Community Va Paper PDF

5/3/2019 Community Paper - Google Docs
Running Head: Community Assessment: VA Northport

Adelphi College of Nursing and Public Health
Community Assessment of VA Northport, New York
Ari Clara
Luisa Cortes
Volha Palitava
Gagandeep Singh
Nicole Hartcorn
Juanita Razak

https://docs.google.com/document/d/1ashYUNUddyjConb1WBEWFhCVsWeOdNPIbiXHex-soPA/edit 1/55
Community Assessment: VA Northport
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Table of Contents
Description of the Community (Luisa Cortes and Ari Clara) ………………………………………. 36
Morbidity and Mortality (Juanita Razak)............................................................................................. 79
Demographics (Nicole Hartcorn)......................................................................................................... 914
Environmental Concerns (Ari Clara, Luisa Cortes)............................................................................ 1416
Public Services (Gagandeep Singh).................................................................................................... 1619
Aesthetics (Volha Palitava)................................................................................................................. 1921
Health Related Facilities (Volha Palitava)......................................................................................... 2123
Care Management Techniques……………………………………………………………………… 2330
Availability of Resources (Gagandeep Singh)..................................................................... 2325
Community Wants and Needs (Juanita Razak).................................................................... 2526
Types of Care (Volha Palitava)............................................................................................. 2627
Standards of Care (Gagandeep Singh)................................................................................. 2729
Interdisciplinary Plan of Care (Nico le Hartcorn)................................................................. 2930
Influences of Resource Allocation Decisions……………………………………………………… 3038
Allocation of Resources (Luisa Cortes).............................................................................. 30
Values and Beliefs (Luisa Cortes)...................................................................................... 3033
Special Interests (Ari Clara).............................................................................................. 3336
Healthcare Insurance Coverage (Ari Clara)...................................................................... 36
Consumer in Healthcare (Juanita Razak).......................................................................... 3637
Healthcare Providers Education (Nicole Hartcorn)........................................................... 3738
Voice of the Community (Group paragraph)................................................................................. 3839
Nursing Diagnosis (Name after diagnosis)................................................................................... 3941
Evaluation (Name after paragraph)............................................................................................... 4144
Teaching Plan……………………………………………………………………………………. 44
References………………………………………………………………………………………. 4546
Appendix A……………………………………………………………………………………... 4647
Appendix B……………………………………………………………………………………...4755

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Description of the Community
The Village of Northport has a population of 7,433 as of July 1, 2018. According to the
NYHomeTownLocator.com, the primary boundaries of the community of Northport include the
following coordinate points latitude 40.904 and longitude 73.345 in Suffolk County. The formal
boundaries for the Village of Northport include a land area of 2.31 sq. miles and a water area of
0.22 sq. miles. Suffolk County is in the Eastern time zone (GMT 5). The elevation is 59 feet.
The Village of Northport is located within Town of Huntington, a minor civil division (MCD) of
Suffolk County.
Northport is a small town with a lot of charm, a waterfront village in the town of
Huntington in Suffolk County. On the main street are located the library, shops, restaurants, and
wellness health facilities that offer yoga and Pilates, as well as at least 7 art galleries, doctors’
offices and dentists’ offices. The town maintains some of the 19th century charm in its buildings’
architecture, and the waterfront parks are one of the main attractions for families. Also,
according to one of the towns persons interviewed, dog ownership is common and valued: the
town stores and restaurants allow the dogs to go into the shops and restaurants. The town has an
old oldfashioned ice cream parlor and a lot of art galleries. “Compared to the rest of the Island
everyone seems to know each other as one shopkeeper shared, they have lived there for a long
time, and it appears that they live in a bubble; a lot of things might go wrong around the world,
but there everyone is happy and are just okay in that town”. Another Northporter who worked in
another antique shop said that she has been living and working there for 37 years and that she has
seen some change over the years. She said that it used to be even more smalltown oriented: they
used to have a butcher, a shoemaker, a bakery, a local doctor, etc. Also, she stated that even

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though the town has a lot of small businesses it is much more commercialized than 30 years ago.
One of the things that the same shopkeeper mentioned was that the community was very diverse;
however other locals did not agree with that statement, that the population was very diverse.
From my perspective, the population was predominantly white. The local shops such as beauty
parlor, barber shops, and restaurants get their usual customers every day. Some customers visit
restaurants and coffee shops every day. One of the local workers at the antique store at 192 Main
Street said that there are a lot of activities and concerts that happen during the weekends and
summer. The people are amicable and are willing to share information with us. One local older
man pulled us into a beauty parlor to talk to his mom who happened to be an Adelphi 1944
graduate. The older lady has lived there all her life; her son has lived there all his life. The lady at
the beauty parlor and former Adelphi graduate mentioned that the town is very safe. Parents from
that neighborhood let their kids play in their front yard, and they don’t even lock their doors
during the day.
On the other hand, the VA Northport Community is much more sheltered to the
parameters of the hospital even though it is within the town of Northport. The veteran
community is a big family and although they come from different cultural backgrounds and
different towns, they share the similar experience of serving our country. The hospital embraces,
recognizes, and warmly welcomes all veterans to the hospital.
The main entrance of the hospital has a beautiful golf course open to the veterans and the local
community for a nominal fee. For selfcontainment purposes the hospital itself has many
buildings that are connected by a tunnel system. Each building is designated for different
healthcare needs and support: a barbershop, a cafe, a cafeteria, a gym, resources office, etc. In

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addition, the VA Northport hospital offers different rest areas that embrace distinct monuments in
honor of veterans’ accomplishments and memorable times in the history of the United States.
The Veteran community has many health problems that encompass the whole health spectrum,
from psychological, sociological, and physiological as an outcome but not limited to their
military service and therefore they are at many health risks. (A. C., L.C.)

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Patterns of Morbidity and Mortality

The focus here is the Outpatient Mental Health clinic, mainly the Partial Hospitalization
Program(PHP)at the Northport VA. The leading causes of Morbidity in the VA are; Post
Traumatic Stress Disorder, Substance and Alcohol Abuse. Morbidity.
Within in the VA system of Northport, the focus of the Partial Hospitalization
Program(PHP)is the treatment of the morbidity of Substance abuse and Alcohol abuse among
the veterans, that I observe are substance and alcohol abuse amongst the Veterans’.This treatment
I observed as I attend group meeting in the program. The Veterans are seeking care because they
want to get sober and clean for themselves and also their families. They come to groups because
they have the support of other veterans and the interdisciplinary staff at the VA. In groups, they
real help each other to overcome their addictions by sharing advice and strategies that they used
and help them. The veterans themselves have sustained a greater amount of Post Traumatic
Stress Disorder PTSD that the civilian population do not have any unusual illness or death within
the VA. The morbidity that is most common in the PHP is overdosing from drugs and alcohol .
There are no records or statistics to give specific information concerning the veterans regarding
morbidity and mortality on substance abuse and alcohol abuse here at the Northport VA. The
data for Northport morbidity and mortality is suppressed on community common website,
because the population of the community is so small that the morbidity and mortality ratio is not
significant to the population.
In the county of Suffolk the Morbidity and mortality that will be focused upon in this
paper are drug poisoning , drug overdose ,premature death and unintentional injury. The
information that is from 2003 2014. The unusual pattern of illness and death in the Suffolk

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county is drugs overdose that result in death. According to community commons it seems as if
premature death is more prevalence morbidity that the county is witness. The other morbidities
that are seen in the county are Obesity, Heart diseases , cancer , etc.
Mortality Premature Death
Report Total Total Total Years of Years of Potential Life Lost,
Area Population Premature Potential Life

