Chamberlain College of Nursing
NR443 Community Health Nursing
Guidelines for Caring for Populations Milestone 2:
Assessment and Diagnosis
PURPOSE
The purpose of this paper is to provide an opportunity to utilize community assessment strategies, uncover a
community health problem, and identify the components of one community health nursing problem related to
the community dynamics.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes.
CO2: Assess the health needs of individuals, families, aggregates, and communities using
demographic and epidemiological data to identify population health risks. (PO 4)
CO6: Utilize a systems-based and collaborative approach to address factors that influence the
health of a community and population health problems. (PO 2)
DUE DATE
Submit to the appropriate basket in the Dropbox by 11:59 p.m. MT Sunday of Week 4.
POINTS: 225 points
DIRECTIONS
Watch the Milestone 2 tutorial by clicking this link. This tutorial is also available on Course Project page
under Course Home as well as Week 4 Assignments page.
This paper is expected to be no more than four pages in length (not including the title page and reference
list). Below are the requirements for successful completion of this paper. Please use the following categories
as the first level headings on your paper. See the documents in the APA category in Course Resources for
assistance with APA formatting.
[Introduction:] This beginning of your paper should catch the reader’s attention with interesting
facts about your community and should include the purpose statement of the paper. This should be
one paragraph. APA states that you should not title this as introduction; however, you are still
expected to write a separate introduction. The title of the paper should be repeated at the top of
page two and centered.
Community Overview: Identify the community that you are assessing by name and state and
provide a general description of the community. What is the general character of the community?
Statistics should not be included here. Your community should be the area you live or work in and
should include a residential area. It should be a large enough area to answer the questions in the
text. This should be one paragraph.
Demographic Data: Compile a range of demographic (population description) data for your
community by examining U.S. Census Bureau reports. Using this data, describe your community.
Compare your community data to state or national data. A summary of this data should be no more
than two paragraphs.
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Epidemiological Data: Compile and summarize a range of epidemiological (illness, morbidity, and
mortality) data for your community by examining data from sources such as city or county health
department reports, County Health Rankings (countyhealthrankings.org), or the Centers for Disease
Control to describe priority health problems in your area. See the Webliography for applicable sites
to search. Compare your community to state or national data. This comparison will help to identify a
priority community health problem specific to your community. A summary of this data should be no
more than two paragraphs.
Windshield Survey: Provide a summary of your observations from your first milestone. Make sure
to discuss observations related to your identified problem. This should be one to two paragraphs.
Problem Diagnosis:
o Using the assessment data, identify one community health nursing problem that you
consider to be a priority concern.
o Relate your choice to one of the Healthy People 2020 specific numbered objectives (not just
a goal). Healthy People objectives are located within a topic area under the Objectives tab.
o Your rationale should also include why this is a problem in your community and factors that
contribute to the problem. Avoid discussion of interventions in this milestone.
o Include a discussion of your problem with information from at least two scholarly sources
(such as professional journal articles). (Review the documents in the APA category in Doc
Sharing for help in determining sources that are considered scholarly—hint, .com websites
are not considered scholarly sources). This should be no more than three paragraphs.
Summary: Summarize your community assessment and diagnosis findings and include a brief
statement about the problem and the major factors that contribute to this problem. This information
should be no more than two paragraphs.
Reference Page: All references should be cited within the paper and should be included on the
reference page.
GUIDELINES
Application: Use Microsoft Word 2010 (or later) to create this assignment.
Use the categories above as APA headings for the sections of your paper.
Length: This paper is expected to be no more than four pages in length (not including the title page
and reference list).
Submission: Submit your file via the basket in the Dropbox: Milestone 2 Assessment and Diagnosis,
by 11:59 p.m. MT Sunday of Week 4.
Scholarly Writing: APA format is required. Review APA documents in the APA category in Course
Resources and use the free resources of SmartThinking for writing tutors.
