: Youth
 
 
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 Tobacco use among the youth related inadequate knowledge about the side effects and ease of tobacco availability in the area as demonstrated in the high state average of tobacco use.
 
 
 
 
 
 
 
 
 
 
References
Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Behavioral health barometer, volume 6https://www.samhsa.gov/data/report/behavioral-health-barometer-state-barometers-volume-6?page=0
County Health Rankings and Roadmaps. (2018). Explore rankings. http://www.countyhealthrankings.org/
U.S. Census Bureau. (2018). State and county QuickFacts.  https://www.census.gov/quickfacts/
 
 
 
© 2019. Chamberlain University LLC. All rights reserved.
4
3/10/21