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SOLVED!! Nursing C228: Task 1

Community Health and Population-Focused Nursing C228: Task 1

More emphasis is being placed on healthier communities as changes are occurring in the fields of healthcare financing, policy, and focus. One of the primary roles of a community health nurse is to assess the community or population in order to determine its health status in relation to its assets and needs. In this task, you will engage in a Community Health simulation for a total of 20 hours to gather information about a virtual community. Sentinel City™ Community Health Simulation is a virtual city developed by Healthcare Learning Innovations to represent what you may find in any real United States city. You will be able to take a virtual bus trip and/or walk around the city while observing the environment and people of Sentinel City™. Through your observations, you will gather information to assess potential health issues and risks within this online virtual learning environment. You will assess different factors that may contribute to or detract from the health and wellness of the community and its citizens. During your trips through the city, you may be asked to describe the people you see and any expected or unexpected findings related to the citizens of Sentinel City™. Your keen observations will be the foundation to successfully completing assignments within your course. The simulation website will automatically log your hours and produce a special report at the end of each session. Be sure to have a notepad to record your observations of Sentinel City™ in preparation for this task. The link to Sentinel City™ is located in the Community Care and Collaboration section of the Course of Study.
Please review the Sentinel City Quick Start Guide, Student Guide, and Troubleshooting and FAQs Guide prior to engaging in the Sentinel City™. You may also want to download the Demographic Assessment, Neighborhood/Community Safety Inventory, Windshield Survey and Population Health Scavenger Hunt tools located in the attachment section to complete section B of this task.
REQUIREMENTS 
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect.
The rubric aspect titles may contain hyperlinks to relevant portions of the course.
A. This part I have completed so you do not have to provide the pictures…. Within Sentinel City™ you will notice a camera icon. Use the camera to take pictures within the simulation. Use the \”enter text\” feature to add your observations to the pictures. Submit a PDF of your action report from Sentinel City™ that includes the following completed activities from Industrial Heights, Casper Park District, Acer Tech Center, and Nightingale Square:
• Interfaith Church
• Sentinel City School District
• Sentinel City Department of Transportation
• Better Health Clinic
• ABC Daycare
• Sentinel City Affordable Housing Project
• City Hall
• Radio Buzz 96.5FM
• Sentinel City Healthcare System
• Lilly’s
• Joe’s Grocery
• Sentinel City Department of Parks and Recreation
B. Complete a needs-assessment summary to determine the health needs and risks of the virtual community in Sentinel City™ by using each of the following tools: Note: These tools can be found either in the web links section or as an attachment to this task.
• Demographics Assessment
• Neighborhood/Community Safety Inventory
• Windshield Survey
• Population Health Scavenger Hunt Note: The name of each of the four tools should be identified in the needs-assessment summary, along with a brief summary of how each of the four tools were used in the needs assessment. 1. Analyze the collected data using concepts of epidemiology and health determinants.
Note: Refer to these three sections of your COS for additional information: Epidemiology and Environmental Health, Epidemiological Data, and Application of Epidemiology.
C. Formulate a community diagnosis for Sentinel City™ by doing the following:
1. Discuss the three problems for Sentinel City™ based on the Healthy People goals.
2. Discuss community resources (e.g., Sentinel City™ Affordable Housing Project, Better Health Clinic) that are available to address one of the problems identified in part C1.
3. Identify a primary prevention topic based on the problem you selected in part C2.
Note: See the attached “Approved Activities List” for guidance in formulating your topic.
D. Discuss how you will apply the assessment strategies you have learned from the simulation environment to your community assessment strategies in your community.
E. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
F. Demonstrate Professional communication in the content and presentation of your submission.
RUBRIC 
A:
SENTINEL CITY ACTION REPORT PDF
NOT EVIDENT: An appropriate action report PDF from Sentinel City is not provided, or is missing the required activities.
APPROACHING COMPETENCE N/A
COMPETENT An appropriate action report PDF from Sentinel City is provided with all required activities.
B:
NEEDS-ASSESSMENT SUMMARY
NOT EVIDENT A needs-assessment summary is not provided.
APPROACHING COMPETENCE The needs-assessment summary is missing information about the health needs or risks of the virtual community. The summary does not appropriately incorporate each of the required assessment tools.
COMPETENT The needs-assessment summary logically includes the health needs and risks of the virtual community. The summary appropriately incorporates each of the required assessment tools.
B1: DATA ANALYSIS
NOT EVIDENT An analysis of the collected data is not provided.
APPROACHING COMPETENCE The analysis is missing key information about the concepts of epidemiology and health determinants. The analysis contains irrelevant details about the virtual community.
COMPETENT The analysis appropriately incorporates the concepts of epidemiology and health determinants. The analysis is well-supported with relevant, appropriate details about the virtual community.
C1:
TOP THREE PROBLEMS NOT EVIDENT A discussion of the top 3 problems for Sentinel City™ is not provided.
APPROACHING COMPETENCE The discussion is missing key information about 1 or more of the top 3 problems for Sentinel City™. The discussion is not supported with Healthy People 2020 goals.
COMPETENT The discussion appropriately addresses the top 3 problems for Sentinel City™ and is supported by the Healthy People 2020 goals.
C2:
DISCUSSION OF COMMUNITY RESOURCES NOT EVIDENT A discussion of community resources is not provided.
APPROACHING COMPETENCE The discussion is missing key details about community resources, or the discussion does not relate to 1 of the problems identified in part C1. COMPETENT The discussion appropriately incorporates community resources relevant to addressing 1 of the problems identified in part C1.
C3:
PRIMARY PREVENTION TOPIC NOT EVIDENT A primary prevention topic is not identified.
APPROACHING COMPETENCE The identified primary prevention topic is inappropriate or does not relate to the problem selected in part C2.
COMPETENT The identified primary prevention topic is appropriate and relevant to the problem selected in part C2.
D:
REFLECTION NOT EVIDENT A discussion of how the candidate will apply the assessment strategies learned from the simulation is not provided.
APPROACHING COMPETENCE The discussion is missing key details about how the candidate will apply the assessment strategies learned from the simulation to community health strategies in the community. The discussion does not appropriately relate to the simulation environment.
COMPETENT The discussion is logical and appropriately addresses how the candidate will apply the assessment strategies learned from the simulation environment to the community.
E:
SOURCES NOT EVIDENT The submission does not include both in-text citations and a reference list for sources that are quoted, paraphrased, or summarized.
APPROACHING COMPETENCE The submission includes in-text citations for sources that are quoted, paraphrased, or summarized, and a reference list; however, the citations and/or reference list is incomplete or inaccurate.
COMPETENT The submission includes in-text citations for sources that are properly quoted, paraphrased, or summarized and a reference list that accurately identifies the author, date, title, and source location as available.
F:
PROFESSIONAL COMMUNICATION NOT EVIDENT Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.
APPROACHING COMPETENCE Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.
COMPETENT Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.
Expert Answer and Explanation
B. Needs Assessment

