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Running Head: COMMUNITY ASSESSMENT PAPER                                    1




   A Community Heath Nurses Role With Cardiopulmonary Resuscitation (CPR)


                            David Theobald-RN

                            Empire State College
Running Head: COMMUNITY ASSESSMENT PAPER                         2


                            Table of Contents

     Introduction………………………………………………………………………5

     Epidemiology……………………………………………………………………..5

     Importance of Cardiopulmonary Resuscitation (CPR)……………………………5

     Population…………………………………………………………….…… .……5

     Community Health Nursing Model………………………………………………5


     Community Health Nurses Role ……...…………………………………………..5

     Windshield Community Overview…………………………………………….….5

     Education…………. ……………………………………………………………...6

     Community Census…………………………………………………………….…6

     Employment survey………………………..……………………………………..7

Employers…………………………………………………………………………7

     Type of Government……………..…………………………………………….…8

Safety……………….... …………………………………………………………8

Hospitals…………………………...…………………………………………….9

Recreation……………………………………………………………………….9

Media……………………………………………………………………………9

Windshield Map boundaries……..……………….……………………………10

History….…………………….…………………………………………….….10

Population……….…………………………………………………………….12

Housing………………….……………………………………………………..12
Running Head: COMMUNITY ASSESSMENT PAPER                                                                   3


Signs of Decay…………….…………………………………………………….……....13

Open Spaces……………….………………..………………………………………..14-15

Transportation…………………………………………………….……………………...16

Health Care services………..…………………………………………………..…….17-18

Crime…………………..………………..……………………………………………….19

Economics………………………………………..……………………………….…......19

Challenges..…………………………….…………………………………….……….…20

Strengths…….....……..……………….………………………………………….…..20-21

Religion………………………………………………………………………………….22

Windshield Conclusion……………………………………………………………….....23

Key Informant Interviews………………………………………………………...…24-30

Epidemiologyof Sudden Cardiac Arrest.……………………………………………30-31

Population aggregate and developmental stage............................................................31-32

Political, Cultural, Economic and laws ……………………………………………...33-34

Community Resource: Adirondack Health & Wellness…………………………………35

Community Health Nursing Role………………………….……………………….……35

Primary Prevention Method……………………………………………………….…….36

Conclusion………………………………………………………………………………37

References………………………………………………………………………………38
Running Head: COMMUNITY ASSESSMENT PAPER                                                      4




1. Introduction


Purpose


A. The purpose of this community assessment paper is to increase awareness of the

importance of Automatic External Defibrillators (AED’s) and Cardiopulmonary

Resuscitation (CPR) training in the City of Saratoga Springs New York.


Population Aggregate/ Statistics


B. Population Aggregate- Saratoga Springs has population of 26,727 people. The

community is involved with youth sports teams. Statistic ―Heart disease is the leading

cause of death for both men and women. More than half of the deaths due to heart

disease in 2009 were in men. About600,000 Americans die from heart disease each

year—that’s 1 in every 4 deaths. Coronary heart disease is the most common type of

heart disease, killing more than 385,000 people annually‖(CDC 2012 Web).


Community Health Nursing Model


D. For this Project we will be using the Interventions Wheel Model. ―The model consists

of 17 identified community health nursing interventions that cross over three levels of

population-based practice: individual-focused, community-focused, and systems-focused

practice. Individual-level interventions are focused on change in individual health status,

knowledge, or skills (Clark, 2008 p 75).
Running Head: COMMUNITY ASSESSMENT PAPER                                                  5


                 Community Health Nurse Role


                 E. Community Health Nurse Role in promoting heart health and implementing CPR and

                 AED programs.




Population by Gender
Male                                                                            12,837              48.28%     12,433
Female                                                                          13,749              51.72%     13,753

Population by Age
Persons 0 to 4 years                                                              1,087              4.09%      1,395




                 COMMUNITY OVERVIEW


                 B. Demographics based on 2010 US Census Bureau Total 26,586




                 Community Overview


                 A. Saratoga Springs NY is small city rich with history and culture. There are community

                 sports programs and recreation leagues in the community were identified as needing life

                 saving AED’s.
Running Head: COMMUNITY ASSESSMENT PAPER                                 6


Persons 5 to 17 years                                                       3,430     12.90%    3,672
Persons 18 to 64 years                                                     17,881     67.26%   17,380
Persons 65 years and over                                                   4,188     15.75%    3,739




                Education Retrieved from National Center for Educational Statistics


                Population 25 years and over 17,127 100.0%


                Less than 9th grade   588    3.4%




                9th to 12th grade, no diploma 1,297 7.6%


                High school graduate (includes equivalency) 4,011 23.4%


                Some college, no degree      3,009 17.6%


                Associate degree      1,557 9.1%


                Bachelor's degree     3,595 21.0%


                Graduate or professional degree     3,070 17.9
Running Head: COMMUNITY ASSESSMENT PAPER                                       7


               D. Ethnicity 2010 Census




Population by Race
American Indian and Alaska native alone                                     55              0.21%       63
Asian alone                                                                521              1.96%      271
Black or African American alone                                            701              2.64%      815
Native Hawaiian and Other Pacific native alone                               7              0.03%        8
Some other race alone                                                      170              0.64%      168
Two or more races                                                          589              2.22%      368
White alone                                                             24,543             92.32%   24,493




               E. Poverty Level, Unemployment ratethe data is based upon 2010 estimates.




               Saratoga Springs employment information

Index                                               Saratoga Springs                       New York
Income per capita                                   $31,762                                $31,957
Median household income                             $54,607                                $67,635
Median household income owner occupied              $74,316                                $79,472
Median household income renter occupied             $32,481                                $41,550
Running Head: COMMUNITY ASSESSMENT PAPER                                                8


Median earnings male                                  $35,233                                     $45,665
Median earnings female                                $19,281                                     $26,443
Unemployment rate (2000)                              4.3%                                        4.5%
Unemployment rate (2010)                              n/a                                         8.2%
Unemployment rate (2012)                              n/a                                         8.0%
Poverty level                                         8.8%                                        8.8%



            Employers


            Many people that live in Saratoga Springs either work for small businesses or commute

            to larger employers in out lying areas. Below are some of the largest employers in

            Saratoga Springs NY.


            1000+ employees        Town # of employees


            Stewart's Ice Cream Co.       Saratoga Springs        1550


            500-999 employees


            Saratoga Springs City School District        Saratoga Springs      988


            Quad Graphics, Inc. Saratoga Springs         825


            Saratoga Hospital      Saratoga Springs      823


            Type of Government For The City Of Saratoga Springs NY


            Commission Form:


            The Saratoga Springs charter specifies a commission form of city government. In the

            news there have been efforts to amend the charter. The charter change proposal will

            appear on the ballot of the November 2012 election.
Running Head: COMMUNITY ASSESSMENT PAPER                                                     9


Safety Fire, Police

―The Saratoga Springs Fire Department is dedicated to the protection of life, property and

the environment for those who live, work, or visit our community. We will accomplish

this by using well trained and dedicated personnel pledged todeliver the highest quality

fire suppression & prevention, public education, advanced emergency medical services,

which are capable of responding to all disasters, natural or man-made.‖(City Saratoga

Springs.org)

Police Department: City Paid Department

―We are a team of law enforcement professionals committed to setting the benchmark for

quality police service by promoting strong community partnerships and upholding the

highest ethical standards. Our mission is to provide a professional, effective, and timely

response to crime and disorder, and to enhance traffic safety in our community.‖(City

Saratoga Springs.org)




Hospital-Saratoga Hospital Saratoga Hospitalis a 207-bed community hospital serving

Saratoga County and the surrounding areas.

