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Health Indicators

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Taylor Spears

on 16 January 2015

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Transcript of Health Indicators

As a citizen of the larger community, the emphasis of [University of Louisville's] School of Nursing is to address the complex health needs of diverse and dynamic populations through nursing education, research, scholarship, and service.
UofL School of Nursing
"The purpose of the Wayside Christian Mission is to respond to human need of the poor and homeless by (1) providing temporary housing/shelter, food, clothing, nurturing, spiritual and social enrichment, encouragement and referrals (2) and by providing the support services and skills that would permit and encourage a return to a state of self-sufficiency so that human diginity can be restored and the love of God can be shared."
Wayside Christian Mission
Mission Statement Comparison
Homeless Population in Louisville, KY
Wayside Christian Mission
Five Leading Causes of Mortality and Morbidity
United States (cdc.gov)
Heart disease
Chronic lower respiratory diseases
Unintentional injuries
Kentucky (chfs.ky.gov)
Heart disease
Chronic lower respiratory disease
Unintentional injuries
Louisivlle Metro (louisvilleky.gov)
Heart disease
Chronic lower respiratory disease
Unintentional injuries
Wayside Christian Mission
Census Data (census.gov)
Below poverty level:

Wayside's Neighborhood
Wayside is located at 432 E Jefferson St., Louisville, KY 40202
It is located at the corner of Jefferson and Jackson
Currently, Wayside is under construction, causing the area to look run down.
Wayside is in the heart of an established urban and commercial neighborhood. It is located in Downtown Louisville, an area where there are plenty of people, sidewalks, red lights, and places to go. There are playgrounds on site, open space, and parks nearby for recreation and exercise.
Jefferson County Metropolitan Sewage District (MSD)

(MSD, 2013)

MSD Vision:
Putting our customers first:
• Clean water
• Green environment
• Growing Community

MSD Mission:
We, at MSD, build, maintain and operate quality waste water and storm water facilities for the people of our community.

MSD Core Values:

: We will be fair and honest.

: We will be accountable for our resources and the well-being of the environment.

: We will be responsive, reliable and adaptable in meeting the needs of our customers and the community.

: We will be dedicated to continuous improvement through teamwork, innovation, and the use of technology.
Food Access

(Louisville Metro Government, 2013)
In Louisville, the consumer demand for food is about $3 billion a year.
As national trends show an increase in diet-related disease and illnesses such as type II diabetes, heart disease and obesity, many of these same health problems plague our community.
•In West Louisville, an area considered one of Louisville’s “food deserts,” 37% of residents report having high blood pressure, 74% report being overweight or obese, and 12% report having diabetes.

Air Quailty
(American Lung Association, 2013)
#12 on list of US cities with worst air pollution
surrounded by hills that can hold dirty air hostage

Water Source & Quality
(Louisville Metro Government)
Ohio River is the source
Won award in 2008 for Best Tasting Tap Water from American Water Works Association
(Louisville Cardinal Newspaper, 2013)
All substance traces found within water is in compliance with Environmental Protection Agency (EPA) guidelines and standards

Garbage Collection
Once a week on Monday-Friday basis including Holidays

“Person down” & theft are main received calls in 40202 zip code
Fire responds alongside Police for calls

Nurse Triage for non-life threatening calls
Ask about insurance to decide where to send patient
First Stop Urgent Care
Frequent callers are periodically checked on and receive medications and treatment services free
Not a 24 hours system (not enough nurses)

Labor force 35.3%
-> employed 33%
-> unemployed 2.3%
Not in labor force 64.7%

Age Ranges
5-24 yrs 22.9%
25-49 yrs 51.4%
50-85+ yrs 25.7%
Male: 63.9%
Female: 36.1%
White 39.3%
Black 54.7%
Other 6%
Owner-occupied housing 6.9%
Renter-occupied housing 93.1%
Avg income
Education level
<9th grade 4.7%
9-12, no diploma 15.8%
HS graduate or higher 79.5%
Bachelors degree or higher 20.6%

Pre-schools/ early childhood education
o 15 in 40202

o 4 in 40202
o Ahrens, Ackerly/Bingham, Brown

Private/ religious schools
o 2 in 40202
o St. Francis, Nativity Academy at Saint Boniface