Demographics

Sentinel City in a virtual city which was developed by Healthcare Learning Innovations to facilitate the practical application of community health assessment. After spending some time assessing the city, the following are some of the findings established. Sentinel city is a developed city that occupies a landmass of approximately 320 square miles. The city is surrounded by four neighborhoods namely; Nightingale Square, Acer Tech Center, Casper Park District, and Industrial Heights

The city has a population of 673,895 citizens. The city has a mixed-race population with non-Hispanic Whites being the dominant racial group. From the statistics obtained, the city is composed of 75% non-Hispanic whites, 13% Hispanics, 6 % African American, and 4% Asian. The remaining 2% comprises of citizens from other minority groups. Cumulatively, it can be said that minority groups in the city consist of 25% of the total population. The average number of persons per household in Sentinel City is 3.6 (Sentinel City, 2017).

The city’s population breakdown in terms of age showed that a majority of the population belonged to the working-age of 18-64 years. This was indicated by a representation of 57% of the population. Children belonging to the ages of 6-17 were the second most populous with 25% representation. The number of children belonging from 0-5 years of age occupied 7 % of the population representation, while the remaining 11 % was the representation of citizens having 65 years and above. Age distribution in community assessment is vital in that it dictates some of the care plans formulated to better the population health outcomes (Greenfield et al., 2015).

A majority of the citizens in Sentinel city are middle-income citizens, with the median income of the city being $49,563. The city has an average of 18.7% of citizens living below the poverty level. This is above the national poverty level, which stood at 11.8 % in 2018 (Fontenot, Semega & Kollar, 2019). The economic status, in most instances, translates to health outcomes of citizens. For example, access to proper nutrition, better housing, and healthcare coverage is linked with the ability to afford such facilities, which ultimately affects the health outcome of an individual (Williams, Priest & Anderson, 2016).

The population in Sentinel city is and educated population with over 76% of the population over 25 years having above high school diploma with a sizable chunk of that population having undergraduate degrees and above.

