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Introduction Role Of Nurses In Infectious Disease Management
In the care and management of patients, the nurse's role is considered to be of utmost importance. A registered nurse extends the services in all disease management and cure processes. In the case of infectious diseases, nurses play an important role in providing the services of healthcare and management to the patients under care. Infectious diseases are highly communicative and contagious. It has been found that in cases of high spread of infectious disease, a pandemic has always happened. The role of the nurse, in this case, is completely based on planned behaviour where they are aware of the consequences and perform their duties by considering their morality and responsibilities.
The research would cover the role of nurses in the management and control of infectious diseases. In the research, the objective with which the nurses fulfil their duties would be highlighted. Along with that, the risks that are associated with the job role and mitigation strategies would also be kept under focus. The present work is a research proposal for the same topic which contains a detailed discussion about the significance, rationale, and discussion of progression of research along with its methodological approach. In this proposal, two articles, one qualitative and in quantitative would be analysed and critiqued with the help of a critical appraisal tool.
The outbreaks of infectious diseases are on the rise. It is considered to be a great challenge in healthcare and management. In the case of control of infectious disease, it is the role of the nurse to implement strategies that are effective in the control of infection and prevention techniques. The nurses who play this role in the control and prevention of infectious diseases are called infection control nurses or ICN (Usa.edu, 2020). An ICN is a registered nurse who is aware of the best practices used for the control of the spread of infectious bacteria, fungi, and viruses (Lee and Lee, 2020, p.9015).
In recent times, the burden of infectious diseases has risen and affected lakhs of people over the world. The quick progression and development of these infectious microorganisms make them lethal and so the rate of mortality has also significantly increased (Baker et al. 2022, p.197). Baker et al. 2022, p.199, have provided one example that can be quoted including the speedy development of "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)" which caused lakhs of deaths around the world. In that period the role of nurses was considered to be pivotal.
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Discussion and rationale
Nurses have always played a critical role in the treatment, support, and care of patients. The U.S. Bureau of Labour Statistics (BLS) has stated that over 3 million nurses are currently in service and work daily to support the treatment and care process (Buheji and Buhaid, 2020, p.17). Infectious disease care is considered one of the toughest care methods as the process requires precautionary and prohibitory steps. The issue of infectious disease management is gaining attention because of the adversity of the spread of the disease. The chain of infection in the case of infectious disease is continuous and is very difficult to break (Chew et al. 2020, p.350). It is seen that 7.2 million people visit the physician for infectious and parasitic diseases (Cdc.gov.in, 2022). Infectious disease like tuberculosis and Sars virus has been reported to cause the majority of the deaths.
The prevention and control of infectious diseases will be done by an ICN who will assess the risks associated with the disease, have foundational knowledge about the pathogen and its transmission route and life cycle, and can develop strategies for its control (Oh, 2019, p.260). The role of nurses has been significant in reducing the number of transmission of highly infectious diseases like Sars CoV-2 in 2020 (Wellcome.org, 2018). It has been estimated by Cdc.gov, 2022, a, that on average approximately 50 to 70 thousand patients recover from infectious diseases due to the critical care and management of the ICN.
The selected articles were assessed with the help of the CASP checklist for quality of the articles. The result was found satisfactory as both the papers achieved high scores for the CASP scores.
Result
The two selected articles showed that healthcare workers and nurses are bound to follow the guidelines presented by major healthcare organisations for the control of infectious diseases. The role of the nurses is to break the chain of infection and take care of the patients by fulfilling the standard elements of precaution. In the article by Houghton et al. 2020, it is found that nurses and healthcare workers who did not follow guidelines struggled to take care of and reduce the mortality rate of patients. It also reported that the use of PPE and additional cleaning added to the burden of the nurses (Houghton et al. 2020). The roles and responsibilities differ according to the workplace culture ad so the output also varied. Some common problems faced included a lack of training, clear communication, insufficient spaces for the isolation of patients, tracking of patients, lack of quality kits, and lack of knowledge and obedience in patients (Oh, 2019, p.259). On the contrary, the article by Lee and Lee, 2020, p.9015, presented some major problems which were faced by South Korean nurses during the Covid 19 pandemic care like "limited preparation time for patients, unavoidable duty calls, high risk of infection to nurses, constant changing guidelines, PPE quality, and use issues and changing symptoms for the disease" (Lee and Lee, 2020, p.9015). The other articles have also highlighted the problems faced by the nurses during management of infectious diseases. The qualitative article by Houghton et al. 2020, has qualified majority of the CASP checklists but does not qualify the transparency in the selected population as it only mention about nurses in general. The paper's methodological approach is based on the secondary data collection and might be based on bias. On the other hand the article by Lee and Lee, 2020, p.9015 has qualified all the CASP checklists as it is based on primary findings and has completed ethical procedures.
