C229 Neighborhood/Community Safety Inventory

C229 Neighborhood/Community Safety Inventory
January 13, 2022
NRNP 6635/NRNP 6635F 9-Psychpathology Diag Reasoning Week 11 Final Exam (2021)
January 13, 2022

C229 Neighborhood/Community Safety Inventory

Community Health and Population-Focused Nursing – C228, Sentinel City, Task,

Community Health and Population-Focused Nursing – C228, Sentinel City, Task,

Introduction:

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 40 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. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

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. 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 2020 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 Topic 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.

PLEASE NOTE THAT YOU HAVE TO HAVE YOUR OWN ACCESS TO SENTINEL CITY, I CANNOT PROVIDE THAT ACCESS FOR YOU

SAMPLE ANSWER

C228 Task 1

Section B

After spending 20+ hours exploring Sentinel City and speaking with its residents, as well as utilizing tools such as demographics assessment, neighborhood safety inventory, windshield survey, and population health scavenger hunt, it became apparent that there are countless areas that the city needs to improve in order to better the quality of life of those that live there. There are numerous problems that plague the residents of Sentinel City including poverty, poor health, violence, and gang activity. Utilizing the assessment tools helps to identify specific problems such as the uneven distribution of wealth and resources that affect the quality of life between twoareas such as Industrial Heights and Nightingale Square. A major key to succeeding as a community health nurse is to be able to assess the needs of those you are helping and make tailored changes to best help them.

Demographics

The demographics tool was used to identify the population and make-up of the citizens that call Sentinel City their home. Sentinel City is home to 663,862 individuals, which is a 9.6% increase in the overall population over the past two years. This indicates Sentinel City is a growing city and it makes it even more important to improve on many of the aspects that contribute to poor quality of life. The city is made up of four neighborhoods which include Industrial Heights, Casper Park District, Acer Tech Center, and Nightingale Square. The median household income for all of Sentinel City is $49,091 with 18.9% of its citizens living below the poverty level. Industrial Heights has the lowest population with only 38,885 people. The median income in Industrial Heights is only $24,672. 37.5% of the residents of Industrial Heights do not have health insurance. Casper Park District has the largest population of the four neighborhoods with 353,643 residents but a median income that is second lowest at $80,134. Acer Tech Center has a population of 168,390 and a median income of $166,300. Nightingale Square is the wealthiest neighborhood by far in Sentinel City. The median income of this neighborhood is $269,550 and has a population of 103,974. Only 0.7% of Nightingale Square residents are uninsured (SentinelU, 2020). Utilizing demographics assessment has clearly identified a drastic disparity between the wealthiest and poorest neighborhoods in Sentinel City, Industrial Heights and Nightingale Square.

Neighborhood Safety Inventory

Being able to identify dangerous areas or aspects of a neighborhood that may bring harm to its residents is an important part of being a community health nurse. After exploring Sentinel City, many issues became apparent. In all neighborhoods but especially in Industrial Heights, there are many areas that are poorly kept. The Better Health Clinic building itself is covered in graffiti and directly across the street sits a broken-down car and countless dumped bags of trash. The homeless population of Industrial Heights is 3,917 and many of them rely on the soup kitchen hosted by the Interfaith Church for meals. Dwayne Thomas, a homeless veteran living in Industrial Heights, says he eats 2 meals a day there but right outside the soup kitchen are more littered bags of trash and even rodents seen running around. There are many stray dogs and cats wandering about the city as well and at the Sentinel City Affordable Housing Project, many of the residents’ complaints are regarding pests. Joe’s Grocery in Nightingale Square has trash scattered directly out front of the building and stray cats can be seen digging through it. Another issue that plagues Sentinel City, like many real cities in this country, is drug use. Within the past year, 18% of the population report abuse of prescription drugs, 12% report use of marijuana, 10% report use of methamphetamines 5% report use of cocaine (SentinelU, 2020). A billboard can be seen be seen behind Joe’s Grocery advertising for Sentinel City Rehab Services but information is limited. Emergency Services in Sentinel City include fire response team, EMS, and advanced life support. The average EMS response time is 7.46 minutes compared to an average 8.63 minutes in 3 other cities. The advanced life support response time in Sentinel City however is slower compared to 3 other cities with 6.41 minutes being the average response time and Sentinel City’s being 7.54 minutes (SentinelU, 2020). Sentinel City has a fair amount of crime and a good percentage of that is violent crime. Within the last year there were 1,231 reports of aggravated assault, 559 reports of robbery, 312 reports of rape, and 20 reports of murder. Unfortunately, a contributing factor to those crimes is gang activity. Of the reported crimes, 100 of the reported aggravated assaults, 40 of the reported robberies, and all 20 of the reported murders were gang-related (SentinelU, 2020).

