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Direct Care Project Part 1: Substance Use Assessment and Diagnosis Template
Vaccines Annotated Bibliography
April 24, 2024Challenges Facing the Queen’s Medical Center
April 24, 2024Directions: Collect the data outlined in this template. Fill in the blanks in the tables provided. There are two parts – online data collection and a modified windshield survey data collection. You will then identify a nursing problem in a vulnerable population and write a nursing diagnosis. See the assignment directions for suggestions and best practices. For full credit, all information in a category must be completed. This will be the topic of your Assessment and Nursing Diagnosis Template and also Parts 2 through 4 of your course project.
Name: Date:
Online Data Collection
- Community Information
| Your Community Data | |
| Name of city or town and state | Phoenix Arizona |
| Population | As of 2019, the state had a population of 1,680,992 |
| Nature of this community (rural, suburban, urban) | Over the years it has become more of urban than suburban |
| Describe your community in 2-3 sentences | Phoenix Arizona is known for its year round warm temperature and high-end spas and resorts. It is the fifth most popular city in the US. It has sophisticated urbanscapes. It is also known for its southwest culture and loads if outdoor adventures. |
- Community Demographics
- Go to https://www.census.gov/quickfacts/fact/table/US/PST045218
- The US data should automatically populate
- Input your zip code or county/township name
- Go to https://www.census.gov/quickfacts/fact/table/US/PST045218
- Then input your state for comparison data
- Enter the data into the table below
- Compare the county, state, and US data
| County Data | State Data | U.S. Data | |
| Population total | 1,680,992 | 7,278,717 | 328,239,523 |
| Male (subtract female % from 100) | 49.8% | 49.7% | 49.2% |
| Female | |||
| Persons under 5 | 7.4% | 5.9% | 6.0% |
| Persons over 65 | 10.3% | 18.0% | 16.5% |
| Race and origin data | |||
| County Data | State Data | U.S. Data | |
| White alone | 72.3% | 82.6% | 76.8% |
| Black or African American alone | 6.9% | 5.2% | 13.4% |
| American Indian and Alaska Native alone | 2.1% | 5.3% | 1.3% |
| Native Hawaiian and other Pacific Islander alone | 0.2% | 0.3% | 0.2% |
| Two or more races | 3.8% | 2.9% | 2.8% |
| White alone, not Hispanic or Latino | 43.0% | 54.1% | 60.1% |
| Significant population characteristics | |||
| County Data | State Data | U.S. Data | |
| Veterans | 73,052 | 487,684 | 18,611,432 |
| Foreign born persons | 19.5% | 13.4% | 13.5% |
| Housing overview | |||
| County Data | State Data | U.S. Data | |
| Housing units | – | 5,388,066 | 139,684,244 |
| Owner-occupied housing unit rate | 53.8% | 63.6% | 63.8% |
| Median selected monthly owner costs with a mortgage | $1,417 | $1,394 | $1,558 |
| Median selected monthly owner costs without a mortgage | $443 | $406 | $490 |
| Median value of owner-occupied housing units | $2,140 | $1,668 | $1,585 |
| Median gross rent | $999 | $1,009 | $1,023 |
| Family and living arrangements | |||
