NRS 445 DSN Epidemiology and Disease the Mosquitoes Yellow Fever Discussion

NUR425 Discussion 1: Epidemiology and Disease 1 Step 1: Choose ONE of the following communicable or tropical diseases: • • • • • Tuberculosis Hepatitis B Zika virus Yellow Fever Typhoid Fever Step #2: Determine the mode of transmission for your chosen disease Step #3: Analyze maps, statistics and reports showing the incidence and spread of your chosen disease worldwide. How has the spread of the disease changed over time? What commonalities do you see between countries with high rates of the disease? Discuss the implication of the disease related to population-based nursing in developing countries. Your post should be 2-3 paragraphs long, following the outlined in the discussion rubric under course materials. In addition, respond to at least two classmates. Use a professional tone when interacting with your peers. Please add to the discussion with informative responses, instead of posts similar to “great idea! I really agree with you.” Make sure that your post and your peer responses are posted by the deadline. APA guidelines and plagiarism prevention matter in discussion posts just like with other scholarly works. Cite all references appropriately using APA format. Response 1 Corbin Typhoid Fever is a disease spread by the bacteria Salmonella typhi. This bacteria is only found in human reservoirs and not transmitted from animals (CPP, 2018). Transmission occurs through fecal-oral or urine contamination of water. Before antibiotic treatment became available, this disease was very widespread and took lives of many. Typhoid Fever thrives in highly populated areas where water contamination is vulnerable. In the early 1900s, New York City suffered outbreaks of Typhoid Fever that lead to the death of thousands. The sad story of Typhoid Mary took popularity in that time when it was discovered to be transmitted through asymptomatic carriers. Mary spent a third of her life in forced quarantine, and likely never understood how she could be the cause of transmission without having any symptoms (Strochlic, 2020). Today, there are multiple vaccines available to ones at risk of catching the disease through travel to countries in poverty. There is also an effective antibiotic treatment available to infected individuals. However, in the US there is a very low incidence because of strict water handling standards as well as strict hygiene standards to prevent contamination of such diseases as Typhoid. In the surrounding world, there is around 21 million cases of typhoid fever and 220,000 deaths occur annually worldwide (CPP, 2018). The key principle to takeaway from Typhoid Fever outbreaks is that preventing water contamination is a vital task for the health of population health. Also, simple hygiene is an important educational task of public health. References: The College of Physicians of Philadelphia (CPP). (2018, April 3). Typhoid Fever. History of Vaccines. https://www.historyofvaccines.org/content/articles/typhoid-fever. Strochlic, N. (2020, February 10). Typhoid Mary’s tragic tale exposed the health impacts of ‘super-spreaders’. History. https://www.nationalgeographic.com/history/article/typhoid-marytragic-tale-exposed-health-impacts-super-spreaders. NRS 445 DSN Epidemiology and Disease the Mosquitoes Yellow Fever Discussion

Response 2 Sarah Tuberculosis is chosen because I feel like it is more prevalent in the United States. What is TB? Tuberculosis is a disease usually affecting the lungs by a bacterium. Most people at risk are “homeless, residents of inner city neighborhoods, foreign born people, those living or working in institutions (LTAC, prisons, shelters, hospitals), IV injecting drug users, poor people and those with poor access to healthcare” (Lewis, Bucher, Heitkemper, Harding, 2017). “A gram-positive acid-fast bacillus that is usually spread from person to person via airborne particles” (Lewis, Bucher, Heitkemper, Harding, 2017). How has the spread changed overtime? The spread of TB started in the late 1800’s in western Canada, the bacteria was identified in 1882 with the transmission reduction in 1919. In 1935 the testing was founded in the UK, 1952 released the isoniazid medication to treat TB. For the first outbreak in the US to happen was in 1970, with the WHO declaring a global emergency for increased TB rates and deaths at 1.3-1.6 million annually. According to the CDC the US has the lowest rates if TB in the world, about 2.7 out of 100,000 persons (CDC, 2020). “In 2019 Asian persons continued to represent the largest proportion of persons with TB (35.5%) followed by Hispanic persons (30.2%) black/African Americans (19.7% and White persons (11.4%) (CDC, 2020). There is so much more information about TB, but as a nurse we need to understand the epidemiology and the pathophysiology of the disease to prevent harm to ourselves, and our other patients and families. We need to educate the population that this disease is real, nobody is exempt from it and decrease the use of IV drug use, always covering mouth with tissue when sneezing or coughing, when traveling to other countries make sure you receive blood work when returning to make sure you do not have it. Watch who you are shaking hands with, do not touch surfaces such as toilets, sinks, utensils, glasses, and clothes. This is an airborne illness meaning spread in the air from mucosal secretions. Resources: Exposure to tb. (2016, March 21). Retrieved April 12, 2021, from https://www.cdc.gov/tb/topic/basics/exposed.htm (Links to an external site.) Lewis, S. L., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2017). Medical Surgical Nursing (10th ed., Vol. 1). St. Louis, MI: Elsevier. Trends 2019. (2020, October 29). Retrieved April 12, 2021, from https://www.cdc.gov/tb/publications/factsheets/statistics/tbtrends.htm NUR435 Discussion 2: Legal Concepts and Ethics in Nursing 4 Step 1 Read the scenario: A new-grad nurse is attending an orientation course for a position on a labor and delivery unit. The course is taught by a member of the nursing staff, who has been working on the unit for over 10 years. The new nurse is instructed on a procedure that is in direct conflict to what the nurse was taught in nursing school. In fact, the nurse was taught that performing the procedure this way could cause serious complications for the patient. When the nurse raises a concern about the procedure the instructor replies “We have always done it this way, and I expect you to do it too, if you want to work here.” Step 2 Answer the Prompts: · How should the new nurse respond to this situation? Why? See rubric downloadfor grading details · What ethical principles are influencing your decision? · NRS 445 DSN Epidemiology and Disease the Mosquitoes Yellow Fever Discussion

What legal concepts are influencing your decision? Step 3 Read other students’ posts and respond to at least two of them. Read and respond to at least two other students’ posts. Use your personal experience, if it’s relevant, to help support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support your opinions. Response 1 Colleen Understanding that the new grad may feel out of line by challenging a staff nurse with a ten year tenure, it is also understood that the new nurse has the knowledge from recent studies that performing this procedure the way the staff nurse is presenting it could cause serious complications for the patient. Although the staff was not receptive and appears to be very closed minded when making the comment “We have always done it this way, and I expect you to do it too, if you want to work here,” even as a new grad I would attempt to speak to the staff nurse after the orientation course about the new literature on the procedure and the evidence based practices on why performing the procedure that way could cause serious complications for the patient. If the staff member remains unreceptive to the new literature then this concern must escalated to a higher authority or hospital safety committee for further investigation. The ethical principles influencing my decision to speak up to the staff nurse and escalate the concern further if needed are benevolence: nurses must be committed to helping patients and seeking out the best possible healthcare outcomes for them, fidelity: nurses should be faithful to their promises and responsibility to provide high-quality and safe care, and non-maleficence requires that nurses avoid causing harm to patients. Nurses are advocates for patients and must find a balance while delivering patient care. Healthcare workers have a duty to refrain from maltreatment, minimize harm, and promote good towards patients (Haddad and Geiger, 2020). The legal concepts that are influencing my decision include personal liability where each professional is responsible for his or her own actions, negligence which is an act of omission or commission that does not meet established standards of care, and unsafe practices which must be reported to higher officials (Haddad and Geiger,2020). Reference: Haddad LM, Geiger RA. Nursing Ethical Considerations. [Updated 2020 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526054/ ReplyReply to Comment • Response 2 Luz I resign from my first nursing job for a similar reason. I was asked by the director/owner of the nursing home I worked for to do something I did not agree with. In this case it was paperwork related to a patient transfer. She wanted me to take responsibility for arranging the transfer. In my opinion the patient should have been taken to the nearest ED, instead the director arranged to have the patient taken to a hospital of her choice. I believe cronyism was involved in this situation. I was never asked to physically perform a treatment that was ethically wrong or would harm a patient. However, after that experience with the administer, I knew it was only a matter of time before I would be asked to do something even more unethical. I would never be able to look the other way or do something that could cause harm to a human life. I would definitely refuse to perform the assigned patient care if I do not think the care is within the nurse’s scope of practice or unethical care. I would seriously consider seeking help from upper management. Nurses have a critical role in the wellness of their patients, their oath binds them to advocate and care for their patients. Nonmaleficence is tied to our duty as nurses, we must protect the patient’s safety. We must not participate in any action or witness any action that will cause harm to our patients. Torts are civil laws that direct legal rights of patients and address the nurse’s responsibilities in the care and relationship with patients. Some of these torts are malpractice and negligence. Negligence constitutes failure to follow established policies, procedures and standard of care. Components of malpractice can include a breach of duty, or connection with an act that causes injury or harm to a patient “legal,” 2021). Legal rights and responsibilities: NCLEX-RN. (2021). Registered Nursing. https://www.registerednursing.org/nclex/legal-rights-responsibilities/ (Links to an external site.) NUR445 Discussion 3: Final Course Project Proposal 2 Step 1 Share your finalized proposal for your course project. NRS 445 DSN Epidemiology and Disease the Mosquitoes Yellow Fever Discussion