Rate per 100,000 Population
Death, Lost,
20142016 20142016
Average
*New Suppressed Suppressed Suppressed Suppressed
York
11768
Suffolk 97,314 14,354 5,220 5,364
County,
NY
New York 55,344,718 186,651 3,320,650 6,000
United 896,379,917 3,642,755 64,739,406 7,222
States

This indicator reports Years of Potential Life Lost (YPLL) before age 75 per 100,000
population for all causes of death, ageadjusted to the 2000 standard. YPLL measures premature

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death and is calculated by subtracting the age of death from the 75year benchmark. This
indicator is relevant because a measure of premature death can provide a unique and
comprehensive look at overall health status.
Note: This indicator is compared to the state average .* According to Community Commons, the reason why
Northport(11768) data is suppressed is that there isn’t a significant amount to death related to the population.
The above graph indicated the premature death related to mostly substance and alcohol
abuse and other death not related to sickness and diseases. ( Community commons, October
12,2018)
In Suffolk County, deaths involving opiates have risen by 30% in the period between
20072011. The incidence of one opiate in particular, oxycodone (which appears in 33% of
opioid related deaths), nearly doubled between 2007 and 2011.(Community Health Assessment
20142017. Retrieved 10/23/2018. http://www.suffolkcountyny.gov From the most recently
available data, there were 11,336 deaths in Suffolk County in 2011. The leading causes of death
were heart disease (3,248 deaths; ageadjusted rate of 187 per 100,000), cancer (2,776 deaths;
ageadjusted rate of 162 per 100,000), unintentional injuries (642 deaths,) (Community Health
Assessment 20142017). (J.R.)
Demographics

In regards to demographics the Northport VA does not track their individual
demographics. The national government does track demographics such as age, gender, period of
service, education level and household income for every state and compares those numbers to
those of the national demographics. There are 806,827 veterans in New York state compared to
20,392,192 veterans across the nation (va.gov/vetdata, 2018). New York has 384,843 veterans

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enrolled in the VA healthcare system, in comparison to 8,873,885 veterans enrolled nationally
(va.gov/vetdata, 2018). The site also tracks and predicts the population changes that have or may
occur in the coming years.
Gender
In the VA healthcare system in New York state there are 58,688 female veterans which
make up 7.27% of the population. Nationally there are 1,860,516 female veterans and they
represent 9.12% of all the veterans nationally (va.gov/vetdata, 2018). As for male veterans there
are 748,139 male veterans in the New York area as well as nationally there are 18,531,676 male
veterans. (va.gov/vetdata, 2018). As seen by the data the majority of the veteran population
receiving treatment in VA healthcare systems are male (Refer to picture above this paragraph for
the gender distribution numbers).
Age
The distribution of age among veterans ranges from 18 years of age to 65 years of age
and older. The largest percent of veterans in the United States are ages 65 years and older. In
New York state the number of veterans ages 65 years and older is 422,254 as compared to the

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national number of 9,560,748 (va.gov/vetdata, 2018). Veterans age 65 years and older make up
52.34% of the totally populations of veterans in New York as compared to 46.88% nationally
(va.gov/vetdata, 2018). This data shows that New York has a higher percent of veterans 65 years
or older than the national average. Veterans 5564 years of age, 4545 years of age, and 3044
years of age each makeup less than 20% of the population. The smallest percent of the
population in composed of veterans 1829 years of age, who make up less than 10%
(va.gov/vetdata, 2018).
Refer to this picture for all data regarding age, periods of service, household income and
education attainment
Periods of Service
The largest number of veterans in New York state and national have served in the
Vietnam Era. In New York state about 33% of the veteran population served in the Vietnam era
as compared to around 35% nationally (va.gov/vetdata, 2018). Peacetime only service accounts
for the next largest percent of veterans with making up 27% of New York’s veterans population

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and 25% of the national veterans population (va.gov/vetdata, 2018). Service from the Korean
War, World War II, Gulf War I, and Gulf War II all represent less than 20% of the population in
New York state as well as nationally (Refer to picture above for all data regarding period of
service).
Educational Attainment
Many veterans in New York as well as nationally have received some varying degree of
further education. More than 20% of veterans nationally as well as in New York alone have
received a bachelor's degree or higher, as well as at least 8% of veterans are enrolled in higher
education (va.gov/vetdata, 2018). When it comes to furthering education the government,
through the GI provides a predetermined amount of money to veterans to cover the cost for their
education for four years (Refer to the image above for all data regarding educational attainment).
The GI Bill provides not time limit in which veterans must use the funding if the where
discharged before January 1st, 2013 (Howell, 2017). If veterans were discharged after January
1st, 2013 they have 15 years from their date of discharge to access the funding from the GI Bill
(Howell, 2017).
Household Income
The largest percent of veterans in both New York state and nation wide is from 50k to
99.9k with more than 30% of veterans reporting those number as their household income
(va.gov/vetdata, 2018). More than 20% of veterans report that their household incomes are
anywhere between 100k199.9k and 25k49.9k (va.gov/vetdata, 2018). The numbers that are
reported for New York state and nationwide are very close to each which shows that New York

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has the same average numbers as nationwide when it comes to household income (Refer to the
image under the paragraph regarding age for all date regarding household income).
Future Trends
The VA website also tracks trends that can occur in the next ten years. Some of the trends
they track are veterans population, age, gender, period of service, and race. The U.S. Department
of Veterans predicts that in the year 2045 the totally veterans population in New York state will
decrease from 838,000 to 317,000 which is and overall annual percent change of 3.19%. It is
estimated that the veterans population nationally will decrease for 20.8 million to 12 million
which is an annual percent decrease of 1.8% (va.gov/vetdata, 2018). It is also predicted that the
number of veterans over the age of 65 will decrease from 440,729 to 299,844 (va.gov/vetdata,
2018). In 2025 it is predicted that the number of gulf war veterans will increase as the number of
veterans from every other period of service decrease (va.gov/vetdata, 2018). Lastly from the year
2015 t0 2020 there will be an increase in the number of female veterans but by the year 2025 that
number will decrease again (va.gov/vetdata, 2018). (N.H.)

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This Chart show the future trends predicted by the U.S. Department of Veterans Affairs
Environmental Concerns

The community of Northport is a town that has a 19thcentury charm, with waterfront
parks, a dock that brings tranquility and peace, and beautiful vintage shops full of wonders. The
buildings have a European style ; they represent the history and culture of the town. The dining
places and town shops are not up to date with handicap modifications, nor they have their
sidewalks restored or straight, which perhaps can be a risk for fall for the older population. The
streets still maintain old train tracks, and they have limited parking spots. In addition the town is
prone to flooding which can contribute to a health disparity. Northport branches off from 25A, on
Main Street run downhill to the downtown and harbor. The Northport VA Medical Center and its
ninehole Northport Golf Course are south of 25A. On the weekends and in the summer, boats
pull up to the public dock; on Saturday mornings from June through mid November a weekly

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farmer’s market is held. On the contrary the VA Northport hospital has other environmental
concerns.
The Veterans Affairs medical system is the nation’s largest integrated health care
organization, has been under close examination since 2016, due to maintenance problems that
have caused a collapse in drainage pipes, clogged underground rainwater collection systems, and
damaged plaster walls that have been painted over rather than repaired.
Evans M, from New York Times reported that the surgical units at the Northport Veterans Affairs
Medical Center were closed from February until June in 2016, after a failure of an
airconditioning system that was contaminating the hospitals operating rooms by expelling metal
fragments; threatening to infect patients with open wounds and or immunocompromised patients.
The compromised environmental conditions provoked a prolonged cancellation of surgeries at
Northport VA Medical Center. Furthers more workers at the VA Medical Center at Northport
reported anonymously that the hospital had broken medical equipment, hazardous conditions,
understaffing, filthy facilities, unresponsive management, and other challenges.
The VA shelter building was closed down due to poor working and living conditions, “VA
employees assigned to the shelter building reportedly had complained for weeks of having to
work in winter coats and use space heaters before the decision was made to close the building
and relocate the shelter residents to nonprofit facilities elsewhere on Long Island”(Evans 2017)
According to Evans from the new york times, an environmental analysis of the air quality at the
Northport hospital by Environmental Analysis Associates, a San Diego firm that specializes in
the identification of indoor airquality problems were connected to dust contamination that came
from the oxidizing metal and crumbling concrete in the building’s duct system built in the early

