Running head: VILLIAGE MEADOWS COMMUNITY ASSESSMENT

Community Assessment of Village Meadows Elementary School
Grand Canyon University

Community Health
October 18, 2010

Community Boundaries
This community is comprised of school-aged children ranging from kindergarten and lasting up until sixth grade. The phenomological community is represented in the fact that the community members are all considered to be in elementary school. The community is made up of children with and without special needs and learning disabilities. These children live in the geopolitical area of Bell Road to the 101 Freeway, and between 19th Avenue and 25th Avenue. This area is the pre-determined area set forth by the county to represent the appropriate amount of households for the school size. The community expands and shrinks as students move into or out of this plotted area. They represent people who are mostly Caucasian and Hispanic, but there is a blend of Slavic and Middle Eastern community members. Many of the community members live in apartments or other grouped housing, and has the ability to interact outside of school as well.
Assumptions
The main assumptions of the community include that some of the children will be poorly educated because of the community in which it resides. It is also assumed that these children are not going to be eager about school, particularly high school and college because the percent of bachelor level families is very low in this area. It is also assumed that a good majority of the students live in difficult situations at home, and probably have two parents that work in order to make ends meet. Either that, or the families just rely completely on the government to be able to survive. One of the best examples that I can give to affirm that some of the children are poorly educated revolves around a fifth grader. The child was sent to the nurses’ office, and the teacher asked the child to write out her own pass to leave class because she thought it adds responsibility for the children. This girl wrote her name out, with the legibility of a first grader. Her g was backwards, and I could not even read her last name. I was appalled to see that his was the work of a fifth grader. During my community teaching, I was surprised to see that so many children were thinking about going to high school and college. I hope that they were motivated by me to seek continuing education as a young adult. In terms of the children living in difficult situations, I believe that this is an understatement. I don’t think I can even comprehend what these children live with at home. After meeting some of the parents, and talking to the children, I am surprised to see that they are doing as well as they are. I think there is so much more that I don’t see, and as a result I cannot even affirm that statement properly.
Community Description
Value/Belief Pattern
• Predominant ethnic and cultural groups along with beliefs related to health o According to the school administrative assistant who collects statistics, the school is approximately half Caucasian and half Hispanic with over 60% of the population receiving help from Welfare. o The administrative assistant also notes that there are a few middle eastern, African American and Native American, Yugoslavian students but they comprise only a small portion of the population
• Predominant spiritual beliefs in the community that can influence health o The administrative assistant states that the predominant religion is Christian
• Availability of spiritual resources within or near the community (churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help, support groups, etc.) o After evaluating the neighborhood, I noticed that there are two Christian churches that border the east and west side of the property o I noticed that that the churches offer vaccination clinics during the school year and organize food and clothing banks for the children and families of the community o Approximately 50% of the older children interview by the student nurse state that these churches are their parishes and that they can go there whenever they would like.
• Do the community members value health promotion measures? What is the evidence that they do or do not? (e.g., involvement in education, fundraising events, etc.) o The school nurse has placed tobacco prevention, drug use prevention, and alcohol prevention posters all over her office. She also calculates BMI screenings and notifies the parents of the results, and she is responsible for puberty education programs. o The school nurse states that she also arranges for dental screenings and fillings as needed for the children yearly. o According to one of the active mothers who volunteers at the school and is a part of the PTA admitted that the PTA helps to raise money to give back to the children. The mothers sell snacks after school every Friday to raise money, and they also have monthly fundraisers to help bring money back to the school to buy whatever the school needs at the time. However, she states that about half of the available snacks are healthy and the other half would be considered junk food. She states that the most popular thing is children sized Jamba Juices that they sell. She explained that they try to have healthy things, but that the children like to also buy candy and soda. o According to the school nurse, there is no soda allowed on campus during school hours. Any child who is found drinking soda will be subject to detention. o Per the nurse who is the head of Student Council, the school council does a yearly garage and intermittent car washes when the weather is warm to raise money
 The student council bought the recycle bins and the group financially supports sending it’s members to leadership training programs
 The student council bought a smart board microscope for the new science lab that has helped to further drive the scientific education afforded to the community. o Per a PTA mother, the school also does clothing drives to collect clothes to be distributed to the community. They have a permanent bin located in the front of the school to collect the clothes
• What does the community value? How is this evident? o Per a physical assessment of the area, the community values a clean and safe environment.
 There are smoke free campus signs around campus,
 The campus is well maintained and clean, the drive is very well organized and easy for parents to pick up and drop off their children
