Nursing Homework

Comprehensive Care Plan for the Aggregate in Homestead, Florida

Homestead is a City in Miami-Dade situated in the state of Florida that consists of typical and contemporary residential, commercial, and industrial areas, parks, and gardens, as well as a cosmopolitan community. As it is with most other areas within the United States, the Homestead community is a high-risk society with respect to health issues like heart disease and cancer. This care plan will outline these critical health threats as well as accompanying nursing diagnoses and interventions after conducting research in the available literature. Moreover, a disaster management plan is provided in terms of acute health crises pertaining to heart disease and cancer to help the community be ready for such disasters. The overall purpose is to incorporate selective nursing care and incident management for residents with these chronic and critical diseases.

Priority Nursing Diagnoses

1. Risk for Ineffective Health Maintenance Related to Cardiovascular Disease

Research on cardiovascular diseases (CVD) reveals them as a significant health problem within Miami-Dade County. Thus, CVD remains a major health issue that affects the local population irrespective of innovations in the sphere of medical care and organizing public health activities. As stated by Miami-Dade County (2022), the number one killer across the United States, as well as in Florida, is heart disease, which results in more deaths per year than any other reason. High blood pressure is one of the leading causes of cardiovascular diseases, stroke, kidney disease and other related ailments. These revelations highlight the importance of targeted early childhood care and medical prevention for cardiovascular health in Homestead.

Strategies

I. Implementation of a Heart-Healthy Diet Program.

Foods with less sodium and fats interlinked with foods that are rich in nutritional value have been associated with low risks of heart diseases. Teaching sessions for the residents and the healthcare staff about the need for dietary changes to minimize cardiovascular events will also be conducted. According to Diab et al. (2023) different diets and their effects on the cardiovascular system should be understood to contribute to coronary artery disease primary and secondary prevention. The dietary recommendations of the American Heart Association can help in the planning of meals and the promotion of the goal of healthy eating among people (American Heart Association, 2022).

II. Regular Physical Activity.

The presence of regular activities for the residents that involve moderate physical exercise can significantly improve cardiovascular health. A lot of exercises, including simple ones like walking, exercising while seated in a chair, and stretching, have been proven to enhance the heart's performance and general health. According to Pinckard et al. (2019), physical exercise results in a plethora of health benefits and is a crucial strategy to combat overweight and its complications, including cardiovascular diseases. Participation and progress will be recorded in the program in order to ensure that the activities can be modified according to the mobility level of participants.

2. Risk for Ineffective Health Maintenance Related to Cancer

Another risk that poses a potential threat to the residents of Miami-Dade County is cancer. Coupled with risk factors like tobacco use, minimal physical activity, alcohol intake, and poor access to preventive care services, this problem is worsened. Current research emphasizes the importance of screening and early intervention in managing cancer fatalities.

Strategies

I. Screening and Early Detection Program.

Cancer checkups such as mammography, colonoscopy, and skin examination are also important in early detection and intervention. If checkups are conducted regularly and follow the recommendations of the American Cancer Society, cancer mortality rates may be lowered.

II. Education and Awareness Campaigns.

Community education outreaches, which will encompass mainly issues related to cancer, will sensitize the community on the possible dangers and signs of cancer. Engagement of the community as a practical solution to decrease cancer disparities and increase fairness in access to healthcare (Kale et al., 2023). This involves issues to do with smoking, skin protection from the sun, as well as information about diets. It has been found that community-based education intervention programs can reduce cancer disparities and facilitate preventive measures. Awareness and preventive measures will be promoted through distributing educational materials extensively.

Disaster Management Plan

Homestead, Florida, is vulnerable to serious adverse health events pointing to heart diseases and cancers among residents. Therefore, creating an emergency management plan to deal with these conditions is essential. This shall outline the interventions to be made before, during and after a health crisis to improve the quality of care afforded to residents.

Strategies for Handling Health Disasters

1. Acute Myocardial Infarction (AMI) Surge

Preparation.

AEDs will be deployed in the community; personnel will be trained in the use of AEDs, BLS, and ACLS. Repetition in practice drills will guarantee preparedness for an appropriate response to emergencies involving the heart.

During the Disaster.

