KLP1 — KLP Task 1: Community Health Simulation
Application of Community Health and Population-Focused Nursing — C228
PRFA — KLP1
Task Overview Submissions Evaluation Report
- Competencies
- Introduction
- Requirements
- Rubric
- Web Links
- Supporting Documents
Competencies
7019.1.1 : Epidemiology
The graduate applies principles of epidemiology to the assessment of the healthcare needs of communities.
7019.1.5 : Environmental Health
The graduate assesses the impact of the environment on the health of the community.
7019.1.8 : Cultural Competency
The graduate analyzes social and cultural factors that affect the care of diverse populations.
Introduction
More emphasis is being placed on healthier communities as changes are occurring in the fields of healthcare financing, policy, and focus. One of the primary roles of a community health nurse is to assess the community or population in order to determine its health status in relation to its assets and needs.
In this task, you will engage in a Community Health simulation for a total of 20 hours to gather information about a virtual community. Sentinel City™ Community Health Simulation is a virtual city developed by Healthcare Learning Innovations to represent what you may find in any real United States city. You will be able to take a virtual bus trip and/or walk around the city while observing the environment and people of Sentinel City™. Through your observations, you will gather information to assess potential health issues and risks within this online virtual learning environment.
You will assess different factors that may contribute to or detract from the health and wellness of the community and its citizens. During your trips through the city, you may be asked to describe the people you see and any expected or unexpected findings related to the citizens of Sentinel City™. Your keen observations will be the foundation to successfully completing assignments within your course. The simulation website will automatically log your hours and produce a special report at the end of each session. Be sure to have a notepad to record your observations of Sentinel City™ in preparation for this task.
The link to Sentinel City™ is located in the Community Care and Collaboration section of the Course of Study. Please review the Sentinel City Quick Start Guide, Student Guide, and Troubleshooting and FAQs Guide prior to engaging in the Sentinel City™.
You may also want to download the Demographic Assessment, Neighborhood/Community Safety Inventory, Windshield Survey and Population Health Scavenger Hunt tools located in the attachment section to complete section B of this task.
Scenario
Assumptions
Requirements
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
- Within Sentinel City™ you will notice a camera icon. Use the camera to take pictures within the simulation. Use the “enter text” feature to add your observations to the pictures. Submit a PDF of your action report from Sentinel City™ that includes the following completed activities from Industrial Heights, Casper Park District, Acer Tech Center, and Nightingale Square:
- Interfaith Church
- Sentinel City School District
- Sentinel City Department of Transportation
- Better Health Clinic
- ABC Daycare
- Sentinel City Affordable Housing Project
- City Hall
- Radio Buzz 96.5FM
- Sentinel City Healthcare System
- Lilly’s
- Joe’s Grocery
- Sentinel City Department of Parks and Recreation
- Complete a needs-assessment summary to determine the health needs and risks of the virtual community in Sentinel City™ by using each of the following tools:
Note: These tools can be found either in the web links section or as an attachment to this task.
- Demographics Assessment
- Neighborhood/Community Safety Inventory
- Windshield Survey
- Population Health Scavenger Hunt
Note: The name of each of the four tools should be identified in the needs-assessment summary, along with a brief summary of how each of the four tools were used in the needs assessment.
- Analyze the collected data using concepts of epidemiology and health determinants.
Note: Refer to these three sections of your COS for additional information: Epidemiology and Environmental Health, Epidemiological Data, and Application of Epidemiology.
- Formulate a community diagnosis for Sentinel City™ by doing the following:
- Discuss the three problems for Sentinel City™ based on the Healthy People goals.
- Discuss community resources (e.g., Sentinel City™ Affordable Housing Project, Better Health Clinic) that are available to address one of the problems identified in part C1.
- Identify a primary prevention topic based on the problem you selected in part C2.
Note: See the attached “Approved Activities List” for guidance in formulating your topic.
- Discuss how you will apply the assessment strategies you have learned from the simulation environment to your community assessment strategies in your community.
- Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
- Demonstrate Professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
Rubric
A:SENTINEL CITY ACTION REPORT PDF
| Not Evident
An appropriate action report PDF from Sentinel City is not provided, or is missing the required activities. |
Approaching Competence
N/A |
Competent
An appropriate action report PDF from Sentinel City is provided with all required activities. |
B:NEEDS-ASSESSMENT SUMMARY
| Not Evident
A needs-assessment summary is not provided. |
Approaching Competence
The needs-assessment summary is missing information about the health needs or risks of the virtual community. The summary does not appropriately incorporate each of the required assessment tools. |
Competent
The needs-assessment summary logically includes the health needs and risks of the virtual community. The summary appropriately incorporates each of the required assessment tools. |
B1:DATA ANALYSIS
| Not Evident
An analysis of the collected data is not provided. |
Approaching Competence
The analysis is missing key information about the concepts of epidemiology and health determinants. The analysis contains irrelevant details about the virtual community. |
Competent
The analysis appropriately incorporates the concepts of epidemiology and health determinants. The analysis is well-supported with relevant, appropriate details about the virtual community. |
C1:TOP THREE PROBLEMS
| Not Evident
A discussion of the top 3 problems for Sentinel City™ is not provided. |
Approaching Competence
The discussion is missing key information about 1 or more of the top 3 problems for Sentinel City™. The discussion is not supported with Healthy People 2020 goals. |
Competent
The discussion appropriately addresses the top 3 problems for Sentinel City™ and is supported by the Healthy People 2020 goals. |
C2:DISCUSSION OF COMMUNITY RESOURCES
| Not Evident
A discussion of community resources is not provided. |
Approaching Competence
The discussion is missing key details about community resources, or the discussion does not relate to 1 of the problems identified in part C1. |
Competent
The discussion appropriately incorporates community resources relevant to addressing 1 of the problems identified in part C1. |
C3:PRIMARY PREVENTION TOPIC
| Not Evident
A primary prevention topic is not identified. |
Approaching Competence
The identified primary prevention topic is inappropriate or does not relate to the problem selected in part C2. |
Competent
The identified primary prevention topic is appropriate and relevant to the problem selected in part C2. |
D:REFLECTION
| Not Evident
A discussion of how the candidate will apply the assessment strategies learned from the simulation is not provided. |
Approaching Competence
The discussion is missing key details about how the candidate will apply the assessment strategies learned from the simulation to community health strategies in the community. The discussion does not appropriately relate to the simulation environment. |
Competent
The discussion is logical and appropriately addresses how the candidate will apply the assessment strategies learned from the simulation environment to the community. |
E: SOURCES
| Not Evident
The submission does not include both in-text citations and a reference list for sources that are quoted, paraphrased, or summarized. |
Approaching Competence
The submission includes in-text citations for sources that are quoted, paraphrased, or summarized, and a reference list; however, the citations and/or reference list is incomplete or inaccurate. |
Competent
The submission includes in-text citations for sources that are properly quoted, paraphrased, or summarized and a reference list that accurately identifies the author, date, title, and source location as available. |
F: PROFESSIONAL COMMUNICATION
| Not Evident
Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic. |
Approaching Competence
Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective. |
Competent
Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding. |
Demographics, Neighborhood/Safety, and Scavenger Hunt Assessment Tools
Demographics Assessment
- Population of Sentinel City _______________
- Age Percentage breakdown of population of Sentinel City _______________
- Race Percentage breakdown of population of Sentinel City ________________
- Median Household Income of Sentinel City _______________
- Percentage of Sentinel City residents living below the poverty level ___________________
- Population of each of the four neighborhoods:
Nightingale Square: _______________
Acer Tech Center: ________________
Casper Park District: ______________
Industrial Heights: ________________
- Median Household Income of the four neighborhoods:
Nightingale Square: _______________
Acer Tech Center: ________________
Casper Park District: ______________
Industrial Heights: ________________
- Percentage of non-insured residents in each of the four neighborhoods:
Nightingale Square: _______________
Acer Tech Center: ________________
Casper Park District: ______________
Industrial Heights: ________________
Neighborhood/Safety Assessment
- Describe any safety hazards seen (i.e. pollution, stray animals, buildings in disrepair, etc.)
- Summarize data related to drug use in the city.
- What are the EMS response times?
- What types of crime are occurring in the area?
- Is there gang violence? Describe.
Scavenger Hunt
Describe the services offered by each of the following community resources. Summarize any other pertinent data found at the site:
- Parks and Recreation
- Healthcare System-Elderly Services
- City Hall-Social Services
- Better Health Clinic (formerly Community Health Center)
- Soup Kitchen
- Affordable Housing Project
Expert Answer and Explanation
B. Needs Assessment
Demographics
As part of conducting community health assessment, an analysis of Sentinel city was done. Sentinel is a virtual city comprising of four major neighborhoods with different socio-demographic characteristics. The four neighborhoods are Nightingale Square, Acer Tech Center, Casper park, and Industrial Heights.
