Breaking the Chain: the Patient with a Communicable Disease Paper
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he M6A4: Breaking the Chain: the Patient with a Communicable Disease Paper counts as 30% of your grade for this course.
We suggest that you develop and outline and use the following time-line as your guide for completing your paper:
Week 1: Review the requirements for the paper.
Week 2: Begin developing an outline for your paper.
Week 3: You should have your outline completed.
Week 4: You should be using your outline to write your paper.
Week 5: Continue work on your paper.
Week 6: Finalize your paper and submit by the end of the week.
Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page.
Information on using an outline and writing a scholarly paper is available through the Excelsior College Online Writing Lab (OWL).
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linked item M6A4: Breaking the Chain: Patient with a Communicable Disease Paper
The registered professional nurse plays an important role in infection control and prevention. The purpose of this written assignment is for you to apply your findings from evidence-based practice (professional nursing references) to a patient with an infectious and communicable disease.
Using APA format, write a six (6) to ten (10) page paper (excludes cover and reference page) that addresses the topic. A minimum of three (3) current professional references must be provided. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.
The paper consists of two (2) parts and must be submitted by the close of week six (6). Each part must be a minimum of three (3) pages in length.
Choose one (1) of the following diseases:
- Human Immunodeficiency Virus infection/Acquired
- Immunodeficiency Syndrome (HIV/AIDS)
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Pertussis
- Tuberculosis
Part 1 – The Chain of Infection (minimum of three (3) pages)
Describe each of the six (6) elements in the chain of infection in terms of the disease you chose for this paper (infectious agent, reservoir, portal of exit, means of transmission, portal of entry, susceptible host). Provide supporting evidence, epidemiologic statistics, and pertinent laboratory data where appropriate.
Part 2 – Nursing Management (minimum of three (3) pages)
Identify treatment options utilized to break the chain of infection and prevent contagion for the disease you chose for this paper. Explore evidence-based practice nursing interventions when managing short-term and long-term consequences for the patient with the disease you chose for this paper. Consider and describe how the registered professional nurse would support patient adherence to these treatment options.
Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format. Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page. Assistance with APA format, grammar, and avoiding plagiarism is available for free through the Excelsior College Online Writing Lab (OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment.
You are required to submit your paper to Turnitin (a plagiarism prevention service) prior to submitting the paper in the course submission area for grading. Access is provided by email to the email address on record in your MyExcelsior account during week 2 of the term. Once you submit your paper to Turnitin check your inbox in Turnitin for the results. After viewing your originality report correct the areas of your paper that warrant attention. You can re-submit your paper to Turnitin after 24-hours and continue to re-submit until the results are acceptable. Acceptable ranges include a cumulative total of less than 15% for your entire paper, and no particular area greater than 2% (excluding direct quotes and/or references).
SAMPLE ANSWER
Patient with a Communicable Disease
Human immunodeficiency virus infection/ Acquired Immunodeficiency Syndrome (HIV/AIDS) is the number one infectious killer in the world with reported 39 million deaths since the first cases were reported in 1981.The majority of people living with this disease leave in low-income and middle-income countries. (Organization, 2014, pg 16) The following report is about the HIV/AIDS and it is divided into two parts.
The first part is meant to look at the chain of infection of the disease.
Infectious agent
The infectious agent for HIV/AIDS is the human immune deficiency virus (HIV). This virus has a single strand, positive sense and the RNA virus enveloped in the genus Lentivirus .For the infection to occur, a significant amount and concentration of the virus must be present. Once in the body the virus affects one’s immune system this is through destroying a special type of cells called the T helper lymphocytes (T-cells). The T-cells are crucial in the functioning of the immune system and the immune response.HIV then replicates itself over a number of times and eventually outnumbers the number of T-cells. (Lala & Merchant, 2012, pg 39)
Reservoir
The virus leaves in the human blood or other body fluids of the infected person. In the blood the virus stays in blood cells whereby it is usually able to remain hidden within the cells. The cells after time adapt the HIV genetic code and remain invisible to the immune defense mechanisms of the body and become insensitive to the drugs. (Lala & Merchant, 2012, pg 39)
Portal of exit
The HIV leaves the body of the infected person to the body of another person through the following mediums.
