Running head: COMMUNITY HEALTH ASSESSMENT 1 Community Health Assessment 5 Pressure Ulcers and the Vulnerable Elderly Population Community Health Assessment Community Health Assessment Introduction Community needs evaluation is the process of collecting and analyzing public health information using both quantitative and qualitative approaches for a specific population. This discussion will focus on health information about the elderly population with pressure ulcers by concentrating on the public resources available, social health drivers, risk factors, quality of life, as well as how Mary Manning Walsh hospital provides essential services to this population. Manhattan Borough, New York City With a promise to give the most astounding quality medical care service to each individual in all the five boroughs in New York City, the NYC Health + Hospitals public healthcare sector is the biggest of its sort in the US (Efraim, 2010). Citizens of Manhattan district get public medical care service from clinics run by NYC. Pressure ulcers (PU) prevalence presents a substantial weight on medical care facilities. Improved therapeutic care and better living conditions have expanded the future of the old populace. Many aging victims experience the ill effects of severe and ceaseless infections, dietary inadequacies, and susceptibility (Issel & Wells, 2017). A major predisposing factor for PU is comorbidities notwithstanding the aging process bringing about idleness. The number of PU victims over the age of 80 years has been increasing due to prolonged life expectancy, leading to higher risk of disability and immobility. Higher mortality rate reported in Manhattan is a result of PU conditions (Barnidge et al., 2013). Another study shows, an average elderly person with stage IV hospital-acquired PU spends an average of $129,248 (Jaul & Menzel, 2014). A review done on repetitive admissions, an average of $124,327 is spent on community-procured PU. The higher appearance of complications and the extended time taken for patients in the facility to heal increases the health cost as the ulcer grade continues to develop. Intricacies, for example, contaminations or osteomyelitis, increase related financial expense altogether. Existing Resources Some of the available national, regional and local resources found in Manhattan borough to help in battling elderly pressure ulcer are: Educational institutions Regional and local community leaders Federally funded Health Care Centers Regional Public Health Networks Local & regional hospitals Department of Health and Human Services State & local police departments Granite State Independent Living Strengths and weaknesses A notable shortcoming that may be a hindrance with executing a public wellbeing program on pressure ulcers is the absence of familiarity as well as knowledge with the etiology of the pressure ulcer development, particularly at the community setting. Non-proficient care pr ...

1. Running head: COMMUNITY HEALTH ASSESSMENT
1
Community Health Assessment
5
Pressure Ulcers and the Vulnerable Elderly Population
Community Health Assessment
Community Health Assessment
Introduction
Community needs evaluation is the process of collecting and

2. analyzing public health information using both quantitative and
qualitative approaches for a specific population. This discussion
will focus on health information about the elderly population
with pressure ulcers by concentrating on the public resources
available, social health drivers, risk factors, quality of life, as
well as how Mary Manning Walsh hospital provides essential
services to this population.
Manhattan Borough, New York City
With a promise to give the most astounding quality medical care
service to each individual in all the five boroughs in New York
City, the NYC Health + Hospitals public healthcare sector is the
biggest of its sort in the US (Efraim, 2010). Citizens of
Manhattan district get public medical care service from clinics
run by NYC. Pressure ulcers (PU) prevalence presents a
substantial weight on medical care facilities. Improved
therapeutic care and better living conditions have expanded the
future of the old populace. Many aging victims experience the
ill effects of severe and ceaseless infections, dietary
inadequacies, and susceptibility (Issel & Wells, 2017). A major
predisposing factor for PU is comorbidities notwithstanding the
aging process bringing about idleness. The number of PU
victims over the age of 80 years has been increasing due to
prolonged life expectancy, leading to higher risk of disability
and immobility. Higher mortality rate reported in Manhattan is
a result of PU conditions (Barnidge et al., 2013). Another study
shows, an average elderly person with stage IV hospital-
acquired PU spends an average of $129,248 (Jaul & Menzel,
2014). A review done on repetitive admissions, an average of
$124,327 is spent on community-procured PU. The higher
appearance of complications and the extended time taken for
patients in the facility to heal increases the health cost as the
ulcer grade continues to develop. Intricacies, for example,
contaminations or osteomyelitis, increase related financial
expense altogether.
Existing Resources
Some of the available national, regional and local resources

