NURS 4006: Topics in Clinical Nursing

NURS 4006: Topics in Clinical Nursing

Discussion – Week 1
  • This week discussion I am focusing on the emerging of Nipah Virus infection.
  •    This virus is caused by Nipah virus that originates in fruit bats, it spreads between infected animals to human by way of direct contact. This is a new virus that was discovered in Malaysia in 2018, most physicians and health care workers did not know what this virus was and how it can into existence. The citizen of Malaysia to be treated for the virus with symptoms ranging from mild to severe. Most people who contracted the virus was unaware they had the virus before spreading it to others. About 50-75% of the population that did show symptoms presented with fever, cough, headache, shortness of breathe with confusion. 40% of the those patients went into a coma 1-2 days after complication of brain and seizure activity. CDC and WHO spent months on trying to figure out what and where the source of this virus dived from and where was the first point of contact. Scientist final discovered that the RNA of the virus was in the genus Henipa virus in fruit bats. This was confirmed by lab blood draw from the infected patients that the hospital samples and test results that where summited. NURS 4006: Topics in Clinical Nursing

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  • Treatment: of this virus is supportive care, with no known vaccination or cure. We as Health care professional have to educated the public and patients on avoiding exposure with those that have came into direct contact with bats, sick pigs anther animals and drinking raw palm sap. Because, scientist have not figure out how to prevent and treat this new emerging virus, in 2018, more than 700 human cases have been reported and of those reported cases 75% died. This outbreak resulted in 17 death in the Indian State of Kerala as of this day.
  • What implications does the disease have for nursing practice? It has to be treated as a highly contagious infection that is contact through direct contact with droplet precaution. Patient has to be place in the same room as a TB patient and remain on quarantine ( defined as being restricted to their room without implementation of any isolation precaution) in a single room or cohorts with another patient diagnosed with Nipah and hand washing is a must and head to toe PPE when coming in contact with patient or given patient care. NURS 4005 NURS 4006: Topics in Clinical Nursing
  • How does the emergence of this disease affect your personal practice? This virus is deadly without a vaccine or direction on how to treat or prevention of a cure. This could impact every health care professional and the community of which the patient has come in contact within, If my staff would come in direct contact with this virus and was unaware of they had this virus, can affect my practice of having to close the facility completely down, requiring everyone to be tested for Nippah virus, require staff to staff to seek immediate emergency care if experiencing any symptoms and notification of CDC and IDPH for guidance and visits to the faculty. The time and cost its going to take to educate the staff as well as the community about the virus and if there is an outbreak, reducing the panic amongst other patients and health care professionals in the facility. Having the answers for families, staff and patients when there is no cure no treatment guidance. This will have a huge impact on my personal practice. NURS 4006: Topics in Clinical Nursing
  • Why do you think that this disease is emerging/re-emerging? Because, a group of the population has chosen to eat animals that are not meant for human consummation. Some scientist are collecting sample of this animal to try to determine their history and what disease or virus they house and these virus are given to other animals as experimental and then spread to other population of non-human and/or human.
  • What is the nurse’s role in preventing and managing the impact of infectious diseases both from the patient and nurse perspective? The role of a nurse is to minimize the impact of any infectious disease, through use of hand washing, PPE, reviewing and interpreting lab results, assessments of patient on admission and throughout stay alerting the primary of any changes of that patient and making sure there are no delay in care. Maintaining the safety of the staff and patient by using safe practices throughout the work day.

Reference:

WHO: Emergency and Responce to Nipha (2018). Retrieved from: https://www.who.int/csr/disease/nipah/en/

Tan, C., & Wong, K. (2020). Infections among Contacts of Patients with Nipah Virus, India. Emerging Infectious Diseases26(8), 1963. https://dx.doi.org/10.3201/eid2608.190722.

 

 

Discussion – Week 2

Initial Post: Genomics

Genomics plays a part in chronic illnesses and other diseases.  Certain genes increase one’s risk of getting illnesses like breast and colon cancers and diabetes (CDC, 2020).  According to the CDC genomics explores how diet, health, and behavior is impacted by genes (2020).  I have firsthand experience on how my genes have impacted my health and my life.  Therefore, this topic has always been fascinating and something that I am always interested in learning more about.

The article “Genomic Competencies for Nursing Practice” discusses the importance of educating nurses in the Veterans Healthcare Administration (VHA) about the benefits of genetic service for veterans (Boyd et al., 2017). The field of genomics is constantly changing, and nurses need to be competent and aware of such changes to provide the resources appropriate for their patients.  Veterans makeup almost 21 million of the healthcare population and only 57% use the benefits available to them at the VHA (Boyd et al., 2017).  In 2011 VHA created an initiative called the Million Veteran Program or “MVP”.  It worked with the veterans to study how genes, behavior, and environment affect health (Boyd et al., 2017).  The Office of Nursing Services (ONS) developed a strategy to establish competencies in genetics and genomics in 2010. This was a four-year plan to establish competencies, evaluate the competencies and make any further recommendations so it can be incorporated into continued education (Boyd et al., 2017).  As a result of this the course “Genomics in Your Nursing Practice” became available to nurses at the VHA via an online platform in 2014 (Boyd et al., 2017).