| County Data | State Data | U.S. Data | |
| Households | 555,013 | 2,524,300 | 119,730,128 |
| Persons per household | 2.87 | 2.69 | 2.63 |
| Living in same house 1 year ago | 83.2% | 82.2% | 85.5% |
| Language other than English spoken at home | 37.5% | 27.2% | 21.5% |
| Computer and Internet Use | |||
| County Data | State Data | U.S. Data | |
| Households with a computer | 89.1% | 89.9% | 88.8% |
| Households with broadband internet subscription | 79.9% | 81.8% | 80.4% |
| Education | |||
| County Data | State Data | U.S. Data | |
| High school graduate or higher | 81.5% | 86.8% | 87.7% |
| Bachelor’s degree or higher | 28.2% | 28.9% | 31.5% |
| Health | |||
| County Data | State Data | U.S. Data | |
| With a disability under age 65 years | 7.7% | 8.6% | 8.6% |
| Persons without health insurance under age 65 years | 16.1% | 12.7% | 10.0% |
| Economy | |||
| County Data | State Data | U.S. Data | |
| Civilian labor workforce ages 16+ | 66.7% | 59.2% | 62.9% |
| Transportation-mean travel time to work (minutes) | 25.7 | 25.3 | 26.6 |
| Income and poverty | |||
| County Data | State Data | U.S. Data | |
| Median household income | $54,765 | $65,213 | $60,293 |
| Persons in poverty | 19.4% | 14.0% | 11.8% |
- Community Epidemiological Data
- Go to: https://www.countyhealthra/org
- Click on your state
- Start with Overall Rankings in Health Outcomes
- Then choose your county
**you will need to use the “+” to see all of the data**
| County Data | State Data | |
| Health Outcome Rank | 3 | N/A |
| Length of life rank | 2 | N/A |
| Premature death | 7,100 | 6,700 |
| Low birth weight | 7% | 8% |
| Adult smoking | 16% | 15% |
| Adult obesity | 28% | 30% |
| Physical inactivity | 22% | 22% |
| Excessive drinking | 17% | 21% |
| Alcohol impaired deaths | 25% | 32% |
| STIs | 564.4 | 589.9 |
| Teen births | 27 | 21 |
| Drug overdose deaths | 16 | 21 |
| Uninsured | 12% | 8% |
| Unemployment | 4.8% | 4.3% |
| Children in poverty | 20% | 16% |
| Violent crime | 435 | 403 |
| Air pollution | 5.8 | 11.5 |
| Drinker water violations | – | – |
| Long commutes | 36% | 41% |
- Substance Use
- Go to: https://store.samhsa.gov/product/Behavioral-Health-Barometer-Volume-5/sma19-Baro-17-US
- Find your state and download the report.
- Review the report and document the following:
- Go to Substance use, abuse and use disorders section. This will be the area that discusses those 12 and older (near end of report).
- Go to: https://store.samhsa.gov/product/Behavioral-Health-Barometer-Volume-5/sma19-Baro-17-US
- Find the following percentages:
| State Average | National Average | |
| Tobacco use | 28.4% | 28.9% |
| Marijuana | 31.5% | 33.0% |
| Marijuana use disorder | 1.5% | 1.5% |
| Heroin use | 0.50% | 0.33% |
| Misuse of Prescription pain reliever | 4.8% | 4.3% |
| Opioid use disorder | 1.1% | 1.3% |
| Illicit drug use disorder | 3.3% | 2.8% |
| Alcohol use disorder | 6.2% | 5.8% |
| Substance use disorder | 7.6% | 7.5% |
Windshield Survey
It is recommended that you have someone drive you around your community at least 2 times, ideally at different times of day and weekend vs. weekday.
| Look at the people in your community.