Firstly, it can be through the infected blood that is if the blood of the infected person comes into contact with the blood of another person. The blood contact can occur through a number of ways for example, through blood transmission, sharing of syringes and through the transplantation of body organs and tissues with an infected person.
Secondly, it can be through the semen and other vaginal secretions. This usually occurs when an infected person has unprotected sex with another person.
Thirdly, it can be through breast milk whereby an infected mother breast feeds a baby.
Statistics show that the concentration of HIV is usually high in the blood followed by the semen and vaginal secretions then the breast milk. (Hall, Hall & Cockerell, 2011, pg 57)
Means of transmission
Transmission usually occurs when there is an interaction between the blood or body fluids of two people and one of them is infected with the virus. There a number of ways through which the infection can be transmitted and this is as follows.
Firstly, it can be through unprotected sexual contact with an infected person and this is usually transmitted through the semen, blood or vaginal secretions. Sexual intercourse can either be through penile, vaginal or rectal tissues. The risk to acquire the infection through this means of transmission usually depends on: the number of sexual partners, one has, the infection prevalence among these partners and lastly the probability of the transmission of the virus during sexual intercourse. Apart from sexual intercourse the virus can also be transmitted through deep kissing.
Secondly, it can be through the direct injection of with syringes and needles which contains HIV infected blood or blood products. This means of transmission has usually been found to be common among drug users who share such needles and syringes when using drugs such as cocaine.
Thirdly, it can be transmitted from a HIV-infected mother to the baby and this is usually through two main ways. Firstly, it can be during the process giving birth. Secondly, an infected mother can transmit the virus to the baby through breastfeeding. This occurs although, the concentration of the virus in the breast milk is minimum because the immune system of a newborn baby is usually very week.
Fourthly, the transmission can be through the transfusion of blood from an infected person to another person. The same can also be transmitted through the transplant of body organs and tissues from an infected person (Hall, Hall & Cockerell, 2011, pg 63)
Portal of entry
There are three main ways through which the HIV can enter into the body of a healthy person. For the virus to enter into the body of a healthy person, the number of the virus must be adequate to cause the infection.
Firstly, the main means of entry of the virus is usually through the blood. This occurs when the blood from an infected person comes into direct contact with the blood of another person for example, sharing of syringes with an infected person. The entry can also be through semen, for example, during sexual contact.
Secondly, the entry can be through semen and vaginal secretions. This usually occurs during sexual contact for example, unprotected sex.
Lastly, the entry can be through the skin membrane which occurs when the membrane is splashed with a body fluid from an infected person. It has been shown that the entry of the virus through this means is usually rare and accounts for less than 1% risk of infection. (Lala & Merchant, 2012, pg 41)
Susceptible host
Any person whose blood or body fluids come into contact with HIV infected blood or body fluids can become infected with the same disease. Statistics show that the people who usually have unprotected sex with a number of different people are at the highest risk of contracting HIV/AIDS. In 2013, an approximated 35 million people worldwide were living with HIV/AIDS. Out of this population, children under the age of 15 years were 240,000. (Organization, 2014, pg 16)
The second part is meant to look at the treatment options that can be used to break down the chain of infection and prevent contagion for the disease, explore evidence based practice nursing interventions when managing short-term and long term consequences for the patients suffering from the disease and describe how a registered professional nurse can support patient adherence to the treatment options.
Treatment options utilized to prevent transmission of HIV
The main treatment use to break down the chain of infection of the disease and prevent contagion is the antiretroviral treatment (ART). The treatment usually works through minimizing the number of microorganisms (HIV) in the blood, semen, vaginal and rectal fluid to an undetectable number. There are a number of options in using this treatment and this is as follows:
Treatment can be given to infected pregnant mothers and a newborn baby so at to prevent transmission through the mother to child infection. The pregnant mother and the baby is given zidovudine (AZT). It has been shown that this treatment has been able to reduce the mother to child prevention from 25% to 8%. Infected mothers using Antiretroviral drugs (ARVs) have also been found to reduce the risk of a mother to transmit the disease while breastfeeding.