Recreation-The Saratoga Springs Recreation Department offers sports leagues for youth

girls and boys. Currently, the City offers soccer, basketball, t-ball, and flag football

lacrosse, field hockey, and volleyball.

Media–Saratoga news paper,WNYT and capital district YNN news.
Running Head: COMMUNITY ASSESSMENT PAPER                                     10




      Windshield
      Survey
      City
      Saratoga Springs, NY
      By David Theobald & Sully
      Empire State College 10-12-12
      Party Cloudy                       Temp. 68 degrees




Map of Saratoga Springs NYWindshield Survey City 29.0 Sq. miles Coordinates 43

’4’31’N 73 46’57”W
Running Head: COMMUNITY ASSESSMENT PAPER                                            11




  •   Saratoga Springs NY First Settled 1776


  •   Area 29.0 Square Miles


  •   Population 26,586


  •   Government Mayor Scott T. Johnson


  •   Major Attractions Horse Racing, The Springs, Performing Arts, Art’s and

      Entertainment


  •   Education Empire State College and Skidmore College


  •   The Saratoga City School district six elementary schools, one middle school and

      one high school grades 9-12
Running Head: COMMUNITY ASSESSMENT PAPER                                           12


  •   Private School’s Saratoga Central Catholic High School, St Clements's, Waldorf

      School and Saratoga Independent School


  •   Population Census by race 2000


  •   White alone - 24,005 (90.3%)


  •   Hispanic - 839 (3.2%)


  •   Black alone - 661 (2.5%)


  •   Asian alone - 516 (1.9%)


  •   Two or more races - 505 (1.9%)


  •   American Indian alone - 41 (0.2%)


  •   Other race alone - 15 (0.06%)


  •   Native Hawaiian and Other Pacific Islander alone - 4 (0.02%)




Housing


  Saratoga Springs ranked 75 of the 100 best places to live in US. According to CNN

  Money
Running Head: COMMUNITY ASSESSMENT PAPER                                           13




     Saratoga Springs downtown district is a very sought after market. Houses are well

     kept and prices reflect that.
Running Head: COMMUNITY ASSESSMENT PAPER                                                                     14




                                   Affordable Housing




            William Ford                Jefferson Terrace             Vanderbilt Terrace

                     Neat and clean units both single and mul family apartments.




                                   Housing Windshield Survey
           The rules and regula ons for Public Housing and Sec on 8 program are determined by the U.S.
         Department of Housing and Urban Development (HUD). The purpose of both Public Housing and the
          Sec on 8 Program is to provide affordable housing to eligible low- and moderate-income families.
Running Head: COMMUNITY ASSESSMENT PAPER                                                    15




                              Open Spaces & Parks




       Saratoga Spa State Park, distinguished by its classical architecture and listed as a

National Historic Landmark, is noted for its diverse cultural, aesthetic and recreational

resources. In addition to the nationally-known Saratoga Performing Arts Center, the Spa

Little Theater, the National Museum of Dance, the Saratoga Automobile Museum, the

Gideon Putnam Resort and Roosevelt Baths and Spa, the park offers a multitude of

traditional recreation opportunities.


The Peerless Pool Complex consists of a main pool with a zero-depth entry, separate

slide pool with a 19' double slide and a children's wading pool with a mushroom fountain.

The Historic Victoria Pool is a smaller pool surrounded by arched promenades. Both pool
Running Head: COMMUNITY ASSESSMENT PAPER                                                    16


areas include food and beverage areas. 
 
 The Saratoga Spa State Park Golf

Course offers two beautiful golf courses; a championship 18-hole course and a

challenging 9-hole course, complete with pro shop and restaurant. The gentle terrain

offers picnic areas, shady streamside trails, suitable for the nature-lover or the casual

walker, as well as certified running courses used by joggers and high school and college

athletes. Winter activities include: cross-country skiing on approximately 12 miles of

trails, ice skating, ice hockey.




                    Many Public Parks with Natural Springs
    There are currently 17 public mineral springs in various locations throughout
                    Saratoga. Each one is naturally carbonated.
Running Head: COMMUNITY ASSESSMENT PAPER                                     17




                             Transportation
      Saratoga has Buses, Taxies, Amtrak, major highways and well
   maintained roads and plenty of traffic lights and easy to follow signs.
Running Head: COMMUNITY ASSESSMENT PAPER                                 18




                          Quality Health Care
    Saratoga Hospital is a 207-bed community hospital serving Saratoga
       County and the surrounding area. Major employer for the area




                  Good Side Walks and Free Parking
   Saratoga has had challenges with parking especially with tourism.
     The city just built a large parking garage for the public to use.
Running Head: COMMUNITY ASSESSMENT PAPER                                        19




              Many Services Available For Those in Need
    Although not as bad as other areas Saratoga did suffer from the difficult
    economic times, which meant many individuals called upon the help and
                       services of The Salvation Army.




                              Four Winds
                        Health and Social Services

        Four Winds is a Private inpatient, partial hospital, intensive
     outpatient and outpatient for mental heath and substance abuse.
Running Head: COMMUNITY ASSESSMENT PAPER                                       20




              Crime Rates Comparison From Area Connect
        Saratoga Springs is one of the safest Cities in the Capital Region.




                                  Economics
   Saratoga Springs is a growing community. There are many new buildings and
    businesses under construction. The major employers are Stewarts Shops,
                         Quad Graphic, Saratoga Hospital
Running Head: COMMUNITY ASSESSMENT PAPER                                                                   21




                                             Challenges
   Although Saratoga Springs is doing well in this economic climate and there appears to be quality
       health care delivery systems in place some challenges could be identified. The challenges
      identified, More low income housing. More agencies may be needed to support the increase
                        number of mentally ill and chemical dependent residents.




                                               Schools
    Education Empire State College and Skidmore College The Saratoga City School district six elementary
                          schools, one middle school and one high school grades 9-12
      Private School’s Saratoga Central Catholic High School, St Clements's, Waldorf School and Saratoga
                                             Independent School
Running Head: COMMUNITY ASSESSMENT PAPER                                 22




             Saratoga Protective services for it’s residents
  Fire Department, Police Station, much of the cities public services
  are located in the down town district. Many officers patrol on foot.
Running Head: COMMUNITY ASSESSMENT PAPER                                        23




                                Down Town
     Saratoga has many Shops and stores that are tailored to Tourism. Down
   town has grocery stores, drug stores, clothing shops and many restaurants.
                      Saratoga many dog friendly stores.




                       Religion In Saratoga Springs
  The Saratoga region has a number of faith-based organizations and places to
   worship. The area houses numerous churches, temples and missions, along
                        with many other organizations.
Running Head: COMMUNITY ASSESSMENT PAPER   24




                        Thank You!
Running Head: COMMUNITY ASSESSMENT PAPER                                               25


 Key Informants


 Key Informant (KI) number one is a Registered Nurse that works and lives in Saratoga

 Springs New York. The informant is 46 year’s old and has been working in the

 Emergency room at Saratoga Hospital for the last 5 years. The Key Informant is a

 married white female who’s native language is English. Highest level of education:

 Bachelors of Science in Nursing. During tis interview the informant will be asked a

 series of questions about the community.