Overall, the city has a population of 672,349 citizens, with the population majorly being multi-racial. The biggest population group within Sentinel are Caucasians who make up over 68% of the population, with Hispanics at 15% and blacks at 9% being the other two major racial groups, population-wise. There are however other minority ethnic communities living within the city like Native Alaskans, Asian American among others who cumulatively make up the remaining 8% of the population (Sentinel City, 2017).
The population distribution of the city varies from one region to another with Casper Park being the most populous area within the city, followed by Industrial Heights, Acer Tech Center and lastly Nightingale Square. A majority of the minority population groups were located in Casper Park and Industrial Heights, as compared to the two other neighborhoods.
The population of Sentinel City had a higher population of people below the ages of 64 years who had a representation of 84% of the total population. Within the age category of those below 64 years, it was noted that those between the ages of 18 to 35 years were the majority with 24% representation. Among all the four neighborhoods, Nightingale Square had the highest population of those who were above 64 years of age, with Industrial Heights having the least.
Likewise, Industrial height had the highest number of those below 18 years of age as compared to any other neighborhood. According to Hubley and Copeman (2018), the age distribution within a community is an important factor to consider when determining the type of healthcare services or health promotion interventions to put in place.
Income status is an important determinant of health since it affects the ability of the population to afford different components that affect their health outcomes like proper healthcare services, healthy nutrition, support facilities among others (Adler, Glymour & Fielding, 2016). In terms of the economic status of Sentinel city, the median household income was $56,485. The average number of low-income earners living within the city was 12%. However, the economic distribution varied greatly from one neighborhood to the other.
Nightingale Square had the highest median household income at $264,985, followed by Acer Tech Center with $248,528. Casper Park had a median household income of $108,549 with the lowest being industrial heights at $38,798. A majority of the low-income households were located in Industrial Heights (Sentinel City, 2017).
Over 30% of the population living in Sentinel City were uninsured with a majority of that population coming from the minority communities. The highest number of the uninsured population was located in Industrial heights, which was represented by 64% of the total uninsured population. The number of uninsured populations can be attributed to the low-income status and maybe lack of awareness on the importance of healthcare insurance for residents living within Industrial heights.
It was also noted that most of the population in Sentinel City were educated, with at least a high school diploma; this was represented by 68% of the total population. Most of the uneducated citizens also came from Industrial Heights, with the highly educated population coming from Acer Tech Center. Mantwill, Monestel-Umaña, and Schulz (2015) notes that literacy level affects the perception of the community on different health aspects including drug and substance use and abuse, social interactions, sexual behavior, to list a few, making it a determining factor in the health status of a community.
Neighborhood Safety Assessment
During the assessment of the neighborhood safety, various things were noteworthy which could have different health implications. The different neighborhoods had different challenges concerning their safety features. Overall the cleanest location was Nightingale, Acer Tech Center, Casper park and lastly Industrial Heights in that order. A common theme that was noted with regards to environmental health was the use of gasoline-powered motor vehicles which was the main mode of transportation as opposed to the urban rail system that was more environmentally friendly (Sentinel City, 2017).
The emission from automobiles is a major contributor to air pollution which poses serious health challenges to the residents of the city. Industrial Heights which was the home to several manufacturing industries was also laced with the highest level of pollution including water and air which was a result of the toxic chemicals and smoke emitted from those industries. This made Industrial Height have the lowest levels of environmental health as compared to other areas.
It was also observed that the city was also littered with trash despite having a waste management system. Garbage was seen in front of the residential buildings located in Industrial Heights which is likely to relate with an increased number in various infections (Frills, 2018). It was also noted that stray dogs were loitering within the neighborhood which actually posed a problem in terms of the number of injuries caused by attacks from stray animals, especially stray dogs. In fact, the number of such incidents according to the EMS services data has been on the rise in industrial Heights and needs to be dealt with (Sentinel City, 2017).
Another feature that was identified in the safety assessment was the use and abuse of different illicit drugs, alcohol, and cigarettes. This was a common trend especially in the lower suburbs of the Industrial Heights neighborhood. The number of persons who were reported to have had an interaction with at least one form of drug during the previous year was more than 9% of the total population, which makes it a serious health concern (Sentinel City, 2017).
Drug and substance use is associated with high-risk exposure to different health issues. Drug use within the Industrial Heights neighborhood can also be attached to the increased number of reported cases of sexual-related violence and an increase in sexually transmitted infections within that region.