The other treatment option used is the Pre-exposure prophylaxis (PrEP). This treatment usually works through people who are HIV-negative using ARV drugs before being exposed to HIV. This treatment has been showed to reduce the risk of the disease up to 92%.
Post-exposure prophylaxis treatment is also used although it is a short term treatment It usually involves using the ARV after being exposed to the virus. Initially, this treatment was used by health workers who had been exposed to infected fluids. Recently, treatment has been used on those who might have been exposed in only one event for example, in cases of sexual assault (Sachdeva & Dutta, 2012, 377)
Evidenced based practice nursing interventions
There are two types of nursing interventions based on whether the consequences are short-term or long-term.
For the long-term consequences, the following nursing interventions would be necessary;
Firstly there is the recommending of the patient to guidance and counseling sessions so as to boost their morale. This will be very useful when it comes to taking the treatment since the patient would now be able to positively appreciating the disease.
Secondly, there would be need to subject the patient to HIV/AIDS awareness education and this is so as to minimize the risk of the patient in transmitting the disease to other people.
Thirdly, the infected person should be supplied with sex protection such as condoms so as to reduce the risk of one infecting his/her spouse. There is also need of counseling the spouse of an infected person and this is also aimed at reducing the risk of infection to the spouse.
Lastly, there is the need of making the patient to appreciate the importance of the treatment that is prescribed to him/her and ensure that the patient adheres to the treatment as prescribed.
As for the short term consequences, the following interventions would be necessary;
Firstly, the nurse can conduct once in a while visits to the patient’s home so as to ensure that the patient is using drugs as prescribed.
Secondly, the nurse can prescribe preferable nutrition to the patient that will ensure that the immune system of the patient is properly working so as to prevent the patient from being infected with other diseases which are related to HIV/AIDS such as Tuberculosis (TB).
Lastly, the nurse could ensure that he/she has the contacts of the close family of the infected person and this is to help in case of any emergency or any other problem (J & S, 2012, pg 690).
Supporting of the patients to adhere to the treatments
There are a number of ways through which a registered professional nurse would support patients in the adherence to the treatment options. Some of these ways are as follows.
The nurse can conduct some guidance and counseling sessions on the patient. During these sessions, the nurse could explain to the patient the importance of adhering to the treatment and also remember to explain to the patient the danger of not taking the treatment.
The nurse can carry out some follow-up on patients. This can be achieved in a number of ways for example, through carrying out of routine visits to the home of the patient so as to ensure that the patient adheres to the treatment.
A professional nurse can keep in touch with the close family of an infected person; the importance is so as to make sure that the patient uses the prescribed treatment. The nurse has to make sure that he/she has explained to the family the importance of the infected person to take the treatment and also remember to explain to this family the danger of the patient in failing to take the treatment. (M, C & M, 2012, pg. 904). In conclusion, although HIV/AIDS has no cure it can easily be prevented once its chain of infection has been understood.
References
Organization, W. H. (2014). World Health Statistics 2014. Geneva: World Health Organization.
Lala, M. M. & Merchant, R. H. (2012). Principles of perinatal and pediatric HIV/AIDS. New Delhi. Jaypee Brothers Medical Publishers.
Hall, J. C., Hall, B. J., & Cockerell, C. J. (2011). HIV/AIDS in the post-HAART era: Manifestations, treatment, and epidemiology. Shelton, CT: People’s Medical Pub. House-USA.
Sachdeva, A., & Dutta, A. K. (2012). Advances in Pediatrics. New Delhi: Jaypee Brothers Medical Publishers
In foster, J. G. W., & In Prevost, S.S. (2012). Advanced practice nursing of adults in acute care.
In Alexander, M.F., In Brooker, C., & In Nicol, M.(2012). Alexander’s nursing practice.
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