 There are painted trashcans that line the areas, and inspirational words are written on the ceiling boards of the walkways. o Per physical assessment of the area, it is apparent that the community values physical activity as many of the children walk or bike to school and the school has multiple outdoor play areas that are particular for the developmental levels
 Many of the children observed were walked or biked to school with an accompanying guardian or older child. o Per the school nurse, the community admits to valuing academics, but they wish they had more funding to be able to have the programs that they would like to have
• What do the community members spend their money on? Are funds adequate? o Per the PTA mother, the community spends their money Jamba juice that is offered every Friday, as well as the candy and snacks that are offered by the PTA every Friday. Although the community does not have much financial means, the community nurse admits that “somehow they scrape up the money” o Per the nurse, the community does not have access to vending machines at school o Per the nurse, many of the community members do not have enough money to spend accessories like jewelry o Per the school nurse, there are children who have cell phones, but the parents pay them for. Children are not allowed to have cell phones on campus, so they must be concealed through out the day. Most of the community does not have the funds to be able to afford electronics.
Health Perception/Management
• Predominant health problems: Compare at least one health problem to a credible statistic (CDC, Maricopa County, or state). o Per the nurse, the predominant health issues among the community members are sore throats, nose bleeds, pediculosis, and infectious communicable diseases like the flu o According to the Maricopa County Department of Public Health, the most important thing to help prevent flu transmission in elementary school aged children is to have appropriate vaccines (Maricopa County Department of Public Health website, 2010) o The CDC states that in 2009-2010, there were a total of 281 reported deaths (CDC, 2010)
• Immunization rates (age appropriate) o Per the school nurse, all community members are immunized other than 6 children who have exemptions out of the 540 students
 Calculations demonstrate that just barely one percent of the community members are not immunized
• Appropriate death rates and causes, if applicable o Per the school nurse, one child enrolled in fourth grade last year was killed in an ATV accident. She was seated behind her sister who was in seventh grade who was driving the ATV when it turned over and crushed her. This is the only reportable death in the last 5 years.
• Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient? o The school nurse teaches tobacco and drug prevention. The school nurse rolls out at least 50 anti-tobacco and drug notices every school year. o According to the nurse, first aid classes not taught to the community o Per the nurse, the neighborhood fire department teaches bike, water, fire, stranger safety
• Available health professionals, health resources within the community, and usage o The school nurse states that she is always on campus (unless there is an emergency), the school psychologist is available through the district, dental help is made available to the community through the County Office of dental health and Midwestern University o The nurse states that each classroom has a first aid kit, and the nurse’s office houses the AED and the emergency kit for an evacuation. o Per physical assessment, the fire station is four blocks away from the school.
• Common referrals to outside agencies o The nurse refers the community to appropriate dental clinics, mental health clinics and Mendys Place for emergency visits with a minimal co pay of $20 required for the children. o Per the nurse, the community is referred to Maricopa County for vaccines
Nutrition/Metabolic
• Indicators of nutrient deficiencies o Per the nurse, the main indicator in the community for nutritional deficiencies is poor growth. o Per the nurse, obesity is another leading factor; these children are getting sugars and fats in place of nutrients.
 Per the nurse, she has collected sample receipts that demonstrate food stamps being used to buy candy, chips and soda.
• Obesity rates or percentages: Compare to CDC statistics. o According to nursing measures approximately 20% of the student community falls in the obese category, with 20% being at risk for obesity o Per the CDC website, in 2007-2008, there were an estimated 17% of children who were obese (CDC website, 2010)
• Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals on wheels, food stamps, senior discounts, employee discounts, etc.) o Per the school nurse, all children who are eligible for the free and reduced lunch program for free breakfast 15 minutes before the first bell every morning o Per the nurse, children of the community are eligible for the free and reduced lunch program o Per the cafeteria attendant, f a child pays for their meals, it is $0.75 for breakfast or $1.25 for lunch o Per the cafeteria attendant, the reduced rate for the eligible community it $0.35 per meal period; 15% of the community has reduced lunches o Per the school administrator, recent data that was collected demonstrates that more than 30% of the community is dependant upon food stamps for meals outside of school o Per the school administrator, 60% of the community has free lunches
• Availability of water (e.g., number and quality of drinking fountains) o Per physical inspection of the grounds, water fountains are by the playgrounds and by all the bathrooms. There are also water fountains available in all buildings for a total of nine sets of two drinking fountains o Per physical inspection, there are two water fountains in the gym; one at a higher elevation than the other. o Per observation, each set of water fountains has one that is appropriate height for older children, and one water fountain that is appropriate for the smallest children o Per inspection, there are a total of twenty drinking fountains on campus.
• Fast food and junk food accessibility (vending machines) o Per observation, there are no vending machines available on campus for the community. o Per the nurse, the only junk food availability for the community on the campus is when the PTA sells soda and candy on Friday afternoons. o Per the cafeteria attendant, the children that come with their own lunches are the main children who bring in food that would be considered to be junk food
• Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.) o Per the community, 10 out of 12 children state that they enjoy the food in the cafeteria even if they might not eat all of their food. o Per the cafeteria attendant, the classes are staggered for their time to have lunch so there is never really a long line. o Per observation, the community always has access to a fruit and salad bar in addition to their hot foods.
• Provisions for special diets if applicable o Per the school nurse, there are no diabetics, no tube feeders and no peanut allergies in the community. o Per the nurse, there is no knowledge of any special dietary needs in the community.
• For schools (in addition to above): o Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards
 Per the nurse, the nutritional content of the food in the cafeteria meets the state standards set by the district dietician.
 Per the nurse, a child who does not want a prescribed item cannot refuse that item; the cafeteria must give it to them. As a result, the nurse states that much food is wasted every day and nothing can be done about it. o Amount of free or reduced lunch
 According to the school administrator, 60% of the children have free meals, and 15% of the community pays the reduced lunch
Elimination (Environmental Health Concerns)
• Common air contaminants’ impact on the community o Per the nurse, the air of the school is average air quality. There are no factories or large pollutants nearby, but the school is near a freeway
• Noise o Per observation, the school is situated between two churches and a large park in a quiet neighborhood that has relatively little traffic o Per observation, most of the noise comes from traffic on 19th avenue, and only during the times that school is starting and the community members are being picked up.
• Waste disposal o Per the nurse, custodians assure that the trash are removed daily as needed, and vomit, blood and other as requested
• Pest control: Is the community notified of pesticides usage? o Per observation, the community is currently being notified about the use of an herbicide. The notice is pasted to the front of the main door and must remain there or a specified period of time before, during and after the use of the herbicide.
 Per the nurse, once the community is sprayed, the poster must be displayed on the front office door for two weeks before and after a spraying.
• Hygiene practices (laundry services, hand washing, etc.) o Per the nurse, the community does have access to a washing machine that is located in the building with the special needs children. The washer is to be used for towels and clothes of the children in case they become soiled, as they constantly need to be changed.
 Per the nurse, often times clothes from the family members of the community are found there if the room is not locked. o Per observation, the community is taught of proper coughing and sneezing techniques in Kindergarten. They are taught to sneeze or cough in the corner of their elbow
• Bathrooms: Amount, inspect for cleanliness, supplies if possible o Per inspection, bathrooms are all maintained well. Soap dispensers are full, and the water can reach warm temperatures needed for proper hand washing techniques. o Per observation, since the community it small, every building has at least one male and female bathroom
 Each bathroom has 3 stalls and two sinks in each bathroom
 Community bathrooms are separate from the staff restrooms
• Universal precaution practices of health providers, teachers, members (if applicable) o Per observation, nurse and staff use universal precautions as applicable. o Per the nurse, each classroom a bag with band-aids and gloves filled by the nurse to start the school year off.
 As soon as supplies are used, the teachers are responsible for going to the health office to get the bag refilled.
• Temperature controls (e.g., within buildings, outside shade structures) o Per observation, all of the buildings all have air conditioning. Each classroom and the gym has it’s own ability to regulate the temperature. o Per observation, there are numerous shady trees on the campus to provide shade, and all of the buildings have large shaded ad covered walkways. o Per the school nurse, the community has won the APS Energy Star Award for reduced energy consumption
• Safety (committee, security guards, crossing guards, badges, locked campuses) o Per the nurse, there is a safety committee on the campus that is comprised of the nurse, principal, principal’s secretary, the custodian, reading specialist and the coach. o Per observation, there are crossing guards directly outside of the school and in the neighborhood before and after school to help accommodate the traffic. o Per observation and the nurse, the teachers rotate duty between the entrance of school and in crossing locations at dismissal of school, at recess, and for aiding with getting the children to their appropriate transportation in a safe manner. o Per observation, all faculty and volunteers wear badges in the community. o Per observation, there are signs outside the front of the school that tell the correct speed limits and signs that note to watch for children. o Per the school administrator, the campus is locked, and the only entrance is through the front gate and the front office once school has begun.
Activity/Exercise
• Community fitness programs (gym discounts, P.E., recess, sports, access to YMCA, etc.) o Per observation, the community has a gym on property that has basketball hoops. o Per the PE coach, PE is in the gym or outside depending on the weather. o Per observation of school schedules, recess is part of the lunch hour, so the community has 45 minutes to have lunch and enjoy recess. This restricts activity; there is only 20 minutes of recess for the whole day. o Per the nurse, PE begins in first grade and is three times a week for 45 minutes.
 The nurse does not agree with this and thinks that more time is needed for physical activity throughout the day. o Per observation, the community has access to locker rooms in the gym. o Per the nurse, there are no athletic programs or teams available to the community. o Per the nurse, there are no after school sports that are available to the community that are funded by the campus. o Per the nurse, there is no close YMCA, but there is a Deer Valley Community Center for the community to go to and engage in recreational activities such as sports, music or dancing.