Test Scores for Brown:
•Vocational training/ Online trade schools/ Certification Programs
o 38 Online
o 5 Vocational in 40202
Colleges/ Universities
o 3 in 40202
o U of L, JCTC, Galen
o 7 Online
Clinical Instructor:

Karen Singleton
Ashley Raney, Charles Melton, Celeste Kute, Venessa Evans, Christina Bennett;
: Alex Cogdell, Whitney Adams, Taylor Spears, Courtney Willis, and Brittany Lilly .
(Google, 2013)
(Google, 2013)
(Wayside Christian Mission, 2013)
(ULSN, 2013)
United States

1. Congestive Heart Failure
2. Coronary Heart Disease
3. Osteoarthritis
4. Chronic Obstructive Pulmonary Disease
5. Mental Disorders (excluding Dementia)
(Kentucky health facts, 2013)
1. Asthma- 14,900 per 100,000 people
2. Heart Disease-6,000 per 100,000 people
3. Cancer-559 per 100,000 people
4. Stroke-48 per 100,000 people
5. Diabetes: 35 per 100,000 people


(Kentucky health facts, 2013)
1. Asthma- 14,900 per 100,000 people
2. Heart Disease-6,000 per 100,000 people
3. Cancer-559 per 100,000 people
4. Stroke-48 per 100,000 people
5. Diabetes: 35 per 100,000 people

Louisville Metro

1. Asthma: 15,000 per 100,000.
2. Heart Disease: 4,700 per 100,000.
3. Cancers: 580 per 100,000.
4. Stroke/Cerebrovascular Diseases: 67 per 100,000 people.
5. Diabetes: 35 per 100,000.

General Resources
Churches, mosques, and cultural centers
Twenty churches
One mosque
Islamic cultural center, Asia Institute Crane House, and Kentucky Center for African American Heritage
Stores, groceries, gas stations
Kroger, Walgreens, and CVS
Candy store
Thorton’s, Big K, BP

Services- law, taxes, housing, etc.
 Legal Aid Society Inc.
 The Center for Women and Families
 House of Ruth, Choices Inc.
 St. John Center for Homeless men
 Wellspring
 House of Hope Kentucky Inc.
 New Directions Housing Corporation

Wayside vans

Social & community services/centers
Baxter community center
Health Resources
School Health Nursing:
JCPS: recommended student-school nurse ratio is 750:1. Current ratio of students to one nurse is 3800:1 (as of June 2011)
(Winsch, 2011).
Occupational Health Services:
Family Health Centers: occupational medicine program available to clients
Employees of all major hospital networks have access to in-house
occupational therapy and services as desired
(Louisville Metro Health, 2013)
Hospitals Frequented by Target Population:
University of Louisville Hospital
Norton Hospital
Jewish Hospital
Louisville VA Medical Center
For General Healthcare and Wellness:
FHC- Portland
Park DuValle Community Health Center
Phoenix Health Center for the Homeless*
Urgent Care Centers:

Lots in Louisville! However, the majority of the homeless population goes to the emergency departments instead
Speciality Clinics
-Wings Clinic (HIV and AIDS patients)
-TB Clinic
-JADAC- Jefferson Alcohol and Drug Abuse Center
(Louisville Metro Health, 2013)
Health Problems
Transportation for emergent health need.
Health Education on:
-Hypertension (HTN)
-Consequences of untreated HTN
Utilization of Resources

Nursing Diagnoses
Risk for injury r/t lack of transportation during emergent health needs.
Deficient knowledge r/t HTN AEB noncompliance with medications and uncontrolled HTN.
Ineffective health maintenance r/t lack of familiarity with neighborhood resources AEB history of lack of health seeking behaviors.

Health Education on Hypertension
Healthy People 2020
o HDS-12 tracks the proportion of adults with hypertension whose blood pressure is under control (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg). HP2020 Baseline: In 2005-08, 43.7% of adults aged 18 years and older with hypertension had it under control (age adjusted). HP2020 Target: 61.2%, a 40 percent improvement over the baseline.
(Clinical Preventive Services, 2013)
• Healthy Kentuckians 2010
o 20.3. To decrease to at least 20 percent the proportion of adult Kentuckians with high blood pressure. Baseline 1997: 27 percent of Kentuckians have been informed that their blood pressure is high, are on blood pressure medicine, or have indicated their blood pressure is high.
o Analyze screening rates by region, as well as by sex and race, to better target opportunities for improvement.
o Target populations with lowest percentages being tested for intervention through education and increased availability of testing.
o Partner with public and private, for-profit and non-profit related organizations to increase availability of blood cholesterol screening.
(Heart Disease and Stroke, 2005)

