NR 443 Week 2 Direct Care Project Part 1

Name

Chamberlain University

NR-443 RN Community Health Nursing

Prof. Name

Date

Direct Care Project Part 1: Substance Use Assessment and Diagnosis Template

Introduction

This template outlines the steps for collecting data on substance use within a specified community, highlighting both online data collection and a modified windshield survey. The objective is to identify a nursing issue within a vulnerable population and formulate a nursing diagnosis. For full credit, all sections must be thoroughly completed, as this will form the basis for the subsequent parts of the course project.

Online Data Collection

Community Information

Community Data	Details
Name of City or Town	Miami
Population	2,761,581
Nature of Community	Urban
Description	Miami is an urban center and the administrative heart of Miami-Dade County, recognized as a significant economic and cultural hub in Florida. The city is experiencing a rise in mental health issues among teenagers, which are often associated with alcohol abuse.

Community Demographics

Demographic Information	County Data	State Data	U.S. Data
Total Population	2,761,581	21,299,325	328,239,523
Male	48.5%	48.9%	49.2%
Female	51.5%	51.1%	50.8%
Persons Under 5	5.8%	N/A	6.1%
Persons Over 65	16.2%	20.5%	N/A
Race and Origin	Whites: 72% Blacks: 17.7% Alaska Native: 0.2% Asian: 1.1% Native Hawaiian: 0.0% Two or More Races: 1.8% Hispanic/Latino: 72.5% Whites Alone (Not Hispanic or Latino): 10.7%	Whites Alone (Not Hispanic or Latino): 76.5% Blacks: 13.4% Asian: 1.3% Hispanic/Latino: 5.9%	Two or More Races: 0.2% Native Hawaiian: 2.7% Hispanic/Latino: 18.3% Whites Alone (Not Hispanic or Latino): 60.4%
Significant Population Characteristics	Veterans: 7,032 Foreign Born Persons: 58.2%	Veterans: 18,611,432 Foreign Born Persons: 13.5%	N/A

Housing Overview

Housing Characteristics	County Data	State Data
Housing Units (V2018)	138,537,078	11-27-19
Owner Occupied Rate	29.8%	63.8%
Median Value Owner	$292,900	$204,900
Median Selected Cost	$1,933	$1,558

Education and Health

Education Statistics	County Data	State Data
High School Graduate or Higher	77.0%	87.7%
Bachelor’s Degree or Higher	27.9%	31.5%
Health Insurance (Under 65 years)	Without Health Insurance: 25.3%	With Disability (Under 65 years): 7.1%

Economy

Economic Indicators	County Data	State Data
Civilian Labor Force	61.8%	62.9%
Female in Civilian Labor Force	55.4%	58.2%

Community Epidemiological Data

To gather epidemiological data, the following website was utilized: County Health Rankings. The results are as follows:

Health Indicators	County Data	State Data
Health Outcome Rank	N/A	6
Length of Life Rank	N/A	2
Premature Death Rate	5,300	7,300
Low Birth Weight	9%	9%
Adult Smoking	16%	16%
Adult Obesity	22%	27%
Excessive Drinking	16%	17%
Alcohol Impaired Deaths	12%	23%
Teen Births	17	21
Uninsured	20%	6%
Children in Poverty	23%	20%
Violent Crime Rate	602	484
Air Pollution	7.2	8.2
Long Commutes	56%	42%

Substance Use Data

Substance use statistics were gathered from the Behavioral Health Barometer for the state:

Substance Use Indicators	State Average	National Average
Tobacco Use	37.5%	42.6%
Marijuana Use	34.3%	33.0%
Marijuana Use Disorder	4.9%	5.1%
Heroin Use	0.28%	0.33%
Misuse of Prescription Pain Relievers	4.2%	4.3%
Opioid Use Disorder	1.1%	1.3%
Illicit Drug Use Disorder	7.1%	7.2%
Alcohol Use Disorder	9.9%	11.0%
Substance Use Disorder	14.4%	15.1%

Windshield Survey

The windshield survey was conducted to observe the community. Key findings include:

Observations	No	Yes	If Yes, Provide Number or State
Pregnant Women	X	✓	Some
Pregnant Adolescents	X	✓	Few
Infants (Under Age 1)	X	✓	Some
Young Children (1-5 Years)	X	✓	Some
School-Age Children (6-18 Years)	X	✓	Some
Adults (18-60 Years)	X	✓	Many
Older Adults (Over 60 Years)	X	✓	Some
People Exercising	X	✓	Few
People Driving	X	✓	Many
People Walking	X	✓	Many
People Biking	X	✓	Some
People Congregating in Groups	X	–	–
People with Hygiene Issues	X	–	–
People Appropriately Dressed	X	✓	Many
Physically Fit People	X	✓	Some
Obese People	X	✓	Many
Undernourished People	X	✓	Few
Healthy People	X	✓	Many
Physically Disabled People	X	✓	Few
People with Mental/Emotional Disabilities	X	✓	Few
Homeless/Unemployed Individuals	X	✓	Few

Note: The starred items () denote vulnerable populations.*

Observations regarding social and economic conditions were made:

Observations	No	Yes	If Yes, Provide Number or State
Run Down or Dilapidated Housing	X	–	–
Areas Undergoing Renewal	X	✓	Some
Public Housing	X	✓	Many
Public Transit	X	✓	Many
Transportation to Health Resources	X	✓	Some
Restaurants	X	✓	Many
Political Signs	X	✓	Few
Health Education Evidence	X	✓	Many
Neighborhood Health Improvement Efforts	X	✓	Some

Health Resources

Health resources in the community were evaluated as follows:

Health Resources	No	Yes	If Yes, Provide Number or State
Hospitals	X	✓	Some
Community Clinics	X	✓	Many
Family Planning Clinics	X	✓	Some
Generalist Doctors	X	✓	Some
Dentist Offices	X	✓	Some
Pharmacies	X	✓	Some
Urgent Care Clinics	X	✓	Some
Skilled Nursing Facilities	X	✓	Many
Mental Health Clinics	X	✓	Few
Public Health Department	X	✓	Few
Substance Abuse Treatment Center	X	✓	Few
Alternative Medicine Practices	X	✓	Some

Environmental Conditions

Environmental observations included:

Environmental Conditions	No	Yes	If Yes, Provide Number or State
Evidence of Pollution	X	✓	Some
Poor Road Conditions	X	–	–
Adequate Traffic Signs	X	✓	Many
Recreational Facilities	X	✓	Some

Problem Identification

Nursing Problem: The data collected indicates an increased risk related to alcohol use.

Vulnerable Population

Vulnerable Population Identification: Teenagers are particularly affected by this issue.

Nursing Diagnosis

Nursing Diagnosis: Increased risk of mental health problems among adolescents related to alcohol use, as evidenced by instances of depression and suicidal ideation documented in community epidemiological 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