Another matter of concern was the high crime rates reported in different areas of the city. There was a recent hostage situation near ABC daycare center which was symbolic of the security issues within the area. According to a news report by Radio Buzz, a majority of the crimes involved armed robbery, breaking and entering, with other cases leading to casualties.
The high crime rates can be attributed to the poor economic status, especially for residents living in Industrial Heights. There were a few reported incidents of gang-related activities within the city which further escalated the crime issue. One area that was praiseworthy was the improving EMS response times, which dropped from an average of ten minutes to eight minutes after reporting of an incident (Sentinel City, 2017).
Scavenger Hunt
Sentinel City had different resources that assisted its residents including the department of parks and recreation that was located in Nightingale Square. The department was responsible for managing different public recreational facilities including swimming facilities that assist people to keep fit. The city also has parks and playgrounds for children where they can play, interact and unwind.
The city also has a community health center located in Acer Tech, where the community at large, including the needy and the elderly, can receive their health and social support services. Better Health clinic, community center, and public health department, also offer different health education services, including information on sexual and reproductive health that is of assistance in elevating the health status of the community members.
Through the affordable housing project located in Casper park district, the low- and middle-income community members can own their own homes at subsidized prices, which plays a role in ensuring that the living condition of the citizens is improved. The Interfaith Church of sentinel city located in Industrial Park also assists in offering social support services for the vulnerable in the community.
Windshield Survey
From the windshield survey, sentinel city was noted to have both new and old buildings with the architecture varying from one neighborhood to another. Most of the non-flats residential houses had lawns that were well maintained. A majority of the houses in Nightingale and Acre Tech center were individual residential houses with more open space as compared to those of Casper Park and industrial height that were mainly flats.
Most of the houses were bricked, with inbuilt air conditioning, heating components and fitted with clean tapped water. It was also noted that some of much older buildings especially in Industrial Heights showed some signs of wear and tear, with some having broken window panes, cracked walls and peeled paint.
The boundaries within Sentinel city can be termed to have different implications. The main geographical boundaries are indicated by signposts that mark the shift from one neighborhood to another. Other boundaries that were observed were gang-related boundaries which were indicated by the visible graffiti printed on different building walls across the different neighborhoods. The main mode of transportation in and out of Sentinel City is road transport with light rail also being used.
The city is very vibrant during the day especially with the different socio-economic activities being conducted within the city. Human activity is also heightened by the presence of various recreational facilities. The Interfaith church located in Industrial heights is one of the meeting spots for a majority of the city’s Christians, where they congregate for their spiritual practices.
Sentinel city also has a bodega located in Industrial Height that supplies the residents with their home supplies. For grocery and other foodstuffs, Joe’s grocery and Lilly’s restaurant supplement the city needs. The city has a media house, Radio Buzz 96.5 FM that offers the residents with information on different issues including politics, social and economic issues, and entertainment
B1. Data Analysis: Interpretation of Data
The data collected from Sentinel city portrays a clear picture of the representation of different factors that might have some implications on the health aspects of the residents. It was noted that different socio-economic factors underlying the different neighborhoods had some implications on the behavior of the residents. For example, it was seen that the low-income areas like Industrial heights, the living condition was of lower quality as compared to other regions.
It was also noted that environmental health was a matter of concern for residents living in Sentinel City. Poor environmental health is usually accompanied by poor health outcomes including a higher risk of getting diseases like cancer. The use of gasoline-powered vehicles, industries, and garbage located in different areas of the city were contributing factors to poor environmental health.
Another noteworthy aspect that was obtained from the assessment of the city was the high number of drug use and abuse cases reported especially in the low-income regions of the city. This was coupled with the increase in STIs, crime rates and violence reported within the city. The presence of gangs within sentinel city was also a major issue of concern, given the reported number of injuries and fatality cases resulting from gang-related activities.
Low uptake of healthcare covers was also an issue identified from the analysis of Sentinel city which greatly affected access to healthcare services especially amongst the minority populations and the low-income earners.
C. Sentinel City Health Concerns
C1. Three Problem Areas
The three problem areas identified in Sentinel city from the analysis were drug and substance abuse, violence and unintentional injuries and environmental health. Drug and substance abuse is an issue that has serious negative health implications for an individual. It is an issue that exposes an individual at high risk of engaging in risky sexual activities, adoption of violent and socially degrading behaviors, and can develop mental health issues (Andreas, Lauritzen & Nordfjærn, 2015).