• Recreational facilities and usage (gym, playgrounds, bike paths, hiking trails, courts, pools, etc.) o Per observation, there is a gym but no pool on the community campus. o Per observation, there is one large playground with swings, tetherball, monkey bars and sand. o Per the nurse, the head start and kindergarten have a large play area with a sandbox and hose to play with in addition to outdoor toys, but it is separate from community resources. o Per observation, the community has a bike path that leads to the campus.
 According to the nurse, bikes are not allowed on campus; if a child uses a bike to get to school there is a designated place to put the bikes in the office. o Per observation, there are no hiking trails in the community. The closest hiking is approximately five miles north of the community neighborhood.
• Safety programs (rules and regulations, safety training, incentives, athletic trainers, etc.) o Per the school nurse, teachers do not have to be first aid certified in the community. o According to the school nurse, there are no athletic trainers in the community.
• Injury statistics or most common injuries o Per the nurse, the most common injuries are head injuries, particularly from the kindergarten community. o Per the school nurse, last year there was one significant reportable injury that required hospitalization for stitches but was not severe.
• Evidence of sedentary leisure activities (amount of time watching TV, videos, and computer) o 15 out of 15 community members who were interviewed admitted that they watch tv and/or play video games every day. o Only ten of the respondents reported having access to computers outside of school.
• Means of transportation o Per observation, most of the community is dropped off at school by their parents, but some children walk or ride their bikes to school. o Per the school administrator, the children must live at least north of Union Hills to qualify for students to take the bus.
Sleep/Rest
• Sleep routines/hours of your community: Compare with sleep hour standards (from National Institutes of Health [NIH]). o There are no children at the school to the knowledge of the nurse who do not have a place to sleep every night o Twenty out of 22 children reported to go to bed before eight o clock. The other children reported that they were awake with things going on at the house till around one pm.
 18 of the children reported that they take showers before bedtime.
• Indicators of general “restedness” and energy levels o Per observation, indicators of “restedness” include mental alertness and the ability to focus in class at an appropriate level. o Per nurse, when children are well rested, they do not ask to go home. Instead, they feel better, and they have much more energy
• Factors affecting sleep: o Shift work prevalence of community members
 To the knowledge of the school nurse, there are only a few families in which at least one parent works night shifts.
 Per the nurse, a majority of the children live in a family environment where the parent(s) or guardians work standard 9am-5pm.
 Per the school administrator, there are a significant amount of parents collecting welfare and/or disability, but the exact count is not known. o Environment (noise, lights, crowding, etc.)
 Per the nurse, most of the families live in a single family house with no more than five or six people total in the house.
 Per observation, there are two siblings, who suffer from chronic headaches that interfere with their ability to sleep. According to their mother, it is a condition that is familiar in the family. It also affects their ability to learn in class. o Consumption of caffeine, nicotine, alcohol, and drugs
 Per observation, the children are very young to have significant issues with substance abuse and the effects they have on sleep
 According to the school nurse, approximately 25% of the members of the community live in conditions where nicotine, alcohol and drugs influence the children and can potentially impact their sleeping patterns.
 Per the school nurse, caffeine, nicotine, alcohol, and drugs are all not allowed on campus, and do not appear to be a problem with the children.
 According to the nurse, she believes that there are two children in particular who are believed to be involved with these substances, but it is not known as to whether it affects their sleep or not. o Homework/extracurricular activities
 Children who do not sleep well do not have good energy, and tend to not perform as well as those children who come to school well rested
 Per the nurse, there are no extracurricular activities at this school. o Health issues
 The children who are being treated with scheduled medications all report to sleep well through the night, and they feel well rested when they wake up in the morning.
Cognitive/Perceptual
• Primary language: Is this a communication barrier? o Per observation, the primary language for 50% of the population is English, the rest is Spanish with a few children who have a Slavik, Arabic or Balkan language as their primary language at home.
• Educational levels: For geopolitical communities, use http://www.census.gov and compare the city your community belongs in with the national statistics. o The school is ranked as “Proficient” but not excelling in State and National comparisons. o According to the census.gov, 80.4% of the community is high school graduates, and only 24.4% are bachelor level graduates.
• Opportunities/programs: o Educational offerings (in-services, continuing education, GED, etc.)
 Per the nurse, there are no further educational offerings beyond the classroom. o Educational mandates (yearly in-services, continuing education, English learners, etc.)
 Per the nurse, there are no further educational mandates beyond the classroom. o Special education programs (e.g., learning disabled, emotionally disabled, physically disabled, and gifted)
 Per school records, there are 46 students at the school who utilize special education programs.
• 21 children have speech and language impairments, and are seen by the speech therapist twice a week for one class period
• 11 children have mild to moderate mental retardation, and the rest of the children have developmental delays or other health impairment
• Library or computer/Internet resources and usage o Per observation, all classrooms have been equipped with smart boards to enhance learning, and each classroom has at least three computers to use as a learning tool. All computers are equipped with standard word processing and the Internet.
