Sunteți pe pagina 1din 55

5/3/2019

Community Paper - Google Docs

RunningHead:CommunityAssessment:VANorthport

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Table of Contents

2

DescriptionoftheCommunity(LuisaCortesandAriClara)……………………………………….3­6

MorbidityandMortality(JuanitaRazak)

7­9

Demographics(NicoleHartcorn)

9­14

EnvironmentalConcerns(AriClara,LuisaCortes)

14­16

PublicServices(GagandeepSingh)

16­19

Aesthetics(VolhaPalitava)

19­21

HealthRelatedFacilities(VolhaPalitava)

21­23

CareManagementTechniques………………………………………………………………………23­30

AvailabilityofResources(GagandeepSingh) CommunityWantsandNeeds(JuanitaRazak) TypesofCare(VolhaPalitava) StandardsofCare(GagandeepSingh) InterdisciplinaryPlanofCare(Nico leHartcorn)

TypesofCare(VolhaPalitava) StandardsofCare(GagandeepSingh) InterdisciplinaryPlanofCare(Nico leHartcorn)
TypesofCare(VolhaPalitava) StandardsofCare(GagandeepSingh) InterdisciplinaryPlanofCare(Nico leHartcorn)
TypesofCare(VolhaPalitava) StandardsofCare(GagandeepSingh) InterdisciplinaryPlanofCare(Nico leHartcorn)
TypesofCare(VolhaPalitava) StandardsofCare(GagandeepSingh) InterdisciplinaryPlanofCare(Nico leHartcorn)

23­25

25­26

26­27

27­29

29­30

InfluencesofResourceAllocationDecisions………………………………………………………30­38

AllocationofResources(LuisaCortes)

30

ValuesandBeliefs(LuisaCortes)

30­33

SpecialInterests(AriClara)

33­36

HealthcareInsuranceCoverage(AriClara)

36

ConsumerinHealthcare(JuanitaRazak)

36­37

HealthcareProvidersEducation(NicoleHartcorn)

37­38

VoiceoftheCommunity(Groupparagraph)

38­39

NursingDiagnosis(Nameafterdiagnosis)

39­41

Evaluation(Nameafterparagraph)

41­44

TeachingPlan…………………………………………………………………………………….44

References……………………………………………………………………………………….45­46

AppendixA…………………………………………………………………………………… 46­47 AppendixB…………………………………………………………………………………… 47­55

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

DescriptionoftheCommunity

3

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

4

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

5

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.)

and therefore they are at many health risks. (A. C., L.C.)
and therefore they are at many health risks. (A. C., L.C.)
and therefore they are at many health risks. (A. C., L.C.)
and therefore they are at many health risks. (A. C., L.C.)
and therefore they are at many health risks. (A. C., L.C.)

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 6
Paper - Google Docs CommunityAssessment:VANorthport 6
Paper - Google Docs CommunityAssessment:VANorthport 6
Paper - Google Docs CommunityAssessment:VANorthport 6
Paper - Google Docs CommunityAssessment:VANorthport 6
Paper - Google Docs CommunityAssessment:VANorthport 6

6

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

7

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

8

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.

Mortality­PrematureDeath

Report

Total

Total

TotalYearsof

YearsofPotentialLifeLost,

Area

Population

Premature

PotentialLife

Rateper100,000Population

Death,

Lost,

2014­2016

2014­2016

Average

*New

Suppressed

Suppressed

Suppressed

Suppressed

York

11768

Suffolk

97,314

14,354

5,220

5,364

County,

NY

NewYork

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

9

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

10

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.

changes that have or may occur in the coming years. Gender In the VA healthcare system

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

11

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).

of age, who make up less than 10% (va.gov/vetdata, 2018). Refer to this picture for all

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

12

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

13

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.)

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

14

Paper - Google Docs CommunityAssessment:VANorthport 14 This Chart show the future trends predicted by the U.S.

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

15

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

16

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

17

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

18

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

19

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

20

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 located 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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

21

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.

Health Related Facilities

There are various health facilities available to the community of Northport. However, we

have to remember that the 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.

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

22

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.

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 services ranging from 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.

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

23

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

CAREMANAGEMENTTECHNIQUES

Availability of Resources

(V.P.) CAREMANAGEMENTTECHNIQUES Availability of Resources

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

24

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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)

CommunityWantsandNeeds

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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. Emotional 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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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)

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Interdisciplinary Plan of Care

29

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.)

INFLUENCESONRESOURCEALLOCATIONDECISIONS

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.)

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport Special Interests 33 The Northport VA provides specialized
Paper - Google Docs CommunityAssessment:VANorthport Special Interests 33 The Northport VA provides specialized
Paper - Google Docs CommunityAssessment:VANorthport Special Interests 33 The Northport VA provides specialized
Paper - Google Docs CommunityAssessment:VANorthport Special Interests 33 The Northport VA provides specialized

Special Interests

33

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

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.)

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)

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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 )

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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,

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.)

VOICEOFTHECOMMUNITY

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Interventions:

41

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.

EVALUATIONOFTHECOMMUNITYASSESSMENTPROJECT

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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.