Windshield Survey

The windshield survey is a tool that is utilized as you navigate your way through SentinelCity to make notice of physical and environmental findings within each neighborhood. The housing and commercial buildings within Sentinel City are more often than not run-down in appearance with graffiti covering the sides and trash along the walls that attract wild animals. A majority of the housing available appears to be apartments with little to no yards at all. The city itself is mostly urban. While there are a few small parks and trees in the city, they are overwhelmed by tall buildings and pavement. The park outside of the school system occupies a small section of one block and is surrounded on three sides by main road with only a short fence separating them. The less affluent the neighborhood, the less likely there is to be anything green or floral. The neighborhoods grow easier to tell apart as the median income rises as things appearto be better taken care of and have more luxury resources such as organic food at Joe’s Grocery. When you go to less affluent areas, you have places like the Bodega where the owners report being scared of the homeless men and young adults that loiter or hang out outside of their store due to fear of being robbed or attacked. The majority of the city appears to utilize walking or public transportation such as the bus to navigate the city. There are many bus stops throughout the city to make navigation via public transportation easier. When talking with the residents of Sentinel City, many of them did not own a car of their own to get around with. While there are many sidewalks and citizens seen walking around, between trash and other discarded debris littering the sidewalks, it’s apparent that there would be no room for a disabled individual to navigate with something such as a wheelchair or crutches. Sentinel City has an about 80% white population but is very diverse in that many other races also reside in the city. There is the Interfaith Church that is accepting of those of all religious beliefs in Industrial Heights and when speaking with members of the community, it appears the church is attempting to bring a lot of good to the less well-off residents of Industrial Heights. There is one hospital located in Acer Tech Center and offers various services such as emergency, elderly, inpatient, pharmacy, ambulatory care, and dentistry services. The City Hall is home to many departments and just outside you can find a group protesting taxes with a few policemen standing close by. Sentinel City is a very diverse environment with many services and places to explore as a community health nurse.

Population Health Scavenger Hunt

The scavenger hunt assessment tool was helpful for identifying resources available in Sentinel City and how they assist their citizens. The Parks and Recreation department dedicated 15% of its budget in the past year to many educational programs such as swimming lessons, nutrition courses, gardening courses, city sports leagues, and after school programs. The SentinelCity Healthcare System provides many services to seniors but unfortunately appears underutilized. Within the past 12 months 8.3% of Sentinel City Seniors utilized medical care advocates, 2.9% utilized community centers, 1.3% utilized meals on wheels, and 6.8% utilized senior transportation services. City Hall Social Services provides services such as adoption assistance, youth independent living services, and a stay at home program. However, one of the most utilized services provided is healthcare assistance. In Sentinel City there are 200,036 citizens receiving Medicaid, 104,240 citizens receiving Medicare, 38,771 citizens utilizing ACA,and 4,116 citizens receiving charitable healthcare (SentinelU, 2020). The Better Health Clinic located in Industrial Heights provides a long list of services to the community that include contraceptive services, pregnancy testing and counseling, infertility services, STD services, breast and cervical cancer screenings, and more. Despite these services provided, Sentinel City still has notable teen (ages 15-17) pregnancy rates. Last year there were 219 teen pregnancies, 199 teen births, and 20 teen abortions. The soup kitchen run by the Interfaith Church of Sentinel City serves around 39,000 to 51,000 meals each month. Of those that receive meals from the soup kitchen, 64% are homeless adults, 3% are homeless children, 12% are veterans, 6% are elderly, 7% are disabled adults, 6% are healthy adults, and 2% are healthy children. The Sentinel City Affordable Housing Project provides studio, one-bedroom, and two-bedroom apartments to those with low income. The average income of each type of unit respectively within the past yearis $26,500, $31,000, and $35,800 (SentinelU, 2020)