3. found in Manhattan borough to help in battling elderly pressure
ulcer are:
Educational institutions
Regional and local community leaders
Federally funded Health Care Centers
Regional Public Health Networks
Local & regional hospitals
Department of Health and Human Services
State & local police departments
Granite State Independent Living
Strengths and weaknesses
A notable shortcoming that may be a hindrance with executing a
public wellbeing program on pressure ulcers is the absence of
familiarity as well as knowledge with the etiology of the
pressure ulcer development, particularly at the community
setting. Non-proficient care providers and the primary group
have a significant responsibility in prevention. Immobile
patients receiving care at home are checked and followed up by
nurses and GP to check the underlying signs of the skin to
effectively plan proper interventions and medications needed
(Issel & Wells, 2017). Occasional training and continuous
coherence of training are significant for the primary group,
caregiver, and the family. Another shortcoming around
community contribution is absent. There is an absence of unity
in this community. Strength in the community is improved care
delivery on teaching and by avoiding outside pressure, shearing
forces, and enhancing the dietary condition of the older just as
regard for care and avoiding dampness of the skin.
Opportunities
There is a prospect for community-based associations to make
an establishment essential for improving quality medicinal
services. The obligation is set on the local setting, such,
officials, and public members, to help with building up a
productive plan. The possibility to diminish the wellbeing
inconsistencies identified with stress-related illnesses is
realistic with a focused on project and crafted by the public as a

4. whole. A few vacant structures in the district offer space that
could be used to make a counseling therapy unit. The chance to
build up an active community wellbeing plan is conceivable.
Barriers
Numerous obstructions can meddle with the fruitful execution
of a community wellbeing plan. Perhaps the most significant
obstacle for the vulnerable populace in this borough is the
geological area. Treatment for pressure ulcers incorporates
routine caregiver visits related to regular doses of medicine.
Inaccessibility of care means the patient will not receive
effective therapy. Availability to treatment centers is frequently
restricted; this is highlighted in rural regions. The four other
boroughs in NY have numerous therapy hospitals, yet
Manhattan has rare treatment offices accessible without
traveling.
The local problems are only one boundary. Financial difficulties
are likewise a boundary to the effective operation of a public
wellbeing program. Empowering nearby organizations,
communal associates, as well as regional and local
administration cooperates to make a plan that is useful to the
public will encourage the accomplishment of the program.
Accomplices can improve the accessibility of assets and can
bolster and perform central assignments (Efraim, 2010). The
lower payment level in rural areas than urban centers
contributes to a higher experienced poverty rate that directly
affects healthcare service delivery.
Conclusion
The higher prevalence of PU among the elderly population has
been contributed by the growing number of aging people, as
well as coexisting disabilities and comorbidities. Higher
immortality and mobilty during hospitalizations is required to
prevent this life-threatening ailment. Medical care sectors are
feeling the burden of skyrocketing expenses associated with PU
management. Awareness and knowledge with preventive
perspectives assume a significant function in the counteractive
action of PU. Proceeding with instruction with relatives,

5. caregivers, and the therapeutic staff are substantial mechanism
employed to counteract and manage PU.
References
Barnidge, E. K., Radvanyi, C., Duggan, K., Motton, F., Wiggs,
I., Baker, E. A., & Brownson, R. C. (2013). Understanding and
addressing barriers to implementation of environmental and
policy interventions to support physical activity and healthy
eating in rural communities. The Journal of Rural Health, 29(1),
97-105.
Efraim, J. A. U. L. (2010). Assessment and management of
pressure ulcers in the elderly. Drugs Aging, 27(4), 311-25.
Issel, L. M., & Wells, R. (2017). Health program planning and
evaluation. Jones & Bartlett Learning.
Jaul, E., & Menzel, J. (2014). Pressure ulcers in the elderly, as
a public health problem. Journal of General Practice.
Running head: General Community Characteristics
1
General Community Characteristics
2
Pressure Ulcers and the Vulnerable Elderly Population