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1970s. These particles and “low concentrations of fiberglass fibers traveled to the air
conditioning system throughout the hospital including the operating rooms. The hazardous fiber
and oxidizing particles are irritants to the skin, eyes and upper respiratory tract. The New York
Times report also noted that there was a presence of spores of Clostridium, a typical mold that
can grow indoors on surfaces when moisture is present and can cause allergic reactions and
respiratory problems.
Ronald Brattain, the chief of the hospital’s engineering service, said that the operating
room airsupply ducts have been wet and regularly exposed to high humidity because they pull
air from the outside, as it was standard in older V.A. hospitals. “The humidity that is in the air is
drawn through the air handler, and so that by itself creates a moist environment,” he said. It is not
only the operating rooms that have been affected at Northport. The airconditioning in the
basement of Building 200, one floor down from the operating rooms, broke down in March
2015, and since that time particles have accumulated in five ultrasound rooms and an M.R.I. area
(Robelo,2018). While the students tour the town of Northport an incident was reported. One of
the students took a fall as they were walking on Main Street. The sidewalks are uneven and
slanted and it would be very difficult for handicapped veterans to enter the small shops in town .
Most of them were not wheelchair accessible. (A. C., L.C.)
Public Services
When it comes to public services Northport VA has specialized services that helps in
attending to emergency issues within the community. Some of these public services include the
VA police which is located on a campus, and a Northport fire department which is available to
assist in any way necessary. On the emergency issue, one can simply call the Veteran

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Administration (VA) police by dialing their telephone number operator that operates 24 hours a
day and they will be escorted to the hospital (“VA Healthcare”, 2018). Further, the VA Northport
has a well established Emergency Disaster Plan that allows people to easily access the health
care. For example, there are emergency care call numbers that are 911in case one is in a
dangerous condition and need quick medical attention. They then receive this emergency service
in the VA Northport emergency room. VA Northport also offers services such as occupational
health and yoga. The recreation serves them well as they refresh their minds through various
activities. Through this, the veterans refresh their minds contributing to mental and physical
wellbeing.
Concerning Fire safety, the village of Northport has a fire department which supports the VA
with all they require in times of fire emergencies. The fire chef’s name is John Jacobson. The
firehouse is located at 204 Main St. The fire department there has 110 members, four fire
engines, one heavy rescue, three command vehicles, and two EMS vehicles. The fire department
also has a marine unit, rescue diving unit, and also a 32foot marine boat which is available for
any rescue job. (Sheridan, First responder (EMS). November 9, 2018). The next public service
available to the veterans at Northport VA is police protection.
Northport VA does not work with the local police precinct as they have their own 24/7 police
department located on the premises. If the veterans on the unit behaviorally act out, there are
measures to keep the staff safe. The nurse interacting with the patient would press the panic
button in which the police in their police car would typically respond in 23 minutes, as the
patient care buildings are spread out. Another safety measure that a nurse on staff can take
regarding a dangerous patient situation is to call the crisis hotline, and everyone from the

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inpatient facility would be removed including all of the team and the other patients, until the
police on the campus can defuse the situation. Also, they use a horizontal method, which shifts
the staff from one side of the building to another behind a door while they take care of the
problem. The time it would take for the police to respond to a transfer of a patient from unit to
the unit would also take 23 minutes. (Rogan, Jennifer . Nurse Manager Partial Hospital
Program(PHP). November 9, 2018) Therefore, VA Northport has many ways to keep the staff
and patients safe. Another major public service provided by the VA Northport is a well
established Emergency Disaster Plan, through the Federal Emergency Management
Agency(FEMA).
As a regulatory body for disaster management, response and planning, Federal Emergency
Management Agency (FEMA) plays a great role in times of emergencies. It deals with any type
of emergencies which take place in Northport whether they occur naturally or are triggered by
human activities. During these type of emergencies, it’s the responsibility of VA employees to
treat civilians on a humanitarian basis. In the event that an emergency occurs, the first step
involves turning on the emergency siren in buildings. The siren alerts the emergency department
staff who takes the least time to prepare for response. In the state of an emergency, the team
follows a contingency plan ahead of time which can mandate that the staff stay at the hospital
until the crisis has finished. (Rogan, Jennifer. Nurse Manager Partial Hospital Program(PHP).
November 9, 2018)
Another function of the VA is the provision of services to the veteran in time of need by
providing high quality of medical services. The Feinberg mental health, a satellite VA Clinic
caters for the mental needs of the families while the VA for the patients. It also offers NAMI

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meetings Wednesday night for families of veterans who suffer from mental illness. Further, it
also provides daycare for patients and employees’ children which is open from 7am to 5:30pm so
the adults can receive treatment or work while their kids are being taken care of. A third of
veterans who go to VA Northport for treatment indicated that they would use day care. The VA
also offers vocational rehab, work therapy, and help with finding jobs for veterans. Veterans can
also go to the chapel which is located at building 40. It's a place where people of all faiths can go
and pray or meditate. For recreation and sport, there is a golf course located right next to the
facility called the Northport golf course. It offers discounted rates for veterans at a price of 8
dollars. The recreation serves them well as they refresh their minds through various activities.
Through this, the veterans refresh their minds contributing to mental and physical wellbeing.
The VA also has several forms of transportation. They have a tunnel system in the campus which
goes from building to building. They have a DAV system, which transports disabled veterans to
places where they can receive treatment. There is also an ambulance on campus available to
transfer patients from buildings to the building 24/7. (Rogan, Jennifer. Nurse Manager Partial
Hospital Program(PHP). November 9, 2018)
In conclusion, VA Northport has many public services they offer. The services it offers to
the veterans as well as their families are great.

Aesthetics

Northport is a historic village in The Town of Huntington, on Long Island. The
combination of ocean frontage, a rich historical past, a stunning landscape, and beautiful views
create, a very attractive community. For this reason, many local residents enjoy living in

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Northport. Northport Village is known for the quaint atmosphere and artistic vibe produced by
art galleries, the John W. Engeman Theater and events hosted across the village. Galleries offer
photography, jewelry, oils, acrylics, watercolors, pastels, linoleum cuts, etchings, and more. With
Northport being the home to five art galleries, the village has both natural and artistically created
beauty, which draws many people to the village. (Personal Communication, Erica Berkowitz,
coowner of Haven Gallery, October 5, 2018).
Other than art galleries, the village is also known for performances at the John W.
Engeman Theater, located at 250 Main St. Tickets can be purchased at the box office or
engemantheater.com. In Northport, St. Philip Neri is the religious institution locate d at 344 Main
St., Northport, NY 11768. St. Philip Neri Church and offers a religious education program.
Trinity Regional School participates in the mission of the Church by providing a Catholic
education on the elementary level. They foster the intellectual, spiritual, social, physical and
emotional development of students. Children are encouraged to incorporate service into their
lives.
Historically Annual Events include Memorial Day Services, Blessing of the Fleet, Cow
Harbor 10K race, Cow Harbor Day, Holiday House Tours, Winterfest, Holiday Decorating and
Caroling, and Summerfest Concerts in the Park and Happenings on Main Street. Cow Harbor
Day is a traditional annual festival celebrating the history of the Village of Northport on Long
Island. The name comes from “The Great Cow Harbor” this is what the Village was called years
ago as the cows use to graze on the fields along the Harbor, which today are two beautiful parks.
Cow Harbor Day is usually held on the third Sunday, in September, always following the Great
Cow Harbor 10K Race. ( http://villageofnorthport.com/cowharbor10k , 2018).