 Key Informant number two (KI2) is a 28-year-old white male from Schenectady NY.

 He is a bartender at a local restaurant now living in Saratoga Springs NY. (KI2) has his

 high school diploma and speaks English.


 1. What are the strengths and assets of the community?

    (KI)- ―Saratoga Springs is a safe place to raise a family. Lots of community events

    and activities. Our community has quality healthcare and cares about our residents.‖

    (KI2) ―Fun city many good restaurants and clubs. I like the race track and Saratoga

    performing arts center.‖

 2. Areas of Improvement for the community?

    (KI) – ―Improving services that expand job growth in the community.‖

    (KI2) ―Better jobs and more businesses.‖

 3. Concerns of Community Members?

    (KI)-Saratoga springs has increasing number of residents that have chemical

    dependencies and mental illness. The increasing number of patients being seen for
Running Head: COMMUNITY ASSESSMENT PAPER                                                      26


    drug abuse and mental illness is increasing. Having more resources to handle the

    influx is essential.‖

    (KI2)- ―Expensive to live here.‖

 4. Do patients have access to quality healthcare?

    (KI)- ―The people of Saratoga Springs have a community hospital that is expanding

    its services to meet the need of the community.‖

    (KI2)-― I can’t afford health insurance even if they offered it to me it’s difficult to

    live in this city unless your have a good job.‖

 5. What do you think it is like for the working poor living in this community?

    (KI)- Given the demand for real estate there is a much higher cost of living. The

    working poor are struggling to buy the essential items needed to live. Minimum

    wage workers have a very tough time getting by in this community.‖

    (KI2) It’s hard and everyone is struggling to make ends meet.‖

 6. How safe do you believe your community is?

    (KI)- ―Saratoga Springs is very safe. We have dedicated and professional

    firefighters, EMT and police that keep our residents safe.‖

    (KI2) Pretty safe we have an occasional bar fights or petty crimes but all in all safe

    compared to my home town.‖

 7. Who has political power in the community?

    (KI) Saratoga has a commission form of Government. The Mayor and the elected

    officials have the political power.‖

    (KI2) ―The mayor of Saratoga all the city spend sit’s money on is making it look

    nice for the tourists.‖
Running Head: COMMUNITY ASSESSMENT PAPER                                                   27


 8. Are there opportunities for the poor and vulnerable population to become involved

      in the political process? Do you believe there voices are heard?

      (KI) ―During the city elections all city residents that own homes and are register

      with the city can vote. No I feel most of the poor probably don’t own properties

      therefore are not allowed to vote on city issues.‖

      (KI2) ―Are beeping kidding me? No only the rich folks have say.‖

 9. What housing is available to people with limited resources? Do you believe it is

      Adequate? ― (KI) a waiting list for housing assistance in Saratoga and not enough

      new low income housing being built.‖

      (KI2) ― I share an apartment with two roommates because it’s expensive to live

      here.‖


10     Is Public transportation available? (KI) ―Yes we have a good bus system.‖


       (KI2) ―Everything is close in the city and if you need a bus there are stops.‖


11. What do you perceive as environmental hazards in the community?


      (KI)―Saratoga Springs is a clean community that is recycling minded. I do not

      perceive any environmental hazards in the community at this time.‖


       (KI2) ― Acid rain and other pollution from surrounding areas.‖




12. Do you believe the public education system meets the needs of the working poor


     In this community‖ How?
Running Head: COMMUNITY ASSESSMENT PAPER                                                  28


(KI) Saratoga Springs public schools are ranked in the top 10% in the area. Every student

regardless of social class or wealth can receive the same quality education.‖


(KI2) I hear the schools are good. I graduated from Schenectady where we ranked poorly

for academics. Saratoga is made up of a bunch of rich kids with no worries.‖


13. Are English as a second Language classes available to the working poor?


(KI) ―I do believe that there is a growing need especially during the Racetrack. Saratoga

springs has many Spanish-speaking workers during the summer months. Many times the

workers come in to the ER because they are ill or injured. This creates a language

barrier.‖


(KI2) ―I am not sure but sounds like a good idea.‖


14. Are there vocational/technical programs available for the working poor? (KI) I do

know of a group called Unlimited Potential that provides training to over 50 people with

mental disabilities. I am not aware of all the programs for the working poor.‖


(KI2) ―I am not aware of any programs other than the ones offered by the library but I

think those are not free.‖


15.Describe your perceptions of the health of the community? (KI) ― The community

overall is very health conscious. Many people exercise and are active. On the other scale

while working in the emergency room unhealthy health issues are more apparent.

Obesity, mental illness, and substance abuse are frequently associated with the working

poor.‖


(KI2) I see a lot of active people running, walking, biking. It seems like a healthy place.‖
Running Head: COMMUNITY ASSESSMENT PAPER                                                    29




16. How adequate and accessible are health services? (KI) ―For the most part very

accessible. The hospital has outpatient centers and urgent care centers located in the city

and neighboring communities. Our hospital also has a 16-bed inpatient mental health

unit. Four winds is a large chemical dependency and mental health treatment center

located in Saratoga Springs. Not all patient’s can go there because it is a private. This

does pose a problem for the working poor.‖


(KI2) Thankfully I never had to us the local health services. I hear the hospital sucks. My

friend was there for a broken foot and he was there for six hours before someone even

looked at him.‖


17.How is the community information transmitted? Is it effective and is it in other

languages? (KI) Mostly all the community news is posted in the Saratogian our local new

paper. Other areas include bulletin boards and news radio. The language is English and I

find it to be largely effective.‖


(KI2) Papers and TV


18.How do the working poor and vulnerable population get important health information?


(KI) ―All emergency room patients revive discharge instructions along with the necessary

referrals for follow-up. These can be for primary care, mental health, chemical

dependency to social services.‖


(KI2) ―I am not sure but guess from the community health centers?‖
Running Head: COMMUNITY ASSESSMENT PAPER                                                  30


19. How does the economy of the community affect the health and social well being of

the community? Poor? Is healthcare affordable? (KI) ―I feel the economy is doing well

but this doesn’t tickle down to affordable healthcare. The good thing is that our

community is caring. Many people donate time and money to the local shelters and food

banks especially during the holidays.‖


(KI2) ―There are not enough high paying jobs for individuals that do not have a good

education. The poor just collect welfare and other free things while the rest of community

works hard to support them. I have no tolerance for lazy people.‖


20.What opportunities for fun and recreation are available for the working poor and are

they utilized? (KI)


―Our city has many public parks and recreation areas around the city. From my

experience I believe parks and community areas events are utilized by all the social

classes.‖


(KI2) Public Saratoga State Park. There are also lots of walking paths and other cool

things. Not much is free anymore and expect many things to go up.‖


21. Can you tell me something about the cultural and spiritual/religious aspects of the

poor population an their family? (KI) There are many churches and community outreach

centers located in the city. The religious leaders in the community especially the salvation

army provide supportive services through ministry and faith.‖


(KI2) ―I am not religious but everywhere you turn there are churches.‖
Running Head: COMMUNITY ASSESSMENT PAPER                                                    31


22. In your opinion, do cultural beliefs of the population affect delivery of health care

services? How? ―I feel that our community is composed of many different believe

systems that are supportive of the poor and vulnerable. I see this the most during the

holiday season. The community uses their beliefs to do more good for the less fortunate.‖


(KI2) ―I don’t see that as a factor.‖


23. Is there anything else you would like to tell me that influences the health of the

community‖(KI) ―I believe the culture of Saratoga springs is rich in culture and history.

