TERNOPIL STATE MEDICAL UNIVERSITY

INSTITUTE OF NURSING

INTERNATIONAL NURSING SCHOOL

 

Community Assessment Paper

 

OBJECTIVES:

● Compare and contrast five types of community needs assessment.

Discuss community needs assessment methods.

Describe four sources of community data.

Discuss the significance of formation of community diagnoses.

 

The following are the steps or phases of the nursing process.

Assessment (of patient's needs)

Diagnosis (of human response needs that nurses can deal with)

Planning (of patient's care)

Implementation (of care)

Evaluation (of the success of the implemented care)

 

Assessment

 

Assessment is the first stage of the nursing process in which the nurse should carry out a complete and holistic nursing assessment of every patient's needs, regardless of the reason for the encounter. Usually, an assessment framework, based on a nursing model is used.

 

The purpose of this stage is to identify the patient's nursing problems. These problems are expressed as either actual or potential. For example, a patient who has been rendered immobile by a road traffic accident may be assessed as having the "potential for impaired skin integrity related to immobility".

 

Components of a nursing assessment

Nursing history

Taking a nursing history prior to the physical examination allows a nurse to establish a rapport with the patient and family. Elements of the history include:[

*  health status

*  course of present illness including symptoms

*  current management of illness

*  past medical history including family's medical history

*  social history

*  perception of illness

 

 Psychological and social examination

The psychological examination may include;

Client’s perception (why they think they have been referred/are being assessed; what they hope to gain from the meeting)

Emotional health (mental health state, coping styles etc)

Social health (accommodation, finances, relationships, genogram, employment status, ethnic back ground, support networks etc)

Physical health (general health, illnesses, previous history, appetite, weight, sleep pattern, diurinal variations, alcohol, tobacco, street drugs; list any prescribed medication with comments on effectiveness)

Spiritual health (is religion important? If so, in what way? What/who provides a sense of purpose?)

Intellectual health (cognitive functioning, hallucinations, delusions, concentration, interests, hobbies etc)

 

Physical examination

A nursing assessment includes a physical examination: the observation or measurement of signs, which can be observed or measured, or symptoms such as nausea or vertigo, which can be felt by the patient.

The techniques used may include Inspection, Palpation, Auscultation and Percussion in addition to the "vital signs" of temperature, blood pressure, pulse and respiratory rate, and further examination of the body systems such as the cardiovascular or musculoskeletal systems.]

 

Models for data collection

The following nursing models are conceptual models, constructed of theories and concepts. They are used to help nurses assess, plan, and implement patient care by providing a framework within which to work. They also help nurses achieve uniformity and seamless care. are used to gather the necessary and relevant information from the patient in order to effectively deliver quality nursing care. This will help the nurse determine the ranking of the problems encountered.

 

Gordon's functional health patterns

Gordon's functional health pattern is a method devised by Marjory Gordon to be used by nurses in the nursing process to provide a more comprehensive nursing assessment of the patient:

*  Health perception and management

*  Activity and exercise

*  Nutrition and metabolism

*  Elimination

*  Sleep and rest.

*  Cognition and perception

*  Self-perception and self-concept

*  Roles and relationships

*  Coping and stress management

*  Sexuality and reproduction

*  Values and beliefs

1.      Case Study 1:  Asthma-related symptoms are higher in Adams County than in surrounding counties. The nurses are planning to use the steps in the nursing process to identify potential reasons for the increased prevalence in asthma, the existing community resources for meeting the needs of clients, considering the three levels of prevention, and planning, implementing and evaluation needed. While conducting a problem-focused assessment for asthma that crossed many ages and geographic locations within the community, a broader picture of the community's needs and resources emerged. The nurses realize that no systematic community assessment has been done in the past 10 years in the county.

a.      What assessment avenues and planning strategies will you use to arrive at the decision-making level in order to provide needed asthma-related services to Adams County? Use information found in Chapters 18 and 19.

b.     When the health care services in Adams and the surrounding counties were assessed, do they appear adequate for the population? What changes would you recommend, and how would you go about assessing the need for change? Use information from Chapters 18 and 19.