 Youtube, myspace and facebook are blocked. o Per observation, there is no library on campus.
• Funding resources (tuition reimbursement, scholarships, etc.) o Per the school administrator, the community does not directly pay for school tuition. The school costs are funded through taxpayer’s money from the district. o Per the school nurse, scholarships are not available or needed for attendance at the school.
Self-Perception/Self-Concept
• Age levels o Per state standards, children must be five years old before September 1st in order to enroll in Kindergarten. o Per the nurse, the head start program is available as part of the community for younger children, but they are not under the direction of the school. The head start program has all of their own resources and rent out the space from the school. o Per the school administrator, the oldest child on campus is 13 years old, but this student has been held back a few years. Usually the oldest child in the community is no older than 12 years old.
• Programs and activities related to community building (strengthening the community) o Per the nurse, he Student Council is the only group within the community; there are no other clubs at school which engage children in strengthening the community o According to the nurse, since funding was cut, all other after school programs have been cut.
• Community history o Per the school administrator, the current principal was a student at the school over 30 years ago. o Per the nurse, the first grade teacher is the longest teaching teacher at the school, and she has taught the community for over 30 years. o Per the nurse, half of the buildings are new over the past five years o The school has been teaching for over 50 tears now.
• Pride indicators: Self-esteem or caring behaviors o Per observation, the community displays a great sense of pride. Their motto is the Vikings, and there are Viking hats everywhere around campus. o Per observation and the nurse, many students wear hand-me-down clothes that are very worn, but the clothes are washed, ironed and matched as best as possible.
 The children are well groomed, and take pride in their hairstyle by keeping their hair well kept and nails trimmed and free from dirt
• Published description (pamphlets, Web sites, etc.) o Per observation, the school does have a website which keeps parents up to date about activities an policies, but it is estimated that only half of the community members and their families have access to the internet or a computer. o Per the school administrator, the school publishes a monthly newsletter called “Messages from the Meadow” that is sent home with each student regularly.
Role/Relationship
• Interaction of community members (e.g., friendliness, openness, bullying, prejudices, etc.) o Per the school nurse, the children in the community do face bullying, but according to the school nurse there is not much prejudice or discrimination because the population is pretty diverse o Per the nurse, the children are friendly and outgoing and have the opportunity to interact with each other
• Vulnerable populations o Why are they vulnerable?
 The vulnerable populations include those who do not have English as a primary language
 The vulnerable populations also include community members who are dependent upon welfare and food stamps to survive.
• The educational and financial resources of the parents limit these community members’ optimal health and wellness. o How does this impact health?
 Lack of funding can mean lack of proper nutrition. Lack of proper nutrition puts the community at an increased risk for developing diseases over time.
 Lack of education and language abilities make it difficult for the parents of the community members to navigate society, and engage in proper health behaviors such as getting vaccines.
• Power groups (church council, student council, administration, PTA, and gangs) o Per the school nurse, the school has student counsel which meets every other week.
 There are fifteen children who are selected from sixth grade to participate in the student counsel o PTA is very active in the community and is led by the school nurse and the sixth grade teacher. o The parents in the PTA also volunteer regularly at the school helping as needed every day. Per the nurse, on any given day there are at least 5-10 parents volunteering.
 According to the school nurse, the parents are not paid; their work is strictly volunteer. o How do they hold power?
 Per the nurse, the students do not really hold power in the community, but rather they serve as an organization in which they contribute back to the school
 The nurse admits that the parents have a good amount of control over what happens in school; they are very influential in decisions that are made and follow a monthly schedule for meetings o Positive or negative influence on community?
 The nurse states that the student counsel and the PTA both have extremely powerful positive effects on the community
• Both groups have the same goal of improving the community
• Harassment policies/discrimination policies o Per school code, there is a no tolerance policy if a child is caught harassing or discriminating another individual on the campus
 Children who are found to be harassing or discriminating outside of the community campus will be dealt with in the same manner
 Punishment varies depending upon the offense, but typically the parents are involved immediately in the situation and it begins with detention, suspension and then it can progress to expulsion
 If the child is expelled the child is referred often times to alternative schools at which they follow a tighter and more closely monitored regimen.
• Relationship with broader community o Police
 Per the nurse, there is no set security on campus; technically the campus is supposed to be closed, but there is always one open gate for the buses to go out
 Per the nurse, the police station is close, so the response time is very quick.
 The nurse states that the police have been called to the campus in the past as a result of a student who was diagnosed with a psychiatric disorder who would be physically abusing other community members and staff. o Fire/EMS (response time)
 Per observation, there is a fire department just a few blocks away and their response time is under five minutes
• The nearby fire department has an EMS response team that includes paramedics o Other (food drives, blood drives, missions, etc.)
