Marissa Brown & Riley Murphy NURS 2020H

Project Note 1
Part 1:
The importance of a community assessment is to evaluate the current and potential needs
of a population in order to provide care that is holistic and targeted towards their specific needs
(Stanhope & Kollmueler, 1997). A community assessment also gives information about the
current status of the community such as policies and other systems and can indicate areas for
health improvement (CDC, 2013). In our specific community, PREPACE, an assessment is
needed to successfully provide relevant interventions to reduce the spread of disease and
infection and ensure they are sustainable. In PREPACE, the social determinants of health that are
affected may include: education, income, access to potable water, employment and working
conditions and food insecurity.
The target population for our project is the caregivers and workers of the orphanage. The
caregivers are mostly women who likely do not have a high level of education or knowledge
base surrounding the topics of handwashing and infection control. This population is different
from the majority of the Honduran population because they are providing care to others and have
a higher risk of transmitting and receiving disease due to the close contact with the children.
They are also different from other caregivers in the country because they are caring for children
with disabilities. This may require different techniques and other specific modifications to our
project to ensure our interventions are safe and successful. The target population is also different
from caregivers in a developed country because they do not have as much knowledge or
resources available regarding handwashing and advanced care methods pertaining specifically to
children with disabilities.
PREPACE is located in el Hatillo about twenty minutes north-east of Tegucigalpa in the
mountains. A boundary that affects the population of PREPACE would be their access to clean
water. The population gets clean, filtered water delivered to them, this water must be preserved
so that it lasts until the next delivery. This could have a negative impact on the population
because if they run out of water, they may drink or use contaminated water. This could increase
their risk for illness and the transfer of disease. Another boundary this population might face is
due to their location as well as special needs. Since the children at PREPACE have varying
disabilities, they may need specialized supports and programs in order to achieve optimal well-
being. Since they are located up in the mountains, they may not have those supports easily
accessible. They also may not be able to have access to a sufficient amount of food, let alone
healthy food, due to factors such as funding and secluded located. This population may face
other boundaries however since we have not visited, we are unclear as to what the community
dynamics are about.
For our project, we would need to know the level of education of the staff in order to
focus our project towards their specific level of understanding. To obtain this information, we
would look at statistics for the community as well as internet searches. We could also speak with
former students and staff on the trip. We would also need to know about their frequency of
access to clean, filtered water (timing, how much) in order to implement a sustainable and
effective handwashing intervention. To find out this information, we would have to connect with
David who can assess the current situation before we leave. During our stay, we can also access
this information ourselves. It would also be useful to know the daily routine of the caregivers in
order to enforce handwashing at relevant times throughout the day. We could gather this
information again from David before we depart as well as while we are visiting.
Marissa Brown & Riley Murphy NURS 2020H

The most practical way to gather information from our community would be through
observation and by asking questions to assess the current situation and formulate the level of
intervention needed. We would be observing the caregivers and assessing the frequency in which
they hand wash and the effectiveness of this handwashing. After our presentation and continually
throughout our stay, we will ask some applicable questions in order to get an understanding for
how much information the caregivers retained. These interventions will ensure that we as a
health promotion team have delivered an effective and sustainable strategy for handwashing. We
will encourage the community to continually hand wash by providing verbal prompts when we
are on site as well as posters on how and when to effectively hand wash for reference when we
leave the country.
A constraint that we face when completing this community assessment is time and the
potential for us to lack necessary materials. As this assessment needs to be done in country and
we are only there for a limited amount of time, our assessment needs to be done quickly,
promptly, and effectively so that we are able to start our project as soon as possible. There is a
possibility that upon assessment, we may discover some unforeseen challenges that we may not
have been prepared for. Since we are in a developing country, we may not have access to
specific materials we need and may need to improvise. A resource that we do have, is the ability
to speak with both the caregivers and our clinical instructor in order to come up with a plan that
is effective and sustainable. Another constraint that we might face with our project is the lack of
previous knowledge of the community before formulating our project. A more ideal (but
impractical) situation would be to visit and assess the community, then formulate our project.
This could potentially reduce the amount of unforeseen challenges that we might face and could
increase the effectiveness of our project.

Part 2:
Project Goal 1:
To educate the caregivers at PREPACE in regard to when, how and why to effectively hand
wash during our time spent at the orphanage. This can be measured through the glo-germ activity
as well as a short verbal quiz testing comprehension of material.

Objectives
1. Facilitate a glo-germ activity to assess how well the caregivers can effectively remove the
glo-germ through handwashing.
o Give a refresher on how to properly wash hands (steps from the CDC graphic).
o Look at hands for left over glo-germ after washing and individually assist those
who may be in need of extra assistance.
2. Educate the caregivers on when to hand wash in order to prevent the spread of germs and
infection.
o Through the cards in the presentation we will be able to visually demonstrate
when the caregivers should be washing their hands relevant to their duties
(before/after meals, before/after care, etc.)
o Asking after presentation for caregiver to repeat the “when’s” of handwashing in
order to ensure comprehension of taught materials.
o Implement posters around washing stations in the buildings to ensure continued
handwashing.
Marissa Brown & Riley Murphy NURS 2020H

3. Educate the caregivers regarding the importance of handwashing in order to prevent the
spread of disease and infection, as well as ensure they know why their hands need to be
washed.
o Provide statistics regarding the reduction of certain diseases/illnesses when
effective handwashing is implemented. Statistics will be provided in a visual
format to ensure comprehension.
o Glo-germ activity shows how germs can be spread through person to person or
through fomites. This will attempt to give a visual on the importance of
handwashing in order to prevent the spread of germs.

Project Goal 2:
To educate about and implement 4 “Veronica Buckets” in various accessible locations around
the orphanage in order to increase the access to and incidence of handwashing. The buckets will
be implemented during our time at the orphanage and can be potentially evaluated by gathering
data in future years about how often the stations are being used as well as incidence of diarrheal
disease related to improper handwashing.

Objectives:
1. Implement the bucket stations in locations that are convenient and accessible.
o Assess upon arrival which locations would be the most effective.
o Throughout the time spent at the orphanage assess and evaluate effectiveness of
locations and make location changes if necessary.
2. Education of the caregivers about how to use the stations while maintaining infection control
measures.
o Educate that the tap for the running water is considered dirty and that after hands
have been washed, the tap must be closed with a cloth or another body part to ensure
hands are not re-contaminated.
o Explain that the “dirty” water collected from washing hands can be used to flush
toilets. This ensures the little water they have will be used to its full potential.
3. Education of the security guard about how to make and repair the stations.
o We will bring an instruction manual for the security guard to use for future reference
with step by step pictures taken during the prototype build.
o Ensure that materials used to make and repair the buckets can be locally sourced and
accessible to guarantee continued use.
Marissa Brown & Riley Murphy NURS 2020H

References

Stanhope M., Kollmueler, R. N., (1997). Public and community health nurse’s consultants: A

health promotion guide. T. Louis, Mosby

(2013). Community Needs Assessment. Atlanta, GA: Centers for Disease Control and Prevention

(CDC).