Aactions a Nurse for Primary Prevention - Report Example

PRIMARY PREVENTION of The paper will address the issues regarding steps taken by nurses in Intensive Care Units (through examples) in order to prevent, primarily, any disorder or disease to surface, which in turn will list some of the many Preventive measures and hence can be utilized by nurses in general. What ‘could’ be absorbed from this paper would be the actions a nurse needs to take to prevent the onset of a disease primarily and hence the importance of the paper to the field of nursing. Primary Prevention What is perceived of the term ‘Primary Prevention’ at a basic and literal level; is simply the very first step taken to avoid anything. However, our concerns with ‘Primary Prevention’, limits the definition of the term to health care; or Intensive Care Units to be more exact. The Encyclopaedia Britannica (online) defines the term as: “Primary Prevention being the pre-emptive behaviour that seeks to avert disease before it develops”. What an Intensive Care Unit is; basically an establishment where patients with critical condition or those requiring any sort of support to sustain their very life are admitted. Patients with a Pre-operative or Post-operative status would also be admitted into these Intensive Care Units wherein, as the name suggests, they are taken care of in a very detailed manner and their every aspect is monitored. Since the patients commonly found in I.C.Us are those to whom the environment crucially matters and affects their condition drastically, the setting is controlled in a manner to suit the patients’ needs and comfort along with the proper management and regulation of temperature, aural atmosphere and of course the overall ‘cleanliness’ of the environment, and by cleanliness the absence of contagious particles or bodies is also addressed, which includes all types of infectious bodies, bacteria, fungi, etc. The nurses that work there are trained to keep themselves as fumigated as possible along with their general sense of handling the patient and steps are also taken to keep the environment of the I.C.Us disinfected or sterilised to be more precise. It must be taken into account that the reason for the admittance of the critical patients in I.C.Us is not only the fact that they need constant monitoring but also to protect them from unclean and contagious environments. Hence the I.C.U. itself acts as a preventive measure against infections through environmental exposures. Let us assume the case of a patient named ‘X’. Patient X is in an I.C.U under post operative care, after being operated at, for Acute Appendicitis. Consider a nurse who steps into the patient’s room, monitors his pulse, temperature, blood pressure and then steps out scribbling something on a clipboard. Mr. X has had no visitors; nor does any other nurse comes to check in ‘before’ the patient develops certain symptoms; of which fever is one. The diagnosis reveals a hospital acquired infection which is further classified as: I.C.U. Acquired Pneumonia. How was the infection acquired? One can only predict the mode of transport of the infectious source in such limited ways; it could have been the nurse’s dirty hands or her infected clothes, hair, shoes or the food or water she was giving to Mr. X could have been contaminated, or even the clipboard she carried could have been held before by an infected person or the equipment used might have been carrying the infectious matter all along or it simply could have been her breath. The point of observation here shouldn’t be the ways mentioned in which the pneumonia was transported or their authenticity but the issues regarding primary prevention which an I.C.U. nurse undertakes. For Instance, keeping the equipment sterilised, wearing a mask always when dealing with such patients, keeping a strict watch on the sanitation of all visitors, keeping herself and her clothes, shoes and hair well disinfected or other alternates such as wearing overalls, masks, shoe-covers or hair caps, are all included in Primary Prevention of any effect which could have surfaced due to the environmental conditions. Simply put; an I.C.U. nurse contributes to primary prevention by preventing the patients’ exposure to the environment (with respect to the stated scenario). Supposition for the second example would be a patient named ‘Y’ brought under intensive care due to an accident. The injuries which Mr. Y suffered from; included severe blood loss via open wounds and a few major fractures along with some broken ribs. While blood loss was neutralised from blood bags taken from matching donors and volume expanders such as saline