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The Northport Chamber of Commerce has strived to support the business community
through innovative yearround programs for over 50 years. Effective networking opportunities,
and continuous community outreach to achieve the collective goal of enriching the quality of the
commercial, civic, and social life of Northport is one of the Chamber of Commerces goal while
working in the community. Monthly meetings allow businesses and residents alike the
opportunity to voice their ideas and opinions.
There are a lot of restaurant located in Northport village and residents enjoy eating out.
On the weekends and in the summer, Northport bustles with visitors and locals looking for
pastries or coffee and a spot with a water view at the Copenhagen Bakery . Many also flock for
tables at Maroni Cuisine or the Ritz Cafe . A weekly farmer’s market is held on Saturday
mornings, from June through midNovember. In August, residents gather for Thursday evening
concerts at the bandshell in Village Park. There are Family Nights held on Main Street which
attract many families with young kids. The Village Park, at the foot of Main Street, offers
turnofthecentury atmosphere featuring free concerts, with a glorious view of the harbor. In
striking contrast is an adjacent contemporary playground, park and gazebo.
( https://www.northportny.com/about , 2018). (V.P.)
Health Related Facilities

There are various health facilities available to the community of Northport. However, we
have to remember that t he supply and accessibility of facilities and physicians, the uninsurance
rate, financial hardship, transportation barriers, cultural competency, and coverage limitations
affect access. Rates of morbidity, mortality, and emergency hospitalizations can be reduced if
community residents access services such as health screenings, routine tests, and vaccinations.

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Prevention indicators can call attention to a lack of access or knowledge regarding one or more
health issues and can inform program interventions. There is one urgent care center in Northport
located at 399 Fort Salonga Rd. They are open 7 days a week, seeing walkin patients. Down Hill
Adult has Assisted Living and Nursing Care senior care options for elderly adults in Northport.
( https://www.health.ny.gov/facilities/adult_care/ , 20 18).
Northport VA Medical Center provides comprehensive outpatient and inpatient health
care with specialties in medicine, surgery, psychiatry, physical medicine and more. The VA offers
a variety of mental health care programs and services to help veterans work toward healthy and
productive lives. Services include: individual psychotherapy, group therapy, supportive therapy,
substance abuse programs, suicide crisis program, weight management, anxiety, depression,
PTSD program. Additional patient services include XRay, MRI, CT, laboratory, in and
outpatient pharmacies, recreational programs/events, pool and gymnasium, veteran child day
care (VA Kids Care). St. Catherine’s of Sienna and Huntington hospitals are the closest ones to
Northport. ( https://www.northport.va.gov/ , 2018).
Huntington hospital offer programs and s ervices ranging fr om preventative healthcare to
specialized diagnostic and treatment services to the community. They offer both inpatient and
outpatient services, and a complete spectrum of care. The Emergency Department (ED) at
Huntington Hospital is a nationally recognized ED that delivers expert care 24 hours a day, 7
days a week to the residents of surrounding communities. For very serious, lifethreatening
conditions requiring a higher level of care, seamless transportation is available from Huntington
Hospital to the most appropriate hospital.
( https://www.huntingtonhospital.org/OurServices.aspx , 2018).

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Incorporated in 1952, Visiting Nurse Service & Hospice of Suffolk located on Main street
is committed to providing the best possible care to patients without regard to race, religion, age,
sex, or ability to pay. As a freestanding, notforprofit, community based home health care and
hospice agency, Visiting Nurse Service & Hospice of Suffolk responds to community needs as
they arise, maintaining a tradition of charitable and compassionate care in the home, as well as
providing community service activities such as blood drives, bereavement support , and flu
clinics. There is no charge for an initial assessment. Visiting Nurse Service & Hospice of Suffolk
will help patients determine what is covered by insurance. As a certified home health care
agency and hospice, we bill Medicare, Medicaid and many other insurance companies and
HMO's. When insurance does not cover a needed service, fees are adjusted based on ability to
pay ( https://www.visitingnurseservice.org/about.html , 2018). (V.P.)

CARE MANAGEMENT TECHNIQUES

Availability of Resources

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Even though the VA has more medical resources it still shows a higher rate of morbidity
pattern among patients compared to non VA hospitals. These morbidity patterns a patient
suffering from diabetes, high blood pressure or stroke, among others. Similarly, inadequate
nursing home and postacute health facilities are other challenges facing VA hospitals therefore
making it hard to attend to all patients, thus leading to early deaths. The Northport VA itself does
have a nursing home for the medically compromised adult. On the other hand, the Northport VA
health center has high rate of emergency attendance that led to lower mortality rate (“U.S.
Department of Veteran Affairs”, 2018). Currently, the community is maintaining a low mortality
rate due to welldeveloped programs that help them to provide quality and emergency care to the
patients. Northport has well laid out a strategic approach to their medical services that aims at
reducing the patient trauma in accessing the quality care. The VA offers partial hospitalization,
aftercare, and outpatient detoxification as programs to treat substance abuse.
In the community of Northport, the life expectancy and mortality rates have varied over the years
between male and female veterans between the ages of 20 to 85 years. Between 20002014,
mortality rates among the U.S veterans have continued to decrease. Furthermore, in the
community of Northport, the VA mortality rates of males U.S veterans are shorter by 0.70.9 life
years compared to the mortality rates of the U.S population with the same old age. As well, the
female veterans have a shorter mortality rate by1.21.3 life years compared to females of other
entire U.S population. The shorter life span of veterans affects those in the ages of 25, 45 and 65.
The average expected life years for VA veterans are shorter by 0.8 and 1.2 life years for the male
and female gender. Education differentials amongst Northport VA veterans are also a critical

25
factor that determines their morbidity and mortality rates. Veterans who are more educated are
likely to have high life expectancy rates because they get better jobs after retirement and are
likely to have more pension and life savings from their previous (Department of Veterans Affairs,
2017). However, the veterans who are less educated have high mortality rates because they lack
enough savings to help in the old age. Income differentials are a critical factor in life expectancy.
Households of VA veterans that have incomes of less than $ 20,000 are likely to have lower life
expectancy rates of between 3.9 and 2.2 less life years compared to the households whose
income is more than $ 50,000. In short, incomes of households of Northport VA veterans can
impact their morality and life expectancy rates. Life expectancy impacts the mortality experience
of Northport VA veterans. The gaps of life expectancy are mainly determined by socioeconomic
differentials of the veterans (Department of Veterans Affairs, 2017). Thus, education and
socioeconomic difference, among the veterans can also affect their mortality rates, which in
comparison to the non veteran population, are overall slightly less. (G.S)

Community Wants and Needs

This part of the paper has limited information and the information given here is from a
primary source within the VA. In the VA the process of involving the consumers in their
healthcare decision is done when they come in to the outpatient clinics. For instance, when the
veterans come into the Partial Hospital program(PHP), they are asked what brought them to seek
help and how the will like to be help. They are given the choices of what programs available to
them and how they go about getting the help they need. The veterans in PHP are given the
opportunities to seek the program that will help them the most. The first process is to get in the

26
PHP and when they completed this part they can move on the that other programs within the VA.
(Rogan, Jennifer . Nurse Manager Partial Hospital Program(PHP). October 12, 2018). (J.R.)

