Select a family within your community for this assignment. The family must have at least 3 members with 1 member under the age of 18 living within the home.
Prior to meeting the family, make sure to:
Review the key points of therapeutic conversation.
Visit the Centers for Disease Control and Prevention (CDC) website for parenting resources (e.g., prevention of child abuse and neglect resources).
Study the definitions of child abuse and neglect in your state regulations.
Watch the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) webinar on screening for child abuse and neglect.
Download and familiarize yourself with the ISPCAN Child Abuse Screening Tools (ICAST-P and ICAST-C). These tools will help you frame questions to screen for child abuse and neglect in a safe, empathetic, and therapeutic manner.
Meet with your preceptor, and together, select 3 key questions from the child and parent versions (3 from each for a total of 6) of the above screening tool to ask your chosen family.
Meet with the family and assess through discussion and observation, critical information to understanding the family unit, including:
Demographic data (i.e., age in years, self-identified race/ethnicity, languages spoken in the home, gender identification, health insurance status of all family members)
Developmental stage and history of family (e.g., Erikson’s developmental stages)
Environmental data (e.g., exposure to lead, house cleanliness)
Family structure (i.e., who makes up the family?)
Family functions (i.e., roles, responsibilities, and occupations)
Family stress and coping (An example of family stress is a family with a child or children with developmental disabilities. Healthy coping strategies include joining a parental support group and/or having an ongoing professional relationship with a caring healthcare provider.)
Family composition (e.g., “Yours, mine, and ours;” caring for an extended family member)
Parenting styles (i.e., authoritarian, permissive, authoritative, neglectful)
Identify any weaknesses, limitations, or vulnerabilities that might be interpreted as or place the family at risk for abuse and/or neglect; and discuss with the parents or guardians ways they might strengthen their parenting skills and/or address the perceived vulnerabilities.
Part 2: Clinical Activities: Community Assessment and Intervention (4 Direct Care Clinical Hours)
Discuss your windshield survey findings with your chosen family. In collaboration with your chosen family:
Prioritize the problems you have identified based on a recognized gap in community resources that could contribute to one or more poor health outcomes.
Identify at least 1 area where parents/guardians might benefit from additional assistance or resources to strengthen their parenting skills (Diagnose).
Provide support and resources to minimize any health risk factors to your family. Resources should include other professionals from the community to work with the family and the public health nurses as part of an interprofessional health care team (e.g., social services, psychiatric/mental health resources, teachers, religious leaders) (Intervene).
Evaluate the family members’ understanding of the information provided. You might accomplish this evaluation by asking the family which of the resources they might consider using. Ask them to tell you how they would access these resources (Evaluate).
Compile your windshield survey data using the Windshield Survey and Family-Level Narrative Template to include:
Data overview of all community components as identified in the Community Toolbox resource
Strengths of community as evidenced by the windshield survey
Weaknesses (gaps in service) as evidenced by the windshield survey
Using the space provided at the end of the Windshield Survey and Family-Level Narrative Template, document the family prioritized problems (Diagnoses) from the windshield survey review, community resources provided, and your evaluation of the family’s understanding of how to access community resources.
List 2 family-level problems (also described as nursing diagnoses):
One family-level problem that is affected by the lack of community resources. For example, a single parent cannot access affordable daycare in the community because the closest subsidized daycare in the county is located 25 miles away in the opposite direction from work requiring the parent to leave the child unsupervised while they work or choose not to work. The problem (or diagnosis) might be written as, “Presence of a family stress point – lack of accessible, affordable childcare.”
One family-level problem based on the family assessment and that you and the parents/guardians together identified that would benefit from strengthening or changing. For example, a grandparent who lives in the home, has chronic cancer pain, and is in palliative care. The grandparent has been prescribed fentanyl patches and has been discarding used patches in the family garbage can. You and the family decide that this is a safety issue. The problem (or diagnosis) might be stated as “Presence of a health threat – potential for accidental opioid overdose.”
Submit your completed Windshield Survey and Family-Level Narrative Template that includes 2 family prioritized problems (nursing diagnoses), community resources provided, and an evaluation of the family’s understanding of how to access community resources.