 Per the nurse, the school uses activities to promote food drives where the admission is a can of food to be donated.
• The classes also have competitions for food drives where the food is donated to St. Mary’s Food bank
• The class who brings in the most amount of canned food will win a pizza party for the class
 Per the school nurse, the school does not organize blood drives.
Sexuality/Reproductive
• Relationships and behavior among community members o Per the school nurse, there appear to be only a few community members who appear to be involved in a sexual relationship.
• Educational offerings/programs (e.g., growth and development, STD/AIDS education, contraception, abstinence, etc.) o The school nurse teaches 5th and sixth grade sexual education; boys are kept separate from the girls.
 Education covers basic anatomy and physiology and lasts for one class session
 The boys are taught more hygiene with puberty
 The children are allowed to be open and ask any questions like they would like from masturbation to sex
• Access to birth control o This is not something that is seen as being needed since the oldest children are in sixth grade. The nurse states that this has never been a concern in the past, but that she would be willing to present this if the topic was ever brought up.
• Birth rates, abortions, and miscarriages (if applicable) o No births, abortions or miscarriages to the knowledge of the school officials in the last five years
• Access to maternal child health programs and services (crisis pregnancy center, support groups, prenatal care, maternity leave, etc.) o The nurse can provide the community with this information if needed, but it is not something that is currently or visibly available to the community
 This information has not been needed in the past.
Coping/Stress
• Delinquency/violence issues o Per the nurse, the community does not have severe issues. She states that violence does occur but nothing that is not resolved.
 Fights happen, but there is never any blood or broken bones. The teacher and principal deal them with.
• Crime issues/indicators o There are none to the knowledge of the nurse
• Poverty issues/indicators o Per observation, poverty is a huge issue at school.
 Many parents don’t have enough money to buy food for the children, so they get free breakfast
 Many children do not have appropriate sized clothes or shoes
• CPS or APS abuse referrals: Compare with previous years. o Per the school nurse, there have been 6 referrals to CPS over the past three years o The nurse states that there have been no referrals this year so far, but there is one child who is believed to be a victim of sexual abuse. This child does not want to talk about anything at this time.
• Drug abuse rates, alcohol use, and abuse: Compare with previous years. o The nurse states that drugs are not very prominent in the community, but it is believed that parents and family members who are involved in substance abuse surround the community members. o The nurse is aware of children who live in households where alcohol is a problem for the patents and the community members are surrounded by it
 Abuse is also suspected for some families, and those that are suspected are reported o According to the nurse, one of the biggest issues is neglect in this community
 The parents are out working or doing their own thing, and they do not spend enough time with their children and they do not stimulate them enough properly and the children are neglected
 There are also cases of medical neglect where parents or guardians give the children medication at their own determination instead of following the prescription.
• Stressors o Per the nurse, the biggest stressor in the community is lack of resources as a result of low income.
 Financial stressors make it difficult for the community to meet the basic needs of living such as having appropriate diets, housing and clothing. o The nurse also states that there are many children in the community who are the product of single parents, or they are living with grandparents or people other than the biological parents who are raising them.
• Stress management resources (e.g., hot lines, support groups, etc.) o Per the nurse, the school does not offer any support groups or hot lines for the community.
 The nurse is seen as one of the best sources for support if a community member requires it.
• Prevalent mental health issues/concerns o When called to pick up a community member from the health office, picking them up was not a priority for 4/5 parents called
 Some parents took up to 3-4 hours to pick up the community members because they were out doing errands even when the nurse explained that they needed to be taken to the doctor immediately. o How does the community deal with mental health issues?
 Per classroom records and scheduling, mental health workers visit the community members with mental health issues on a regular basis in the classroom based on their condition. o Mental health professionals within community and usage
 According to the nurse, there is one psychiatrist for the district that is to be utilized as needed.
• Some of the community members utilize mental health providers outside of the school. o These community members are medicated and visited by mental health workers as needed based upon their diagnosis.
• Disaster planning o Past disasters
 Per the nurse, there have been no disasters in the past in the past five years.
 Per observation, there is a disaster plan that is posted in all of the rooms. o Drills (what, how often)
 Per the school administrator, there are regular fire drills once monthly.
• The evacuation plan is that all the community will meet out on the fields in case of a fire alarm
• Fire department comes out to teach the children the importance of stop, drop and roll and fire safety once yearly
Planning committee (members, roles)
 The school nurse, head custodian, the principal, secretary and one teacher are the planning commit for disaster preparedness o Policies
 Per the nurse, the evacuation plan is implemented as needed based upon the situation.
 Per the school nurse, if there is a threat, the school is placed on lockdown depending upon the threat.
 If there is a fire plan then everyone goes out to the playground. o Crisis intervention plan
 Per the nurse, the crisis intervention plan is dependent upon the emergency
• No matter the crisis, one person is always sent out to call 911 to initiate the EMS cascade and then the interventions that follow depend on situation