Did you observe: |
No | Yes | If Yes, provide number or state “many” “some” or “few” |
| · *pregnant women | Yes | some | |
| · *pregnant adolescents | Yes | few | |
| · *infants (under age of 1 year old) | Yes | some | |
| · *young children (1-5 years old) | Yes | many | |
| · *school-age children (6-18 years old) | Yes | many | |
| · adults (18 – 60 years old) | Yes | many | |
| · *older adults (over the age of 60 years old) | Yes | few | |
| · people exercising | Yes | few | |
| · people driving | Yes | some | |
| · people walking | Yes | many | |
| · people biking | Yes | few | |
| · people congregating in groups on the street | No | – | – |
| · *people that had hygiene issues or were unkempt | Yes | few | |
| · people that were appropriately dressed | Yes | many | |
| · people that were physically fit | Yes | some | |
| · people that were obese | Yes | some | |
| · *people that were undernourished, thin | Yes | few | |
| · people that appear healthy | Yes | many | |
| · *people that have obvious physical disabilities, such as those using walkers or wheelchairs | Yes | Few | |
| · *people with apparent mental/emotional disabilities | No | – | – |
| · *people who appeared homeless or unemployed | Yes | few |
*Represents vulnerable populations
| Social and Economic Conditions
Did you observe: |
No | Yes | If Yes, provide number or state “many” “some” or “few” |
| · housing that was run down or dilapidated | Yes | Few | |
| · areas undergoing renewal | Yes | Some | |
| · public housing | Yes | Many | |
| · public transit (subway, train, buses, taxis, etc) | Yes | Many | |
| · transportation to health care resources | Yes | Few | |
| · landfills | No | – | – |
| · restaurants | Yes | Many | |
| · any political signs | Yes | Few | |
| · any evidence of health education on billboards, advertisements, or signs | No | – | – |
| · any efforts to improve the neighborhood’s health such as advertisements for health-related events, health fares, clinics, or lectures | Yes | Few | |
| · any group efforts in the neighborhood to improve the living conditions or the neighborhood | Yes | Few | |
| · churches, synagogues, and other places of worship | Yes | Few |
| Health Resources
Did you observe: |
No | Yes | If Yes, provide number or state “many” “some” or “few” |
| · hospitals | Yes | Few | |
| · community clinics | Yes | Few | |
| · family planning clinics | Yes | Some | |
| · generalist doctors | No | – | – |
| · dentist offices | Yes | Few | |
| · pharmacies | Yes | Some | |
| · urgent care clinics | No | – | – |
| · skilled nursing facilities | Yes | Some | |
| · mental health or counselling clinics | Yes | Few | |
| · homeless or abuse shelters | Yes | Some | |
| · public health department office | Yes | Some | |
| · substance abuse treatment center | Yes | Few | |
| · alternative medicine practices, botanicals, or herbal medicine shops | Yes | Few |
|
Answer the following question: |
|
If some of the above health resources were not observed, approximately how far away would a person need to travel to find these resources?
For some of the health services like generalist doctors, which were not found within the area, one has to travel about 93.34km to Arizona town where the services are available. This would take approximately one hour while using private means.
|
| Environmental Conditions
Did you observe: |
No | Yes | If Yes, provide number or state “many” “some” or “few” |
| · evidence of anything that might make you suspicious of ground, water, or air pollutants | Yes | Many | |
| · poor road conditions with potholes, or poor drainage | Yes | Some | |
| · adequate traffic lights, signs, sidewalks, and curbs | Yes | many | |
| · railroad crossings fitted with warnings and barriers | Yes | Many | |
| · streets and parking lots well lit | Yes | some | |
| · handicapped access to buildings, sidewalks, and streets | No | ||
| · recreational facilities, playgrounds, and/or facilities like the YMCA | Yes | Some | |
| · children playing in the streets, alleys, yards, or parks | Yes | Some | |
| · evidence of nuisances such as ants, flies, mosquitoes, or rodents, or stray animals observed | Yes | Few |
Problem
Identify a nursing problem based on your data and observations. The problem must be related to substance use. Example: Alcohol use
Problem Identification: Marijuana Use
Vulnerable Population
Identify the vulnerable population that is most impacted by this problem. Example: Adolescents
Vulnerable Population Identification: Youth
Diagnosis
Write a nursing diagnosis based on your problem. Fill in the blanks below.
Example: Increased risk for alcohol use among adolescents related to lack of sufficient knowledge about the long and short-term impacts demonstrated in community epidemiological data.
Nursing Diagnosis: Increased risk of marijuana use among the youth aged 12-17years related topeer pressure, curiosity and lack of adequate knowledge on its effects on health as demonstrated in County health rankings data.
References
Substance Abuse and Mental Health Services Administration (SAMHSA).(2019). Behavioral health barometer, volume 5.https://store.samhsa.gov/product/Behavioral-Health-Barometer-Volume-5/sma19-Baro-17-US
County Health Rankings and Roadmaps.(2018). Explore rankings.http://www.countyhealthrankings.org/
U.S. Census Bureau.(2018). State and county QuickFacts. https://www.census.gov/quickfacts/