Section B1

After spending time in Sentinel City, there were many health and safety concerns that became blatantly obvious. Many of the health and safety concerns are ones which can exacerbate other health and safety concerns, leading to a cyclical downwards spiral of the health and safety of Sentinel City Residents. The first concern that came to my attention was the poor health of Sentinel City residents.A big area of health concern in my opinion, is the cardiovascular health aspect. Cardiovascular health is so important to maintain as it affects nearly every other body system and poor cardiovascular health can easily lead to death. According to Sentinel City Healthcare Services, the third highest type of inpatient surgery is cardiovascular with 2,246 in the past year. 15% of the patients seen in the emergency department come in complaining of chest pain but there are other complaints that can also be linked to poor cardiovascular health such as shortness of breath accounting for 12% (perhaps in the setting of heart failure exacerbation). When looking at which medications Sentinel City residents are most commonly prescribed, there are a handful of cardiacmedications. 11% of the population are taking simvastatin, 10% are taking lisinopril, 8% are taking amlodipine, and 4.5% are taking hydrochlorothiazide (SentinelU, 2020). Sentinel City EMS reports that they responded to 145 sudden cardiac arrest victims in the last year, higher thanall three of the comparison cities. A major factor of managing cardiovascular health can be done non-pharmacologically with things such as healthy eating, cutting out tobacco, and frequent exercises. In Sentinel City, 24% of the residents report using tobacco products. There is one healthy grocery store and that is all the way in Nightingale Square. Additionally, the city is practically devoid of any outdoor spaces or indoor gyms to utilize for activity or exercise. The Department of Parks and Recreation offer services that help promote exercise but they are underutilized as residents have complaints about the increasing homeless population and cleanliness of the public parks. In Industrial Heights, the poorest neighborhood in Sentinel City, 37.5% of the residents do not have health insurance (SentinelU, 2020). In order to promote better cardiovascular health amongst its citizens, Sentinel City needs to work on making healthcare more affordable and attainable, cleaning up the city, and providing more resources to help citizens exercise more and eat better.

Section C1

Utilizing the Healthy People goals, there are three problems identified in Sentinel City that need to be addressed. As previously discussed, the residents of Sentinel City are in poor health and the resources to help them better their health are numbered. Unfortunately, there is a large disparity between the socioeconomic status of the wealthiest citizens in Nightingale Square and the poorest citizens in Industrial Heights. This disparity becomes extremely apparent when analyzing statistics between the two neighborhoods, most plainly, the percentage of insured citizens. 37.5% of Industrial Heights citizens are uninsured whereas 0.7% of Nightingale Square citizens are uninsured. Being uninsured is a major deterrent to seeking medical care for most people. In order to achieve health equity, these disparities need to be eliminated to improve the health of all of the citizens in Nightingale Square (Healthy People, 2020). Another issue identified in Sentinel City is the overwhelming urban environment coupled with the lack of greenspaces, parks, and natural areas. The trash and pest problem in Sentinel City is rampant. The city also only has a few very small, very rundown parks for their citizens. The city needs to work on improving the parks that they have as well as adding more natural areas for their citizens to enjoy o meet the Healthy People goal of creating a physical environment that promotes good health for all (Healthy People, 2020). Finally, Sentinel City has a fair number of adolescents aged 15 to 17 experiencing teen pregnancy. Within the past year there were 219 teen pregnancies, with 20 ofthose ending in abortion (SentinelU, 2020). Babies that are born to teen mothers are more likely to be in poor health when compared to those born to adult mothers so it is important to educate Sentinel City citizens and provide services to help decrease the number of teen pregnancies to meet the Healthy People goal of improving pregnancy planning and decreasing the number of unwanted pregnancies (Healthy People, 2020).

Section C2

A resource available in Sentinel City is the Better Health Clinic. This clinic in Industrial Heights provides contraceptive services, pregnancy counseling and testing services, as well as other services that can be utilized by the community to decrease the number of teen pregnancies. The number of teen pregnancies for the first 3 years rose from 202 to 320 but has since started to decrease so it is the hope that these services are beginning to work for the community (SentinelU, 2020).

Section C3

Relating to the maternal, infant, and child health in Sentinel City, the primary prevention would be prevention of unwanted pregnancies. In order to prevent teen pregnancies and unwanted pregnancies there needs to be resources available to provided sex education, contraception, and other maternal health resources.

Section D

As a nurse, I can utilize these new community health assessment tools regularly in my own community. I work in Baltimore, MD which reminds me a lot of Sentinel City in the sense that there are poverty-striken neighborhoods as well as more affluent neighborhoods. I can utilizemy windshield assessment knowledge to make observations between different neighborhoods and see where there are differing safety concerns. I can also use my neighborhood safety inventory skills to assess the individual needs within the community. The needs of some in the community may be completely different from others in the community and by utilizing all that I have learned with community health nursing, I will be able to help even more of the population in my own community

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