Data Collection

The data for the Functional Health Pattern Assessment was collected over the course of five weeks by interviewing community members and the staff at the school. Statistical information was gathered mostly from the school administrator. Since they have access to all of the paperwork on their computer system, it was easy to ask a question and quickly have a complete answer. For man of the volunteer and fundraising involvement, a few of the moms on the PTA were interviewed. They were volunteering my first few weeks with the hearing and vision screenings, and were on campus every other day helping out as needed. They are very well informed about the school, and always know what is happening on campus. A good portion of the assessment was collected from my nurse who is absolutely knowledgeable about almost every single topic. She is so involved at the school, that there is almost nothing that she does not know. As children were brought in for screenings, or came into the health office to be seen, they were interview about things such as sleep habits so that I would have a better understanding from the community members themselves. Information was also gathered from the schools website and the pamphlets that are available in the front office.
Cluster Cues

• Many community members come from single-parent homes or homes in which a guardian takes are of them.
• When called to pick up a child from the health office, picking up the children is not a priority for 4/5 parents called.
• Per observation, the primary language for 50% of the population is English and 24% of the population has a bachelors degree
• Community is low income; many are on welfare
• Nurse believes that many of the parents are substance abusers

Altered growth and development related to parental knowledge deficit and parental separation as evidenced by children having difficulties writing their names in advanced grades and not having attentive parents.

• Per the nurse, she has collected sample receipts that demonstrate food stamps being used to buy candy, chips and soda.
• Obesity rates or percentages: Compare to CDC statistics. o According to nursing measures approximately 20% of the student community falls in the obese category, with 20% being at risk for obesity
•
Altered Nutrition: less than body requirements related to the community not eating satisfactorily nutritional foods at home as evidenced by the receipts the nurse keeps that demonstrate food stamps being used to purchase soda, chips and candy.

Also….

Altered Nutrition: more than body requirements related to the community eating foods that are not nutrient dense, but high in sugar, fats and calories as evidenced by the receipts the nurse keeps that demonstrate food stamps being used to purchase soda, chips and candy.

• Many community members come from single-parent homes or homes in which a guardian takes are of them.
• Per observation, the primary language for 50% of the population is English and 24% of the population has a bachelors degree
• Community is low income; many are on welfare
• Nurse believes that many of the parents are substance abusers

Risk for violence related to residing in a stressful, low income and low education neighborhood where many of the families suffer from substance abuse

Also….

Altered family processes: substance abuse related to being uneducated and having a low income as evidenced by the nurse believing that many of the parents are substance abusers.