The city was founded on its healing waters and natural springs. I feel that history still

rings true to this day.‖


(KI2) ―The number of fast food restaurants.‖


3.Epidemiology-―is the study of the distribution of health and illness within a population,

factors that determine the population’s health status, and use of the knowledge generated

to control the development of health problems‖(Clark 2008 p.62). During my windshield

survey of the City of Saratoga Springs I’ve identified a community need based on the

population groups. According to Healthy People 2020 Heart disease remains the highest

percentage of all mortality rates in the nation. Although the city of Saratoga Springs is a

health conscious community the people are still at risk for heart disease and sudden

cardiac arrest. Chart 1.3 is from Healthy People 2020 and shows the greatest amounts of

deaths of all ages in the United States of America.
Running Head: COMMUNITY ASSESSMENT PAPER                                                         32




1.3 Source: Centers for Disease Control and Prevention, National Center for Health Statistics;
data from the National Vital Statistics System (2006). Data are not age-adjusted.

Based on the vital statistics from the CDC New York State including Saratoga County

NY is not immune to heart disease and sudden cardiac arrest. Developing a CPR and

AED teaching plan the community health nurse can have a significant impact on the

people of Saratoga Springs NY and the surrounding community. “Community health

nurses employ knowledge attitudes, and skills, in application of several specific processes

when providing care to individuals, families, and population groups”(Clark 2008 p.74).

The health problem of heart disease and cardiac arrest affects all communities and does

not discriminate against populations groups, racial/ethnic, rich or poor. In this community

assessment project I have identified nursing actions that will increase life saving

interventions for sudden cardiac arrest associated with heart disease.
Running Head: COMMUNITY ASSESSMENT PAPER                                                   33


Population aggregate and developmental stage-

According to the population aggregate ages 18-65 years old make up 67.2 % of the

people in the community. Using Eric Erikson’s eight stages of life we will examine the

early adulthood and middle age community members. Sudden cardiac arrest can impact

people of all ages but this population is the most at risk. Erikson describes early

adulthood “as development of one’s capacity for reciprocal relationships”(Clark 2008

p.497). The community involvement with CPR and AED training is a perfect prevention

tool for the community. Young and old people can make to make a difference in their

community. Being certified in CPR is helping both early adulthood and middle age

citizens participate in life having strategies to help any one suffering from sudden cardiac

arrest.

As a community nurse I will use this information to increase awareness about the risks of

heart disease and sudden cardiac arrest. Community health nurses help resolve health

problems through teaching and services.“Nursing services may include activities such as

health related education and influenza immunizations for older adults in an adult day care

center, blood pressure screenings and nutritional counseling at a community health fair,

stress management group discussion at a local church, or a cardiopulmonary resuscitation

(CPR class in a school”(Blais & Hayes 2011 p.348)


Political, Cultural, Economic and laws


The City of Saratoga currently teaches CPR to the community through local Emergency

Medical Services, Fire Departments, American Red Cross and the American Heart

Association. The economical issues are the cost for the training, which can be between

$25 to $50 dollars per person. Although some CPR training & AED is free most is
Running Head: COMMUNITY ASSESSMENT PAPER                                                    34


provided of a fee. This could inhibit community members from getting trained. The

media and community do support CPR training and offer training through community

centers and the American Red Cross. Recent laws in NYS are increasing awareness of

CPR and its importance in the community.


Currently, CPR is gaining national attention with bill S2491. This act is to amend the

education law, in relation to requiring schools to provide instruction for CRP as part of

their high school curriculum. If this bill becomes law it will have a significant impact on

saving life’s from sudden cardiac arrest. “In addition to measures of disease and

mortality, changes in the composition of a population over time are also important in

planning for health services (Shi & Singh 2008 p.71). This bill will provide life saving

measures that addresses the leading cause of death in the United States.



Community Diagnosis

Diminish risk of sudden cardiac arrest’s deaths in the City of Saratoga Springs through

expanding initiation of community CPR & AED training in the community.



Community Resource: Adirondack Health & Wellness

Adirondack Health & Wellness is a nurse owned and operated PLLC with locations in

Clifton Park and Saratoga Springs NY.

Company Mission: When it comes to employee health, it takes more than just offering

sick days to keep your employees healthy and productive. Prevention is the best

medicine. Adirondack Health & Wellness and health educators can then help them make

positive lifestyle changes for the long term, improving their health and well being. We all
Running Head: COMMUNITY ASSESSMENT PAPER                                                  35


need positive reinforcement, especially when it comes to change.

The philosophy of the company is doing good for the community you serve. Adirondack

Health & Wellness provides CPR & AED training to corporations and medical

professionals. Because of the corporate sponsors and members the company is able to

donate free CPR and AED’s to community sports leagues. This organization is working

with members of the community to identify area sports leagues in need of CPR & AED

training.

Community Health Nursing Role

The role of the community nurse in this setting is to become certified to teach CPR &

AED certification classes. “Community health nurses employ knowledge, attitudes, and

skills in the application of several specific processes when providing care to individuals,

families, and population groups”(Clark 2008 p.74).

The ideal nursing role for the community health-nursing model is the interventions wheel

fig 1.4. “The model consists of 17 identified community health nursing intervention that

cross over three levels of population-based practice: individual-focused, community-

focused, and systems-focused practice”(Clark 2008 p75). Using this model we can break

it down into primary, secondary, and tertiary prevention.
Running Head: COMMUNITY ASSESSMENT PAPER                                              36




fig. 1.4 Minnesota Department of Health, St. Paul,

Minnesota 55164-0975, USA.



Primary prevention method for this population base oneducating the community on the

importance of AED’s and trained member’s of the community to use them. Another

primary prevention is advocacy in the community for increased awareness of the

importance of CPR & AED training in the community.

Secondary prevention can be accomplished with health teaching and diagnostic

screenings in the community. Free Blood pressure and cholesterol screening in the

community can help identify people more at risk for developing heart disease.
Running Head: COMMUNITY ASSESSMENT PAPER                                                37


Tertiary prevention is the treatment if consequences through life saving CPR & AED

interventions in the community. Another highlight is prevention of recurrence by use of

AED’s in public places and more people trained to use them.

Conclusion for Community Assessment

Heart disease remains as the number one heath problem in the United States of America.

The City of Saratoga Springs is not immune from this epidemic. The community

assessment project gave me the skills to identify the dimensions of a health problem and

skills on preventing recurrences of the problem. ―The focus in community nursing is the

community: it is a practice that is comprehensive and continues, takes place in a wide

variety of settings, is directed toward all age-groups, and commands the utilization of all

professional nursing roles‖(Clark 2008 .344). In summery this project will provide a

valuable benefit for the City of Saratoga Springs. Through collaboration and

communication with community leaders more citizens will be trained in life saving CPR

& AED. By creating this program community health nurses are creating a safer place to

live, work, and play.
Running Head: COMMUNITY ASSESSMENT PAPER                                             38




                                     References

   Blais, K.K. and Hayes, J.S. (2011). Professional Nursing Practice: Concepts and

             Perspectives, (6th ed.). Upper Saddle River, NJ: Prentice Hall

           The Center For Disease Control. (November 27,2012) Retrieved

                        From:http://www.cdc.gov/heartdisease/

 Clark, M., (2008). Community Health Nursing Advocacy For Population Health, (fifth

                        edition.). Peasron, Upper Saddle, N.J.