As nurses we are taught to advocate for our patient and provided the best care.  This includes continuing to educate ourselves on advances that impact our patients.  Genomics is a topic that is continuing to evolve and help create patient specific care that is tailored to the individual.  We must also have the resources to provide to our patients so they can make informed decisions and offer them all possible option so they can make the right choice for them.  Nurses must explore the patients’ family history in greater detail, screening, and understand the role genetics plays in chronic illnesses or the risk it may pose to the patient.  Understand available resources and care coordination is essential to providing patient centered care.

There are considerations when exploring genomics that must be addressed.  Protecting racial/personal discrimination from health insurance or employer is important to providing cost effective care for all.  A person must not be punished for their genetic makeup.  There must be laws and policies that reflect the advancement in medical care specifically related to genomics/genetics.  As nurses we must not make assumptions about our patients health related to their race/ethnic background but must also consider genetics. NURS 4006: Topics in Clinical Nursing

References

Boyd, A., Alt-White, A., Anderson, G., Schaa, K., & Kasper, C. (2017). Genomic Competencies for Nursing Practice: Implications for Nursing Leadership. JONA: The Journal of Nursing Administration47(1), 62–67. https://doi-org.ezp.waldenulibrary.org/10.1097/NNA.0000000000000438

Public Health Genomics. (2020, October 01). Retrieved October 21, 2020, from https://www.cdc.gov/genomics/default.htm

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Discussion – Week 3
While working in the long term care unit, there was an incident in which a resident with dementia had been complaining of pain and had become less ambulatory. In a review of the medication administration record, the resident was receiving more pain medication than before. As a nurse manager, the staff was asked questions about the ambulation change, and no reasons for the change were documented. A couple of weeks later, there was a call-out on the 11-7 shift I had to cover as the charge nurse. When speaking with the unit secretary familiar with the resident, we began discussing the decreased mobility and pain concerns. During this conversation, the unit secretary told me,” you did not know?” and I replied, “know what?” A couple of weeks ago, the unit secretary replied that the resident was trying to stand from a sitting position and fell backward. Didn’t the nurse tell you? My response was,” I did not receive any incident report from a witnessed fall.”

At this time, I began to review documentation from the date the resident fell. There were no neurological checks, no vital signs taken, and no mention of any falls in the documentation that a fall occurred. From here, I was responsible for filling out an incident report, notified the physician, family member, and administration.  The physician was made aware of the X-ray recommendation, with findings, noted a lumbar fracture. This finding was reported to the Department of Health as it is a reportable incident. My initial thoughts were, I cannot believe the nurse would not share this information. The nurse working on duty the day of the incident was placed on administrative leave for three days while the case was being investigated. After interviewing multiple staff on all three shifts, the activities director, the maintenance staff, and the Certified nursing assistants, the investigation’s conclusion led to the termination of the Licensed Practical Nurse. As a nursing obligation, I was responsible for reporting neglect/abuse to the local Ombudsmen, Adult Protective Services, and the Department of Health Professionals. This was an unfortunate situation that affected this patient’s overall health, in which he later was admitted to hospice and expired.

The first challenge in this situation is that the patient had dementia and could not verbally express what had happened. Another challenge was that the unit secretary assumed management was aware of the fall. Strategies included interviewing the staff who provided care to the resident and interviewing those who may have had some interaction with the resident during the past couple of weeks.  A second strategy, when the patient initially was given pain medications, an X-ray should have been obtained after a few days of given pain medications.

All employees were required to complete an abuse inservice on the initial hire and yearly. After this incident, we hired a consultant to come into the facility to review abuse training, which was mandatory for all licensed staff members.” Since the knowledge influences awareness of abuse, expertise, and preparedness of caregivers, the care team, and nurses as the first line of treatment is responsible for identifying and reporting mistreatments and supporting vulnerable populations such as the elderly (Saghafi, et al., 2019, para, 7).”

Abuse is something not to take lightly and is a reportable offense in which you can lose your nursing license. I had two takeaways from this situation. The first is being more intuned to the care given to dementia residents. Secondly, some nurses will surprisingly make a poor unethical decision, affecting others’ health outcomes.

Reference:

Saghafi, A., Bahramnezhad, F., Poormollamirza, A., Dadgari, A., & Navab, E. (2019). Examining the ethical challenges in managing elder abuse: a systematic review. Journal of medical ethics and the history of medicine12, 7.