6. General Community Characteristics
New York City has five predominantly recognized boroughs
demographically. Manhattan is amongst the most densely
populated city whereby it is a recognized district with historical
origin, culturally identified, economically stable and equipped
with different health care centers. Manhattan being a
coextensive district in NYC, it receives over 30 million visitors
per year, though most of the tourists hardly see away from the
“22.6 square miles (58.5 square km)” of Manhattan Island, the
smallest urban district. Manhattan is easily recognized by
residents and visitors since it is divided alluring 220 east-west
streets and 12 north-south avenues. It is overloaded with places
of enduring interests, cultural institutions and one of the world
largest skyscraper. Sachs (2016) states that other neighbouring
cities recognizes Manhattan as the primary borough hub for
business, center for administrative services, and a financial
center for metropolis and their origin of their renown. Inside
this considerable historic disparity, Manhattan is mainly made
out of neighborhoods that give tranquil sanctuaries to satisfied
occupants. No region of NY exhibits dynamism and
transformation as ultimately as Manhattan. Crowds enter it day

7. by day to look for their prosperities, and extra millions come to
wonder about their endeavors. It is Manhattan that they name an
"incredible place, yet I wouldn't have any desire to live there."
Demographic and Socioeconomic Characteristics
Manhattan is one of the highly densely populated district in
NYC, though smallest geographically. In the United States,
NYC is the leading county with highest population and the
leading densely populated region globally (Stanhope &
Lancaster, 2018). This facts is supported by the 2010 census
report that the district has the highest population compared to
other boroughs because it holds a populace of “1,585,873 living
in a land area of 22.96 square miles (59.5 km2), or 69,464
residents per square mile (26,924/km²)” (U.S. Census Bureau
QuickFacts). It is the wealthiest county that stabilize U.S
economy with a 2005 per capita income above $100,000.
Manhattan is the smallest in land area but the third –largest
populated borough in NYC.
United States has referred Manhattan as the center that does
well economically and culturally develop. NYC serves as the
monetary capital center for both NASDAQ as well as the New
York Stock Exchange, with an estimated GDP of over $1.2
trillion. Universities, museums, tourist’s attractions sites are
amongst the famous landmarks that distinguish Manhattan
community from other boroughs. United Nations Headquarters
are as well located in this borough. The city is described as a
metropolitan center where most of the government business are
conducted, businesses, simulation activities as well as where
national banks can be accessed.
Key Community Groups and Health Concerns
In Manhattan city, some people are more vulnerable than others.
Specifically, elderly and children are mostly affected since
according to U.S. Census Bureau QuickFacts 16.1% and 9% of
elderly and children respectively live in abject poverty. That is
why, in Mary Manning Walsh Nursing Home, they strive to
identify this portion to understand their level of vulnerability so
as to provide appropriate interventions. According to Stanhope

8. & Lancaster (2018), limited and uneven distribution of
resources in the community is the leading causes of subjecting
these populations to vulnerability. Aging population need
prompt intervention to alleviate life-threating effects like
developing depression which leads to pressure ulcers. The
hospital contends that, to increase resilience, the situation can
be reversed when accessible resources are allocated properly.
Poverty maybe as result of low income amongst the elderly,
which later contribute to their poor health like developing
pressure ulcers due to stress and also lack of accessing quality
healthcare system. As indicated from the county health
statistics, elderly population without insurance coverage in
Manhattan city is estimated as 10% which is higher than
Hampshire city which has an average of 10%. This is why;
Sachs (2016) argues that, Individuals at the two closures of the
age difference are frequently less ready to adjust to stressors
physiologically". Kids in poverty are likewise an extraordinary
concern of society. An investigation of Stanhope & Lancaster
(2018) expressed that the "rate of kid destitution is an
expanding function of the level of salary imbalance". Likewise,
"the higher is the pay disparity, the more prominent is the rate
of kid poverty.
Children are another vulnerable group predisposed to
malnourishment, underweight and poor health. Vulnerability
contributes to loss of lifespan work opportunities and shortfall
of quality education (Stanhope & Lancaster, 2018). Report from
county ranks states that compared to other neighbouring
borough; Manhattan carries a 36% of children in who are
eligible to get reduced-price lunch. Also, 3% consist of
uninsured children and 40% is the mortality. Generally, medical
attendants play significant roles in coordinating and connecting
vulnerable population with the accessible resources in the
community and different organizations. They can work with
others as well as offering health education in the public to
establish a wellbeing program. Most importantly, medical
attendants can impact enactment and health policies that

