PURPOSE.To describe the application of group-appropriate methods to derive actual nursing diagnoses for a community.
METHODS.A triangulation method using multiple sources of data, including an environmental survey, fish consumption survey, government reports, publications, and community assessments
FINDINGS.Three priority community environmental nursing diagnoses for aggregates within the community: Knowledge deficit among community residents related to lack of awareness of contaminants in the Anacostia River; “risk for adverse human health effects” among pregnant and nursing women and preschoolers related to consumption of chemically contaminated fish; and knowledge deficit among community residents related to lack of awareness of health effects of consuming chemically contaminated fish.
CONCLUSIONS. The diagnoses serve as the basis for community education and other interventions. The methods are practical and useful for this type of research.
PRACTICE IMPLICATIONS. The nursing profession is experiencing a growing awareness of the close relationship between environmental health and the health of individuals and communities. There is a need for diagnostic labels to describe the responses of aggregates and communities to environmental hazards and conditions.
Agency for Toxic Substances and Disease Registry. (1999). Toxicological profile for mercury. Atlanta, GA: U.S. Department of Health & Human Services, Public Health Service.
2.
Agency for Toxic Substances and Disease Registry. (1996). Toxicological profile for polychlorinated biphenyls. Atlanta, GA: U.S. Department of Health & Human Services, Public Health Service.
3.
Agency for Toxic Substances and Disease Registry. (1995). Chlordane. Atlanta, GA: U.S. Department of Health & Human Services, Public Health Service.
4.
Agency for Toxic Substances and Disease Registry. (1993). Toxicological profile for lead. Atlanta, GA: U.S. Department of Health & Human Services, Public Health Service.
5.
BaldwinJ.H.CongerC.O.AbegglenJ.C.HillE.M. (1998). Population-focused and community-based nursing: Moving toward clarification of concepts.Public Health Nursing, 1512–18.
6.
BlockE. (1990). Organochlorine residues and histopathologic examination of fish from the Potomac and Anacostia Rivers, Washington, DC, Annapolis, MD: U.S. Fish and Wildlife Service.
7.
ColerM.S.PaulaN.M.AciolyC.M. (1999). Nursing diagnosis and its utilization in the development of a community. In RantzM.J.LemoneP., (Eds.), Classification of nursing diagnoses: Proceedings of the thirteenth conference (p. 585). Glendale, CA: CINAHL.
8.
ColerM.S.FilhaM. de O.F.OzaltingG.GormanD.RigolA.OudN. (1999). Violence: A NANDA nursing diagnosis targeted as a universal problem: One proposal for prevention and intervention. In RantzM.J.LemoneP., (Eds.), Classification of nursing diagnoses. Proceedings of the thirteenth conference (pp. 377–389). Glendale, CA: CINAHL.
9.
DenzinN. K. (1989). The research act (3rd ed.). New York: McGraw-Hill.
10.
DC Coalition on Environmental Justice. (1996). Troubled waters: A survey of pollution sources in our nation's capital. Washington, DC: Author.
11.
EPA Summer Interns. (1996). The forgotten river: A survey of fishing habits and fish consumption of residents of Washington, DC. Richmond, VA: Virginia State University.
12.
GreenP.M. (2000). Taking environmental health education seriously.Nursing and Health Care Perspectives, 27234–239.
13.
Howard University Senior Nursing Students. (1999). Community health nursing course projects—Community assessments of Wards 7 and 8 (1996–1999). Washington, DC: Author.
14.
KlassenC.D.AmdurM.A.DoullJ. (1996). Casarett and Doull's toxicology: The basic science of poisons (5th ed.). New York: McGraw-Hill.
15.
KnaflK.A.GalloA. (1995). Triangulation in nursing research. In TalbotL.A., (Ed.), Principles and practice of nursing research (pp. 495–509). St. Louis: Mosby.
16.
LindemanC. (1993). To prepare a preventionist.Nursing and Health Care, 14486.
17.
LipscombJ. (1994). Environmental health: Assuming a leadership role.American Association of Occupational Health Nursing Journal, 42314–315.
18.
NeufeldA.HarrisonM. (1990). The development of nursing diagnoses for aggregates and groups.Public Health Nursing, 7251–255.
19.
NeufeldA.HarrisonM. (1994). Use of nursing diagnosis with population groups.Nursing Diagnosis, 5165–171.
20.
NeufeldA.HarrisonM. (1995). Integrating nursing diagnosis for population groups within community health nursing practice.Nursing Diagnosis, 637–41.
21.
NeuferL. (1994). The role of the community health nurse in environmental health.Public Health Nursing, 11155–162.
22.
NightingaleF. (1969). Notes on nursing: What it is and what it is not. New York: Appleton. (Originally published 1859).
23.
North American Nursing Diagnosis Association. (1999). Introduction to the proposed taxonomy II: A multiaxial health patterns framework. In NANDA nursing diagnoses: Definitions and classification 1999–2000 (pp. 160–166). Philadelphia, PA: Author.
24.
PenderN.J. (1992). Environmental compatibility: Accepting the challenge.Nursing Outlook, 40200–201.
25.
PinkneyA.E.BurtonL.C.ScottG.J.FrithsenJ.B. (1993). An assessment of potential effects of the January 1992 oil spill in the Anacostia River. Columbia, MD: Versar.
26.
PolitD.F.HunglerB.P. (1999). Nursing research principles and methods (6th ed.). Philadelphia: Lippincott Williams & Wilkins.
27.
PopeA.M.SnyderM.A.MoodL.H. (1995). Nursing, health and the environment: Strengthening the relationship to improve the public's health. Washington, DC: National Academy Press.
28.
RogersB.CoxA.R. (1998). Expanding horizons: Integrating environmental health in occupational nursing.American Association of Occupational Health Nursing Journal, 469–13.
29.
SalazarM.K. (2000). Environmental health: Responding to the call…Public Health Nursing, 1773–74.
30.
SchultzP.R. (1987). When the client means more than one: Extending the foundational concept of person.Advances in Nursing Science, 10 (1), 71–86.
31.
ShamanskyS.L.PeszneckerB. (1981). A community is…Nursing Outlook, 29182–185.
32.
ShusterG.F.GoeppingerJ. (1996). Community as client: Using the nursing process to promote health. In StanhopeM.LancasterJ., (Eds.), Community and public health nursing (4th ed., p.299). St. Louis: Mosby.
33.
StanhopeM.LancasterJ. (2000). Community and public health nursing (5th ed.). St. Louis: Mosby.
34.
U.S. Department of Health and Human Services. (2000). Healthy people 2010. Washington, DC: Author.
35.
VelinskyD.J.CumminsJ.D. (1994). Distribution of chemical contaminants in wild life fish species in Washington, DC. Rockville, MD: Interstate Commission on the Potomac River Basin.
36.
WarnerA.SheppD.CornishK.GalliJ. (1997). An existing source assessment of pollutants to the Anacostia Watershed. Washington, DC: Department of Environmental Programs, Metropolitan Washington Council of Governments.