c.      Based on the employment data for Adams County, does it appear that there is enough business and industry to support a population of 70,000? Based on the age and educational level of employable adults, what additional types of business and industry are needed? Where might employable adults work if they do not work in Adams County, recognizing the distances to possible jobs in other counties?

d.     Note the top 10 employers in Adams County. Make a list of possible health problems among employees in each of the 10 areas. If you were to present health information classes to groups of these employees, what topics would you cover? Do any of the top 10 industries or work situations in Adams County cause or aggravate asthma symptoms?

e.      Many religious resources in Adams County are shared. Identify what information will help you as you work with clients in the county. In addition, what additional services might you suggest some religious centers offer? How would you go about beginning to initiate such services? Use information from Chapters 8, 18, and 19.

f.       Are there additional volunteer agencies and services this county needs? What services would you add? How would you go about adding these services? Whom would you contact and with whom would you consult? Use information from Chapters 8 and 19.

g.      What is your impression of the library services available to the county residents? In order to get more information and other opinions, you talk to the librarians, teachers, and some parents. They feel there is much needed in the area of reading, reading materials, and accessibility. What might you do as a community health nurse to help with this issue? Is this an issue with which a CHN should become involved? Use information from Chapters 8, 9, and 19.

2.      Case Study 2:  Because of the growth of Pushton as a "bedroom community" for employees in Newtown, both communities are concerned about traffic patterns/safety. They have established a safety task force on which a community health nurse serves. Considering the health and safety of the Adams County population and the traffic issues between Pushton and Newtown, respond to the following questions.

a.      After reading the brief overview of Pushton and Newtown in the information about Adams County, what types of services at the primary, secondary, and tertiary levels of prevention are needed in order to keep the traveling public safe between the two communities? What do you envision your role as a community health nurse will be on this task force?

View the data for Adams County:

  Adams County

Rural/suburban Adams County is located in the midwestern United States. There are no major highways connecting the major towns and villages, but all communities are connected by two-lane roads, and occasionally four-lane roads exist for a mile or so out of town to accommodate the traffic. An alphabetical listing of linkages follows the image of Adams County. Some links will have very pertinent data, others will not be helpful for the case study activities. You will have to sort out the value of each data set.

Business Directory

Top ten employers in Adams County:

§        Various small business employees (full and part-time) - 4889

§        Fordham Leather Tannery - 1822

§        Adams County employees (government, fire and safety, water) - 1216

§        Adams County schools (admin., teachers, custodians, food service, bus drivers) - 962

§        Small business owners - 856

§        Worthmore Construction (lumber, building supplies, manufacturing, construction) - 578

§        Hospital/health department staff - 535

§        Community College District employees (administration, faculty, support staff) - 344

§        County service employees(telephone, parks and recreation, sanitation, roads) – 330

§        Family owned farms (hiring approximately 1300 people during growing season) – 203

 

Census Data

Adams County population: 70,000               Male - 30,000                         Female - 40,000

         500            under 1                        600

         1000          1-4 years                        1200

         1500          5-12 years                     2100

         1200          13-15 years                   1600

         1700          16-19 years                   2100

         2500          20-25 years                   3000

         4100          25-35 years                   4400

         7800          36-50 years                   10,000

         7100          51-65 years                   9000

         3200          66+ years                      6000

County racial composition:

         White         48,000

         Hispanic      12,000

         Black         5000

         Asian         4000

         Native American   1000

Educational level of residents over 18:

         less than 8 years of school                10%

         some high school          22%

         completed high school            29%

         some college/tech training               13%

         completed 4 years college                 20%

         more than 4 years of college             6%

* Brown County population - 120,000

* Culvert County population - 55,000

* Denton County population - 80,000

Incorporated Towns in Adams County

Newtown - pop. 40,000:

Chamber of Commerce description: This city is nestled in the foothills of the Redhorn Mt. range along the Salmon River in this predominantly rural county. The county's airport and major industries are located in Newtown. Newtown takes pride in attracting the Fordham Leather Tannery plant to the county and has a growing community college.

Pushton - pop. 8,000:

Chamber of Commerce description: This is a "bedroom community" for the nearby city of Newtown (22 miles to the southeast). It has grown from 1400 inhabitants in 1995 to today's 8,000 people. There is a climate of brisk growth, with new neighborhood subdivisions filling the corridor along the mountainous state Route #76 between downtown Newtown and Pushton.