Healthy People 2020
o AHS-8 (Developmental) Increase the proportion of persons who have access to rapidly responding prehospital emergency medical services
(Access to Health Services, 2013)
Healthy Kentuckians 2010
o 10.13. (Developmental) Increase the proportion of all individuals who have access to rapidly responding pre-hospital EMS.
(Healthy Kentuckians 2010, 2005)
Utilization of Resources

Healthy People 2020
o Increase the quality, availability, and effectiveness of educational and community-based programs designed to prevent disease and injury, improve health, and enhance quality of life.
(Healthy People 2020, 2013)
Healthy Kentuckians 2010
o Increase by 65 percent the percent of health care organizations that provide patient and family education.
(Healthy People 2010 Kentucky, 2005)
Healthy People 2020 and Healthy Kentuckians 2010 Objectives
: Available EMS responders in area, understanding of how to contact EMS, and efficient EMS. High cost, lack of availability, lack of insurance coverage, inconvenience, and timing.
Education on Hypertension
: Access to healthcare and medications, smoking, diet, and exercise.
Utilization of Resources
: Changing aspects of the physical or organizational infrastructure; changing community attitudes, beliefs, social norms.
Also, lack of funds, lack of health care professionals, and lack of transportation
Factors that have an impact on meeting these objectives:
a. Short-term goal: By the end of our teaching session, the client will verbalize the appropriate time to call 911.
b. Long-term goal: Thirty days after the teaching session, 50% of clients will have forwarded emergent situations to 911.
a. Short-term goal: By the end of the teaching session 75% of clients will restate 2/4 given ways to control HTN.
b. Long-term goal: Thirty days after the teaching session, 50% of the clients will have implemented 2/4 given ways to control HTN.
a. Short-term goal: By the end of the teaching session, the client will identify 1/3 local health resources and how to access it.
b. Long-term goal: Thirty days after teaching session, 25% of clients will have scheduled an appointment to visit their designated healthcare facility.

Health problem selected for intervention:
Deficient knowledge r/t HTN aeb noncompliance with medications and uncontrolled HTN.
Acuity, severity, or priority of problem:
High priority due to large prevalence of cases in the aggregate population. The severity of uncontrolled HTN, and incidence of extreme emergent HTN.
Scope of problem:
30% of adults in Kentucky have high blood pressure
(Division for heart, 2007)
Available resources:
Skills to screen, Finances for handouts, Knowledge of HTN and risks r/t, Time to conduct intervention/evaluation
: Men and Women of Wayside
: Screening for HTN and Educating on HTN
: 11-21-13
: Wayside Christian Mission, Louisville, KY
: Screening of Blood Pressures, and education of 4 ways to control HTN.
a. Specific group, aggregate or population: Men and women residents/visitors of Wayside Christian Mission.
b. Time frame (date, length of time spent, single/multiple contacts): One session, on 11-21-13, one contact.
c. Location of intervention: Wayside Christian Mission, Louisville, KY
d. Contents of health education programs
• Four ways to control HTN
o Medications
o Decreased Sodium
o Smoking Cessation
o Increased Exercise
• Proper screening and identification of HTN (knowledge of the parameters of Pre-HTN and HTN)
e. Specific activities: Screening of blood pressures, Client education on HTN
f. Resources and materials used: handouts and posters on smoking cessation, signs and symptoms of stroke and heart attack, etc.
g. Ongoing benefits: Improved lifespan, decreased CVD, MI, CVA, PVD

• The intervention is primary, secondary, and tertiary.
Short-Term Goal:
-At least 80% able to restate 2/4 given ways to reduce HTN
-39 clients screened
-16 clients were educated
-15 out of 16 clients (94%) were able to restate 2/4 given ways to reduce HTN

Long-Term Goal:
-Anticipate that 50% or more of those screened would have implemented at least 2/4 given ways to control their HTN
-If goal was not met:
1. Have more resources to hand out pertaining to medication habits
2. Have more ways to decrease sodium

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Description of Intervention:
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