From the geographical estimation of the four neighborhoods, the largest in terms of both size and population was Nightingale Square. The population of Nightingale Square was 251,437. The dominant racial group in Nightingale Square are non-Hispanic Whites with a representation of 79 %, followed by Hispanics who had a representation of 11 % of the total population, with African Americans being the third with 4 % representation. The median household income for this district is $ 49,439, with the community having a mixture of citizens from different economic levels. The number of uninsured patients in Nightingale Square is 9.3%, which is above the national average that stood at 8.5%, according to the Kaiser Family Foundation (2018).

Acer Tech Center was another neighborhood bordering Sentinel city with a population of 145,764. The population of this neighborhood is predominantly Caucasian, having a representation of 77 %. Hispanics are the second most represented with 10 %, followed by African Americans with 6 %. Other minority populations share the remaining 7 %. The median household income of Acer Tech Center is $ 58, 749 with a majority of the population being middle-income earners. The number of citizens who are uninsured in Acer Tech Center being 8.7%.

Casper Park District is also a neighboring district which has a population of 180,738 residents. The district, just like other Sentinel neighborhoods, is predominantly occupied by non-Hispanic Whites with a representation of 76 %. The Latino population in Casper Park District is approximately 12 %, while African Americans are 7 %. The district has most of its households falling in the middle-income level, with a few being low-income households. The number of uninsured residents of Casper Park District is 10.2 % of the total population, which is the second-highest of the four Sentinel City neighborhoods.

The last of the four neighborhoods is Industrial Heights, where most of the industries serving Sentinel City and beyond are located. The district is the least populated with 74,566 citizens. 66 % of the population was Caucasian, 18 % were Hispanics, 11 % were African Americans, and the remaining 5 % belonged to other racial groups. The district is primarily composed of middle-income households with low-income households occupying a sizable chunk. The median income of Industrial Heights is $ 49,562, with a sizable population living there falling below the poverty line. This is the lowest amongst all the neighboring districts. Industrial Heights also has the highest population of uninsured citizens at 12.7 %.

Neighborhood Safety Assessment

From the observations made, it appears that the city has its fair challenges with regard to environmental health. The same applies to its surrounding neighborhoods. In as much as the city has an established waste collection system, there was still presence of littered wastes in different parts of the city. The method of waste management after collection was also an issue. Whereby, the company in charge of dealing with the disposed waste, uses the incinerator system, which is not environmentally friendly. Residents living in industrial heights where the company is located usually complain of air pollution caused by smoke from that company. Access to water and sewerage system is adequate, which is a plus for the community. However, the disposal of waste in the river that borders Sentinel city and Casper Park District seems to be apparent. This may ultimately have a negative impact on the health of those who use that water for personal consumption.

With regard to environmental health, the residents of Industrial Heights seemed to be most affected. This is due to the presence of several industries in that region, which to some point, had an impact on the environmental conditions of that region. Very few stray animals were observed within the city. However, the situation was different for Industrial Heights, where stray dogs were seen. This might have been one of the contributing factors to the high number of reported cases of injuries caused by dog bites (Sentinel City, 2017).

Drug and substance abuse is an issue that affects Sentinel city, with illegal narcotics and alcohol being some of the abused drugs. Last year, 9.8% of the population were reported to have abused at least one form of illicit drug, with some cases involving the abuse of multiple drugs (Sentinel City, 2017). The city has an active emergency system, with the response time varying depending on the location. On average, the response time is 10 minutes.

Crime is another issue faced by Sentinel city, where over 1500 cases of breaking and entering cases were reported with a sizable number of those cases located in industrial heights. Almost 2000 incidents of violence related crimes were reported with homicide cases being 5. The presence of gangs is not as apparent in the city as it is in the neighboring districts. There are however, some isolated cases of gang activities in the lower suburbs of the city. Casper Park district and Industrial Height had the highest number of reported cases of gang activities, with some of the streets being alleged to be run by certain gangs. This usually leads to occasional gang-related confrontations, with two people having lost their lives as a result of gang-related violence.

Scavenger Hunt

Sentinel city Department of Parks and Recreation, which is located in Casper Park District, is responsible for managing most of the public recreational facilities. There are various recreational resources at the disposal of Sentinel residents, including a public park with playgrounds for children. The city also has a river which is at the border of Casper Park District, used as the preferred weekend spot for boat riding, kayaking, to list a few.

The city also has elderly healthcare services provided by the Better Health Clinic located in Nightingale Square.  The system caters to various healthcare needs of the elderly, including meal-on-wheels, medical check-ups, among others. Better Health Clinic, other than offering geriatric care, offers additional services including emergency services, surgical services, and occasionally holds public events to educate the population living in Sentinel on good health practices. City Hall offers a variety of social services, including facilitating food stamps, child adoption services to list a few.