solutions and plasma were used, the nurse puts Mr. Y on Antibiotics. The nurse also notices an abnormality in the pulse of the patient and after a few moments in which her thoughts were processed and Mr. Y’s condition was scrutinised, she subjects the patient to cardio-tonics such as dopamine or adrenaline. All these measures may seem pretty routine in such a case, for an observer considering only the speedy recovery of Mr. Y, but in-fact a part of the ‘measures taken’ were not routine and certainly not textbook treatment. The nurse gave antibiotics to a patient because he had broken bones, or because he had a severe blood loss? No, the reason for the implication of the antibiotics was to ‘primarily prevent’ any infection that could contaminate and enter through the open wounds or already might had. Another instance from this very case implies the use of cardio tonics by the nurse, who acted in a manner to prevent any possible cardiac anomaly that could have been a major problem later on. What must be taken into consideration are the two preventive measures applied primarily in order to avert an infection and a cardiac anomaly. Hence what the nurse did was to increase human resistance against any possible problems that could surface later on, during or after the treatment for the actual cause of admittance. Now let us consider a patient submitted in I.C.U. due to some severe case of allergy. The patient feels the need to scratch and he scratches too hard. But the itch doesn’t go away...only gets worse, so he keeps on scratching till he damages his skin and hurts himself. The instance is given not only to demonstrate that allergies could be ‘itchy’ but also the fact that if the patient was advised or more likely ‘educated’ about how he shouldn’t scratch, it would have prevented him from hurting himself and his wounds would now be more susceptible to infections. Thus an I.C.U. nurse also prevents by educating about behaviours which could result in some sort of a risk to the patient. Similarly, a nurse would tell a patient who got fractured to not to move much thus by reducing the chances of patient carelessly moving and then feeling severe pain in fractured areas. Parallel would be the example of a patient in Post operative care in an I.C.U. who tears his stitches just because he was not educated or reminded repeatedly to ‘lie still’ rather than moving here and there. What these examples indicate is the importance of relevant education/information to an I.C.U. patient who is informed of all of the relevant things he/she needs to know by an I.C.U. nurse as a step to prevent further damage. A research conducted by Jérôme Robert concerning primary Blood Stream Infection rates revealed that: Our data suggest that, in addition to other factors, nurse staffing composition (ie, pool‐nurse–to–patient ratio) may be related to primary BSI risk. Patterns in intensive care unit nurse staffing should be monitored to assess their impact on nosocomial infection rates. A nurse takes a lot of Primary Preventive measures which helps patients to control and regulate their illness before they can get out of control and really serious. Examples given indicate what steps the nurses should take in order to prevent further harm to the patient. What we have focused on, in this paper, is the Primary Prevention by: Preventing environmental exposures, Improving the patients’ resistance against disease and Education to reduce self-inflicted risks. And their application by I.C.U. nurses. References Ali, Nadir. (2010, April 1). Primary Prevention. (Junaid, Interviewer) Deborah J. Cook, M. H. (1998,279(20)). Risk Factors for ICU-Acquired Pneumonia. JAMA , 1605-1606. Jérôme Robert, MD, MPH; Scott K. Fridkin, MD; Henry M. Blumberg, MD; Betsy Anderson, RN; Nancy White, RN; Susan M. Ray, MD; Jinlene Chan, MSc; William R. Jarvis, MD Infection Control and Hospital Epidemiology 2000 21:1, 12-17 Kellum, J. A., Leblanc, M., Gibney, R. T., Tumlin, J., Lieberthal, W., & Ronco, C. (2005). Primary Prevention of Acute Renal Failure in the critically ill. In Current Opinion in Critical Care (pp. 537-541). Lippincott Williams & Wilkins, Inc. Marshall, B. (2002, October 29). How Shepherd Center Works. Retrieved April 2, 2010, from HowStuffWorks.com: http://health.howwstuffworks.com/shepherd-center.htm primary prevention. (2010). In Encyclopædia Britannica. Retrieved April 02, 2010, from Encyclopædia Britannica Online: http://www.britannica.com/EBchecked/topic/476180/primary-prevention primary prevention. (2008).In A Dictionary of Nursing. Retrieved April 02, 2010 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O62-primaryprevention.html Read More