          Minnesota Department of Health. (December 7, 2012). Retrieved

     from:(http://www.dhs.wisconsin.gov/phnc/InterventionWheel/index.htm

   Schuster, P. and Nykolyn, L (2101). Communication for Nurses: How to Prevent

   Harmful Events and Promote Patient Safety,(1st ed.) Philadelphia PA:F.A. Davis

                                      Company

Shi, L., & Singh, D. A. (2008). Delivering health care in America: A systems approach

                     (4th ed.). Burlington, MA: Jones & Bartlett.

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Community Assessment Highlights Importance of CPR Training

  • 1. Running Head: COMMUNITY ASSESSMENT PAPER 1 A Community Heath Nurses Role With Cardiopulmonary Resuscitation (CPR) David Theobald-RN Empire State College
  • 2. Running Head: COMMUNITY ASSESSMENT PAPER 2 Table of Contents Introduction………………………………………………………………………5 Epidemiology……………………………………………………………………..5 Importance of Cardiopulmonary Resuscitation (CPR)……………………………5 Population…………………………………………………………….…… .……5 Community Health Nursing Model………………………………………………5 Community Health Nurses Role ……...…………………………………………..5 Windshield Community Overview…………………………………………….….5 Education…………. ……………………………………………………………...6 Community Census…………………………………………………………….…6 Employment survey………………………..……………………………………..7 Employers…………………………………………………………………………7 Type of Government……………..…………………………………………….…8 Safety……………….... …………………………………………………………8 Hospitals…………………………...…………………………………………….9 Recreation……………………………………………………………………….9 Media……………………………………………………………………………9 Windshield Map boundaries……..……………….……………………………10 History….…………………….…………………………………………….….10 Population……….…………………………………………………………….12 Housing………………….……………………………………………………..12
  • 3. Running Head: COMMUNITY ASSESSMENT PAPER 3 Signs of Decay…………….…………………………………………………….……....13 Open Spaces……………….………………..………………………………………..14-15 Transportation…………………………………………………….……………………...16 Health Care services………..…………………………………………………..…….17-18 Crime…………………..………………..……………………………………………….19 Economics………………………………………..……………………………….…......19 Challenges..…………………………….…………………………………….……….…20 Strengths…….....……..……………….………………………………………….…..20-21 Religion………………………………………………………………………………….22 Windshield Conclusion……………………………………………………………….....23 Key Informant Interviews………………………………………………………...…24-30 Epidemiologyof Sudden Cardiac Arrest.……………………………………………30-31 Population aggregate and developmental stage............................................................31-32 Political, Cultural, Economic and laws ……………………………………………...33-34 Community Resource: Adirondack Health & Wellness…………………………………35 Community Health Nursing Role………………………….……………………….……35 Primary Prevention Method……………………………………………………….…….36 Conclusion………………………………………………………………………………37 References………………………………………………………………………………38
  • 4. Running Head: COMMUNITY ASSESSMENT PAPER 4 1. Introduction Purpose A. The purpose of this community assessment paper is to increase awareness of the importance of Automatic External Defibrillators (AED’s) and Cardiopulmonary Resuscitation (CPR) training in the City of Saratoga Springs New York. Population Aggregate/ Statistics B. Population Aggregate- Saratoga Springs has population of 26,727 people. The community is involved with youth sports teams. Statistic ―Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men. About600,000 Americans die from heart disease each year—that’s 1 in every 4 deaths. Coronary heart disease is the most common type of heart disease, killing more than 385,000 people annually‖(CDC 2012 Web). Community Health Nursing Model D. For this Project we will be using the Interventions Wheel Model. ―The model consists of 17 identified community health nursing interventions that cross over three levels of population-based practice: individual-focused, community-focused, and systems-focused practice. Individual-level interventions are focused on change in individual health status, knowledge, or skills (Clark, 2008 p 75).
  • 5. Running Head: COMMUNITY ASSESSMENT PAPER 5 Community Health Nurse Role E. Community Health Nurse Role in promoting heart health and implementing CPR and AED programs. Population by Gender Male 12,837 48.28% 12,433 Female 13,749 51.72% 13,753 Population by Age Persons 0 to 4 years 1,087 4.09% 1,395 COMMUNITY OVERVIEW B. Demographics based on 2010 US Census Bureau Total 26,586 Community Overview A. Saratoga Springs NY is small city rich with history and culture. There are community sports programs and recreation leagues in the community were identified as needing life saving AED’s.
  • 6. Running Head: COMMUNITY ASSESSMENT PAPER 6 Persons 5 to 17 years 3,430 12.90% 3,672 Persons 18 to 64 years 17,881 67.26% 17,380 Persons 65 years and over 4,188 15.75% 3,739 Education Retrieved from National Center for Educational Statistics Population 25 years and over 17,127 100.0% Less than 9th grade 588 3.4% 9th to 12th grade, no diploma 1,297 7.6% High school graduate (includes equivalency) 4,011 23.4% Some college, no degree 3,009 17.6% Associate degree 1,557 9.1% Bachelor's degree 3,595 21.0% Graduate or professional degree 3,070 17.9
  • 7. Running Head: COMMUNITY ASSESSMENT PAPER 7 D. Ethnicity 2010 Census Population by Race American Indian and Alaska native alone 55 0.21% 63 Asian alone 521 1.96% 271 Black or African American alone 701 2.64% 815 Native Hawaiian and Other Pacific native alone 7 0.03% 8 Some other race alone 170 0.64% 168 Two or more races 589 2.22% 368 White alone 24,543 92.32% 24,493 E. Poverty Level, Unemployment ratethe data is based upon 2010 estimates. Saratoga Springs employment information Index Saratoga Springs New York Income per capita $31,762 $31,957 Median household income $54,607 $67,635 Median household income owner occupied $74,316 $79,472 Median household income renter occupied $32,481 $41,550
  • 8. Running Head: COMMUNITY ASSESSMENT PAPER 8 Median earnings male $35,233 $45,665 Median earnings female $19,281 $26,443 Unemployment rate (2000) 4.3% 4.5% Unemployment rate (2010) n/a 8.2% Unemployment rate (2012) n/a 8.0% Poverty level 8.8% 8.8% Employers Many people that live in Saratoga Springs either work for small businesses or commute to larger employers in out lying areas. Below are some of the largest employers in Saratoga Springs NY. 1000+ employees Town # of employees Stewart's Ice Cream Co. Saratoga Springs 1550 500-999 employees Saratoga Springs City School District Saratoga Springs 988 Quad Graphics, Inc. Saratoga Springs 825 Saratoga Hospital Saratoga Springs 823 Type of Government For The City Of Saratoga Springs NY Commission Form: The Saratoga Springs charter specifies a commission form of city government. In the news there have been efforts to amend the charter. The charter change proposal will appear on the ballot of the November 2012 election.
  • 9. Running Head: COMMUNITY ASSESSMENT PAPER 9 Safety Fire, Police ―The Saratoga Springs Fire Department is dedicated to the protection of life, property and the environment for those who live, work, or visit our community. We will accomplish this by using well trained and dedicated personnel pledged todeliver the highest quality fire suppression & prevention, public education, advanced emergency medical services, which are capable of responding to all disasters, natural or man-made.‖(City Saratoga Springs.org) Police Department: City Paid Department ―We are a team of law enforcement professionals committed to setting the benchmark for quality police service by promoting strong community partnerships and upholding the highest ethical standards. Our mission is to provide a professional, effective, and timely response to crime and disorder, and to enhance traffic safety in our community.‖(City Saratoga Springs.org) Hospital-Saratoga Hospital Saratoga Hospitalis a 207-bed community hospital serving Saratoga County and the surrounding areas. Recreation-The Saratoga Springs Recreation Department offers sports leagues for youth girls and boys. Currently, the City offers soccer, basketball, t-ball, and flag football lacrosse, field hockey, and volleyball. Media–Saratoga news paper,WNYT and capital district YNN news.
  • 10. Running Head: COMMUNITY ASSESSMENT PAPER 10 Windshield Survey City Saratoga Springs, NY By David Theobald & Sully Empire State College 10-12-12 Party Cloudy Temp. 68 degrees Map of Saratoga Springs NYWindshield Survey City 29.0 Sq. miles Coordinates 43 ’4’31’N 73 46’57”W
  • 11. Running Head: COMMUNITY ASSESSMENT PAPER 11 • Saratoga Springs NY First Settled 1776 • Area 29.0 Square Miles • Population 26,586 • Government Mayor Scott T. Johnson • Major Attractions Horse Racing, The Springs, Performing Arts, Art’s and Entertainment • Education Empire State College and Skidmore College • The Saratoga City School district six elementary schools, one middle school and one high school grades 9-12
  • 12. Running Head: COMMUNITY ASSESSMENT PAPER 12 • Private School’s Saratoga Central Catholic High School, St Clements's, Waldorf School and Saratoga Independent School • Population Census by race 2000 • White alone - 24,005 (90.3%) • Hispanic - 839 (3.2%) • Black alone - 661 (2.5%) • Asian alone - 516 (1.9%) • Two or more races - 505 (1.9%) • American Indian alone - 41 (0.2%) • Other race alone - 15 (0.06%) • Native Hawaiian and Other Pacific Islander alone - 4 (0.02%) Housing Saratoga Springs ranked 75 of the 100 best places to live in US. According to CNN Money
  • 13. Running Head: COMMUNITY ASSESSMENT PAPER 13 Saratoga Springs downtown district is a very sought after market. Houses are well kept and prices reflect that.
  • 14. Running Head: COMMUNITY ASSESSMENT PAPER 14 Affordable Housing William Ford Jefferson Terrace Vanderbilt Terrace Neat and clean units both single and mul family apartments. Housing Windshield Survey The rules and regula ons for Public Housing and Sec on 8 program are determined by the U.S. Department of Housing and Urban Development (HUD). The purpose of both Public Housing and the Sec on 8 Program is to provide affordable housing to eligible low- and moderate-income families.
  • 15. Running Head: COMMUNITY ASSESSMENT PAPER 15 Open Spaces & Parks Saratoga Spa State Park, distinguished by its classical architecture and listed as a National Historic Landmark, is noted for its diverse cultural, aesthetic and recreational resources. In addition to the nationally-known Saratoga Performing Arts Center, the Spa Little Theater, the National Museum of Dance, the Saratoga Automobile Museum, the Gideon Putnam Resort and Roosevelt Baths and Spa, the park offers a multitude of traditional recreation opportunities. The Peerless Pool Complex consists of a main pool with a zero-depth entry, separate slide pool with a 19' double slide and a children's wading pool with a mushroom fountain. The Historic Victoria Pool is a smaller pool surrounded by arched promenades. Both pool
  • 16. Running Head: COMMUNITY ASSESSMENT PAPER 16 areas include food and beverage areas. 
 