An action plan will be implemented when signs of a heart attack are noticed, which involves the calling of the healthcare response team and administering aspirin where necessary. Breathing patterns will be observed, and other treatments will be given as appropriate until the arrival of the emergency medical services (EMS).

Post-Disaster.

There are plans for the review of the disaster response and response effectiveness that will indicate the need for improvement. Those residents and staff who would have been emotionally traumatized by the occurrence of the incident will be provided with support services. These results will be significant in the revision of future training as well as the modification of protocols.

2. Cancer-Related Emergencies

Preparation.

Symptom-relieving drugs required in case of an emergency, for example, due to cancer pain, nausea or vomiting, will also be accessible. Care staff will be trained on how to recognize and handle possible complications of cancer, such as tumor lysis syndrome and infections resulting from a low white blood cell count. Specific guidelines shall be followed when calling for an ambulance when one is required.

During the Disaster.

In an emergent condition, there will be a guided procedure on how to handle the situation as it unfolds. Suitable medication and nursing intervention will be administered so as to bring the patient to a stable state.

Post-Disaster.

Evaluations will be conducted after disasters to study the effectiveness of the response and to improve it in the future. Any changes in emergency plans and further staff training will be performed as needed.

Disaster Supply Kit Recommendations

· Automated External Defibrillators (AEDs)

· Emergency medications for cardiac and oncological crises such as nitroglycerin, aspirin, pain medications, and antiemetics.

· Basic and advanced life support equipment such as oxygen, resuscitation bags, and intravenous supplies.

· Personal protective equipment (PPE)

· Emergency contact information for cardiologists and oncologists

· Documentation forms for emergency response

· Educational materials for residents and staff on recognizing symptoms of heart attacks and cancer emergencies

Conclusion

This particular health care intervention plan targets the leading causes of morbidity and mortality among the people of Homestead, Florida: heart diseases and cancers. Combining the objectives of preventive efforts and disaster preparedness, this plan is designed to improve the quality of life and safety for this population. These approaches should be reviewed from time to time to ensure they fit the needs of the community.

References

Community Strengths, CNAs' Challenges, and Health Risks

June 24, 2024

Community Strengths, CNAs' Challenges, and Health Risks

MM is a thirty-seven-year-old, female Cuban immigrant. She has been here for ten years and currently lives in a home owned by her bother who is a nurse. She is married to a mechanic and has two children both female, ages fourteen and 12. MM works full time (40 hours a week) as a CNA in a ALF. She previously worked at Walgreens before obtaining her CNA certification. She does not have any injuries but does suffer from lower back pain from time to time and is overweight. She has not changed jobs due to her back pain or any other injury. At her job, she is responsible for the resident’s ADLs, laundry, feedings, bathing and skin care. She takes vital signs and informs the resident’s nurses of their families if there are ever any medical issues. (Pfefferle & Weinberg 2008). At her job she is exposed to alcohols and cleaning products. She uses PPE such as gloves, gowns and face shields/masks when there are respiratory diseases in the ALF. Her work environment is typically clean and ventilated by a normal air conditioner system. Her lunch breaks are spent in the kitchen or in her vehicle. Her job requires a uniform (scrubs) which she washes at home. She washes her hands very often at work, such after any exposure to fluids, waste and always before and after any patient contact. She does not shower before leaving work. Her job does not expose her to any grinding, welding, soldering or polishing. At home she has a normal AC unit and an electric stove. Her home was built in the year 2014 and does not have any recent renovations. There no pesticides used in her home. MM enjoys hobbies such as drawing with her children, TV and music. There are no industrial plants, landfills, sources of air pollution, toxic spills or waste sites close to her home. Her drinking water comes from the tap/public source. MM’s family structure consists of herself, her husband, her two children and her brother. Her children are in middle school and high school. Her family would be considered lower to lower middle class. Their recreation activities consist of TV, drawing, visiting water parks, movies and they have been to Disney a few times. Both parents and MM’s brother are employed. Their home is in good condition and the family has each other for support as well as a church community and work friends.