Save your paper with your last name in the document title (e.g., Smith Assessment and Diagnosis).
Late Submission: See the course policy on late submissions.
BEST PRACTICES IN PREPARING THE PAPER
The following are best practices in preparing this project.
Complete the demographic, epidemiologic, and windshield survey prior to choosing a problem to
focus on.
Choose one nursing problem specific to your community.
Make sure all elements of the paper are addressed and headings for each category are included.
Review directions thoroughly.
Cite all sources within the paper as well as on the reference page.
Proofread prior to final submission.
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Check for spelling and grammar errors prior to final submission.
Use the A column of the rubric below to ensure that you have included all the needed elements.
Abide by the CCN academic integrity policy. The paper must be your original work. Once submitted
to the Dropbox, check back to ensure that your Turnitin similarity index is less than 24%, if not revise
and resubmit prior to the deadline.
GRADING RUBRIC: MILESTONE 2: ASSESSMENT AND DIAGNOSIS (225 POINTS)
Criteria
Introduction
10 points
Community
Overview
20 points
Demographic
Data
30 points
Epidemiologica
l Data (Disease
or health
behavior rates)
30 points
Windshield
Survey
20 points
Problem
Diagnosis
40 points
A
(92–100%)
Outstanding or
highest level of
performance
B
(84–91%)
Very good or
high level of
performance
C
(76–83%)
Competent or
satisfactory
level of
performance
Includes the purpose of
the paper and catches
the reader’s attention
with interesting facts
(9–10 points)
Community identified
and adequately
described
(18–20 points)
Missing purpose
of paper or hook
(8 points)
Missing purpose
of paper and
hook
(7 points)
Community
identified but
description is
inadequate
(16 points)
Adequate
demographic
data described
but missing state
or national
comparison
(25–27 points)
Adequate
epidemiological
data described
but missing state
or national
comparison
(25–27 points)
Windshield
survey findings
adequately
summarized but
not clearly related
to identified
problem
(16 points)
Problem not
related to Healthy
People objective
or lacks rationale
with supportive
data
Describes a range of
demographic data
about your community
from U.S. Census
Bureau reports with
comparisons to state or
national data
(28–30 points)
Describes a range of
epidemiological data
about community from
appropriate reports with
comparisons to state or
national data
(28–30 points)
Community windshield
survey findings
adequately summarized
and findings relate to
identified problem
(18–20 points)
Assessment data used
to identify one priority
community health
problem, Healthy
People 2020 specific
objective included, and
NR443 Milestone 2 Assessment Diagnosis Guidelines
F
(0–75%)
Poor or
failing or
unsatisfacto
ry level of
performance
Introduction
missing
(0–6 points)
Pts
Community
identified but
description is
missing
(15 points)
Little
demographic
data and missing
state or national
comparisons
(23–24 points)
Community
not identified
or described
(0–14 points)
/20
Lacks
demographic
data and
missing state
or national
comparisons
(0–22 points)
/30
Little
epidemiological
data and missing
state or national
comparisons
(23–24 points)
Lacks
epidemiologic
al data and
missing state
or national
comparisons
(0–22 points)
Windshield
survey
findings not
described
(0–14 points)
/30
Problem
discussion
missing
(0–29 points)
/40
Windshield
survey findings
not adequately
summarized and
not related to the
problem (15
points)
Problem not
related to Healthy
People objective
and lacks
rationale with
supportive data
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Application of
EvidenceBased
Scholarly
Resources
30 points
rationale for problem
selection stated with
supportive data (such
as factors that
contribute to this
problem) from two
scholarly articles
(37–40 points)
Two or more quality
references from
professional literature
discussed with clear
support of your problem
rationale
(28–30 points)
Summary
20 points
Summary includes
assessment and
diagnosis findings, a
brief statement about
the problem, and
factors that contribute
to this problem
(18–20 points)
Presentation
10 points
Discussion well
organized and logical
and structure is clear
and compelling to
reader; paragraphs are
linked together
logically, and main
ideas stand out
(9–10 points)
Excellent mechanics
with no more than two
of the following errors:
- correct grammar,
spelling
-complete sentences
-all sources cited in the
text
-all references listed on
the reference page and
in APA format
-title page in APA