The Healthy People 2020 master plan, lists drug and substance uses as being a major community health issue. According to Healthy People 2020 program, the goal as pertains to drug and substance abuse is to reduce the vice and in doing so, protect the health, safety, and quality of life more so in children (HealthyPeople.gov, 2019).
Violence and other unintentional injuries were also observed to be a serious health issue in Sentinel City. Injuries can lead to disability which may hinder the productivity of an individual. Likewise, if the injuries are not treated in time, they can lead to death. The Healthy People 2020 goal as pertains to unintentional injuries is “to reduce the number of unintended injuries and violence, thereby reducing their consequences” (HealthyPeople.gov, 2019).
Environmental health was also considered to be a major issue of concern in Sentinel City. Poor environmental health is associated with different negative health outcomes including the likelihood of getting gastrointestinal and respiratory infections, cancer, and other chronic illnesses.
According to the health People 2020 master plan, the objective regarding environmental health involves six key items; to improve the quality of outdoor air, to improve the quality of surface and groundwater, to reduce/eliminate toxic substances and hazardous wastes, to improve the environmental quality in homes and communities, to foster the infrastructure and global environment health
C2. Discussion of Community Resources
The selected health issue is environmental health, whereby, the intention is to improve the air quality for Sentinel city residents. To assist in this venture, several resources can be of help, all of which are located within the city. The first resource is the Department of Public Health in conjunction with the city hall.
Through instituting and implementing government policies by the department, some of the toxic emissions from vehicles and industries can be reduced. Such policies include taxing heavy fines on industries that emit toxic gases to the environment and instituting levies on personal gasoline vehicles to dissuade people from using them, instead, opt for more environmentally-efficient public transport.
Another resource is the local radio station which can be a strategic tool to be used in sensitizing the community on why they deserve to have clean outdoor air and the measures they can put in place to ensure they do so. The last resource is the Interfaith church, where the Christian congregants can be informed of why they need to encourage a clean and healthy environment using their religious principles.
C3. Primary Prevention Topic
The selected primary prevention topic is the improvement of outdoor air quality which is part of the key features in the Healthy People 2020 environmental health agenda (HealthyPeople.gov, 2019). The choice of this topic is based on the health implications attached to poor environmental health. The number of reported cases of patients suffering from respiratory conditions is an issue that should raise concern.
Prevention of such conditions can be easily done by managing the release of toxic air released in the environment. By sensitizing the community members and other stakeholders, including manufacturing industries on the harm caused by polluted air, it is anticipated that the number of chronic respiratory conditions and infections will be reduced drastically.
D. Application of Assessment Strategies/Tools between Simulation and My Community
There are several major takes that I have obtained from the community health assessment of Sentinel city that I can apply in my community. For example, though the assessment I was able to learn how to identify the strengths, weaknesses, threats, and opportunities as pertains to the health status of the community. I was also able to learn how I can identify the most ideal health promotion tool to use to create a great impact on the health status of community members.
I was also able to learn how I can link different socio-economic determinants with some of the health issues faced by different population groups living within the community. All these skills will be of great importance in my nursing practice especially in contributing to better community health.
References
Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. Jama, 316(16), 1641-1642. doi:10.1001/jama.2016.14058
Andreas, J. B., Lauritzen, G., & Nordfjærn, T. (2015). Co-occurrence between mental distress and poly-drug use: a ten-year prospective study of patients from substance abuse treatment. Addictive behaviors, 48, 71-78. https://doi.org/10.1016/j.addbeh.2015.05.001
Friis, R. H. (2018). Essentials of environmental health. Jones & Bartlett Learning.
Healthcare Learning Innovations (Sentinel City) (2018). Sentinel City 2.3 [Computer software]. Aurora, Co. Retrieved from https://wgu.ucertify.com/?func=ebook HYPERLINK “https://wgu.ucertify.com/?func=ebook&chapter_no=7″& HYPERLINK “https://wgu.ucertify.com/?func=ebook&chapter_no=7″chapter_no=7#03tlb
Healthy People 2020 [Internet]. Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion [cited October 2019]. Available from: www.healthypeople.gov.
Hubley, J., & Copeman, J. (2018). Practical health promotion. John Wiley & Sons.
Mantwill, S., Monestel-Umaña, S., & Schulz, P. J. (2015). The Relationship between Health Literacy and Health Disparities: A Systematic Review. PloS one, 10(12), e0145455. https://doi.org/10.1371/journal.pone.0145455
Office of Disease Prevention and Health Promotion (HealthyPeople.gov) (2018). Environmental Health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-health
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