This family communicates very well. The children are taught values such as honesty, hard work, studying to go to college. Both mother and father are a unified team with the father taking the lead in the family and the mother taking on a supporting role. The power in the family is balanced between them and as per MM, this works well for them. Their children are respectful and value good grades and respecting their elders. They as a family, believe in God and try to be good people with good values. The value honesty and hard work. There are no family conflicts. The children are well adjusted and the family is unified, with a desire to make each other happy. The children are valued within the family and are above all else, encouraged to study and go to college. The older child has a desire to be a nurse like her uncle. The family has a good understanding of health care as several members work in the health care system. MM is in charge of meal planning, shopping and cooking. Their overall physical activity could be better. They do not have many active hobbies. There are no drugs or smoking in the house. Dental health could also be better. Typically, they visit the dentist every 4 years or so. Vaccines are up to date for all family members. They have an overall healthy family history. There is diabetes on the mother’s side (grandmother) but not in any of the core family members discussed here. Both parents and children have health insurance and there are no active health problems to address.

Job related stress affects MM but not her husband. MM does not have a specific way to deal with her stress and until recently had not considered ways to alleviated it, instead she focuses on doing her best for her children. The children do stress about receiving good grades as they both plan to go to college. They cope by interacting with their peers and by working at their hobbies. In the past, MM’s husband used to smoke. He has since quit (six years ago).

JR is a thirty-six-year-old female Cuban immigrant. She has been here for twelve years. Her husband is a boat repair man and also installs panels. They have one child together, male aged eleven. They have been here for twelve years. JR works full time (40 hours a week) at an ALF as a CNA. Before working in this ALF, JR used to be a private duty for an elderly woman. JR has pain in her right wrist that sometimes requires the use of a brace due to her profession. She is otherwise in good physical health. She has not changed jobs due to this injury. As a CAN she is responsible for ADL’s of the residents, feeding them, bathing them, doing their laundry and skin care. She takes vital signs daily and informs the appropriate parties if there are any health concerns. (Pfefferle & Weinberg 2008). As a CAN, she is exposed to alcohols and cleaning products. She uses PPE such as gloves and gowns. Special equipment such as face shields/masks are also used when there are respiratory diseases in the ALF. Her work environment is typically clean and ventilated by a normal air conditioner system. JR prefers to spend her lunch breaks in the backyard of the ALF. She is required to use scrubs at work, which she washes at home. She washes her hands very often at work, always before and after any patient contact, or after exposure to any fluid/waste. She does not shower before leaving work. Her job does not expose her to any grinding, welding, soldering or polishing. Her home is ventilated by a normal AC unit. JR and her family rent a small two-bedroom apartment. She is not sure when it was built but it is in good condition. JR enjoys watching movies at home with her husband. She also enjoys cooking. There no pesticides used in her home. There are no industrial plants, landfills, toxic spills, sources of air pollution, or waste sites close to her home. Her drinking water comes from the tap/public source. JR’s family structure includes herself, her husband and her child. Her son is in middle school. This family would be considered lower to low middle class. Their recreation activities consist of TV, social media, and going to the movies. Both parents are employed. Their home is rented but in good condition. The family is very close and has each other for support as well as neighbors and work friends.

The family is small and they communicate well. The power is balanced between them with both of them taking equal part in decisions. Their child is mild mannered and well adjusted. He values his friends and his parents. He doesn’t like school very much and wants to be a tradesman like his dad. The family is not very religious but they do believe in God and strive to be good, honest people. Both JR and her husband value their child above all else and want another one in the near future. The family has a fair understanding of health care. JR is in charge of meal planning, shopping and cooking. She enjoys cooking not only for her family but also as a hobby. Their overall physical activity is good and they are all in good physical health. There are no drugs or smoking in the house. Dental health is good. The parents make sure that the child goes to the dentist at least once a year. Vaccines are up to date for all family members, although they are skeptical regarding the Covid vaccine. JR thinks this vaccine was developed to quickly. They have an overall healthy family history. Both parents and the child have health insurance and there are no active health problems to address. Job related stress affects both parents. JR works a very demanding job and her husband worries when there isn’t steady work. JR does not have many ways to cope with her stress but will hopefully acquire them through this project. Their child does not worry about school much and isn’t stressed by it. There have been no maladaptive ways to cope with stress in this family.