format
-correct APA format of
headings
-12 point font, double
spaced, 1 inch margins
(14-–15 points)
Mechanics
15 points
NR443 Community Health Nursing
(34–36 points)
(30–33 points)
Two references
discussed, but
information does
not clearly
support problem
rationale or
references are
not scholarly
(25–27 points)
Lacks reiteration
of assessment
findings or
problem
identification or
contributing
factors
(17 points)
Only one
reference
discussed that is
directly relevant
to problem
rationale
(23–24 points)
No
references
discussed
(0–22 points)
/30
Summary lacks
two or more of:
reiteration of
assessment
findings, problem
identification, and
contributing
factors
(16 points)
Discussion
missing two of
the organizational
elements in
column one and
overall flow is
difficult to follow
(7 points)
Summary not
completed
(0–15 points)
/20
Paper
appears
disorganized
and is difficult
to understand
(0–6 points)
/10
Four mechanical
or APA errors of
elements listed in
column one
(12 points)
More than
five
mechanical
or APA errors
of elements
listed in
column one
(0–11 points)
/15
Discussion
missing one of
the organizational
elements in
column one and
has some minor
organizational
concerns
(8 points)
Three
mechanical or
APA errors of
elements listed in
column one
(13 points)
Total Points:
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Chamberlain College of Nursing
NR443 Community Health Nursing
Caring for Populations: Milestone1: Community Windshield Survey Form
Directions: Please refer to the Milestone 1: Community Windshield Survey Guidelines and grading rubric
for specific instructions in order to complete the information below. This assignment is worth 150
points.
Type your name, date, and observations directly on this form. Click Save as and save the file with the
assignment name and your last name; for example, NR443 Windshield Survey Form_Smith. When you
are finished, submit the form to the Week 2 Caring for Populations: Windshield Survey Dropbox by the
deadline indicated in your guidelines.
Your Name Marylen Rabelo
Criteria
1. Introduction of
Community (20 points)
Identify the city and state
of your community and
briefly describe the
community you will be
using for this assignment.
It should be the area
where you live or the area
surrounding your work
setting but must include a
residential area.
Demographic data are not
needed.
Date: 05/11/2016
Your response
Houston is a metropolitan city in Texas State. The community is very
urban and it is identified as the capital city of Texas. It has a very
high population of people working within the city over 2.239 million
as at 2014. Tall buildings occupy the city where major large global
companies have set up shop. The city is surrounded by Lake Houston,
Lake Livingston and Lake Conroe, where the city outsources its
water. Apart from the residents living in the tall apartment buildings,
other residential homes can be found on the outskirts of Houston
main town, especially near the lakes. Houston’s economy is largely
propelled by the Oil and natural Gas business that takes advantage of
the port for transportation. When it comes to health care Huston is a
giant, hosting the Texas Medical Center, which has over 13 medical
hospitals and many other research institutions.
2. Windshield Survey (100
points)
a. Vitality: Use a
majority of the
questions from Box 6-2
in your text to describe
your observations
about the community
vitality.
Houston is very populous hence people are very visible, and
population is the diversity of the people, in terms of ages and race is
very apparent. This diversity is due to the port in the land that has
become the key entrance point for people from various places. The
setup of global businesses has also contributed to the diversity of the
Houston residents. Majority of the residents are able bodied and
generally look healthy. However, due to the fast pace of the city life,
signs of fatigue and mild depression or stress can be visible on the
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some of the adults’ faces. Houston being a port city and a beautiful
place, there are many tourists, who accelerate lifestyle vices like too
much alcohol drinking, smoking and even use of illegal drugs. In the
urban outskirts the pace is slower, families, kids, and pregnant
women can be seen strolling and playing in the parks. Compared to
the main city dwellers, these residents look calmer and almost
happier (Nies & McEwen, 2015).
b. Indicators of social
and economic
conditions: Use a
majority of the
questions from Box 6-2
in your text to describe
your observations
about the social and
economic conditions.
