Community Health and Population Focused Nursing field experience

Introduction
Overview
The Community Health and Population Focused Nursing field experience will assist you to
become familiar with field experience aspects of health promotion and disease prevention,
applicable to the community health nursing environment. You will practice skills based on field
experience priorities, methodology, and resources that positively influence the health of
populations, and will demonstrate critical thinking skills by applying principles of community
health nursing in a variety of settings as you design, implement, and evaluate a project in
community health and develop health promotion and disease prevention strategies for
population groups.
Upon successful completion of this course, you will:
assess community health, populations, epidemiology, and the role of the community
health nurse
analyze the effects of social, cultural and environmental components on health status
incorporate nursing research into evidence-based nursing practice
utilize assessment to plan nursing care for individuals, families, groups, and
communities
articulate the principles of health promotion for the prevention of disease and injury and
ways to collaborate with the community to achieve goals
analyze internal and external influences on population health and the necessary steps to
overcome barriers to improving the population’s health
conduct a community assessment, including the collection and analysis of demographic
data, the diagnosis of a community health need, and recommendation of appropriate
interventions

Competencies
This course provides guidance to help you demonstrate the following 5 competencies:
Competency 7019.1.1: Epidemiology
The student applies principles of epidemiology to the assessment of the healthcare
needs of communities.
Competency 7019.1.2: Community Care and Collaboration
The student plans and coordinates community care in collaboration with community
partners.
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C229 – Community Health and Population-Focused Nursing Field Experience
Course of Study
Competency 7019.1.3: Community Advocacy and Cultural Competency
The student develops culturally sensitive and relevant strategies to advocate for
populations, based on knowledge of community health systems.
Competency 7019.1.4: Community Health Promotion
The student proposes health promotion initiatives and services to promote disease and
injury prevention.
Competency 7019.1.5: Environmental Health
The student assesses the impact of the environment on the health of the community.

C229 – Community Health and Population-Focused Nursing Field Experience
Course of Study

Field Project
The following will walk you through the necessary steps to complete your field project, broken
down on a week-by-week basis.
Week 1
Welcome to the Community and Population Health Nursing field project! The field work is an
assessment. It is as if your county officials had come to you and said “We know we have this
public health concern, we know our county is one of the worst in the state. We want you to look
into it for us and write an action plan for improvement.”
Your role in the field project is to do a community wide assessment related to preventing this
public health concern and the factors that contribute to it. You should be in the assessment
mode, casting a wide net of assessment throughout the county, talking with representatives of
agencies, institutions, organizations, and entities within the community that are (or should be)
working on preventing this concern. The focus is on what the community can do collectively to
prevent this problem. In population health, we believe in the phrase “it takes a village” and this
assessment is about what is the village doing to prevent this problem.

