CORTNEY OCONNORS

Health Planning Project II Paper

NURS 471-Community Health Nursing II
Purpose of Assignment
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
This assignment was a conglomeration of written work prepared by all of nine members
of my community health group. The community health group that I was a part of spent two
semesters at a daycare called Noahs Ark Day School in a lower socioeconomic area of Norfolk,
Virginia. While at the daycare, the group focused on the primary nursing diagnosis of deficient
knowledge related to disease transmission, personal hygiene, and hand washing techniques. To
improve this lack of knowledge, the group and I provided education to the staff members on
these topics as our primary intervention. The main part of this paper that I wrote was the barriers
we encountered when carrying out the intervention.
Reason for Inclusion of the Assignment in the Portfolio
v Critical Thinking
Uses decision-making skills in making clinical or professional judgments.
Revises actions and goals based on evidence rather than conjecture.
Example: In the beginning of the first semester at Noahs Ark, the group was able to
identify the primary nursing diagnosis of deficient knowledge related to disease
transmission, personal hygiene, and hand washing techniques. This remained our
primary nursing diagnosis throughout our time in community health. However, when
we first started at the daycare, the group was planning on providing education and
learning activities for the children of the daycare about our primary diagnosis. This
changed when certain barriers, such as behavior problems of the children, lead the
group to decide to provide the education to the staff instead. This decision, as
reflected in the paper, required clinical judgments about our aggregate to make the
most out of our time at Noahs Ark. Evidence of barriers that lead to the decision of
changing our focus to staff members rather than children included observed chaos
during every clinical day at the daycare caused by understaffing, too many children
per staff member based on Virginia standards, and lack of time to teach the children
based on verbalization of this fact by the director. Overall, focusing on staff members
was a more manageable and realistic goal.
Engages in creative problem solving.
Example: The group and I had to engage in creative problem solving in order to
overcome all of the barriers that the group encountered that interfered with carrying

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out our primary intervention. For example, Noahs Ark had a very high staff turnover
rate, making it difficult to achieve our goal of an evidenced long-term improvement
of deficient knowledge within the daycare. In order to overcome this barrier, we made
infectious disease binders of the most common communicable childhood diseases to
leave at the daycare for future staff members and for re-referencing purposes. Also,
the barrier of overworked staff was creatively overcome by bringing many group
members to fill in for the staff during the one-on-one teaching sessions. We did
achieve our goal of a long-term improvement in deficient knowledge as evidenced by
improvement in post-test scores when compared to pre-test scores taken before the
teaching intervention.
v Nursing Practice
Implements traditional nursing care practices as appropriate to provide holistic health
care to diverse populations across the life span.
Example: Although the primary intervention was provided to the adult staff members
of the daycare, there were smaller interventions provided to the children. This
included re-teaching hand washing techniques that were initiated by the students who
were at Noahs Ark the previous year.
Establishes and/or utilizes outcome measures to evaluate the effectiveness of care.
Example: As a requirement of this assignment, specific measureable outcomes were
to be identified based established objectives. Two main outcomes, short- and longterm, were identified so that the group would be able to identify effectiveness of care.
The short-term desired outcome was that, following the teaching intervention, all fulltime staff members would be able to answer at least 80% of the questions on the posttest correctly. The long-term desired outcome was that, one month later, all five fulltime staff members would still be able to answer at least 80% of the questions on the
second but identical post-test correctly.
v Communication
Adapts communication methods to patients with special needs.
Example: Because our aggregate was mostly children, the group and I had to adapt
our way of communication so that the children would not only understand, but would
respond to us. An example of this adaptation was the use of the well-known nursery
rhyme Twinkle-Twinkle Little Star to educate the children about how long they
should be washing their hands. We also adapted all educational material provided to
the staff members to be written at a fifth grade reading level to ensure the
comprehension of those who have achieved lower levels of education.
Expresses oneself and communicates effectively with diverse groups and disciplines using
a variety of media in a variety of contexts.

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Example: To carry out the planned interventions to the diverse daycare staff, a variety
of different media was used. One type of media used were the written disease
prevention binders that the group made to leave at the daycare for further reference.
Another form of media was the poster board that assisted the group in presenting our
disease prevention information. The information written in this paper was also
presented to a multidisciplinary group of classmates, professors, and colleges in the
form of a PowerPoint presentation at the end of the semester.
Accesses and utilizes data and information from a wide range of sources to enhance
patient and professional communication.
Example: In order to complete this written assignment, there were ten different
resources used that came from a wide range of sources. These sources included
nursing journals, multidisciplinary journals, and professional websites. These sources
did not include those that were used to formulate the original health planning project
paper that was completed after the first semester of community health. The original
health planning project paper acted as a backbone to this paper and included much of
the research needed to complete our final project. Additionally, the group and I spent
almost an entire semester observing our aggregate, which served as an excellent
source of information for this paper and for our final presentation of the information.
By using a wide range of sources, the group was able to formulate an accurate and
quality presentation to deliver to the aggregate as a teaching intervention and to our
classmates and professors as a final project.