The tall majestic buildings in Houston town illustrate a picture of a
prosperous town. These buildings are clearly a sign of a vibrant
economy. Large cooperates have also established entities in Houston,
indicating the positive economic conditions of the city. The lakeside
houses in the outskirts are comfortable and large. They are almost
luxury houses, which indicate an expensive taste of the residents. At
the port the business is brisk with a lot of ships docking, this has
created many employment opportunities for the residents of Houston.
Most of the residents in Houston use the electric train, cars and taxi’s
to move around, buses are very rare. However, just like any other city
in America, there are areas associated with poverty in Houston. This
has been widely associated with lack of good education especially in
public schools in Houston.
c. Health Resources:
Use a majority of the
questions from Box 6-2
in your text to describe
your observations
about the health
resources.
Health Care is probably one of the biggest investment in the Texas
state especially Houston. It accommodates the internationally
renowned Texas Medical Center, one of the largest healthcare and
research in the world. This facility has 73,600 employees, 13
hospitals, 2 specialty institutions, 2 medical schools, 4 nursing
schools, and schools of pharmacy, dentistry and public health. In fact,
some of the tourists are in Houston, for medical reasons. Most of the
problems people in Houston are likely to suffer from include:
depression, stress, diabetes, hypertension, and cancer. These are
mostly lifestyle-induced diseases. A lot of research is equally done in
the city, with many institutions taking up education of nurses and
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doctors as part of their service delivery.
d. Environmental
conditions related to
health: Use a majority
of the questions from
Box 6-2 in your text to
describe your
observations about the
environmental
conditions.
The environment in the Houston is a bit mixed. With the environment
in the town being congested and polluted by different gaseous
emissions. The tall built buildings, many vehicles and high
population make the town feel so crowded and the environment is
very unconducive, a typical city environment. The lakes are clean and
are the source of water to the city however under severe threats from
pollution of effluent from the major industries in the city. Further, the
high population in Houston, to production of lot of excess waste. The
outskirts of the city are best, with fresh air, vegetation and trees
teeming from everywhere. These green areas make life very
comfortable for the lakeside residents.
e. Social functioning:
Use a majority of the
questions from Box 6-2
in your text to describe
your observations
about the social
functioning.
The society in Houston is very functional with churches, mosques
and temples focusing on offering the people a variety in religious
background. In education, the city has over 300 private schools.
Other vanguard schools focusing on health professions, performing
and visual arts among other sciences. Major universities in Houston
include Texas Southern University, University of Houston, Rice
University among others. People in Texas enjoy watching their games
at the NRG Stadium and Minute Maid Park. The Galleria is the
largest mall in all of Texas housed in Houston. Art Lovers visit the
Houston museum of fine arts.
f. Attitude toward
healthcare: Use a
majority of the
questions from Box 6-2
in your text to describe
your observations
about the attitudes
toward healthcare.
People living in Houston are very sensitive about their health. This
culture has been natured due to the large number of quality health
resources around the city. Secondly, most of the people living in
Houston are in the health profession or most likely know someone
who is a health provider. This has allowed them to embrace the
importance of healthcare. The local politicians and leaders as well,
seem to advocate for the rights of their people to enjoy quality
healthcare
3. Conclusion: (20 pts)
One of the key Problems affecting the city of Houston is inequality,
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Provide a summary of your with most of the residents leaving in opulence while some languish in
findings and your
poverty. The city is overcrowded and the life is very costly and
conclusion. What
problems did you identify? demanding. This can lead to development of lifestyle related diseases
among the citizens of Houston. The population and industrialization
if not controlled can lead to pollution of the lakes around the city,
contaminating the water source. The residents are very aware of
health issues and have many healthcare facilities to meet their needs.