Pullton - pop. 6,000:

Chamber of Commerce description: Pullton is the third largest town in Adams County, located in the northern part of the county bordering the more populous Brown County. Largely agricultural, it recently built 3 new buildings at the county fairgrounds, located in Pullton, increasing the fairgrounds' capability to attract more visitors to the annual county fair.

Preston - pop. 5,000:

Chamber of Commerce description: Preston is the fourth largest town in Adams County, located in the southern part of the county bordering Culvert County. In the past decade Preston has grown from village to town status, with Oasis Corporation building a 500-bed continuing care retirement living center in Preston. People of all ages are attracted by the rural location, and Nuby Lake, which neighbors Preston, is popular year around for a variety of water sports.

Easton - pop. 3,500:

Chamber of Commerce description: This small town is located in the northeastern corner of Adams County. It is deep into the foothills, popular with tourists for its accessibility to nearby winter and summer vacation spots.

Weston - pop. 2,500:

Chamber of Commerce description: This small town is located in the western part of the county. It provides needed services to the neighboring agricultural areas of Adams and Denton Counties. It offers rest, refreshment, and gasoline for agricultural and commercial travelers along Interstate 44 in eastern Denton County.

Educational/Library Resources

All schools in this county are full inclusion - students of all academic and physical abilities attend classes together. If special attention is needed, the student is pulled out of class for one or two subjects taught in small groups with other students who need special attention, or in some situations a teen may attend the alternative high school.

One city high school in Newtown:

Newtown High School - grades 9-12, 2200 students, 6 counselors, 1 psychologist, 1 school nurse; offers 12 different sports and has 23 clubs. Ninety percent of the students graduate and 65% of the students go on to college. Thirty percent of the teachers have a master's degree. Four foreign languages are taught: German, French, Spanish, and Latin. The school is well known statewide for its athletic programs.

Three regional high schools located in Pushton, Preston, and Weston:

Each regional high school is located near one of the three towns in the county. They are similar is size, with 1000-1200 students. They each offer 6 different sports and each has 12 clubs. Eighty-two percent of the students graduate at Central High near Preston. The other two graduate 77%. Forty-five percent of the graduates go on to college from each school. Twelve percent of Central High's teachers have master's degrees. Only the principals and counselors have master's degrees in each of the other two high schools. Each school offers French and Spanish as foreign language choices. Central High is well known for its football team. The other two schools have agricultural programs and sponsor 4-H activities. Four counselors and two psychologists and two school nurses serve the three schools.

Three middle schools - grades 6-8 - in Newtown, Pullton, and Preston:

Walters Middle School is in Newton and serves children from Easton. It is the largest middle school with 1200 students. It offers an enrichment program that children test to get into from the fifth grades in the elementary schools in the county. Those children coming from the far western part of the county have a 90-minute school bus ride each way to attend the classes; thus, few children from Weston attend.

Lawrence Middle School in Pullton serves the town of Pullton and Weston and the rural north western part of the county. 1000 students attend this school. Many students come from largely rural areas and the population in this part of the county is growing rapidly, especially towards Pushton. The children attend a school designed for 800 students.

Victors Middle School is located between Weston and Preston and has 500 children attending. In this rural part of the county, the distances between homes/farms is great; most children ride school buses and have at least a 30-minute ride each way to and from school. Many children attending this middle school are absent on a regular basis to help their families with farm chores.

There is one counselor in each school, and two school nurses split their services among the three schools.

Eight elementary schools - grades 1-8 - three in Newtown, one in each of the other towns:

Two counselors and two school nurses provide services to the eight schools. Each school has a parent-teachers association. Those in central Newtown and Weston Elementary are the least active. One school serves a rural population and one serves an inner-city, working-class population. The other six are very active and they provide good communication between school administration, the teachers, and families.

One community college with two satellite centers:

Newtown Community College: The larger center is in Newtown and offers most courses the community college district offers. It has 1400 full- and part-time students. The two satellite centers (Pushton and Preston) have limited course offerings with 300 and 200 students attending. Students from the western part of the county who want to continue at the community college have a 70-mile drive to the main campus in Newtown. The community college in Denton County is closer.