Types of Care

Providers at the VA, PHP (partial hospitalization program) use a Four Domain Model of
Wellness. The model includes physical, emotional, spiritual and mental needs. Making the Four
Domain Model of Wellness part of daily life can improve mental and physical health for people
with mental and/or substance use disorders. It is an inherent part of group programming which is
primary. Spirituality can be viewed in a variety of ways from a traditional understanding of
spirituality as an expression of religion or through whatever way the Veteran sees fit to help with
their own recovery. The physical part includes recognizing the need for physical activity, eating
healthy foods, and getting enough sleep. E motional is coping effectively with life and creating
satisfying relationships and mental is recognizing creative abilities and finding ways to expand
knowledge and skills. (Tina, RN, PHP at the VA of Northport).
There are two main types of care provided at the PHP: individual care and group care.
Veterans are encouraged to participate in community programs, especially AA or NA. Every
Saturday morning the veterans relay to our group they have an opportunity to attend the AA
group in town. They have breakfast before the meeting which is a good way to get to know each
other and that helps the meeting to be more effective.
Northport VA provides treatment for substance abuse, beginning Access Center located
on the first floor of building 63, open weekdays. They accept walkins and have caring mental
health doctor available 24/7 in the Emergency Room . The VA providers at PHP use medications

27
to treat substance dependence. Effective medications can help manage withdrawal symptoms,
reduce craving, and promote abstinence, which is refraining from using the addictive substance .
Vivitrol is a brand name formulation for naltrexone. It can be used to help people maintain
abstinence while recovering from an opioid or alcohol dependence. Formulations of naltrexone
are available in oral tablet form, but Vivitrol is administered as an intramuscular solution once
per month. It is important that veterans in treatment for an addiction to opioids, first completely
detox from these substances and then maintain abstinence for 710 days prior to starting Vivitrol;
otherwise, this prescription medication can elicit withdrawal symptoms. (Jennifer Rogan,
Program Director at PHP, October 5th, 2018)
VA of Northport provides specialized care programs like Community Home Health care
Services, Support Groups, Psychosocial Rehabilitation Recovery Center (PRRC), Mental health
Care. The PRRC is a large outpatient mental health program that provides a supportive
environment where veterans can develop the skills and confidence necessary to live satisfying
lives and function successfully in the community. Therapeutic activities include peer support
services, group therapy, psychoeducational programs, skills training groups, socialization,
recreation, and self help activities (Barbara, RN at PRRC. October, 2018). (V.P.)

Standards of Care

VA Northport has a well established standard of care that is set by having a collective and
integrated evidenced based approach that enhances continuous learning for the provider for the
provider and high quality care for the patient. In the outpatient mental health clinics, the
assessment is initiated by the use of the Colombian suicides scale upon the patients’ admission.

28
The standard of care supports the data that about 30% of US population is at high risk of alcohol
dependencies while 8% experience alcohol disorders. Due to a high number of drug dependent
patients, at VA Northport the Short AuditC questionnaire, is used to assess and identify the level
of alcohol dependency in the veteran patient. Again in applying the standard of care, the provider
then assesses the patient’s frequency of drug use. Then finally when the assessment in the
counseling session is completed the healthcare provider offers educational material which may
include how to stop alcohol consumption, and if needed, prescribes medication to the patient.
(“US Department of Veteran Affairs”. 2018). VA Northport uses an approach known as Strategic
Analytics for Improvement and Learning (SAIL) in order to improve the comprehensive
performance of quality care and mental health care. The metrics are organized into 9 quality
domains and one efficiency and capacity domain. The quality domain represents the overall
quality. Relative performance is compared with other VA medical centers with a star rating going
from 15. An improvement from star rating is compared to a medical center’s own performance
form the past year. VA Northport had a slight improvement with its star rating remaining a 4.
(“Quality of Care”, 2018). Other test administered includes PHQ2 and PHQ9 in order to assess
the physiological depression among the patients. Lastly, the treatment team conducts Military
Sexual Trauma (MST) and the PTSD Screen in order to assess for the traumatic disorders in
patients. If any of the tests become positive the Veterans need to be safely held for 24 hours
while undergoing more suicide tests. These tests are designed to assess mental health disorders
and dependencies to help determine a plane of care toward recovery for the veteran. (“US
Department of Veteran Affairs” , 2018) Therefore the VA has a very good standard of care for
their patients. (G.S)

29

Interdisciplinary Plan of Care

In this community there are many forms of interdisciplinary care offered. The
veterans/patients has their care team which involves there doctor, social worker, physicians
assistant, therapist, certified addictions therapist, and the nurse manager of the PHP (partial
hospitalization program). The team is very active in the care of the veterans, they are constantly
developing new programs and groups to help with the veterans recovery and sobriety (Jennifer
Rogan, October 12, 2018). When the a veteran completes their 20 days in the PHP program they
are then recommended to an aftercare program based on need, by the interdisciplinary care team,
and are followed by the same doctor and social worker that were part of their team in PHP. If
their after care is done in the community setting, for example a CBOC (community based
outreach clinic), the veteran would meet with a PA (physician assistant) and a nurse a couple
times a week, and would only visit their doctor when they need prescription refills or a consult
(Jeff Sparks, October 5, 2018).
Some of the other resources available to the veterans at the VA are also integrated into
their interdisciplinary care, and the people who oversee these programs become part of the
healthcare team. Vocation therapy will be integrated at the end of the veterans 20 days in PHP,
this program helps veterans learn job skills as well as bridge gaps in employment by providing
them programs such as I.T. (incentive therapy) or V.I. (veterans industry), which allow them to
work on the grounds of the VA in jobs such as housekeeping or transport (Monica Lanning,
October 12, 2018). Another program that can be added to the interdisciplinary care for the
veterans is the MOVE program. This program is a weight loss program for obese veterans that

30
bridges recreational therapy and nutrition. The MOVE program helps to reduce certain health
risks by teaching the veterans small changes to their diet and exercise programs to help them stay
healthy and lose weight (move.va.gov, 2018). (N.H.)

INFLUENCES ON RESOURCE ALLOCATION DECISIONS

Allocation of resources
The veteran community depends mainly on government funding. The hospital receives
$2,200 dollars per patient regardless of the services the veteran patient is using or needs. The
health care fare for older adults and patients diagnosed with mental illness or dementia increases.
The veteran community depends on government funding to meet the medical, psychological,
physiological, and sociological needs of each patient. The VA does have outside sources that
fund the VA hospital, but even so it is not enough to cover all the of the veteran’s medical needs,
the facility, the programs, and personnel. According to Mr. Sparks; the acting associate and chief
director of nurses, the VA is the most extensive healthcare system in the world, and on that note,
they are always in need of funding. (L.C.)
Values and Beliefs of the Community
Northport Village is full of places that offer yoga, Pilates, and meditation. The town
fosters vegan food, organic markets, and has no fast food restaurants within the village. The only
“unhealthy food” is the town's pizzeria. Everyone seems to be very active, walking their dogs
everywhere. The community of the Village of Northport seems to embrace a holistic health
approach. One of the workers of Organically Yours said that many of the customers are regulars