The affordable housing project in Casper Park district has been of tremendous help in making available, affordable houses, especially for low-income earners. Some of the houses will be put up for mortgage, while others will be rented (Sentinel City, 2017).

Windshield Survey

From the observations made, Sentinel City appeared to have a mixture of both old and new buildings, which were well maintained. Nightingale Square and Acer Tech center were the neighborhoods that seemed to have the best housing units. Most of them being bungalows, some made with concrete while others with timber. Most of the houses in these two areas had well-tended lawns. Casper Park District had newer houses, with most of them being constructed with timber. The lawns were however smaller than those in Nightingale Square and Acer Tech center. Most of the houses in Industrial Height were high-rises, with most of them being old buildings with some signs of breakage. Casper Park District had the most tree cover than any other district. The district also had the biggest size of lush green land, most of it being located in public parks and recreational fields.

Other than the river bordering Casper Park District and Sentinel City, the other neighborhoods were separated mainly by roads. The most common mode of transport in Sentinel city is road transport, with highways connecting the other neighboring towns. The city also has a light rail system that ferries people within the city boundaries.

The city residents are served by Lilly’s restaurant located in Acer Tech Center, which offers a variety of fast foods. The city also has Joe’s Grocery located in Nightingale Square, which serves the city with healthy food options, mainly fresh vegetables. There is also a Bodega one within the city that provides various consumables and household products for the residents.

Unlike other neighborhoods, where human activity is mainly during day time, the community living in Industrial Heights is usually vibrant both in the daytime and during the night, with clubs, bars, discotheques, and other social spots being mostly located there. The city residents are predominantly Christians, with the Interfaith Church located in Nightingale Square being one of the main places of worship.

Sentinel City also has a vibrant media house, Radio Buzz 96.5FM, located in Acer Tech Center. The radio station serves the city with both entertainment and current, informative news and informative messages on a diverse range of topics, including matters pertaining to social justice.

B1. Data Analysis: Interpretation of Data

From my assessment of the city, I noticed with concern that environmental health, especially in Industrial Height, was an issue. This was mainly due to air pollution caused by industries located in that area. Air pollution is a leading cause of respiratory illnesses, including chronic conditions such as lung cancer (Celedón et al., 2014). I also noticed that there was over dependence of petroleum powered vehicles as the preferred means of transportation by the city residents. This trend not only contributed to air pollution but also affected the level of physical exercises done by the residents.

I also noted after having observed the social trends in Industrial Heights that there were a lot of risk associated behaviors, which might pose a health risk to the residents living there. The use and abuse of some drugs available at the social joints exposed the residents to issues such as high risk of getting sexually transmitted diseases. Drugs and substance abuse is said to be a contributing factor to the high prevalence of getting STIs (HealthyPeople.gov, 2018).

From my observation of the reported violence incidents, and the number of people hospitalized in Better Health Clinic due to violence-related cases, I found it a matter of concern, which had an impact on the overall health status of the city. The number of reported cases might, to some extent, be influenced by the existence of gangs within the city’s neighborhoods.

The fourth issue I observed in Sentinel City was the number of healthy food restaurants and vendors. There were about three locations selling fresh groceries, including Joe’s Groceries. This, compared to the numerous fast food joints in almost every street, was a worrying trend. Nutrition is an essential element in obtaining positive health outcomes. According to (Kahan & Manson, 2017), health problems such as; overweight, obesity, diabetes, and cardiovascular disorders are usually a result of poor nutrition.

C. Sentinel City Health Concerns

C1. Three Problem Areas   

According to my analysis of Sentinel City, the three problem areas identified were drug and substance abuse, violence, and nutrition. Drug and substance abuse is an issue that affects not only the users but the community as a whole. Drug and substance abuse exposes the community to violence and injuries, teenage pregnancy, and increases the risk of getting sexually transmitted infections. According to HealthyPeople 2020, the goal with regards to substance abuse is to reduce the vice and in doing so, protect the health, safety, and quality of life more so in children (HealthyPeople.gov, 2019).

Violence related injuries are said to be a major issue in Sentinel city with the previous year, recording almost 2000 violence-related cases (Sentinel City, 2018). Injuries and violence have a detrimental effect on the productivity of an individual, financial status, mental health, and can even cause premature death. According to a World Health Organization report, the number of injury-related deaths globally stands at approximately 5.8 million people annually. This shows the magnitude of the issue (World Health Organization, 2018). The HealthyPeople 2020 goal on this matter is to reduce the number of unintended injuries and violence, thereby reducing their consequences.