 The Saratoga Spa State Park Golf Course offers two beautiful golf courses; a championship 18-hole course and a challenging 9-hole course, complete with pro shop and restaurant. The gentle terrain offers picnic areas, shady streamside trails, suitable for the nature-lover or the casual walker, as well as certified running courses used by joggers and high school and college athletes. Winter activities include: cross-country skiing on approximately 12 miles of trails, ice skating, ice hockey. Many Public Parks with Natural Springs There are currently 17 public mineral springs in various locations throughout Saratoga. Each one is naturally carbonated.
  • 17. Running Head: COMMUNITY ASSESSMENT PAPER 17 Transportation Saratoga has Buses, Taxies, Amtrak, major highways and well maintained roads and plenty of traffic lights and easy to follow signs.
  • 18. Running Head: COMMUNITY ASSESSMENT PAPER 18 Quality Health Care Saratoga Hospital is a 207-bed community hospital serving Saratoga County and the surrounding area. Major employer for the area Good Side Walks and Free Parking Saratoga has had challenges with parking especially with tourism. The city just built a large parking garage for the public to use.
  • 19. Running Head: COMMUNITY ASSESSMENT PAPER 19 Many Services Available For Those in Need Although not as bad as other areas Saratoga did suffer from the difficult economic times, which meant many individuals called upon the help and services of The Salvation Army. Four Winds Health and Social Services Four Winds is a Private inpatient, partial hospital, intensive outpatient and outpatient for mental heath and substance abuse.
  • 20. Running Head: COMMUNITY ASSESSMENT PAPER 20 Crime Rates Comparison From Area Connect Saratoga Springs is one of the safest Cities in the Capital Region. Economics Saratoga Springs is a growing community. There are many new buildings and businesses under construction. The major employers are Stewarts Shops, Quad Graphic, Saratoga Hospital
  • 21. Running Head: COMMUNITY ASSESSMENT PAPER 21 Challenges Although Saratoga Springs is doing well in this economic climate and there appears to be quality health care delivery systems in place some challenges could be identified. The challenges identified, More low income housing. More agencies may be needed to support the increase number of mentally ill and chemical dependent residents. Schools Education Empire State College and Skidmore College The Saratoga City School district six elementary schools, one middle school and one high school grades 9-12 Private School’s Saratoga Central Catholic High School, St Clements's, Waldorf School and Saratoga Independent School
  • 22. Running Head: COMMUNITY ASSESSMENT PAPER 22 Saratoga Protective services for it’s residents Fire Department, Police Station, much of the cities public services are located in the down town district. Many officers patrol on foot.
  • 23. Running Head: COMMUNITY ASSESSMENT PAPER 23 Down Town Saratoga has many Shops and stores that are tailored to Tourism. Down town has grocery stores, drug stores, clothing shops and many restaurants. Saratoga many dog friendly stores. Religion In Saratoga Springs The Saratoga region has a number of faith-based organizations and places to worship. The area houses numerous churches, temples and missions, along with many other organizations.
  • 24. Running Head: COMMUNITY ASSESSMENT PAPER 24 Thank You!
  • 25. Running Head: COMMUNITY ASSESSMENT PAPER 25 Key Informants Key Informant (KI) number one is a Registered Nurse that works and lives in Saratoga Springs New York. The informant is 46 year’s old and has been working in the Emergency room at Saratoga Hospital for the last 5 years. The Key Informant is a married white female who’s native language is English. Highest level of education: Bachelors of Science in Nursing. During tis interview the informant will be asked a series of questions about the community. Key Informant number two (KI2) is a 28-year-old white male from Schenectady NY. He is a bartender at a local restaurant now living in Saratoga Springs NY. (KI2) has his high school diploma and speaks English. 1. What are the strengths and assets of the community? (KI)- ―Saratoga Springs is a safe place to raise a family. Lots of community events and activities. Our community has quality healthcare and cares about our residents.‖ (KI2) ―Fun city many good restaurants and clubs. I like the race track and Saratoga performing arts center.‖ 2. Areas of Improvement for the community? (KI) – ―Improving services that expand job growth in the community.‖ (KI2) ―Better jobs and more businesses.‖ 3. Concerns of Community Members? (KI)-Saratoga springs has increasing number of residents that have chemical dependencies and mental illness. The increasing number of patients being seen for
  • 26. Running Head: COMMUNITY ASSESSMENT PAPER 26 drug abuse and mental illness is increasing. Having more resources to handle the influx is essential.‖ (KI2)- ―Expensive to live here.‖ 4. Do patients have access to quality healthcare? (KI)- ―The people of Saratoga Springs have a community hospital that is expanding its services to meet the need of the community.‖ (KI2)-― I can’t afford health insurance even if they offered it to me it’s difficult to live in this city unless your have a good job.‖ 5. What do you think it is like for the working poor living in this community? (KI)- Given the demand for real estate there is a much higher cost of living. The working poor are struggling to buy the essential items needed to live. Minimum wage workers have a very tough time getting by in this community.‖ (KI2) It’s hard and everyone is struggling to make ends meet.‖ 6. How safe do you believe your community is? (KI)- ―Saratoga Springs is very safe. We have dedicated and professional firefighters, EMT and police that keep our residents safe.‖ (KI2) Pretty safe we have an occasional bar fights or petty crimes but all in all safe compared to my home town.‖ 7. Who has political power in the community? (KI) Saratoga has a commission form of Government. The Mayor and the elected officials have the political power.‖ (KI2) ―The mayor of Saratoga all the city spend sit’s money on is making it look nice for the tourists.‖
  • 27. Running Head: COMMUNITY ASSESSMENT PAPER 27 8. Are there opportunities for the poor and vulnerable population to become involved in the political process? Do you believe there voices are heard? (KI) ―During the city elections all city residents that own homes and are register with the city can vote. No I feel most of the poor probably don’t own properties therefore are not allowed to vote on city issues.‖ (KI2) ―Are beeping kidding me? No only the rich folks have say.‖ 9. What housing is available to people with limited resources? Do you believe it is Adequate? ― (KI) a waiting list for housing assistance in Saratoga and not enough new low income housing being built.‖ (KI2) ― I share an apartment with two roommates because it’s expensive to live here.‖ 10 Is Public transportation available? (KI) ―Yes we have a good bus system.‖ (KI2) ―Everything is close in the city and if you need a bus there are stops.‖ 11. What do you perceive as environmental hazards in the community? (KI)―Saratoga Springs is a clean community that is recycling minded. I do not perceive any environmental hazards in the community at this time.‖ (KI2) ― Acid rain and other pollution from surrounding areas.‖ 12. Do you believe the public education system meets the needs of the working poor In this community‖ How?