31
that are vigilant of their health and wellbeing. She mentioned that illness is not something that
she sees a lot of, everyone seems very healthy even though the population is predominantly
older. One of the town's holistic stores had an article in the window that informed the public
that spiritualism took hold in Early Northport. The article mentioned that the Northport colony of
spiritualist was founded by Mr. Jarvis in 1859; a Northport resident that was diagnosed with liver
failure and could not find a cure with western medicines decided to turn to a medium that cured
him (Reid, 2016). Another Northport resident that was caught in the spiritualist movement and
discovered herself as a medium was Jesse Jarvis. The town has one drug store in the village and
many shops with natural remedies, essential oils, chiropractors, acupuncturists, and Psychics
(Reid, 2016).
The beliefs of the VA community of Northport has the same holistic approach, but the
veterans’ needs require Western medicine to treat major chronic medical conditions as well as
addictions, and mental health illnesses. The VA Northport veterans hospital offers the following
services: online interactive educational training for veterans and their families, extended care and
rehabilitation, former POW Advocate, helpline, home base and primary health care (HBPC),
hospice and palliative care, interactive training GBT Patientcentered care, mental health , nurses
helpline, physical medicine and rehabilitation services, primary care, social worker, specialty
care, training, and VA Nurse helpline among other services with these titles. The areas that the
group focused and was more involved with during the clinical rotation was the mental health
clinic and substance abuse program, as well as in the PTSD recovery center. “Northport VAMC
provides a full continuum of mental health care that includes diverse inpatient, outpatient and
community based treatment programs.” (Northport Handbook) Some of the programs that are

32
offered are: Psychosocial Rehabilitation Recovery Center, Health Psychology, Vocational
Rehabilitation, Substance Abuse Residential Rehabilitation Treatment Program (SARRTP),
Mental Health Intensive Case Management, Acute Inpatient Services, Emergency Treatment,
Substance Abuse Treatment”( VA website) .
The psychological rehabilitation center is a day program that offers longterm treatment
for patients that have a mental illness diagnosis such as, bipolar disorder. The patients are seen at
least three months for medicine adherence, evaluation and treatment plan (Jeffery Sparks).
The acting associate chief of nurses services for mental health Jeffery Sparks expressed his views
in regard to values and beliefs of the community as they relate to health and illnesses. He said
that the veteran community is in need of many services, most of which the hospital provides and
if they don't provide, they can arrange for outside sources to provide these service3s on their
behalf. They even have Northport VA Medical Center’s Mobile Health Unit Outreach Program,
that consists of a mobile health unit team that offers a variety of programs such as hypertension
screenings, diabetes education, and customized programs including an overview of VA’s
TeleHealth and My HealtheVet programs. Although the VA Northport offers many services to
promote health and wellness, there is still a need for more. The programs do not have the
monetary resources to run longer, or the health care providers to treat everyone, and resources to
provide inpatient programs that last longer. The Northport Veteran’s mission is to provide
veterans exceptional health care that improves their health and wellbeing and focuses in
prevention of illness through research and education ( Philip Moschitta). (L.C.)

33

Special Interests
The Northport VA provides specialized programs for homeless Veterans that serve
hundreds of thousands of homeless and atrisk Veterans each year. Independently and in
collaboration with federal and community partners, these VA programs provide Veterans with
housing solutions , employment opportunities , health care , justice and reentryrelated services
and more .
Through public housing authorities, The Housing and Urban Development (HUD) provides
rental assistance vouchers for privately owned housing to Veterans who are eligible for VA

34
health care services and who are experiencing homelessness. VA case managers may connect
these Veterans with support services such as health care, mental health treatment ,and substance
use counseling to help them in their recovery process ,and with their ability to maintain housing
in the community. Among the VA homeless continuum of care programs, HUDVASH (
Veterans Affair Public Housing ) enrolls the largest number and largest percentage of Veterans
who have experienced longterm or repeated homelessness. As of Sept. 30, 2015, HUD had
allocated more than 78,000 vouchers to help house Veterans across the country. ( Veterans, 2015)
( A.C.)
Community Resource and Referral Centers (CRRCs)
CRRCs provide Veterans who are homeless and at risk of homelessness with onestop access to
communitybased, multi agency services to promote permanent housing, health and mental
health care, career development and access to VA and nonVA benefits. ( Veterans , 2015) (A.C.)
VA Vet Centers
These communitybased outlets provide a broad range of counseling, outreach and referral
services to combat Veterans and their families. Vet Centers guide Veterans and their families
through many of the major adjustments in lifestyle that often occur after a Veteran returns home
from combat. Services may include individual and group counseling in areas such as
PostTraumatic Stress Disorder (PTSD), alcohol and drug assessment and suicide prevention
referrals. All services are free and strictly confidential. (Veterans , 2015)

35
Also, among other programs offered to the PHP members to promote the vocational and
community adjustment of the veterans served , Monica Lanning of Vocational Rehabilitation
Services directed a PHP group where information was given to the veterans concerning these
opportunities. The veterans can choose from 6 different vocational rehabilitation programs
(Vocational , 2018) (A.C.)

1. S.E. Supported Employment Program
Offers assistance to Veterans who have difficulty finding and maintaining competitive
employment due to the ups and downs of mental issues.
2. CBES Community based Employment Services
Offers rapid exploration of competitive employment opportunities to Veterans after
identifying their goals ; Job Development placement services, and the identification of
job site accommodations are also provided.
3. V.I . Veterans Industries (Work Therapy leading to employment)
Veterans participating in the Substance Abuse Residential and Rehabilitation Treatment
Program (SARRTP) are automatically referred for consideration for V.I. (7 months of
participation). There is no waiting list, and assignments are based on availability.
4. C.W.T. Compensated Work Therapy ( Workshop /Work Therapy)
This program is open to any Veteran with a referral from a providing team member at the
Northport VAMC. CWT is designed in a factory setting . It is a piece rate work in which
payment is received on the volume of work produced.
5. I.T. Incentive Therapy ( work therapy )

36
Referral process is needed here as is with CWT. Various assignments throughout the
Northport VA. These assignments are located in housekeeping, recreation, nutrition/ food
service, transport services ,and logistics. .
6. Vocational Assistance
This program is open to Veterans in need of minimal assistance with job searches and for
preparation to return to competitive employment.
Impact in the community is made as veterans identify goals, and work as they build
confidence, selfesteem and feelings of worth.Veterans find healthy ways to adjust to changes in
the work environment as they learn to build skills. Finally, they enhance their skills and attitudes
to be able to compete and be successful in the job market ( Vocational , 2018). (A.C.)

Healthcare Insurance Coverage

“ The VA will take a daily co payment for the day for service connected veterans ( which is
$20.00) The insurance is also available which covers the family. The VA will never refuse to care
for a patient . If the patient is covered by a private insurance, this insurance will be taken.
However, the patient who does not have access to a private insurance, care will be provided
regardless. When the services are not available at the VA Northport , the patient that is approved
by the VA will be sent to a private source , and that health provider will be reimbursed ” (Acting
Associate Chief Nurse Service Mental Health Jeff Sparks) (A.C.)
Consumer in Health Care

The veterans seek care that is not provided in the VA of Northport. For instance, they are
looking for medical facilities that are close to their homes, because many of them do not have

37
their own transportation and have to rely on public or VA transportation services. “Some veterans
say that going to an outpatient clinic in North Hempstead is easier than going to the two existings
clinics in Valley Stream and East Meadows, or to the Northport VA Medical Center”. (Chung, C.
2018). In group meeting with the Veterans you can hear them talking about the problems they
encounter to get to the Northport VA. There is an extensive volunteer service provided to the
Disabled Army Veterans which provides transportation from all over Long Island.
The Veterans like to congregate with their own age group. In the Northport VA they are Veterans
from different war periods. The ages ranges from the Vietnam war to Operation Enduring
Freedom (OEF). The veterans from the younger group would appreciate a clinic for themselves.
The older vets have access to transportation, for example Disabled Army Vets (DAV) that will
organised their transportation needs to and from their homes to the VA. The veterans also have
services that including Physical Therapy that is provides services to their homes .(J. Rogan ,
personnel). The services that are not provided by the VA are provided in the communities, but
the providers have to be approved by the VA before any services or procedures can be done .The
veterans can not go to any outside providers that is not approved by the VA.( Sparks,Jeff.
10/5/2018). (J.R.)
Health Care Providers Education