Overall Objectives of the Field Project in Community Health Nursing (CKA1 )
At the end of the field experience, the student will:
Have performed a detailed assessment related to preventing a specific public health
concern and the factors that contribute to it.
Describe the role of community organizations in addressing the chosen topic and/or
target population.
Describe the community health programs, policies, resources, and services that serve
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C229 – Community Health and Population-Focused Nursing Field Experience
Course of Study
the population.
Participate in community-based committee meetings to identify the community partners
and collaborative relationships that address the chosen topic/target population.
Become familiar with the agencies and organizations that collaborate in the community
to achieve positive health outcomes.
Research: Introduction
Gather further background information on your topic (refer back to task 1), addressing the
following:
Describe your health topic.
Describe the health issue at the national level.
Describe the health issue at the state level.
Describe the health issue at the local level.
What has been the trend for this problem over the last 20 to 30 years? Provide
references.
In your opinion, has the problem gotten better, worse, or stayed the same? Provide your
rationale.
What are the improvement goals for the next 5 to 10 years?
How does your county compare on this issue to the state level? Provide references.
How does your county compare on this issue to the national level? Provide references.
Discuss the national level in terms of Healthy People 2020.
Describe why this level is an issue of concern.
In your opinion, what will happen if this issue is left unresolved?
What do you believe are the consequences for the individual and for the community
related to this issue?
If you are unable to answer any of these questions, consider using them as interview questions.
Additionally, describe the target population (geography, age, gender, ethnic group, etc) of
interest you have chosen. You may choose to keep your population broad in the beginning and
as you conduct your assessment determine which population is in most need.
The following documents should assist you in your planning:
Approved Topic List
Clinical Intensive and Time Log
Community and Population Health Nursing Field Project_CA students 2_27
How to Approach Possible Sites
California students,
please download this document before moving forward
Review: Supplemental Learning Materials
As you work through Week 1 of your field experience, you can review the following resources
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for more information on the topics you will encounter this week.
Watch the following video:
Disease Detectives: Epidemiology
Week 2
Sufficient planning will help you complete your field project successfully and in a timely
manner.
Complete: Planning
Who is your client?
Generally in nursing we think of patients and families as our clients. In population health, the
community is the client. Your focus is on assessing the community. What are the health issues
for the community as a whole? What is currently being done for the ‘client’?
Understanding the health status and health issues of your client (the community)
You will need to contact and visit many different groups, organizations, services, and individuals
within agencies to learn how your health issue is currently being addressed in your chosen
community. Some, but not all, of these contacts may have the ability and resources to assist
you in meeting your health promotion objectives.
Partnerships
Community-based nurses work and partner with community organizations/agencies to be
successful in achieving health promotion objectives. As you meet with the agencies and
organizations that address your health issue, you need to identify what entities would be
appropriate partners.
Questions to ask
It is important to have in mind what it is you will be asking as you meet with organizations and
groups to assess the current programs in place that address your health topic. In the end, you
will want consistent data and consistent data generally means asking consistent questions.
Think about the questions in relation to the mission of the organization or the job title and
responsibilities of the person you are questioning. In other words, how does the role, mission,
responsibilities influence the responses to questions?
In your summary paper, you may be aggregating the responses you get to the questions you
ask. It is very helpful to create a table and use it as one of the appendices in your paper with the
analysis in the narrative.
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C229 – Community Health and Population-Focused Nursing Field Experience
Course of Study
Make a list of approximately 20 agencies/experts/stakeholders who address your topic in
your community.
Make a list of upcoming community events/meetings/classes/activities regarding your
topic.
Create a list of interview questions that will help you gain insight into the efforts currently
being made to address your topic.
a.
From the agency/staff perspective, what are the gaps in primary prevention
efforts related to the topic/issue?
b.
What would be their recommendations to improve efforts?
Start reaching out to the listed agencies via phone, email, and/or drop-by visits to set up
interview appointments.
Review: Supplemental Learning Materials
As you work through Week 2 of your filed experience, you can review the following resources
for more information on the topics you will encounter this week.
Watch the following videos:
Flint health fair provides free screenings for the community
What is Building Healthy Communities?
Read the following sections in
Foundations of Nursing in the Community
:
pages 211 and 228 of chapter 12
(“Community Assessment and Evaluation”)

APA Citation:
Stanhope, Lancaster, M. (2014). Foundations of Nursing in the Community: Community-Oriented Practice [VitalSouce bookshelf version]. Retrieved from

http://online.vitalsource.com/books/9780323100946/id/B9780323100946000215_f0010
“In the past, nurses have viewed the community as a client and as a partner in improving the health status of its citizens. Since the days of Florence Nightingale and

Lillian Wald, nurses have looked at what is going on in the communities and environments in which they found their clients. Florence Nightingale defined her community

as war-torn Crimea and discovered that the lack of fresh air, sanitation, and hygiene was contributing to the illnesses of the soldiers. Lillian Wald found that the

neighborhoods around the Henry Street Settlement were impoverished, with poor housing conditions and sanitation, improper nutrition, and crowding contributing to the

problems of new mothers and children. Both women became political activists, worked with the leaders in their communities, and even solicited help from their

respective governments to help change the conditions for the individuals and families in their communities.

Although in the past nurses have sometimes viewed the community as a client, many community-oriented nurses have come to consider the community their most important

client and, more recently, their partner (Anderson and McFarlane, 2010; Butterfoss, 2009). This chapter clarifies community concepts and provides a guideline for

nursing practice with the community client. The core functions of public health nursing (PHN) include assessment, policy development, and assurance. A public and

private group partnership, the Council on Linkages between Academia and Public Health Practice (2009), defined competencies for the core functions of public health

practice (see Chapter 1 for more details). In the area of assessment, 11 competencies for the nurse and other health providers working in the community are listed (Box

12-1).

The nursing process from assessment through evaluation is used to promote community health. This process begins with community assessment, one of the core functions,

which involves getting to know the community. It is a logical, systematic approach to identifying community needs, clarifying problems, and identifying community

strengths and resources. This chapter provides the nurse with the knowledge necessary to develop the community assessment core competencies. Nurses in community health

are interested in these concepts because they want to know how the community’s health affects their individual, family, and group clients.
Evaluating the intervention for Community health

Simply defined, evaluation is the appraisal of the effects of some organized activity or program. An example of evaluation is provided in the Evidence-Based Practice

box on p. 217. Evaluation may involve the design and conduct of evaluation research, or it may involve the more elementary process of assessing progress by contrasting

the objectives and the results (Butterfoss, 2009). This section deals with the basic approach of contrasting objectives and results.