9. influence the susceptible populace.
References
U.S. Census Bureau QuickFacts: New York County (Manhattan
Borough), New York. Retrieved from:
https://www.census.gov/quickfacts/fact/map/newyorkcountyman
hattanboroughnewyork/INC110217
Sachs, J. D. (2016). High US child poverty: Explanations and
solutions. Academic pediatrics, 16(3), S8-S12.
Stanhope, M., & Lancaster, J. (2018). Foundations for
population health in Community/
public health nursing (5th edition). St. Louis, MO: Elsevier.
NUR 350 Module Five Health Education Activity Guidelines
and Rubric
Overview: To supplement your final project and your shared
experiences with peers in this course, you are asked to perform
eight hours of clinical practice
experience in the field. For this activity, you will first review
available data and demographics for your local area, then
choose a vulnerable population to assess,
diagnose their need, then plan, implement, and evaluate a health
education activity as a response to the need. Examples of a
qualifying health education activity

10. include a presentation on how to include physical activity into
daily life at a senior center, an interactive activity for school-
age children teaching them about
eating healthy, or a presentation to healthcare providers on
incorporating cultural competence into their practice.
Guidance will be provided in each module to keep you on track
with this activity, which follows the nursing process. Though
nothing is due until Module Five,
you are strongly encouraged to follow the recommended
timeline to avoid last-minute rushing to get things done.
Additionally, note that you must obtain permission (using the
Clinical Practice Experience Permission Letter) from the site
where you plan to complete your
activity prior to implementing it. Finally, students must also
submit the following completed evaluation form: NUR 350
Evaluation of Facility which they will
complete. Students will not be providing direct patient care.
Prompt: To complete this activity, ensure that you fill out the
provided worksheet (Health Education Activity Planner and
Log) completely for each critical
element. Each section should be one to two paragraphs in
length:
Assessment: In the Module One discussion, you will review
available data and choose a local vulnerable population as the
focus of the rest of this
activity. For this section, write a summary of your assessment
of the community where the activity is being presented.
Diagnosis: Identify the health needs of the chosen vulnerable
population. Include a NANDA community nursing diagnosis and
support with evidence.

11. Plan: Outline your plan for implementing a health education
activity that will meet the needs of your chosen vulnerable
population. This should include
the articulation of two SMART goals, and plans to evaluate the
achievement of these goals.
Implementation: Explain the implementation process for your
health education activity. You do not need to include the
planning steps again, but discuss
what you did and how you did it.
Evaluation: Evaluate the success of your health education
activity based on feedback from the audience. Do you think that
you achieved your SMART
goals? Why or why not? Support your evaluation with evidence.
Reflection: Look back on all the steps you have completed so
far (assessment through evaluation) and reflect on the strengths
and weaknesses of your
approach. Knowing what you know now, how could you
improve future health education opportunities?
Log of Hours: Ensure that you have completed eight hours of
clinical practice experience. You are encouraged to fill this log
out as you go, and it should
be an accurate depiction of how you spent your time preparing
for, implementing, and evaluating your health education
activity.
Rubric
Guidelines for Submission: You must complete all fields in the
provided Planner and Log worksheet. Each section should be
one to two paragraphs in length,