When healthcare providers are hired at the VA, they are required to go through trainings
from the federal government on information such as HIPAA training, and trainings on how to
assess a veteran that has seen combat. The mental health units also have multiple additional
trainings that need to be renewed every year such as trainings of high risk populations, as well as
education on depression and suicidal signs in veterans (Personal Communications, October 5,

38
2018). If you do not renew these certifications, the VA hospital locks you out of the computer so
you can not do your necessary work until you renew these certifications. This can cause many
issues because it can interfere with nurses doing their necessary jobs like documentation, and
also can cause units to be short staffed (Personal Communication, October, 12 2018). (N.H.)
VOICE OF THE COMMUNITY

The voice of the community is being heard on PHP unit. The health care provides are
listening to the veterans and they are trying to meet their needs. Veterans are ready to travel to
the VA just to see their provider. The provider has a very positive rapport with the patients they
treat, and they really get to know them and their case. Veterans have at least seven meeting a day.
Friday morning starts with weekend planning meeting following in the afternoon they have a
recovery group that is tailored to what the veterans would like for that day. Veterans can
communicate with their providers at any time they need. CBOC offers weekend hours as well as
veterans travel to AA (alcoholic anonymous) as well as NA (narcotics anonymous) together on
Saturday. CBOC supports the veterans and their families by providing programs for the veterans
families through Northwell, so when the veteran is being treated the family can be as well (Jeff
Sparks, October 5, 2018). In regards to the complete VA Northport system there are some
problems when it comes to providing services to the veterans. Some of these include the pool
being closed which prevents veterans from receiving relaxation and weight management
benefits. The gym is also not completely finished which prevents veterans from being active as
they can be. Most of the buildings are in a poor conditions which leads to closing of some
programs such as the homeless shelter on campus due to being unsafe. Some positive programs
for the community provided for the veterans include VA child care which allows the veterans to

39
drop their children off while they are receiving care. The also have a store called the PX, barber,
chapel, and library that they veterans can access on campus.
Nursing Diagnosis

Impaired comfort related to injuries at war. (Luisa)
● Most of the veterans suffer from back problems or some kind of injury do to their service
in the military.
Readiness for enhanced health management as evidence by patient seeking help and
attending the outpatient PHP program. (Luisa)
● This diagnosis is appropriate for my paragraph because patient that are in the PHP
program are there because they want help, they want to get better, they know they can't
do it on their own.
Risk for infection related to contact with contagious agents as evidenced by oxidation and
fiberglass expelled from the vent system. (Ari)
Infections occur when the natural defense mechanisms of an individual are inadequate to
protect them. Organisms such as bacteria, virus, fungus, and other parasites invade
susceptible hosts through inevitable injuries and exposures. People have dedicated cells
or tissues that deal with the threat of infection.

Readiness for enhanced coping as evidenced by active involvement in rehabilitation
program. (Ari)
Explore with client their process and growth in mastering a situation or crisis that
enhanced their resilience.

40
Risk of premature death related to overdose on substance and alcohol.( Juanita)
This diagnosis is related to my paragraph because this is why the Veterans comes to the
VA PHP for help.
Readiness for knowledge related to seeking further education (Nicole)
The patients in PHP are extremely interested in receiving information on programs and
medications they can utilize to prevent relapse when they complete the program.
Risk for depression related to substance abuse (Nicole)
Many of the patients have lost family member support due to the substance abuse
problems. Also many of them have loss jobs, and homes do to their substance abuse.
Therefore this can all be contributing factors in risk for depression.
Anxiety r/t traumatic war experience,environment change, lack of support system. (Olga)
Ineffective coping r/t stress and distancing from family. (Olga)
Risk for ineffective coping related to substance abuse (Gary)
Decreased ability to handle stress of illness resulting from substance abuse
Risk for chronic low self esteem related to substance abuse (Gary)
social stigma attached to substance abuse and some of their past life choices have led to it
Main Nursing Diagnosis
1. Readiness for enhanced health management as evidence by patient seeking help and attending
the outpatient PHP program.
Rationale :
This diagnosis is appropriate for my paragraph because patient that are in the PHP program are
there because they want help, they want to get better, they know they can't do it on their own.

41
Interventions:
1. Educate the veterans about the community resources available to them, such as AA, NA
and THRIVE.
2. Recognize/ Identify “enabling” behaviors and teach the veterans about healthier patterns,
and how to avoid relapsing because of HALT (hungry, angry, lonely, tired).
3. Teach the veterans about the administration Vivitrol.
4. Educate the patients about the side effects of vivitrol.

EVALUATION OF THE COMMUNITY ASSESSMENT PROJECT

Benefits and Limitations of the Project

Luisa Limitations to completing this project were the amount of time interacting with patients,
the limited time spent in each unit if any time spent at all, a walk of the premise of the VA
Northport hospital itself. A limitation of Northport town consisted of the inability to do more
than one drive through to the town. Also when it rains, it is impossible to visit the town.
Ari As students we could only participate as observers and we were unable to ask questions to
the patients. Among the benefits of working in this project , we learned about the importance of
teamwork . Even though we all have different personalities we worked as a group to complete
this project. Also , we learned about Veterans stories and some of the struggles they face every
day . This project made me more aware of the culture of our veterans and this experience helped
me understand them better.
Gary Their were some limitations. Being able to only follow as observers and not being able to
question the patients was a detriment to our learning process. Although I believe the staff were

42
very accommodating as they provided us with anything they possible could to further our
learning process. Listening to the patients speak also helped me understand the kind of care they
were experiencing through the VA.
Juanita There were several limitations to my parts, in Northport VA there are not enough
information on the morbidity and mortality rate in the VA as well as in the town of Northport it
self. The VA does not keep any statistics on morbidity and mortality on it Veterans because the
vets are from different communities. There are limited information for the parts on Community
Wants and Needs and Consumers, because we are only there for observation. We are limited to
what we can do with the Vets.
Olga I would like to have more interactions with the veterans. It would be nice if we could
interview them and wright a care plan. We didn’t got a chance to know the veterans and learn
about treatment plan for specific mental health illnesses. We also didn’t see an assessment
process, which is a critic part of nursing. Benefits of the project were learning about management
and treatment of patients with PTSD, depression, anger. We also learned a lot about stress
reduction techniques and holistic nursing.
Nicole I ran into several limitation when it came to composing my paragraphs for the paper. The
first limitation I faced was that VA Northport does not keep demographics of their hospital, the
only demographics I was able to access is demographics for all of the VA systems in New York.
Another issue was when it came to the healthcare education portion of the the paper. Much of the
information for this section is from primary sources, and the VA does not require a lot of
education for their healthcare providers. Although there were limitation when it came to the
paper I feel like we really worked well together as a group. I also feel significantly more

43
confident in completing a community assessment after completing this project. This project also
showed me how important assessing the community can be to community health nurses.
What Aspects would you Change
Luisa It would be essential to spend more time in town interviewing people at different times of
the day to be able to assess the community. For any clinical experience, it is crucial to have more
interaction with the patients, interviewing them, and perhaps work with them to personalize a
plan of care or work with them to help them plan their weekend planning.
Ari The Northport VA is enormous . I feel we only got to see , and explore a very small
portion. Also, I would have liked to be able to ask questions and interact more with the veteran .
Some of them like to share their experiences during combat , and I would have enjoyed that
interaction.
Nicole I wish I would have been able to spend more time with patients instead of just observing
multiple group therapies. I would have also liked to spend more time exploring the VA as well to
get a feel for what it is like to be part of that community and be on the campus continually.
Lastly it would have liked to maybe be able to write the paper completely about VA Northport or
completely about the Town of Northport instead of having each part be about one of them
depending on how much information was provided about the VA.
Olga Due to limited interactions with veterans I wish we could have access to patients charts
and nurses progress notes.

