Running Head: Care Plan for Struthers’ Community Struthers Care Plan 1

Struthers Community Care Plan

Youngstown State University

 Struthers Care Plan 2

Healthy People Goal 2020:

- The goal is to improve the health and well being of women, children, infants and
families. (healthypeople.gov)

Short Term Goal:

- Set a plan with the local council members in order to provide teaching and grant access
for pregnant women, or women who plan on becoming pregnant, to prenatal care and
care throughout their pregnancy.

Long Term Goal:

- With the teaching and access to health care there would hopefully be a decrease in the
infant mortality rate within the city of Struthers.

Outcome Criteria:

- In the first three months, there will be a local council meeting, with the public
community invited, to discuss possible options on how to increase prenatal health care
and education. The six council members will then begin planning a way to make the
ideas become possible.
- At 6 months, the council members will meet with the Struthers Board of Education to
implement that the importance of prenatal care and checkups as part of the sex
education curriculum. This would reach young adolescence which is one of the most at
risk groups to not receive prenatal care and to have pre term labor or other
complications.
- By 18 months, the city will begin creating a clinic that can provide females with
education on pregnancy, yearly checkups, and prenatal care.
- After 24 months, the clinic will be well established in an area that is easy to access due
to close proximity of the local bus stop and residents will have access to the health care
they need.
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Nursing Diagnosis:

- Risk for ineffective Childbearing Process related to lack of prenatal health visits and
deficient knowledge.

As Evidenced By:

- In 2010 only 46% of mothers had first trimester prenatal care and of the 2,419 births
that year, 9 of them resulted in death and 247 had low birth weights.
- 411 mothers admitted to smoking while pregnant which could lead to miscarriage, low
birth weight, pre-term labor, still birth and neonatal anomalies.
- Struthers has no OBGYN specialist or local health clinics nearby that could provide
access to prenatal care both before pregnancy and during. This would mean that
residents would have to drive to Boardman and Poland areas for the health care they
need which may not be possible.
- The schools provide no education to their students on the importance of prenatal care
even with the rising number of teen pregnancies and adolescence being one of the most
at risk for not receiving prenatal care.

Interventions:

- Ensure that pregnant clients have an adequate diet and take multimicronutrient
supplements during pregnancy.
- Assess smoking status of pregnant client and offer effective smoking-cessation
interventions.
- Assess for signs of depression and make appropriate referral: inadequate weight gain,
underutilization of prenatal care, increased substance abuse and premature birth.
- Refer a client to a centering pregnancy group (8-10 women of similar gestational age
receive group prenatal care after initial obstetrical visit).

Rationale:

- Nutrition plays an important role in the growth and development of the fetus. Overall
the diet of pregnant women has been reported to be deficient in calories and
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micronutrients. Prenatal supplementation was associated with significantly reduced

low-birth-weight infants and improved birth weights. (Shah et al, 2009)
- Smoking in pre term infants is associated with delivery of preterm infants, low infant
birth weight, and increased infant mortality. After delivery, exposure to secondhand
smoke can increase an infant’s risk for respiratory tract infections and for sudden infant
death syndrome. (Tong et al 2009)
- Engagement is important as untreated depression in pregnancy may have unfavorable
outcomes for both women and children. (Sexton et al 2012)
- African-American women in group care had significantly lower preterm births. (Klima
2009). Birth weight was greater in infants with group prenatal care compared to those
with individual care. (Jafari et al 2010)