Evaluation begins in the planning phase, when goals and measurable objectives are established and goal-attaining activities are identified. After implementing the

intervention, only the accomplishment of objectives and the effects of intervention activities have to be assessed. Nursing progress notes direct the nurse to perform

such appraisals concurrently with implementation. In assessing the data recorded there, the nurse is requested to evaluate whether the objectives were met and whether

the intervention activities used were effective. Such an evaluation process is oriented to community health because the intervention goals and objectives come from the

nurse’s and the community’s ideas about health.

Role of outcomes in the evaluation phase

The measurement of outcomes is a particularly important part of the evaluation process. This is one reason for placing emphasis on measurable objectives. Cashman et al

(2008) emphasize outcomes questions about appropriate and effective interventions, such as the following:

•Was the appropriate intervention done ineffectively or effectively?
•Were the objectives sensitive enough to measure change?
•Was an inappropriate intervention used?
•Has the health problem been resolved or the risk reduced?”

Weeks 3 -16
Once you have finished planning, you are ready to initiate your field project.
Complete: Field Project
The length of time spent on your field project will vary significantly. Create a schedule of the
activities in which you plan to engage (where you will go and when). Appropriate activities
include:
interviews
site visits/tours
coalition meetings
community meetings
community classes
seminars
conferences
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C229 – Community Health and Population-Focused Nursing Field Experience
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discuss any other ideas with your course mentor
Complete your field interviews and activities. Document each in the “activity log.” Include:
Date
Activity
Contact person
Facility address &/or phone number
Review: Supplemental Learning Materials
As you work through Weeks 3-16 of your field experience, you can review the following
resources for more information on the topics you will encounter this week.
Watch the following videos:
Nurturing Cultural Competence in Nursing: Promising Practices for Education and
Healthcare
Public Health and Disease Prevention (part 3 of 4)
Colorado Department of Public Health &Environment
Read the following sections in
Foundations of Nursing in the Community
:
page 189 of chapter 11
(“Using Health Education and Groups in the Community “)

“Healthy people 2020 objectives for health education

APA Citation:
Stanhope, Lancaster, M. (2014). Foundations of Nursing in the Community: Community-Oriented Practice [VitalSouce bookshelf version]. Retrieved from

http://online.vitalsource.com/books/9780323100946/id/B9780323100946000203_s0025

“The document Healthy People 2020 lists national health needs and outlines goals and objectives designed to improve health. The Healthy People 2020 educational

objectives emphasize the importance of educating various populations (based on age and ethnicity) about health promotion activities in the priority areas of

unintentional injury, violence, suicide, tobacco use and addiction, alcohol or other drug use, unintended pregnancy; human immunodeficiency virus (HIV) and acquired

immunodeficiency syndrome (AIDS); sexually transmitted diseases (STDs); unhealthy dietary patterns; and inadequate physical activity (U.S. Department of Health and

Human Services [USDHHS], 2010).
HEALTHY PEOPLE 2020

Selected examples related to health education are as follows:

•ECBP-2: Increase the proportion of elementary, middle, and senior high schools that provide comprehensive school health education to prevent health problems in

the following areas: unintentional injury, violence, suicide, tobacco use and addiction, alcohol or other drug use, unintended pregnancy, HIV/AIDS and STIs, unhealthy

dietary patterns, and inadequate physical activity.
•ECBP-3: Increase the proportion of college and university students who receive information from their institution on each of the priority health-risk behavior

areas listed previously.
•ECBP-8: Increase the proportion of worksites that offer a comprehensive employee health promotion program to their employees.
•ECBP-9: Increase the proportion of employees who participate in employer-sponsored health promotion activities.
•ECBP-11: Increase the proportion of local health departments that have established culturally appropriate and linguistically competent community health promotion and

disease prevention programs.”

With your field project completed, it is time to write a summary paper.
Complete: Final Performance Assessment
You are now ready to begin your final performance assessment write-up. Consider the
following:
Based on your field experience, what are the aspects of the population health
concern/gap not currently being addressed?
Based on your field experience, what could be done to address the identified population
health concern/gap?
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C229 – Community Health and Population-Focused Nursing Field Experience
Course of Study
Based on your field experience, who will you need to partner with in the community to
put your plan into place?
Create a specific timeline for your population-focused nursing interventions.
How will you evaluate whether the efforts to improve the health concern were effective?
Reflect on how your perspective of the community’s health has changed as a result of
your fieldwork.

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