4. References:
Nies, M., & McEwen, M. (2015). Community/Public Health
optional: List in APA
Nursing, 6th Edition; Promoting of Health
format any references that
Populations. New York: Saunders.
you used. If you include
any references here, you
must also include an intext citation (author,
year).
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Running head: CARING FOR POPULATIONS MILESTONE 2
Caring for Populations Milestone 2: Assessment and Diagnosis
Elaine Calana
Chamberlain College of Nursing
Sally Fitzgerald
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CARING FOR POPULATIONS MILESTONE 2
Assessment & Diagnosis
They say in Houston you can find a doctor on every corner. This is as a result of its
intense investment in the healthcare industry in terms of health care facilities, hospitals and
medical teaching institutions. The windshield survey done in Houston is aimed at having an
objective view of the Houston community and most importantly to diagnose the health problems
facing the city dwellers. Apart from the survey’s observations, the objectives of the paper should
be met using secondary data on the demographic and Epidemiological status of the city. This
already recorded data plus the survey’s observation will assist in providing key diagnosis of the
health problems and determine potential solutions. An assessment and diagnosis of health
problems facing the Houston community is the subject of this discussion.
The Houston Community
Houston is revered as a metropolitan city inside the Texas State. The city is commonly
referred to as the Texas state capital city. The community is very much urban in nature; this is
evident from the fact that most of its population works in the city. Houston population was
estimated at 2,195,914, in the 2013 population census. The Houston city is beautifully filled with
magnificent towering buildings, which hold office for major global brands and companies. The
Companies represent the cities leading industries: healthcare and energy. They provide
employment to most of the Houston residents. Lake Houston, Lake Conroe and Lake Livingston
surround the city and provide it with water. The Lakes propel the Houston economy through
facilitation of the cities port that acts as an entrance to the city. This has led to the growth of the
natural gas and oil business, which use the port for transportation. A lot of investment has also
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CARING FOR POPULATIONS MILESTONE 2
been done in Houston on the health care industry; the city boasts of hosting the Texas Medical
Center, which includes 13 hospitals and numerous research institutions.
Houston Demographic Data
Demographic data refers to the description of different characteristics of a population in
terms of gender, age, race, education level, and income. In 2013, Houston’s population was at
2,233,310 people occupying 675 square miles of land. In 2010, the Houston population was held
at 2,096,798, which signifies 4.7% growth in population from 2010 to 2013. 49.8% of the
Houston population represents female while 50.2% represent male resident. This means in terms
of gender equilibrium the Houston population is almost equally balanced. Looking at the
Houston population’s age distribution, 8.1% are under 5 years, 25.9% are above 5 years but
below 18 years, 9% are 65 years and over. This means that most of the Houston’s Population
57% composes of active adults (Census, 2013).
Race wise, the majority of Houston population is 50.5% white, compared to the entire
Texas state, which has over 70% representation; this figure is lower. African Americans
represent 23.7%, 43.8% represent the Latino and Hispanic races. Education levels in Houston are
high with 75% of the population representing high school graduates while 29% represents
University graduates. The average Houston resident earns $45,010. When compared with the
entire Texas City at $51,900, this is lower. Similarly, this fact is further explained by the poverty
levels; with 23% residents of Houston believed to be living under poverty comparable with 17%
in the entire Texas state.