v Teaching
Evaluates the efficacy of health promotion and education modalities for use in a variety
of settings with diverse populations
Example: While at Noahs Ark, health promotion and education modalities were
evaluated by establishing specific goals and outcomes and determining whether these
were achieved through observation of behavior post-intervention and through the
administration of pre-and post-tests. Observation of behaviors was used to determine
the efficacy of interventions for the children and the staff, which addressed diverse
populations.
Uses information technologies and other appropriate methods to enhance ones own
knowledge base.
Uses information technologies and other appropriate methods to communicate health
promotion, risk reduction, and disease prevention across the lifespan.
Example: Not only did the group and I use behavioral observations to gather a
knowledge base about our aggregate, but this paper also utilized information
technologies to gather ten different articles. Some of these articles were research
articles, where others were to gather general information about our aggregate. Also
included in our reference list were nursing as well as interdisciplinary articles. These

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information technologies assisted us in developing the teaching interventions for the
aggregate that focused on health promotion, risk reduction and disease prevention
through interactive verbal and written presentations. In this case, the teaching was
focused on children (with verbal hand washing education) and the adult staff.
v Research
Applies research-based knowledge from nursing as the basis for culturally sensitive
practice.
Example: This paper demonstrates that the group and I researched our aggregate to
determine how the teaching interventions should be organized to complement the
culture of the aggregate. For example, the group found that the majority of the staff
working at the daycare had an education level of graduating high-school or less
(demonstrating a culture of lower education). We then researched to find that
education is a major indicator of communicable disease prevention. So, the group and
I chose to improve disease prevention in the daycare by educating the staff using no
higher than a fifth grade reading level in all of the teaching materials.
v Leadership
Assumes a leadership role within ones scope of practice as a designer, manager and
coordinator of health care to meet the special needs of vulnerable populations in a
variety of practice settings.
Organizes, manages, and evaluates the development of strategies to promote healthy
communities
Example: While in community health, certain group members were leaders,
designers, organizers, managers, and coordinators of different tasks. I took a
leadership role in developing the infectious disease binders that are described in the
paper. I also worked with other group members to organize and coordinate the
numerous binder pages as well as the design of the binder. The evaluation of
strategies to promote a healthy community within our aggregate was a group effort.
As a group we successfully adapted to our population based on our evaluation of
health promotion strategies by shifting focus from educating the children to educating
the adults.
Initiates community partnerships to establish health promotion goals and implements
strategies to meet those goals
Example: The task of establishing a partnership with our assigned community was an
endeavor that lasted the entire time in community health. The group first established
a partnership by providing much-needed help with watching after and caring for the
children. As noted in the paper, this was the main implementation that the director
wanted us to participate in. After providing this assistance, while observing behaviors
simultaneously, the group began to come up with actual health needs of the

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aggregate. From here, the teaching intervention was developed, funding was raised,
and our previously established goals were met.

v Culture
Articulates an understanding of how human behavior is affected by culture, race,
religion, gender, lifestyle and age.
Integrates knowledge of cultural diversity in performing nursing interventions.
Example: Culture widely affected our goals and interventions while at Noahs Ark.
The fact that the daycare was a government subsidized facility in a very low
socioeconomic area of Norfolk, Virginia made a big difference in where our
interventions were focused and how they were achieved. For example, where the
director of this daycare sought free labor, fund raising, and new toys when asking her
what she thought the daycare needed, the group as nursing students were able to
realize the need for teaching about hygiene. If this daycare were in a different
location with a different surrounding culture, perhaps there would have been different
expressed needs. The fact that the daycare included many lower-income families, this
also changed the expected lifestyle of this population. Many families did not have
time to come into the daycare and spend time learning about health promotion with
the staff or children, because they were too busy trying to put food on the table. This
is a reason why the staff was the main focus and not the families for our teaching
intervention. The daycare consisted of all African American children and staff
members. Seeing as how our group was primarily Caucasian, This may have caused
a slight barrier when attempting to establish rapport with the daycare. Many of the
children even made comments about my white-girl hair. Age came into play, as
many of mothers of the children were very young. This predisposes families to
financial strain and lack of education. Since the staff members were also found to be
lacking higher education, we adapted our teaching intervention to be written at a fifth
grade reading level. Since the daycare was held in a church, the content taught to the
children did include religious references. Gender came into play with the staff
members who were all women, except for the maintenance man. Demographics and
culture were studied in this paper and shines through in our goals and interventions.
Ultimately, the group was able to provide the helping hands and fund raising that the
director wanted as well.