Community Assessment of

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Community Assessment of

• Puyallup

Heather Brook, Lauren Eaton, Kristin Faber,
Christine Le, Nicole Reinke, Sarah Voelpel
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Map and Boundaries

• Encompasses approximately 11 square miles
• Bounded by
• Highway 167 to the North
• 136th St to the South (encompassing South Hill)
• Highway 162 to the East
• Fruitland Ave to the West
• Cut in half by Highway 512
• Surrounding cities include Edgewood, Bonney Lake,
  Sumner, Orting

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Demographic Information

• Puyallup population is 36,930 (City of Puyallup)
• Washington population is 5,894,121 (US Census)

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Demographic Information

• Population Age
• Under 5 years old 6.9
• Under 18 years old 27.3
• Older than 65 years old 10/9
• Median Age 34.1 years

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Ethnicity
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Poverty and Unemployment Rates
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Education bar graph http//www.clrsearch.com/RSS/
Demographics/WA/Puyallup/Education_Level_Profile
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Employment

• Common Occupations
• Men
• Construction 14
• Transportation equipment 8
• Women
• Healthcare 17
• Education 14

• Largest employers in the area
• Fort Lewis Army Base
• McChord Air Force Base
• Tacoma Public Schools
• Madigan Army Medical Center
• Pierce County
• Puyallup School District
• Franciscan Health System

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History

• First settlers came in 1830s
• The Puyallup School District was formed in 1854
• First school house and library were built in 1862
• Washington was admitted to the union as the 42nd
  state in 1889
• The first fair was developed in 1900

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Patterns of Movement

• Puyallup is easily accessible from surrounding
  highways
• Downtown Puyallup consists of one way streets and
  is a mixture of small business and suburban
  housing
• South Hill/Meridian area has high traffic
  congestion and many retail businesses
• Due to proximity to Mt. Rainer, Puyallup has an
  evacuation route and shelter, should an eruption
  occur

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Transportation

• High traffic congestion
• Personal car commute time 27 mins
• Sound Transit Train
• Pierce Transit Bus
• Commute time 59 mins

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Safety

• 33 Registered sex offenders
• Good Samaritan Hospital is the only hospital in
  the community
• 1.54 police officers per thousand residents

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Recreation and Gathering Places

• 14 City Parks
• Recreation Center
• Senior Services at Puyallup
• Activities Center
• South Hill Mall
• Pioneer Park Grayland Park
• Western Washington State Fair Grounds
• Bradley Lake
• Puyallup Main Street Farmers Market

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Puyallup School District

• 22 Elementary schools
• 7 Junior high schools
• 4 High schools

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Puyallup Community A Systems Approach
School District 22 elementary Schools 7 Middle
Schools 4 High schools
Bradley Lake
Agriculture
Input State funding Individual
Finances Residents Educational
background Employment History Resources (raw
materials imported) Imported Food
Output Retail goods (Mall/shops)
Jobs Money Mail Satisfied Community
Members Hidden Valley Landfill
Several Parks/ outdoor recreation facilities
Banks
Western Washington State Fairgrounds
Bus Station
Costco
Library
Throughput
Mayor
Good Samaritan Hospital
South Hill Mall
Police Station/Fire Department
Meeker Mansion
Chamber of Commerce
Government
Churches
Sounder (Train)
Retirement Homes/Elderly Services
Feedback
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Key Informants

• Puyallup Mayor
• Good parks
• Good education systems
• Lack of knowledge regarding evacuation route
• Annual flooding in Puyallup valley
• High rate of homeless from surrounding areas come
  to Puyallup for resources

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Key Informants Continued

• Pastor
• Insurance rates and coverage
• Immunizations
• Homeless becoming a bigger problem
• Park Kids
• Kathy Afflerbaugh, (School Board President)
• Immunizations remain problem for all of WA
• Puyallup making strides to get more kids
  immunized but still a problem

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Initial ImpressionsAccording to Community
Members and our Windshield Observations

• Strengths
• Open spaces and parks
• Safe community
• Quiet
• Friendly town and people
• Downtown businesses are thriving
• Clean
• Transit system is available
• Farmers Market
• School system
• Retail shopping

• Weaknesses
• Traffic
• Homelessness
• Drugs/Gangs/Crime
• Park Kids
• Only 1 major hospital
• High dropout rate from high school
• Not much job opportunity
• Lack of recreational activities for youth
• Low insurance coverage

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Key Informant

• Jean Kinnaman
• Supervisor of health services for Puyallup School
  District
• Puyallup School District has a higher percentage
  than the Washington state average but a lower
  percentage than other Pierce county school
  districts.
• 13 (Nurse-school ratio)
• Immunizations remain problem in Puyallup
• Convenience is biggest issue
• Parents are compliant with immunizations when it
  fits into their schedule
• Tacoma School District has implemented the mobile
  services for students with much success.