The environment, home and family in both cases were assessed through self-reports/interviews. The main participants of this study (the CNAs) face significant risks due to their jobs. These include physical strain from lifting and caring for residents, exposure to infections due to close contact with patients, and emotional stress from forming close bonds with residents and their families. There are also safety concerns for these participants. They include environmental hazards in diverse neighborhood conditions to potential aggression from residents. Limited training opportunities, cultural and language barriers, and resource constraints, especially to manage stress. These risks are difficult to address and ongoing training and safety measures are needed to ensure mental well-being and quality care provision and workplace safety. (Walton, A. L., & Rogers, B. 2017).

As gathered previously during this course long project and through the windshield survey, we know that Homestead Florida has diverse housing options, a large immigrant population, and proximity to metropolitan facilities. (Data USA n.d). For the chosen members of this study, these strengths are important, especially as immigrants themselves. Weaknesses include socioeconomic disparities and safety concerns across different neighborhoods. The Certified nursing assistants in the local ALF bring strengths as employees and community members. The have experience in healthcare, cultural competence, and a strong commitment to community care. They face challenges including workplace hazards like physical strain and emotional stress, and health risks such as infections. They need support from their employers to overcome these issues. They need support systems, better training, and implementing effective safety measures.

References

Pfefferle, S. G., & Weinberg, D. B. (2008). Certified nurse assistants making meaning of direct care.  Qualitative health research,  18(7), 952–961. https://doi.org/10.1177/1049732308318031

Working with the public can be a draining and stressful experience. Anticipating the needs and wants of others can not only be difficult, sometimes it is impossible. Working with a sick and physically dependent population, such as residents of an Assisted Living Facility, adds and extra hurdle to this task. Care takers not only have to cater to individuals, but also work under the constrains and policies of the health care system.

To explore this topic, the focus will be placed on the experiences of three certified nursing assistants. These women are all over thirty-five years of age, they are all first generation immigrants and they are married with children. They work in an Assistive Living Facility where the residents are all physically or mentally impaired. The workers perform tasks of daily living for the residents such as bathing and feeding them. They are also tasked with informing nurses and families of any significant changes in the patient’s conditions and addressing those changes whenever possible and appropriate.

The facility where our aggregate is located resides in Homestead, Florida. This is a city located in Miami-Dade County in the southeastern part of the state. It is about 35 miles southwest of Miami and is considered part of the Greater Miami area. The city has a total area of approximately 15.3 square miles, according to the United States Census Bureau. The population of Homestead is approximately 82,614 people, according to the last available census data in 2024. The city was incorporated in 1913, and developed as an agricultural community, with farming being a major economic activity. The city continued to grow rapidly in the early 20th century with the extension of the Florida East Coast Railway in this area. (…………….)

According to Data USA (n.d), “78.8% of the population of Homestead, FL has health coverage, with 31.7% on employee plans, 28.1% on Medicaid, 4.22% on Medicare, 13.3% on non-group plans, and 1.46% on military or VA plans”. According to FloridaHealthCharts.gov, “In 2022, in Miami-Dade County, the rate per 1,000 live births of Infant Mortality (Aged 0-364 Days) (All) was 5.9 compared to Florida at 6.0.” The leading causes of death in Miami Dade County are similar to the rest of the country. They are namely heart disease, (including coronary artery disease, heart attacks and other cardiovascular diseases), cancer, respiratory diseases and accidents (including motor vehicle accidents and falls). The life expectancy in Miami Dade as of 2020, was around 78.8 years.(………………………………)

I chose this aggregate because I have lived in some part of this city through my entire adult life and I have worked in health care for the last eight years. This is my city and these are my people. I have moved more south as the years have passed and as such, I have seen that even a short distance has a huge impact in the population. I do not plan to leave this community any time soon and as such, I want to explore the reasons behind that impact as well as ways to improve my community.

While driving around my chosen aggregate community, I have been able to observe much. The homes are quite a mix. In some parts they are brand new communities of mostly two story townhomes. It is not uncommon to drive only a few minutes away from such communities and find a block of section 8 housing. There are also areas filled with large, older family homes with large backyards and even pools. It is quite a mixed area. These places are not far away from each other at all. It sometimes only takes a short five to ten minute drive to see a totally different area made up of older or newer homes. The same applies to parks and public spaces. While some are new, big and right by a shopping center, others are small and unkempt, next to woods or desolated areas. The community areas closer to popular shipping or eating areas tend to be clean and in shape. Others are less well kept but not exactly dirty. The area where the windshield survey took place, even those less well kept are still mostly clean.

References