Community_Public_Health

Running head: CONCEPTS IN COMMUNITY AND PUBLIC HEALTH Concepts in comm. p.1 Concepts in Community and Public Health XXXXXXXXXX Grand Canyon University NRS-427V October 17, 2010 October 13, 2010 Senator Barbara Boxer 112 Hart Senate Office Building Washington DC, 20510 Dear Senator Boxer, My name is XXXXX RN Nurse Coordinator in charge of the Health Clinic X17. This health organization requires a continual re-evaluation of services to ensure that the customers are receiving meaningful, state-of-the-art service that will improve the health, safety, and productivity of the county workforce. One of the tools we employ is a “Customer Satisfaction Survey.” Over the past nine months, I have noted 83 negative comments that made reference to this facility. These issues have been addressed with the area nurse manager, the building manager and the contracting company, yet continue to be problematic. The Health Center is located in the first subterranean floor, between the loading dock and entrance to the parking garage. Concerns have been expressed about potential exposure to vehicle exhaust. OSHA has conducted surveys for common airborne contaminates in the past. The results of these surveys have always yielded the same; the concentration of none of these contaminates reaches or exceeds OSHA Permissible Exposure Limits (PEL). The building has made improvements to the ventilation system in the Health Center. Unfortunately complaints continued. The perception rested primarily with my health care professional staff. Through the Customer Satisfaction Surveys, it is now apparent that the perception of an unhealthy environment is not limited to the staff that spends eight hours a day in the Health Center. Clients spending less than an hour in the Health Center are complaining about the conditions. Even though the exposures are below the PELs almost all clients are able to detect an odor. The PELs are established by the Department of Labor (29CFR1910 subpart Z) for industrial setting. They were not intended for office or clinical settings. Never the less they are the only regulations that can be applied to this situation. The indoor contaminates do not exceed the PEL, yet there is a problem, all be it perceived. Under ideal circumstances, the Health Center would be located on an upper floor. Hopefully we can reach a solution that will both meet our needs, a better impression for our clients and fit into the building occupancy plan. There is a need with eliminating the source of the odors, dirty, and feelings of “dinginess.” As the problem is one of aesthetics, it may be more difficult to correct than if faced with a violation of OSHA regulations. The placement of the Health Center, in the basement, sandwiched between two entrances to an underground parking garage makes this extremely difficult. The ideal solution would be to move the Health Center to a different location. A ground level or an above location with some windows would be most desirable. A different location, from the lower level, would eliminate the feeling of a dark, dingy, and dirty environment. Any relocation will be costly. When space is available it would have to be built to meet the needs of a health care facility. It is imperative that the above steps be considered. Thank you for considering my request and I look forward to hearing from you. Please contact me at xxx-xxx-xxxx Sincerely,