NURS 7011 : Role Of Nurse Leader
Question:
Using the Epidemiologic Triangle concept, consider the relationship among causal agents, susceptible persons, and environmental factors. Then, respond to the following:
As a BSN-prepared community health nurse, what steps should Debbie take next?
Considering economic and social considerations within the community, what are the primary, secondary, and tertiary interventions that Debbie might use in managing this outbreak?
Can similar interventions be applied to your community and its TB prevalence?
What considerations need to be addressed within your community that are different form Debbie’s community?
Answer:
Response to post:
Incidence and prevalence of TB in community
The incidence of tuberculosis (TB) has been higher within various boroughs in the province of New Jersey. The rates have been considerably higher within certain sections of the society such as the Asian and Hispanic people. The rates have been 146 per 100,000 people in the Asian community itself. Moreover the rate of TB cases has been seen to be higher in the foreign born people compared to the nationals (Tucker et al., 2017). Therefore, the Hudson borough of New Jersey has relatively higher number of cases of tuberculosis compared to the Mercer region.
Relationship among environmental factors, casual agents and susceptible persons
The epidemiologic triangle could be used to draw a relationship between the casual agents of a disease, the environmental factors which contributes towards development of the disease and the prevalent health conditions of the person.
The causative agent for tuberculosis is a bacterium named Mycobacterium tuberculosis. The bacteria infect the lungs and spreads to other body parts. TB is a contagious disease and mainly spreads though air. The persons susceptible to the infection are the ones living in near vicinity to the patients contracted with TB (Graham, 2016). Additionally, closed and damp places have been seen to increase the chances of contraction of TB by increasing the chances of exposure to the causative agent (Chitnis, Robsky, Schecter, Westenhouse & Barry, 2015). The lowered immunity can also act as a contributing factor.
Primary, secondary and tertiary interventions in breaking the outbreak of tuberculosis
The primary line of prevention which could be applied by the nurse Debby is provision of BCG vaccination to the patients. The secondary intervention which could be applied over here are identification of the person who have developed TB through screening methods such as Tuberculin skin test (TST) along with administration of Directly observed therapy (DOT) (Vaghela et al., 2015). The tertiary line of defence which could be applied by the nurse Debby are tretatemnt of active TB through administration of drugs such as rifampin and isoniazid.
Consideration to be applied within own community
In comparison to the mercer region the rates have been comparatively high in the Hudson region. Hence, some of the possible loopholes which have been identified over here are lack of effective screening procedures and vaccination programs.
References:
Chitnis, A. S., Robsky, K., Schecter, G. F., Westenhouse, J., & Barry, P. M. (2015). Trends in tuberculosis cases among nursing home residents, California, 2000 to 2009. Journal of the American Geriatrics Society, 63(6), 1098-1104.
Graham, S. (2016). The Union’s Desk Guide for the Diagnosis and Management of TB in Children.
Tucker, A., Mithoo, J., Cleary, P., Woodhead, M., MacPherson, P., Wingfield, T., … & Squire, S. B. (2017). Quantifying the need for enhanced case management for TB patients as part of TB cohort audit in the North West of England: a descriptive study. BMC public health, 17(1), 881.
Vaghela, J. F., Kapoor, S. K., Kumar, A., Dass, R. T., Khanna, A., & Bhatnagar, A. K. (2015). Home based care to multi-drug resistant tuberculosis patients: a pilot study. Indian Journal of Tuberculosis, 62(2), 91-96.
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