One alternative high school program:

Located in Newtown, busing teens from all over the county, mainly from Pushton and Easton. Students from Weston, Pullton, and Preston attend on a part-time basis while home schooling and/or working. The campus is located in the annex of City Hall. Students with truancy problems and other juvenile crime issues attend. In addition, there is an alternative program for pregnant teens and a day care center for their infants. The middle and high schools in the county do not offer any special programs for pregnant teens. About 40 teens give birth in Adams County each year. Many drop out of high school or switch to home schooling during their pregnancy. When possible, a community health nurse provides health education to the teens.

One home schooling center:

In Newtown and Weston there are two small centers that administer the state's home schooling program. Most typically, the students home schooled in the Newtown center are children who have had emotional or physical problems. The students in Weston are from farm families and this choice makes it possible for them to assist with the family farm duties.

One county library in Newtown:

The library is in a two-story building with 500,000 holdings. It has Internet access and supports two mobile libraries. The two mobile libraries are staffed by a librarian and volunteers arrive two days a week in each of the 5 towns and villages. They are equipped with a computer for Internet searches. Plans are being made to make one available on Saturdays to the retirees at the Oasis Village Retirement Center in Preston

Health Care

Adams County Health Department: A small comprehensive health department with five community health nurses, one LPN/LVN, one medical director, two laboratory technicians, one health educator, one mental health specialist, one statistician, and three support staff.

A health maintenance clinic operates out of the Preston Community Church by their parish nurse.

Newtown Community Hospital: There are sixty-six beds, twelve are for maternity clients and newborns. There is an MICU for adults and an active hospital auxiliary with senior and teen volunteers.

Nine physicians: two planning to retire within three years, five in general practice, two in OB/GYN, one pediatrician, one surgeon. All have privileges in hospitals in the four counties.

Three dentists: one retiring in two years

Home health is provided through two private agencies located in Newtown or through the proprietary services of Newtown Community Hospital.

Services in Neighboring Counties

Brown County

A satellite health department as a part of a regional health department located in Center County north of Brown County where the state capitol is and the bulk of the state's population. The health department is staffed with 1 community health nurse, one LPN/LVN, a part-time medical director, health educator, and mental health specialist, and two support staff.

A surgi-center for elective surgeries in Alabaster City

Two physicians, one just in obstetrics

Two dentists, one dental clinic staffed by student dentists from the state university in Center County

Three midwives in private practice

Home health services are provided by one private agency in Alabaster City

Culvert County

A small comprehensive health department with 7 community health nurses, 2 LPN/LVNs, 1 medical director, 2 laboratory technicians, 1 health educator, 2 mental health specialists, 1 statistician, and 5 support staff

A community hospital in Corner Groves with 140 beds,;20 are for maternity clients and newborns, has a new children's wing with a NBICU and PICU

Home health is provided through a proprietary home health agency of the hospital in Corner Groves serving Culvert County and parts of Adams, Brown, and Denton Counties

10 physicians, 2 planning to retire within 3 years, 6 involved in general practice, 2 specializing in GYN/OB, 1 orthopedic surgeon, 1 pediatrician

Denton County

A small comprehensive health department - 4 community health nurses, 1 medical director, 1 laboratory technician, 1 health educator, 1 mental health specialist, 1 statitician, and 3 support staff

A community hospital in Valley Center with 80 beds; 16 are for maternity clients and newborns; has an SICU, MICU, and special care nursery

Seven physicians and two nurse practitioners, no retirements planned within the next three years, all in general practice with two focusing on gerontology

Four dentists

One chiropractor

Seventy-two beds for assisted living/skilled nursing for older adults; 1 facility with 36 beds and 6 board and care homes, each housing 6 elders

Home health services are provided through the proprietary agency of the hospital in Valley Center and one private agency in Valley Center

Legal System

County government:

County commissioner (4-year term)

Oversee all utility, road, and parks and recreations services in the county

City and township governments:

Elected mayor and city council in Pushton, Pullton, and Preston (6 members rotating service for 2 years each term). The mayor and city councils make decisions regarding city safety, growth, and other matters brought to the city by residents. They preside at holiday occasions and store openings and promote town attributes through the chamber of commerce

Honorary mayors in Easton and Weston preside at holiday occasions, store openings, promote village attributes.

