Community Assessment, Papers of Nursing

Community Assessment for Galen Louisville. Community Nursing

Typology: Papers

2025/2026

Uploaded on 02/04/2026

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COMMUNITY ASSESSMENT REPORT FORM
Name of Community
Part I: Community Data
Component: Community Data (express results in
%)
Live Births:
Community/County
General Death
Mortality (general)
Infant
Heart Disease
Cancer
Stroke
Accidents
Diabetes
Suicide
AIDs
Morbidity
Tuberculosis
Syphilis
Gonorrhea
AIDS
Life Expectancy
Component: Census Data (% where indicated)
Population Count
Persons under 5 years (%)
Persons under 18 years (%)
Persons 65 years and over (%)
White alone (%)
Black or African American
alone (%)
Asian alone (%)
Native Hawaiian and other
Pacific Islander alone (%)
Two or More Races (%)
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Name of Community Part I: Community Data Component: Community Data (express results in %) Live Births: Community/County General Death  Mortality (general)  Infant Heart Disease Cancer Stroke Accidents Diabetes Suicide AIDs Morbidity Tuberculosis Syphilis Gonorrhea AIDS Life Expectancy Component: Census Data (% where indicated) Population Count Persons under 5 years (%) Persons under 18 years (%) Persons 65 years and over (%) White alone (%) Black or African American alone (%) Asian alone (%) Native Hawaiian and other Pacific Islander alone (%) Two or More Races (%)

Hispanic or Latino (%) Foreign Born Persons (%) High School Graduate or Higher (age 25+) (%) Language other than English spoken at home (%) Bachelor’s degree or higher (%) Veterans (%) Median household income Poverty (%) Identify Vulnerable Populations & Identify 2 Potential Health Care Needs Vulnerable Population: Click or tap here to enter text. Two health care needs: Click or tap here to enter text. Part II: Environmental Assessment Component: Environmental Assessment Assessment Describe the Implications of:  Chemical exposure on health  Lead exposure on health  Poor Air quality on health  Unequal Distribution of Burden Toxic Chemicals :  Top Polluter in County  Top Chemical Released in County Click or tap here to enter text. Click or tap here to enter text. Lead Hazards:  % of houses with high risk of lead Click or tap here to enter text. Air:  Top Polluter in County Click or tap here to enter text. Environmental Justice: (Environmental Justice Mapper)  Identify Click or tap here to enter text.

Email: Click or tap here to enter text.

  1. Develop a community diagnosis. Use the correct format: Health Risk/problem/potential of/for (specific injury, illness, or potential of, complications of, etc.) among (specific population) related to (supporting evidence of risk factors) as evidenced by (contributing factors). Click or tap here to enter text.
  2. Identify 1 possible solution to address targeted need. Click or tap here to enter text.
  3. Identify 1 primary, secondary, or tertiary intervention strategy to address targeted need. Click or tap here to enter text.
  4. Develop 1 expected outcome in the form of a measurable objective - delineate who, what, and when (outcome objective, process objective, management objectives). Click or tap here to enter text.
  5. Delineate 2 evaluation strategies (to determine if the intervention was successful). Click or tap here to enter text.
  6. Identify potential resources needed to address targeted need (list a minimum of 3). Click or tap here to enter text.