  • 28. Running Head: COMMUNITY ASSESSMENT PAPER 28 (KI) Saratoga Springs public schools are ranked in the top 10% in the area. Every student regardless of social class or wealth can receive the same quality education.‖ (KI2) I hear the schools are good. I graduated from Schenectady where we ranked poorly for academics. Saratoga is made up of a bunch of rich kids with no worries.‖ 13. Are English as a second Language classes available to the working poor? (KI) ―I do believe that there is a growing need especially during the Racetrack. Saratoga springs has many Spanish-speaking workers during the summer months. Many times the workers come in to the ER because they are ill or injured. This creates a language barrier.‖ (KI2) ―I am not sure but sounds like a good idea.‖ 14. Are there vocational/technical programs available for the working poor? (KI) I do know of a group called Unlimited Potential that provides training to over 50 people with mental disabilities. I am not aware of all the programs for the working poor.‖ (KI2) ―I am not aware of any programs other than the ones offered by the library but I think those are not free.‖ 15.Describe your perceptions of the health of the community? (KI) ― The community overall is very health conscious. Many people exercise and are active. On the other scale while working in the emergency room unhealthy health issues are more apparent. Obesity, mental illness, and substance abuse are frequently associated with the working poor.‖ (KI2) I see a lot of active people running, walking, biking. It seems like a healthy place.‖
  • 29. Running Head: COMMUNITY ASSESSMENT PAPER 29 16. How adequate and accessible are health services? (KI) ―For the most part very accessible. The hospital has outpatient centers and urgent care centers located in the city and neighboring communities. Our hospital also has a 16-bed inpatient mental health unit. Four winds is a large chemical dependency and mental health treatment center located in Saratoga Springs. Not all patient’s can go there because it is a private. This does pose a problem for the working poor.‖ (KI2) Thankfully I never had to us the local health services. I hear the hospital sucks. My friend was there for a broken foot and he was there for six hours before someone even looked at him.‖ 17.How is the community information transmitted? Is it effective and is it in other languages? (KI) Mostly all the community news is posted in the Saratogian our local new paper. Other areas include bulletin boards and news radio. The language is English and I find it to be largely effective.‖ (KI2) Papers and TV 18.How do the working poor and vulnerable population get important health information? (KI) ―All emergency room patients revive discharge instructions along with the necessary referrals for follow-up. These can be for primary care, mental health, chemical dependency to social services.‖ (KI2) ―I am not sure but guess from the community health centers?‖
  • 30. Running Head: COMMUNITY ASSESSMENT PAPER 30 19. How does the economy of the community affect the health and social well being of the community? Poor? Is healthcare affordable? (KI) ―I feel the economy is doing well but this doesn’t tickle down to affordable healthcare. The good thing is that our community is caring. Many people donate time and money to the local shelters and food banks especially during the holidays.‖ (KI2) ―There are not enough high paying jobs for individuals that do not have a good education. The poor just collect welfare and other free things while the rest of community works hard to support them. I have no tolerance for lazy people.‖ 20.What opportunities for fun and recreation are available for the working poor and are they utilized? (KI) ―Our city has many public parks and recreation areas around the city. From my experience I believe parks and community areas events are utilized by all the social classes.‖ (KI2) Public Saratoga State Park. There are also lots of walking paths and other cool things. Not much is free anymore and expect many things to go up.‖ 21. Can you tell me something about the cultural and spiritual/religious aspects of the poor population an their family? (KI) There are many churches and community outreach centers located in the city. The religious leaders in the community especially the salvation army provide supportive services through ministry and faith.‖ (KI2) ―I am not religious but everywhere you turn there are churches.‖
  • 31. Running Head: COMMUNITY ASSESSMENT PAPER 31 22. In your opinion, do cultural beliefs of the population affect delivery of health care services? How? ―I feel that our community is composed of many different believe systems that are supportive of the poor and vulnerable. I see this the most during the holiday season. The community uses their beliefs to do more good for the less fortunate.‖ (KI2) ―I don’t see that as a factor.‖ 23. Is there anything else you would like to tell me that influences the health of the community‖(KI) ―I believe the culture of Saratoga springs is rich in culture and history. The city was founded on its healing waters and natural springs. I feel that history still rings true to this day.‖ (KI2) ―The number of fast food restaurants.‖ 3.Epidemiology-―is the study of the distribution of health and illness within a population, factors that determine the population’s health status, and use of the knowledge generated to control the development of health problems‖(Clark 2008 p.62). During my windshield survey of the City of Saratoga Springs I’ve identified a community need based on the population groups. According to Healthy People 2020 Heart disease remains the highest percentage of all mortality rates in the nation. Although the city of Saratoga Springs is a health conscious community the people are still at risk for heart disease and sudden cardiac arrest. Chart 1.3 is from Healthy People 2020 and shows the greatest amounts of deaths of all ages in the United States of America.
  • 32. Running Head: COMMUNITY ASSESSMENT PAPER 32 1.3 Source: Centers for Disease Control and Prevention, National Center for Health Statistics; data from the National Vital Statistics System (2006). Data are not age-adjusted. Based on the vital statistics from the CDC New York State including Saratoga County NY is not immune to heart disease and sudden cardiac arrest. Developing a CPR and AED teaching plan the community health nurse can have a significant impact on the people of Saratoga Springs NY and the surrounding community. “Community health nurses employ knowledge attitudes, and skills, in application of several specific processes when providing care to individuals, families, and population groups”(Clark 2008 p.74). The health problem of heart disease and cardiac arrest affects all communities and does not discriminate against populations groups, racial/ethnic, rich or poor. In this community assessment project I have identified nursing actions that will increase life saving interventions for sudden cardiac arrest associated with heart disease.