12. double-spaced.
https://learn.snhu.edu/d2l/lor/viewer/view.d2l?ou=6606&loIdent
Id=22803
https://learn.snhu.edu/d2l/lor/viewer/view.d2l?ou=6606&loIdent
Id=22804
https://learn.snhu.edu/d2l/lor/viewer/view.d2l?ou=6606&loIdent
Id=22805
Critical Elements Proficient (100%) Needs Improvement (70%)
Not Evident (0%) Value
Assessment Assesses a local vulnerable
population for its health needs
Assesses a local vulnerable population
for its health needs, but description is
unclear or has gaps
Does not assess a local vulnerable
population for its health needs
10
Diagnosis Develops a community nursing
diagnosis for the health needs of a
local vulnerable population and
supports choice with evidence
Develops a community nursing
diagnosis for the health needs of a
local vulnerable population, but
description contains insufficient detail

13. or lacks evidence
Does not develop a community
nursing diagnosis for the health needs
of a local vulnerable population
15
Plan Articulates the steps involved in the
planning process for the health
education activity and includes two
SMART goals
Briefly articulates the steps involved in
the planning process for the health
education activity, or a SMART goal is
missing
Does not articulate the steps involved
in the planning process or the SMART
goals associated with the health
education activity
20
Implementation Explains the implementation
process for the health education
activity
Explanation of the implementation
process is brief or lacks sufficient detail
Does not explain the implementation
process
20

14. Evaluation Evaluates the health education
activity for how it achieved the
articulated SMART goals
Briefly evaluates the health education
activity with respect to articulated
SMART goals, or fails to address one or
both of the SMART goals
Does not evaluate the health
education activity for how it achieved
the articulated SMART goals
15
Reflection Reflects on the process of
developing and implementing the
health education activity, and
provides sufficient detail on future
improvements
Briefly reflects on the process of
developing and implementing the
health education activity, with gaps in
explanation of future improvements
Does not reflect on the process of
developing and implementing the
health education activity
15
Log of Hours Logs hours Does not log hours 5
Total 100%

15. Module Five Health Education Activity Planner and Log
In each section below, write one to two paragraphs, double-
spaced. For full instructions, review the Module Five Health
Education Activity Guidelines and Rubric document.
Process Step
Explanation/Student Response
Assessment
Write a summary of your assessment of the community where
the activity is being presented (one to two paragraphs).
Diagnosis
Include a NANDA community nursing diagnosis (for example,
“Insert diagnosis related to as evidenced by . . .”). Then,
support your diagnosis and be sure to include evidence (one to
two paragraphs).
Plan
Share two SMART goals here. Then, discuss your plan to
achieve these two goals and how you will evaluate their
achievement (one to two paragraphs).
Implement
Discuss the process of implementing your health education
activity. You do not need to include the planning steps again,
but discuss what you did and how you did it (one to two
paragraphs).
Evaluate
Now that you have completed the educational activity, evaluate
the achievement of your two SMART goals. Be specific and
provide examples (one to two paragraphs).

16. Reflection
Look back on all the steps you have completed so far
(assessment through evaluation) and reflect on the strengths and
weaknesses of your approach. Knowing what you know now,
how could you improve future health education opportunities?
(One to two paragraphs)
Instructions: Fill out the time log below for each activity you
complete while working on your health education activity. This
includes time spent on each step of the nursing process. You
should plan to spend two hours assessing and diagnosing, three
hours planning, and one hour each implementing, evaluating,
and reflecting. Your log likely won’t be broken down into such
neat pieces, but we strongly encourage you to record the time as
you complete it. If you spend 1.5 hours planning one night, and
then another 1.5 hours planning another night, please record
them separately.
TIME LOG
Date
Hours
Activity
Where does this activity fit into the nursing process?
How does this activity connect to the course objectives?
Date
Hours
Activity

17. Where does this fit into the nursing process?
How does this activity connect to the course objectives?
Date
Hours
Activity
Where does this activity fit into the nursing process?
How does this activity connect to the course objectives?
Date
Hours
Activity
Where does this activity fit into the nursing process?
How does this activity connect to the course objectives?
Date
Hours
Activity
Where does this activity fit into the nursing process?
How does this activity connect to the course objectives?