In a post of approximately 150 words, describe your finalized proposal for the course project. Include the quality improvement measure, the location, and the credentials of your preceptor. Share any new feedback, questions, or concerns that have developed. Step 2 Read other students’ posts and respond to at least two of them by Friday at 11:59pm MT. In each of your response posts, include one creditable research article and summarize or evaluate its use to support your peer’s project. Response 1 Danielle The quality improvement measure I will be working on is improving the number of hospital acquired pressure injuries to inpatients of all units such as ICU and/or surgical units. My aim would be achieve a 50% reduction in hospital acquired pressure injuries on inpatient hospital units. “HAPI significantly increases healthcare costs, including use of resources (dressings, support surfaces, nursing care time and medications). They also have a significant impact on patients in terms of pain, worsened quality of life, psychological trauma and increased length of stay.” (A quality improvement programme to reduce hospital-acquired pressure injuries., 2020). After researching methods I think the Plan-Do-Study methodology would best suit my quality improvement measure. “The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change — by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method, used for action-oriented learning.” (Science of Improvement: Testing Changes: IHI., n.d). This method is known as one to test results within a shorter period of time than other methods. The location I will focus most on is my current workplace of Good Samaritan Hospital with the primary focus being on my unit of med/surg/oncology. We frequently receive patients from the ICU unit. My preceptor is a co-worker of mine that currently has her BSN but is also in school for her FNP of which she is about half way finished. She has been a nurse for about 9 years. I know I am able to rely on her with any questions or issues I am having. A concern I have is coming up with evidence based practice ideas that will both be beneficial to our patients but also not be overwhelming to the nurses already hectic workload. What would be some ideas that you believe would be time effective as well as easy to teach & implement into your work flow. I would also like to incorporate more use of a screening tool. We do screen patients for pressure injuries when they are admitted but I think the assessment questions could be improved upon. References Gupta, P., Shiju, S., Chacko, G., Thomas, M., Abas, A., Savarimuthu, I., … Andrews, W. (2020). A quality improvement programme to reduce hospital-acquired pressure injuries. BMJ Open Quality, 9(3). https://doi.org/10.1136/bmjoq-2019-000905 (Links to an external site.) Science of Improvement: Testing Changes: IHI. Institute for Healthcare Improvement. (n.d.). http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx. Response 2 John My course project will look at how to reduce catheter-association urinary tract infections(CAUTI). Working in an outpatient clinic we do a lot of urinary catheter changes and instruction in the care of catheters for our patients. Some of our patients have had urinary catheters for years others only need them for a month or less. The goal of CAUTI reduction will be 20%. This will be accomplished through thorough staff training and patient’s instruction and compliance with home care. Many of our patient live in group homes of assisted living facilities. Staff at these institutions will need to be educated on proper urinary catheter care as well. Along with these will be the decrease in the length of time patients have catheters. I believe by decreasing CAUTI a significant reduction in hospitalizations and costs will be seen. Not only do CAUTI affect the urinary system but infection can spread throughout the body(Atkins, 2020). Confusion can be induced causing patients to have accidents such as falls which could cause injury or worse(Atkins, 2020). In confused states patients can cause harm to themselves and others. This is why it is so important to properly manage urinary catheters. Measurement of success or failure of this project will rely on reported infections. Cultures of urine samples will be necessary to compare pre-intervention rates and post-intervention rates. The location of this project will be our outpatient clinic. The preceptor I choose for this project will be out assistant manager. Our manager is far too preoccupied and our assistant manager is a newer graduate who is very knowledgeable and helpful. He is a BSN-RN who works both at our clinic and at a local ER. Reference Atkins, Lou (2020) Reducing Catheter-associated Urinary tract Infections, IMPLEMENTATION SCIENCE, https://implementationscience.biomedcentral.com/articles/10.1186/s13012-02001001-2 …