Part2:ApplicationofassessmentintoaCommunityHealthTeachingPlan

Objective:Toidentifyhealtheducation/promotionprojectwithyourtargetCommunityHealth

clinicalpopulationbasedonthehealthissuesidentifiedatyourclinicalsite.

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

44

1. AssessyourtargetpopulationandcommunityusingtheCommunityAssessment/

WindshieldSurveyfromPart1

2. Identifiedhealthneedandtheeducationaltopicofthattargetgroupwithsupportingdata–

rationaleastowhythegroupchosethisteachthetopic.(Thisshouldonlybe1­2paragraphsatthe

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

45

Chung, Christine. (July 16, 2018). Shumer joins push to open a veterans medical clinic in North Hempstead.Reterive: 10/12/2018. www. newday.com/long­island/nassau/north­hempstead.

Community Health Assessment 2014­2017. Retrieved 10/23/2018. http://www.suffolkcountyny.go

Department of Veterans Affairs, & Veterans Health Administration. (2010, October 14). Northport VA Medical Center. Retrieved from https://www.northport.va.gov/

Rebelo, K. (2016, May 19). Decaying Long Island V.A. Hospital Closes Operating Rooms. Retrieved October 11, 2018, from

https://www.nytimes.com/2016/05/20/nyregion/decaying­long­island­va­hospital­closes­operatin

g­rooms.html

Evans, M. C. (2017, September 27). Northport VA Medical Center problems blamed on poor maintenance oversight. Retrieved October 11, 2018, from https://www.newsday.com/news/health/northport­va­medical­center­problems­blamed­on­poor­

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 https://www.northport.va.gov/services/homeless/index.asp

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

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

46

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

“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

“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

Pleaseidentifythedatesandtimesofdatacollection,aswellasthesourcesofinformationusedinall partsofthisassessment. Eachteammembermaycollectnotesseparately,andtheinformationforthe wholegroupshouldbeplacedinthisAppendix.

Onparagraphone Ispoketotown personalandresidentsof thetownofNorthportonFridaythe

5th,2018.(Luisa)

OntheallocationofresourcesparagraphIspoketoMR.Sparks onFridaythe5th2018(Luisa)

Regardingthehealthcareproviderseducationparagraph,spoketoJeffSparks,aswellasJennifer

RoganabouteducationattainmentonOctober5th,2018.(Nicole)

RegradingthedemographicsparagraphIaccessedthedemographicinfofromtheVAwebsiteas

wellasaccessedinformationontheGIeducationbillonOctober10th,2018.(Nicole)

WithregardstotheinterdisciplinaryplansofcareparagraphIspoketoJeffSparks,Jennifer RoganandMaryaboutthecareprovidedtotheveterans.AswellIobservedaninterdisciplinary teammeetinginthemorning.(Nicole)

RegardingMorbidityandMortality,IobtainedinformationthewebsiteofCommunityCommons andSuffolkHealthDepartment.(Juanita)

ForConsumerHealth andHealthneedsandwantofthecommunityIobtainedinformationform

RoganandSparksOctober5th,2018.(Juanita)

RegardingtheestheticsIobtainedinformationfromtheresidentsandNorthportwebsite.(Olga)

RegardingthetypesofcareIobtainedinformationfromtheVAemployees.(Olga)

Interview with Monica Lanning (Ari)

Vocational Rehabilitation Programs Northport VAMC [Advertisement] (Ari)

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

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

AppendixB–SupplementalData

Placepictures,newspaperarticles,fliers,andothersupplementalmaterialhere. (Donottakepicturesof residentsthatcanrevealtheiridentity. Distantgroupshots,withoutidentifyinginformationare acceptable).

acceptable).
acceptable).

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 48
Paper - Google Docs CommunityAssessment:VANorthport 48
Paper - Google Docs CommunityAssessment:VANorthport 48
Paper - Google Docs CommunityAssessment:VANorthport 48
Paper - Google Docs CommunityAssessment:VANorthport 48

48

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 49
Paper - Google Docs CommunityAssessment:VANorthport 49
Paper - Google Docs CommunityAssessment:VANorthport 49
Paper - Google Docs CommunityAssessment:VANorthport 49

49

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 50
Paper - Google Docs CommunityAssessment:VANorthport 50
Paper - Google Docs CommunityAssessment:VANorthport 50

50

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 51
Paper - Google Docs CommunityAssessment:VANorthport 51
Paper - Google Docs CommunityAssessment:VANorthport 51

51

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52
Paper - Google Docs CommunityAssessment:VANorthport 52

52

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 53
Paper - Google Docs CommunityAssessment:VANorthport 53
Paper - Google Docs CommunityAssessment:VANorthport 53
Paper - Google Docs CommunityAssessment:VANorthport 53
Paper - Google Docs CommunityAssessment:VANorthport 53
Paper - Google Docs CommunityAssessment:VANorthport 53

53

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport ­ 54
Paper - Google Docs CommunityAssessment:VANorthport ­ 54
Paper - Google Docs CommunityAssessment:VANorthport ­ 54
Paper - Google Docs CommunityAssessment:VANorthport ­ 54

­

54

5/3/2019

Community Paper - Google Docs

CommunityAssessment:VANorthport

Paper - Google Docs CommunityAssessment:VANorthport 55

55