 

Week 1: Emerging and Re-emerging Infections Across the Lifespan

Introduction

Infections, if not treated properly, can lead to potentially fatal complications that otherwise could have been prevented. Unfortunately, patients who are sick or recovering from surgery are at greater risk of developing infections. While hospitals and other medical facilities have strict policies about cleanliness and have measures in place to help prevent the spread of infectious organisms, it is not always possible to be 100% effective. There is no firewall protection against viruses and potential infections from occurring in these health care settings. For this reason, it is critical that nurses and other medical workers be aware of potential hazards in order to recognize symptoms of infection.

This week, you will consider the many emerging and re-emerging infections that a patient may contract and examine how the quality of care provided by a nurse might help ameliorate the situation. Nurses have an obligation to learn about potential diseases or infections, their symptoms, and the best course for treatment. You will also review different types of infections and explore how nurses can improve the care provided.

Learning Objectives

Students will:
  • Analyze emerging and re-emerging infectious diseases for nursing practice
  • Analyze emerging and re-emerging infectious diseases in local communities
  • Analyze the role of the nurse in preventing and managing the impact of infectious diseases
  • Develop Fact Sheets on an infectious disease to use as a guide to improve public health

Learning Resources

Required Readings

Required Media

Laureate Education. (Producer). (2009c). Topics in clinical nursing: Emerging and re-emerging infections across the lifespan [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 9 minutes.

 

 

Discussion: Emerging and Re-emerging Infectious Diseases

As presented in this week’s readings, many individuals acquire infections in the community as well as during treatment in the hospital. As a nurse, it is important to know what is going on in the world. In addition to reading scholarly literature, reading the paper and watching the news helps to keep a nurse aware of what is going on currently. In addition, many organizations like the Centers for Disease Control and Prevention (CDC) track current health trends and post updates on their websites, along with Fact Sheets to help educate, prevent, and treat new and re-emerging diseases. These Fact Sheets are made to be short and easy to read so that health care professionals and patients are more likely to read and understand the information.

For this Discussion, you will examine an emerging or re-emerging disease and the nurse’s role in prevention and management of the disease. Locate an article in a newspaper, in a lay magazine, or on an organizational website that discusses an emerging or re-emerging infectious disease that is currently affecting your community. Reflect on the article you selected and think about how the emerging or re-emerging disease might affect nursing practice.

By Day 3

Respond to the following:

Briefly summarize the article you selected and provide the reference. Then, address the following:

  • What implications does the disease have for nursing practice?
  • How does the emergence of this disease affect your personal practice?
  • Why do you think that this disease is emerging/re-emerging?
  • What is the nurse’s role in preventing and managing the impact of infectious diseases both from the patient and nurse perspective?

Support your response with references from the professional nursing literature.

Note Initial Post: A 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

By Day 7

Read two or more of your colleagues’ postings from the Discussion question (support with evidence if indicated).

Respond with a comment that asks for clarification, provides support for, or contributes additional information to two or more of your colleagues’ postings.

Post a Discussion entry on three different days of the week. Refer to the Discussion Rubric found in the Course Information and Grading Criteria area.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:

Week 1 Discussion


Assignment: Emerging and Re-emerging Diseases Fact Sheet

Sir Francis Bacon said, “Knowledge is power.” This is most definitely true when it comes to diseases and how to prevent and treat them. As a nurse, you are charged with teaching patients how to prevent infectious diseases and what to do if they become infected. A powerful tool in your arsenal is the Fact Sheet. Usually comprised of one page of easy-to-read content, these leaflets can be distributed easily and can effectively inform your practice.

To prepare for this Assignment:

  • Select one disease that is either emerging or re-emerging in the world today.
  • Research the disease using both scholarly and non-scholarly resources.
  • Determine your audience (patients, other nurses, schools, etc.) that you would want to share the Fact Sheet with.
  • Select pieces of information that are appropriate for your audience.

By Day 7

Submit: A 1- to 2-page Fact Sheet.

  • Indicate the audience on the Fact Sheet.
  • Give a brief history of the disease.
  • What are the implications of the spread of the disease?
  • How does one detect and prevent the spread of this disease?
  • How is this disease treated?

Your Fact Sheet should be visually stimulating, appropriate for your audience, and formatted with bullet points for easy reading.

Support your “facts” with references.

Note: Your Fact Sheet must be supported with at least three scholarly sources of evidence in the literature.

Writing Resources and Program Success Tools

For this Assignment, review the following:

  • AWE Checklist (Level 4000)
  • Assignment Rubric

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 1 Assignment


Week in Review

This week, you analyzed emerging and re-emerging infectious diseases in local communities and for nursing practice and ways to prevent and manage the impact of them. You also developed a Fact Sheet on an infectious disease as a guide to improving public health.

Next week, you will explore strategies that provide better patient care for those with chronic health problems and how genetics and genomics influence nursing practice.