Media and Communication Services

Newspapers:

Newtown

§        One daily and Sunday (circulation 7500) that contains world, national, and regional news and syndicated columns and features.

§        One Monday-Wednesday-Friday (circulation 2600) that focuses on regional and local news, store advertisements. Offers free notices of meetings and events sponsored by nonprofit organizations.

Pushton, Pullton, and Preston

§        Residents subscribe to the daily Newtown paper.

§        Each town has a weekly publication with local news and advertising- distributed free to each town's postal addresses

Radio stations:

Two located in Newtown - 1 easy listening, 1 country/western

Television stations:

*   None in Adams County, but the major networks broadcast in the county.

*   Cable or satellite TV is available in Newtown and coming soon in Preston, Pullton, and Pushton

Publishers:

Redhorn Press is located in Newtown - a small, independent publisher focusing on self-help books and books on local interest topics.

Religious Resources

Twenty-six houses of worship are listed in Adams County

Ninteen Protestant denominations:

Nine in Newtown:

*  Community Methodist Church offers 2 services on Sunday. It has a daycare program, AA, NA, and GA meetings. It has a "food pantry" for indigent families. It has an active youth fellowship and a young married couples club.

*  Savior Lutheran Church offers two services on Sunday. It has a meeting room used by Weight Watchers and TOPS (Take Off Pounds Sensibly). It has a thrift store open each Saturday from 9 - 1.

*  Redeemer Christian Church has three services on Sunday and one on Wednesday evening. It has a preschool program and a large youth ministry.

*  Christ Baptist Church has two services on Sunday and one on Wednesday evening. It offers a "home hot meal program" to shut-ins on a donation-only basis. It has a large recreation program for youth and young adults, sponsoring several sports teams.

*  The Church of Christ has two services on Sunday and one on Tuesday. It has two Bible study groups and an active outreach service with a "traveling ministry" to the rural parts of the county.

*  The four other protestant churches are small and have services on Sunday. Each minister has access to funds/resources to help families in need - primarily members of that church.

 

Three in Pushton:

*  Pushton Community Church - is the largest and most active church in Pushton, offering two services on Sunday and Bible Class on Wednesday. It has an active youth group and a program for 6- to 12-year-olds on Tuesday evenings from 6 - 8 pm. It holds a monthly "church yard sale" as a community service and fundraiser.

*  The other two smaller churches hold one service on Sunday and have part-time ministry staff.

 

Two in Pullton:

*  Valley Christian Church - has two services on Sunday, a day-care program and offers a meeting room for nonprofit groups to meet.

*  Pullton Mission Church - has one service on Sunday and one on Wednesday evening. It has an active outreach to assist people to increase their work skills and find jobs.

 

Two in Preston:

*  Preston Community Church - has two services on Sunday -one in the main sanctuary and one at Oasis Retirement Village. It uses a meeting room as a senior center - staffed by volunteers. It has a health maintenance clinic staffed by the parish nurse.

*  Trinity Christian Church - one service on Sunday and has an active youth program.

 

One in Weston:

*  Weston Christian Church - one service on Sunday and a late evening (9 PM) service on Sunday night for farm workers to attend. It has many community services using the meeting room during the week - AA, NA, GA, PWP (Parents Without Partners).

 

Two in Easton:

*  Easton Community Church - one service on Sunday and one on Wednesday evening. Serves the mountain area of the county and has more frequent services during the summer months and winter months when vacationers are in the community.

 

Five Catholic churches:

Three in Newtown:

*  St.Andrew's is the largest Catholic church - it has five services on Sunday and two on Saturday. Has Bingo on Thursday night, frequent fundraisers, and an active ministry serving families in need in the community.

*  Our Lady of Hope has three services on Sunday and has a craft store - profits go to missions.

*  St. Luke's has two services on Sunday and one on Friday. It offers a meeting room for nonprofit groups to meet.

One in Pushton:

*  St. Mary's is a large church with many young families attending. It offers five services on Sunday, a preschool and a day care program, a "food and clothing" bank, several rooms for community groups to meet and a Father's Club - for the men in the church.