The last health issue is nutrition, which has a direct correlation with the health outcomes of Sentinel City residents. Nutrition plays an essential role in defining our health outcomes. Nutrition can be used as a preventive measure in dealing with diseases. However, if poor nutritional habits are adopted, for example eating junk foods, or not taking a balanced meal, then health challenges are to be expected. Poor nutrition can lead to various medical conditions mentioned earlier.  The HealthyPeople 2020 goal of in the subject of nutrition is to promote good health practices and reduce chronic diseases through proper nutrition and maintenance of healthy body weight.

C2. Discussion of Community Resources

My selected health issue is drug and substance abuse. To deal with the issue of drug and substance abuse, the following are some of the resources at the disposal of Sentinel City. The first resource is the availability of recreational parks within the city. By engaging in productive and healthy social habits as an alternative to using drugs can help to deal with the menace. The second resource is ABC daycare and other educational facilities, where children from a young age will be taught on how to deal with drug and substance abuse. The local government I city hall can also pass policies in place to help curb the vice. One such policy would be to increase the penalty associated with peddling illicit drugs.

Another available resource is the Better Health clinic, which can offer rehabilitation services for drug and substance abuse victims. The clinic can also provide health promotion activities, for example, community education initiatives on the harmful effects of using drugs and other illicit substances. Radio Buzz 96.5 FM can also be instrumental in spreading the message on the fight against drug and substance abuse. Media can be a vital tool in spreading important health messages to the community and changing the trends for the better (Chang et al., 2016).

C3. Primary Prevention Topic

My primary prevention topic will be the prevention of illegal drug use, which falls under the topic of substance abuse in HealthyPeople 2020 (HealthyPeople.gov, 2019). Illegal drug use is a vice that affects the society in various ways. Addiction to illegal drugs, in most cases, results in increased instances of violence, suicides, homicides, to list a few. Unfortunately, the prevalence of illegal drug use is mainly in low-income areas where other health disparities are present. Therefore, by communicating the health promotion message of preventing the use of illicit drugs, the community, especially the social and economically vulnerable, will benefit.

D. Application of Assessment Strategies/Tools between Simulation and My Community

From the simulation assessment, one of the things I learned, are the various approaches a community healthcare worker can use to assess a community and come up with proper interventive measures to improve their health outcomes. I have also learned some of the factors which can be enablers to identifying prevalence factors or social determinants which affect the health outcomes of a community. By using this knowledge, I can be able to assess my community and help them come up with measures to improve their health outcomes.

References

Celedón, J. C., Roman, J., Schraufnagel, D. E., Thomas, A., Samet, J., & a working group of the Health Equality Subcommittee of the American Thoracic Society. (2014). Respiratory health equality in the United States. The American thoracic society perspective. Annals of the American Thoracic Society11(4), 473-479.

Chang, F. C., Miao, N. F., Lee, C. M., Chen, P. H., Chiu, C. H., & Lee, S. C. (2016). The association of media exposure and media literacy with adolescent alcohol and tobacco use. Journal of health psychology21(4), 513-525.

Fontenot, K., Semega, J., & Kollar, M. (2019). Income and poverty in the United States: 2018. Washington DC: US Government Printing Office.

Greenfield, E. A., Oberlink, M., Scharlach, A. E., Neal, M. B., & Stafford, P. B. (2015). Age-friendly community initiatives: Conceptual issues and key questions. The Gerontologist55(2), 191-198.

Healthcare Learning Innovations (Sentinel City) (2018). Sentinel City 2.3 [Computer software]. Aurora, Co. Retrieved from https://wgu.ucertify.com/?func=ebook HYPERLINK “https://wgu.ucertify.com/?func=ebook&chapter_no=7″& HYPERLINK “https://wgu.ucertify.com/?func=ebook&chapter_no=7″chapter_no=7#03tlb

Healthy People 2020 [Internet]. Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion [cited October 2019]. Available from: www.healthypeople.gov.

Kahan, S., & Manson, J. E. (2017). Nutrition counseling in clinical practice: how clinicians can do better. Jama318(12), 1101-1102.

Kaiser Family Foundation. (2018). Key facts about the uninsured population.

Office of Disease Prevention and Health Promotion (HealthyPeople.gov) (2018).  Sexually transmitted diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases

Williams, D. R., Priest, N., & Anderson, N. B. (2016). Understanding associations among race, socioeconomic status, and health: Patterns and prospects. Health Psychology35(4), 407.

World Health Organization. (2018). Injuries and violence: the facts. Geneva: World Health Organization; 2010.

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