Houston Epidemiological Data
Epidemiology data is important information about a community that indicates the
distribution and highlights determinants of the health state of the community. This data is useful
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CARING FOR POPULATIONS MILESTONE 2
in assessing, diagnosing and controlling community health problems. The factors that can be
used to describe the epidemiology data are illness, mortality, morbidity, and mortality and risky
behavior. The average life expectancy of a Houston citizen is estimated at 78.3 years. This is
very high compared to other locations worldwide. In 2012, the male life expectancy was 75
while the female’s is 82. The two leading causes of mortality in Houston are heart diseases and
Cancer. Risky behaviors attributed to poor health among the Houston residents include the use of
tobacco, alcohol and other illegal drugs, obesity and overweight due to poor eating habits,
depression, stress and hypertension. 13% of the Houston adult populations are smokers, whereas
40% of the cancers reported in the same year are lung, trachea or bronchus cancers. Only 14.3%
of the Houston residents eat fruits and vegetables daily. This has contributed to the obesity and
overweight issues (Houston, 2015).
Survey Observations
The First observation from the survey on the Houston community is the high population
of the city. This means that theirs high competition among the residents for the limited
opportunities and resources. Most of the population 57% is adult, skilled and educated; this only
serves to intensify the competition for jobs and opportunities. The growing sectors in the
Houston are Energy and Health industries, these sectors require highly skills levels and are
considered stressful work environments. These two factors may contribute to the issue of the
young adults in Houston facing stress and depression. The lakes form an entry point that
encourages a lot of tourist and with it external influences. Some influences can be damaging like
smoking, drugs and alcohol abuse. Young adults under intense pressure from the society may fall
victim to this vices. The Houston population is ever busy and on the go. This means they lack
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CARING FOR POPULATIONS MILESTONE 2
time to prepare and enjoy healthy meals. Instead, they depend on fast food, which is the primary
source of obesity and overweight issues among the population.
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CARING FOR POPULATIONS MILESTONE 2
Problem Diagnosis
The Houston Population’s key problems are poor nutrition, abuse of drugs and alcohol
and the struggle with stress and depression. They key community nursing health problem is the
increased number of residents with overweight and obese issues. It is a concern as poor weight
can lead to other diseases such as diabetes, hypertension and even some cancers. Socially, it
makes one loose self-esteem and confidences. Many residents do not recognize the risk associate
with being overweight, until it is too late. This is evident by the lack of awareness by many
residents on their BMI index, which helps identify weight problems in individuals (Ellis,
Abrams, & Wong, 1999).
Overweight and obese people are less active in life in pursuant of their goals. This
problem relates to the Health People 2020 objective number NWS-9 Reduce the proportion of
adults who are obese (HealthyPeople, 2015). This problem is observed in the Houston
community, thanks to the busy schedules of individuals in the city all geared towards earning a
better income. Most of the residents are with busy at work, therefore, they lack time to shop for
healthy groceries such as fruits and vegetables and add them to their meals. Numerous fast food
joints litter the Houston City. The restaurants serve food high in fats and cholesterol to adults as
well as young children. This is the major contributor to obesity among adults and school going
children (Reilly & Kelly, 2011).
Conclusion
To sum up, poor nutrition can lead to overweight and obese health problems. These are
becoming popular lifestyle diseases in many fast moving cities as observed in the Houston Case
study. This is attributed to the increased focus on business and work and disregarding the
individuals Healthy needs. The results are dangerous diseases with even more dire consequences.
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CARING FOR POPULATIONS MILESTONE 2
References
Census, H. (2013, November 12). Houston Demographic Data. Retrieved from
http://www.houstontx.gov/planning/demographic-data
Ellis, K. J., Abrams, S. A., & Wong, W. W. (1999). Monitoring Obesity: Assessment of the
Weight/Height2 Index. American Journal of Epidemiology, Pp. 939-946.
HealtyPeople. (2015, January 15). Nutrition and Weight Status. Retrieved from
http://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weightstatus/objectives
Houston. (2015). The State of Health of Houston/Harris County 2015-2016. Houston: Houston
Department of Health and Human Services.
Nies, M., & McEwen, M. (2015). Community/Public Health Nursing, 6th Edition; Promoting of Health
Populations. New York: Saunders.
Reilly, J. J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and
adolescence on morbidity and premature mortality in adulthood. International Journal of
Obesity, Pp 891-898.
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