Part 2: Application of assessment into a Community Health Teaching Plan

Objective: To identify health education/promotion project with your target Community Health
clinical population based on the health issues identified at your clinical site.

44

1. Assess your target population and community using the Community Assessment /
Windshield Survey from Part 1
2. Identified health need and the educational topic of that target group with supporting data –
rationale as to why the group chose this teach the topic. (This should only be 12 paragraphs at the
most.)

As a group we decided to teach our target group who are the veterans in the PHP program
about pharmacological and nonpharmacological intervention they can use to manage and
prevent relapse during their treatment. The first component of our teaching involves educating
the veterans about the injectable medication Vivitrol that last for 28 days and can help control
their cravings and help prevent relapse. We will be educating the veterans on the administration,
mode of action, side effects, interactions, dosage and safety of Vivitrol. Also as a group we
created a poster board to leave with the PHP program that include all the key information the
veterans need to know about Vivitrol.
As for the nonpharmacological piece of our teaching we will be educating the veterans
with the help of our professor the benefits of aromatherapy. We developed three question to ask
the veterans that will allow us to get to know them better, and they will also be able to get to
know us better as a group. Aromatherapy can be very beneficial to these veterans because
different scents can help with different aspects, such as relieving pain or helping lessen strength
and anxiety. Using aromatherapy can be a great nonpharmacological way to help the veterans
deal with the stress and cravings that come with addition.

References

45
Chung, Christine. (July 16, 2018). Shumer joins push to open a veterans medical clinic in North
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Community Health Assessment 20142017. Retrieved 10/23/2018.
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Department of Veterans Affairs, & Veterans Health Administration. (2010, October 14).
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http://villageofnorthport.com/cowharbor10k

Rebelo, K. (2016, May 19). Decaying Long Island V.A. Hospital Closes Operating Rooms.
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Evans, M. C. (2017, September 27). Northport VA Medical Center problems blamed on poor
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maintenanceoversight1.14290367

Rogers, T. B. (2013, August 15). MOVE! Weight Management Program. Retrieved October 12,
2018, from https://www.move.va.gov/MOVE/index.asp

US Department of Veterans Affairs, & Veterans Health Administration. (2015, June 9). Northport
VA Medical Center. Retrieved October 12, 2018, from
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Vocational Rehabilitation Programs Northport VAMC [Advertisement]. (2018, October 12).
United States Department of Veterans Affairs, 12.
Planning , O. O. (2015, July 09). National Center for Veterans Analysis and Statistics. Retrieved
from https://www.va.gov/vetdata/stateSummaries.asp
“U.S. Department of Veteran Affairs”. (2018).
https://www.mentalhealth.va.gov/substanceabuse/index.asp

46
“U.S. Department of Veteran Affairs”.(2018). Mental
Health. https://www.mentalhealth.va.gov/ptsd/resources.asp

“US Department of Veteran Affairs”.(2018). National Strategy For Preventing Veteran
Suicide. https://www.mentalhealth.va.gov/suicide_prevention/docs/OfficeofMentalHealthand
SuicidePreventionNationalStrategyforPreventingVeteransSuicide.pdf

“VA Healthcare”.(2018). Veteran Health CarePatient Services and Information.
https://www.northport.va.gov/docs/northportpthandbook.pdf

Howell, T. (n.d.). GI Bill Top 5 Things to Know. Retrieved October 17, 2018, from
https://www.military.com/education/gibill/5mustknowgibillfacts.htm

“Quality of Care.” Go to VA.gov , 25 Oct. 2017,
www.va.gov/QUALITYOFCARE/measureup/End_of_Year_Hospital_Star_Rating_FY2017.asp.

Appendix A

Please identify the dates and times of data collection, as well as the sources of information used in all
parts of this assessment. Each team member may collect notes separately, and the information for the
whole group should be placed in this Appendix.
● On paragraph one I spoke to town personal and residents of the town of Northport on Friday the
5th, 2018. (Luisa)
● On the allocation of resources paragraph I spoke to MR. Sparks on Friday the 5th 2018 (Luisa)
● Regarding the healthcare providers education paragraph, spoke to Jeff Sparks, as well as Jennifer
Rogan about education attainment on October 5th, 2018. (Nicole)
● Regrading the demographics paragraph I accessed the demographic info from the VA website as
well as accessed information on the GI education bill on October 10th, 2018. (Nicole)
● With regards to the interdisciplinary plans of care paragraph I spoke to Jeff Sparks, Jennifer
Rogan and Mary about the care provided to the veterans. As well I observed an interdisciplinary
team meeting in the morning. (Nicole)
● Regarding Morbidity and Mortality, I obtained information the website of Community Commons
and Suffolk Health Department. (Juanita)
● For Consumer Health and Health needs and want of the community I obtained information form
Rogan and Sparks October 5th, 2018. ( Juanita)
● Regarding the esthetics I obtained information from the residents and Northport website. (Olga)
● Regarding the types of care I obtained information from the VA employees. (Olga)
● Interview with Monica Lanning (Ari)
● Vocational Rehabilitation Programs Northport VAMC [Advertisement] (Ari)

47
● In regards to standards of care i accessed the VA website to obtain information on
substance abuse and the way to treat abuse. (Gagandeep)
● I was also able to access information about SAIL and other policies directly on the va
website

Appendix B – Supplemental Data

Place pictures, newspaper articles, fliers, and other supplemental material here. (Do not take pictures of
residents that can reveal their identity. Distant group shots, without identifying information are
acceptable).

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49

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following coordinate points latitude 40.904 and longitude ­73.345 in Suffolk County. The formal

The Village of Northport is located within Town of Huntington, a minor civil division (MCD) of

Huntington in Suffolk County. On the main street are located the library, shops, restaurants, and

but there everyone is happy and are just okay in that town”. Another Northporter who worked in

seen some change over the years. She said that it used to be even more small­town oriented: they

One of the things that the same shopkeeper mentioned was that the community was very diverse;

restaurants and coffee shops every day. One of the local workers at the antique store at 192 Main

different towns, they share the similar experience of serving our country. The hospital embraces,

Report Total Total Total Years of Years of Potential Life Lost,

Area Population Premature Potential Life

*New Suppressed Suppressed Suppressed Suppressed

Suffolk 97,314 14,354 5,220 5,364

New York 55,344,718 186,651 3,320,650 6,000

United 896,379,917 3,642,755 64,739,406 7,222

health care fare for older adults and patients diagnosed with mental illness or dementia increases.

fund the VA hospital, but even so it is not enough to cover all the of the veteran’s medical needs,

the facility, the programs, and personnel. According to Mr. Sparks; the acting associate and chief

director of nurses, the VA is the most extensive healthcare system in the world, and on that note,

fosters vegan food, organic markets, and has no fast food restaurants within the village. The only

approach. One of the workers of Organically Yours said that many of the customers are regulars

addictions, and mental health illnesses. The VA Northport veterans hospital offers the following

hospice and palliative care, interactive training GBT Patient­centered care, mental health , nurses

Rehabilitation, Substance Abuse Residential Rehabilitation Treatment Program (SARRTP),

for patients that have a mental illness diagnosis such as, bipolar disorder. The patients are seen at

that the veteran community is in need of many services, most of which the hospital provides and

monetary resources to run longer, or the health care providers to treat everyone, and resources to

regardless. When the services are not available at the VA Northport , the patient that is approved

by the VA will be sent to a private source , and that health provider will be reimbursed ” (Acting

S-ar putea să vă placă și

following coordinate points latitude 40.904 and longitude 73.345 in Suffolk County. The formal

seen some change over the years. She said that it used to be even more smalltown oriented: they

hospice and palliative care, interactive training GBT Patientcentered care, mental health , nurses