• School is currently using an herbicide on premises
• The population of the school begins with children who are curious 5 year olds as well as special needs children who are vulnerable

Risk for poisoning related to use of herbicide in an elementary population

• Many community members come from single-parent homes or homes in which a guardian takes are of them.
• Per observation, the primary language for 50% of the population is English and 24% of the population has a bachelors degree
• Community is low income
• Many of the families live in the apartments nearby, and typically there are no more than 5/6 people in each residence, but that is a lot for a small space

Impaired home maintenance management related to overcrowding, low income and education as evidenced by some family members of the community using the school washing machines and facilities to help maintain cleanliness

Prioritization

The main priority for the community is growth and development since they are so young. It is important that they have a stable and proper living environment that facilitates the ability to grow and develop. This includes safety and nutrition on part of the parents. The children are showing signs that they are not being educated well compared to national standards and the school ranks only as “satisfactorily”. This will only cause the cycle of poor education from the parents to continue. Poor education is linked to poor health and unsafe living conditions. Because the community is low income and not well educated, this is the starting point for problems to begin and progress.
Once this is managed properly, it is important to focus on the physical health and well being and making sure that the children are eating the right foods. This population has a higher than average rate of obesity and this is because they are not eating the nutritionally supportive foods at home, and are instead eating foods that contribute to weight gain and can lead to further problems in the future.
The next dangers for the community are being surround by families who are substance abusers. Because they are in an environment such as this, it can further encourage the community members to engage in risky behaviors. This puts them at a might higher risk for violence that results from substance abuse as well as risky behaviors. Finally, the last dangers are the current herbicide which is taken care of properly by the school, and unclean living environments that result from the low income and poor living conditions.

References
Anderson, J. (2010, October 7). School Nurse, Village Meadows. Interview.
Edelman, C., & Mandle, C. L. (2006). Health promotion throughout the life span (6th ed.). St. Louis, MO: Mosby.
Gordon, M. (1994). Nursing diagnosis process and application (3rd ed.). St. Louis, MO: Mosby.

Knope, C. (2010, October 14). PE Teacher, Village Meadows. Interview

Retrieved from the Centers for Disease Control on October 18, 2010 at: http://www.cdc.gov/flu/weekly/

Retrieved from the Maricopa County Department of Public Health on October 18, 2010 at: http://www.maricopa.gov/Public_Health/ControlPrevention/default.aspx

Retrieved from the Centers for Disease Control on October 18, 2010 at: http://www.cdc.gov/obesity/childhood/index.html Smith, A. (2010, September 2). PTA Mother, Village Meadows. Interview.

REQUIREMENTS: POSSIBLE ACTUAL
1) Community Boundaries: Briefly defined boundaries for the community including:
a) People
b) Place (geopolitical or phenomological and rationale)
c) Social interactions, common interests, and goals 10
2) Assumptions: Addressed the following:
a) Assumptions or information taken for granted prior to assessment
b) Analysis of initial assumptions, explaining if they were correct or incorrect 3
3) Community Description
a) Used the template Clinical Resource 9: Functional Health Pattern Community Assessment Guide for recording collected data (each FHP category worth 4 points)
b) Used bullet point headings under each FHP section to record appropriate assessment data.
c) If a bullet point heading does not apply to identified community, stated why under that heading.
d) Added additional bullet points for information applicable to the FHP for the community but not included in the FHP template. 44
4) Sources
a) Listed sources that provided information, such as people, pamphlets, textbooks, Web sites, etc. 3
5) Analysis of FHP section
a) Highlighted abnormal data in yellow.
b) Highlighted data reflecting strengths in green.
c) Neutral data is not highlighted.
d) Performed aforementioned highlighting by identification of concerns and strengths in FHPs by comparing to theoretical knowledge, standards, and risk factors within your thought processes. 10
6) Cluster Clues
a) Copied the related highlighted data from multiple FHPs and combine into clusters.
b) Data in clusters retained highlighted color.
c) The number of clusters was determined by the analysis of the FHP data. 10
7) Community Nursing Diagnosis
a) Under each set of clustered data, created an appropriate community nursing diagnosis.
b) Diagnoses are actual, risk for, or wellness.
c) May also have used a positive functioning assessment statement if no diagnoses are applicable (rare).
d) Used Carpentio-Moyet text and Clincial Resource 10. 15
8) Prioritize Diagnosis
a) Placed and numbered nursing diagnoses in order of the highest priority (life-threatening) to the lowest priority. Used Maurer et al., pp. 438-438.
b) Explained rationale for the prioritization. 4
9) Submitted this grading rubric at the end of the assignment (not a separate attachment) 1
TOTAL 100

Once the total has been added together, calculate the following: ___/100 x 12 =