One in Pullton:

*  St. Benedict's offers three services on Sunday. It has Bingo on Tuesday evenings and offers a "hot meal program" to seniors on a donation basis.

One Budhist temple:

*  Located in Weston, it is a new and small temple, attended primarily by the county's Asian population - mostly living in the rural, farming Weston area. The temple is attended by two nuns. They can arrange temporary food and shelter for work in the temple or on the grounds if needed by anyone.

One Synagogue:

*  Located in Newtown, a rabbi comes from Alabaster City in Brown County to hold services twice a month. The synagogue is small and offers classes in Judaism once or twice a year.

Recreational and Entertainment Resources

Community Recreational Services:

YM/WCA - located in Newtown; a large YM/WCA facility with indoor and outdoor swimming pool, a summer recreational/day camp program for children ages 6-12. Sports teams, various arts and crafts classes. Services offered to anyone based on a fee schedule. Some membership scholarships are available.

Country Clubs:

Newtown Country Club - membership by invitation. 18-hole golf course, tennis courts, restaurant and lounge.

Pushton Country Club - open membership to anyone who pays the fees. Offers an outdoor swimming pool, 18-hole golf course, tennis courts, restaurant and lounge.

Gardens:

Pushton Gardens - 1/2 acre in Pushton Park attended by the Oasis Retirement Village Garden Club - has a variety of local annual and perennial plants along walking paths.

Golf - public courses:

Newtown links - 9-hole course offering carts, clubs, and balls for rent. It has a driving range and a snack bar.

Oasis Retirement Village - 9-hole course open to the public for a fee, offering carts, clubs, and balls for rent.

Pushton Mini-golf - three 18-hole miniature golf courses with three different themes - popular with families. Has a video game room and a snack bar.

Parks:

Newtown Community Park - 112 acres of green hills, pathways, ball parks, children's play areas, dog walking area, walking, running, and biking paths. Daily admission and annual passes.

Pushton Park - 20 acres for biking, children play areas, a baseball diamond, and 4 basketball courts.

Preston - 4 acres for picnics and walking paths - no bikes or animals allowed.

Theaters (live):

Newtown Dinner Theater - buffet dinners followed by a stage play - usually a musical or a comedy. Discounts for matinees, occasionally has performances for fund raising.

Newtown Community College Theater - sponsors plays 4 times a year performed by community college students at reasonable prices.

Easton Melodrama - a small theater offering melodramas during the summer tourist season.

Theaters (movie):

Newtown Cinema - 4 theaters playing the latest movies. Afternoon and senior discounts.

Newtown Arts Complex - 2 theaters - 1 playing foreign films, 1 playing "classic" films - silent films with accompanying piano player

Pushton Theater - 3 theaters playing the latest movies. Afternoon and senior discounts.

Preston Theater - 1 theater playing the latest movies. Afternoon and senior discounts.

Safety - Fire and Police Protection

*  Newtown - city fire and police protection. The police department has three substations located around town in addition to the main downtown station. The fire department has paramedic-trained firefighters and is located on the east and west sides of town.

*  Pushton, Preston, and Pullton - city fire and police protection. The departments are small but are manned 24 hours a day by paid police officers and fire fighters. They use volunteer staff for public education and outreach. In Preston, Oasis Village has its own security staff but they work closely with the Preston police department.

*  Weston and Easton - both have volunteer fire departments; however, Easton is adjacent to National Park land and receives fire protection services as a way to protect National Park land. Both towns are serviced by county sheriffs and deputies.

*  The county highway system is patrolled by county police officers.

*  State troopers serve the Weston area as part of their services along Interstate 44.

Visitor's Bureau

*  Newtown - county visitor's bureau, located in a small office in City Hall. Maintains a complete selection of brochures of nearby attractions; staff assist with local information for travelers and newcomers to the county.

*  Easton - in Sarah's Country Story there is an information booth, attended by volunteers during the summer, where information about motels, resorts, attractions, and other amenities of the foothills and the national park area just out of Easton can be found

Volunteer Agencies and Services

American Cancer Society - has its county headquarters in Newtown where it maintains a small office containing lay and professional literature and videos and conducts fundraising activities. It maintains a thrift store on Center Street. It assists with disposable supplies for cancer patients and helps with medications for a short period of time if needed.