  • 33. Running Head: COMMUNITY ASSESSMENT PAPER 33 Population aggregate and developmental stage- According to the population aggregate ages 18-65 years old make up 67.2 % of the people in the community. Using Eric Erikson’s eight stages of life we will examine the early adulthood and middle age community members. Sudden cardiac arrest can impact people of all ages but this population is the most at risk. Erikson describes early adulthood “as development of one’s capacity for reciprocal relationships”(Clark 2008 p.497). The community involvement with CPR and AED training is a perfect prevention tool for the community. Young and old people can make to make a difference in their community. Being certified in CPR is helping both early adulthood and middle age citizens participate in life having strategies to help any one suffering from sudden cardiac arrest. As a community nurse I will use this information to increase awareness about the risks of heart disease and sudden cardiac arrest. Community health nurses help resolve health problems through teaching and services.“Nursing services may include activities such as health related education and influenza immunizations for older adults in an adult day care center, blood pressure screenings and nutritional counseling at a community health fair, stress management group discussion at a local church, or a cardiopulmonary resuscitation (CPR class in a school”(Blais & Hayes 2011 p.348) Political, Cultural, Economic and laws The City of Saratoga currently teaches CPR to the community through local Emergency Medical Services, Fire Departments, American Red Cross and the American Heart Association. The economical issues are the cost for the training, which can be between $25 to $50 dollars per person. Although some CPR training & AED is free most is
  • 34. Running Head: COMMUNITY ASSESSMENT PAPER 34 provided of a fee. This could inhibit community members from getting trained. The media and community do support CPR training and offer training through community centers and the American Red Cross. Recent laws in NYS are increasing awareness of CPR and its importance in the community. Currently, CPR is gaining national attention with bill S2491. This act is to amend the education law, in relation to requiring schools to provide instruction for CRP as part of their high school curriculum. If this bill becomes law it will have a significant impact on saving life’s from sudden cardiac arrest. “In addition to measures of disease and mortality, changes in the composition of a population over time are also important in planning for health services (Shi & Singh 2008 p.71). This bill will provide life saving measures that addresses the leading cause of death in the United States. Community Diagnosis Diminish risk of sudden cardiac arrest’s deaths in the City of Saratoga Springs through expanding initiation of community CPR & AED training in the community. Community Resource: Adirondack Health & Wellness Adirondack Health & Wellness is a nurse owned and operated PLLC with locations in Clifton Park and Saratoga Springs NY. Company Mission: When it comes to employee health, it takes more than just offering sick days to keep your employees healthy and productive. Prevention is the best medicine. Adirondack Health & Wellness and health educators can then help them make positive lifestyle changes for the long term, improving their health and well being. We all
  • 35. Running Head: COMMUNITY ASSESSMENT PAPER 35 need positive reinforcement, especially when it comes to change. The philosophy of the company is doing good for the community you serve. Adirondack Health & Wellness provides CPR & AED training to corporations and medical professionals. Because of the corporate sponsors and members the company is able to donate free CPR and AED’s to community sports leagues. This organization is working with members of the community to identify area sports leagues in need of CPR & AED training. Community Health Nursing Role The role of the community nurse in this setting is to become certified to teach CPR & AED certification classes. “Community health nurses employ knowledge, attitudes, and skills in the application of several specific processes when providing care to individuals, families, and population groups”(Clark 2008 p.74). The ideal nursing role for the community health-nursing model is the interventions wheel fig 1.4. “The model consists of 17 identified community health nursing intervention that cross over three levels of population-based practice: individual-focused, community- focused, and systems-focused practice”(Clark 2008 p75). Using this model we can break it down into primary, secondary, and tertiary prevention.
  • 36. Running Head: COMMUNITY ASSESSMENT PAPER 36 fig. 1.4 Minnesota Department of Health, St. Paul, Minnesota 55164-0975, USA. Primary prevention method for this population base oneducating the community on the importance of AED’s and trained member’s of the community to use them. Another primary prevention is advocacy in the community for increased awareness of the importance of CPR & AED training in the community. Secondary prevention can be accomplished with health teaching and diagnostic screenings in the community. Free Blood pressure and cholesterol screening in the community can help identify people more at risk for developing heart disease.
  • 37. Running Head: COMMUNITY ASSESSMENT PAPER 37 Tertiary prevention is the treatment if consequences through life saving CPR & AED interventions in the community. Another highlight is prevention of recurrence by use of AED’s in public places and more people trained to use them. Conclusion for Community Assessment Heart disease remains as the number one heath problem in the United States of America. The City of Saratoga Springs is not immune from this epidemic. The community assessment project gave me the skills to identify the dimensions of a health problem and skills on preventing recurrences of the problem. ―The focus in community nursing is the community: it is a practice that is comprehensive and continues, takes place in a wide variety of settings, is directed toward all age-groups, and commands the utilization of all professional nursing roles‖(Clark 2008 .344). In summery this project will provide a valuable benefit for the City of Saratoga Springs. Through collaboration and communication with community leaders more citizens will be trained in life saving CPR & AED. By creating this program community health nurses are creating a safer place to live, work, and play.
  • 38. Running Head: COMMUNITY ASSESSMENT PAPER 38 References Blais, K.K. and Hayes, J.S. (2011). Professional Nursing Practice: Concepts and Perspectives, (6th ed.). Upper Saddle River, NJ: Prentice Hall The Center For Disease Control. (November 27,2012) Retrieved From:http://www.cdc.gov/heartdisease/ Clark, M., (2008). Community Health Nursing Advocacy For Population Health, (fifth edition.). Peasron, Upper Saddle, N.J.
 Minnesota Department of Health. (December 7, 2012). Retrieved from:(http://www.dhs.wisconsin.gov/phnc/InterventionWheel/index.htm Schuster, P. and Nykolyn, L (2101). Communication for Nurses: How to Prevent Harmful Events and Promote Patient Safety,(1st ed.) Philadelphia PA:F.A. Davis Company Shi, L., & Singh, D. A. (2008). Delivering health care in America: A systems approach (4th ed.). Burlington, MA: Jones & Bartlett.