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Key Informants

• Sally Durkett, LPN- Mobile Health Services
• Free and reduced clinics closed, many people
  without coverage
• Low immunization rates
• School Nurses
• Puyallup is abysmal
• Only 3-5 exempt, however havent taken into
  account the kids incomplete
• Exemption rate is higher in Pierce County than
  any other county in WA

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Themes of Health Issues

• Immunization
• Insurance Coverage
• Traffic
• Homelessness
• Lack of activities for youth

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Immunizations

• Healthy People 2010 goal is 90
• National Rate of 74 in 2007 (CDC)
• Western Washington 69 in 2007 (down from 71 in
  2006)

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Limitations of Assessment

• Lack of verifiable data because immunization
  records are not returned to the state until
  November.
• Variable perception of immunization problem among
  individual school nurses.
• No specific immunization rate was available for
  the city of Puyallup.

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Nursing Diagnosis

• Risk for communicable disease outbreak among
  school age children in Puyallup related to low
  vaccination rates.

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Healthy People 2010

• Goal Prevent disease, disability, and death from
  infectious diseases, including vaccine-preventable
  diseases.
• Immunizations remain one of the leading health
  indicators

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Plan

• Arrange for health mobile to visit every
  elementary school in the Puyallup school district
  for immunizations during the school day.

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Goals/Objectives

• Short-term
• Increase immunization rates among school-age
  children in Puyallup
• Health mobile will make a visit to all elementary
  schools in Puyallup by January 1st, 2009.
• 60 of children who need immunizations will be
  immunized during health mobile visit
• Long-term
• Increase and maintain immunization rates among
  school-age children in Puyallup
• Puyallup School District will meet and maintain
  the Healthy People 2010 goal of 90 immunization
  rate by 2010.

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Core Function

• Assurance
• Providing immunizations for the community to
  ensure that students are up to date.
• Level of Prevention Primary

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Implementation

• As students, we will
• Meet with Jean Kinnaman, supervisor of health
  services in Puyallup School District to discuss
  project proposal.
• Contact Good Samaritan mobile services to
  determine dates of availability.
• Hand over assessment and plan to Jean Kinnaman,
  who will implement the project with all school
  nurses in Puyallup School District.

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Implementation Cont.

• School nurse will
• Schedule mobile visit in cooperation with Good
  Samaritan mobile services by November 1st, 2008
• Gather information from each students
  immunization record to determine need for
  vaccination 3 weeks prior to mobile visit.
• Send permission slips and information packets
  home with children who have incomplete
  immunization records at least 1 week prior to
  mobile visit.
• Record immunizations received on day of mobile
  visit for each individual student.

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Evaluation

• Formative
• During project implementation evaluate ease of
  meeting each objective and feasibility of
  completion of goals in given time period.
• Mobile visit will be evaluated by daily records
  on immunizations given at each school.
• One month post mobile visit updated immunization
  records will be reviewed and immunization rate
  will be calculated and compared between schools.
• Evaluate if 60 of the children who needed
  immunizations received them, by comparing old and
  new records.
• Summative
• Determine by 2010 if all schools in the district
  have reached immunization rates of 90, in
  accordance with Healthy People 2010.

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Resources

• AreaConnect. 2008. Puyallup Population and
  Demographics. Retrieved September 17, 2008, from
  Area Connect. Website http//puyallup.areaconne
  ct.com/statistics.htm.
• Chelsey, F. (2008). Puyallup Thumbnail History.
  Retrieved September 16, 2008, from
  HistoryLink.org . Web site http//www.hisorylink
  .org/index.cfm?DisplayPageoutput.cfmFile_Id8447
  
• City-Data.com (2008). Puyallup, Washington
  detailed profile. Retrieved September 18, 2008
  from City- Data.com website http//www.city-data
  .com/city/Puyallup-Washington.html.
• City of Puyallup (2008). City of Puyallup Home.
  Retrieved September 18, 2008 from City of
  Puyallup Website http//www.cityofpuyallup.org/i
  ndex.php.
• CLR Choice. (2008). Puyallup, Washington, real
  estate area demographics. Retrieved September
  25, 2008, from CLR search.com. Website
  http//www.clrsearch.com/rss/demographic/wa/puyall
  up.
• Department of Health and Human Services-Centers
  for Disease Control and Prevention. 2008.
  Vaccines and immunization statisticss and
  surveilance. Retrieved September 18, 2008, from
  Centers for Disease Control and Prevention.
  Website http//www.cdc.gov/vaccines/stats- surv/n
  is/data/tables_2006.htm.
• Puyallup Chamber of Commerce. 2008. Demographics.
  Retrieved September 17, 2008, from
  Puyallup/Sumner Chamber of Commerce. Website
  http//www.puyallupchamber.com/demographics.php.
• US Census Bureau. (2000). Census 2000 Demographic
  Profile Highlights. Retrieved September 15,
  2008, from Puyallup City, Washington Fact Sheet
  Web site http//factfinder.census.gov/servlet/SA
  FFFacts?_eventSearchgeo_id _geoContext_stre
  et_countyPuyallupcityTownPuyallup_state0400
  0US53_zip_ lang en_sseonpctxtfphpgsl010
  show_2003_tabredirectY.