Website - www.cancer.org

 

American Lung Association - has an office in Newtown with lay and professional literature and videos. It conducts fundraising activities and sponsors a summer camp for children with asthma and their siblings.

Website - www.lungusa.org

 

Hospital Auxiliary - volunteers (predominantly seniors and teens) work in Newtown Community Hospital. It also staffs the hospital gift shop and holds fundraising events.

 

March of Dimes - has its office in Newtown and focuses on the prevention of birth defects. It conducts fund raising and sponsors a summer camp for handicapped children. It is working with the Rotary Club to build a handicapped-accessible playground in Newton Park for nonambulatory children.

Website - www.modimes.org

 

4H Club and FFA (Future Farmers of America) - The two regional high schools in Pullton and Preston (which serves the Weston area) have active chapters.

 

Scouting - Girl and Boy Scout troops. Area Council headquarters in Newtown. The county supports 22 Boy Scout troops and 16 Girl Scout troops. They meet in various churches.

 

Service clubs - Lions, Rotary, VFW, Elks and Moose Lodges. All have meeting halls in Newtown and Pushton. The Lions and Rotary Clubs are also located in Preston. Each service club has an interest in serving the community in some way. The Lions Club focuses on services to the blind and offers college scholarships. The Rotary Clubs provide college scholarships and promote community beautification. The various lodges provide a social outlet and participate in fundraising for community projects.

 

Senior Centers - the county has 5 senior centers. Two are located in Newtown, and one each is in Preston, Pullton and Easton. The most active is in Preston, with many older adults moving to that community. They provide a full schedule of activities Monday -Friday from 9 - 3. They also have arrangements with Oasis Village to use their van to pick up people in a 10-mile radius of the center.

Social Welfare System

The county social services department is in Newtown - satellite centers in Pullton and Weston.

Services include:

*  Children and Adult Services - social services for children and adults who are being abused or neglected. Through these services children are placed in foster care and families receive counseling. This agency works closely with the police and judicial systems. Older adults who are neglected and/or abused are served through the AAA (Area Agency on Aging) located within these services.

*  Employment Opportunity Office - offers job training and placement, works closely with the county unemployment services center.

*  Income Maintenance - temporary financial help is available to women and families with dependent children. This federal and state program can offer financial assistance while parents received the training and/or education needed to support their children for up to five years.

*  Social Security Office - any person eligible for Social Security benefits or those wanting to inquire about benefits can receive information and/or begin the necessary paperwork. People generally eligible for Social Security benefits are the permanently disabled, aged, widowed and the dependent children of those adults.

*  WIC (Women, Infants, and Children) Program - this federal program provides healthy foods to children up to five years of age and pregnant and lactating women who are income eligible. Self and professional referrals are accepted.

 

READINGS

1.      Allender, J. A., Spradley, B.W. (2001). Community Health Nursing: Concepts and Practice (5th edition). Lippincott Williams & Wilkins; 5th edition (January 15, 2001). 799 pages. ISBN-13: 978-0781721226. Chapters 8, 9, 17-21.

2.      Stanhope, M., & Lancaster, J. (2000). Community and Public Health Nursing (5th Edition) St. Louis: Mosby.

3.      Stanhope, M., & Lancaster, J. (2006). Foundations of Nursing in the Community: Community-Oriented Practice (2nd Edition) St. Louis: Mosby-Elsevier.

4.      Allender, J. A., Spradley, B.W. (2004). Community Health Nursing: Promoting and Protecting the Public's Health (6th Edition) Lippincott Williams & Wilkins, 2004. – 992 p.

Selected Readings:

1.      Brink, S. (2002). Living on the edge. U. S. News & World Report, 133(14), 58–64.

2.      Center for Medicare and Medicaid Services. (2002). Retrieved October 3, 2003, from http://www.cms.gov

3.      Conger, M.M. (1999). Managed care: Practice strategies for nursing. Thousand Oaks, CA: Sage.

Prepared by                                                                    Nataliya Haliyash, MD, BSN

18/08/2009