Current literature and key policies
The incidences of infectious disease have increased and the responsibilities of infection control nurses have increased. It has been found by Oh, 2019, p.261, that nurses' exhibit care behaviour based on the planned behavioural theory. The nurses are trained for the services and are provided with knowledge about the pathogens and care process in the training period. The nurses are trained to follow the "IPC (Infection prevention and control)” guidelines to reduce the number of transmissions. The IPC guidelines recommend the “use of gloves, masks, sanitisers, and PPE (personal protective equipment)” for the control process (Lotfinejad et al. 2020, p.776). These tools help control self infection of nurses while providing care to the patients. The "World Health Organisation (WHO)” provides guidelines about infectious disease management and control. WHO issued "evidence-based guidelines incorporated in an implementation manual on the core components of IPC” in 2016 (Oh, 2019, p.258). Also, other organizations like the “Centres for disease control and prevention (CDC)" provide guidelines and strategies for the control of infectious diseases (Cdc.gov, 2022, b). The nursing objective that is associated with infectious disease control includes the elements of standard precaution published by the CDC, which is, "hand hygiene, use of PPE, maintenance of respiratory hygiene, sharps safety, safe injection practices, use of sterile instruments and devices and maintaining a clean and disinfected care environment” (Cdc.gov, 2022, b).
The reason for the selection of this topic is that the burden of infectious diseases is increasing day by day. There is a gap in the knowledge about the prevalence of infectious diseases and their management. This research will help examine and present the role of nurses in an infectious disease outbreak. Houghton et al. 2020 have said that this kind of research would help identify the common problems faced by nurses in infectious disease control and would suggest some mitigation strategies to control the risk of the spread of infection to nurses that can be kept under consideration.
Evidence-based data and facts are required to shed light on the global increase in the incidences of infectious diseases that have created havoc pandemic in recent years. The research is required to bring out the difficulties and burdens of nurses and to present the risks that nurse's face in a daily routine while giving services in infectious disease control (Lee and Lee, 2020, p.9015). The research question is required to mention the population, intervention, and outcome of the study.
Research question
The present study has been developed on the topic which was demonstrated briefly in the above section and based on the present context the research questions have been created.
RQ: “What is the role of a nurse during the care and management of an infectious disease?”
Aim and objectives
Aim
The aim of the present research is “to examine the role of nurses in the management and care of infectious diseases”.
Objective
Based on the research question and discussion of the present concept the objectives of the study have been identified. The aim of the study helps to show the main purpose of the study and based on those overview developed objectives are mentioned below;
- To identify the role and responsibility of nurses during the management of infectious disease
- To evaluate risks associated with the management and care of infectious disease management
- To recommend appropriate principles and strategies for nurses to reduce the risk factor of infectious diseases management
Methodological framework
The methodology is identified as the methods used for developing a research and framework of ideas needed to complete a research. Three stages may follow in the methodological framework where the evidence of the framework is identified, data is extracted and refining of the data is done (Greco et al. 2019, p.70).
The research will be developed as a “qualitative research framework” where identification of the research approach is effective for understanding the relationship with the data collection process. In present two types of approaches, the “inductive research approach” will be followed for systematic analysis of the research topic (Cr, 2020). The use of the present research approach helps to fulfil the evaluated objectives related to the role of nurses in infectious disease management. On the other hand, the deductive approach will be neglected as testing of hypotheses or application of theories for the generation of theory will not be appropriate for the present context (D?wigo? and D?wigo?-Barosz, 2018, p.427).
A secondary qualitative research framework will be followed where philosophical beliefs may be appropriate for understanding the role and responsibility of nurses. The “interpretivism research philosophy” will be followed where data related to the social aspect will be interpreted for understanding the outcomes (Fu et al. 2020, p.103526). On the other hand, positivism or realism research philosophy will not be appropriate for analysis of the role of nurses as those who believe in personal values. Therefore, the use of an interpretivism philosophical overview will be appropriate for the analysis of present research topics and selects appropriate data.
A qualitative study based on the secondary data will be developed based on the appropriate data which will be collected from an authentic database. "Google Scholar, PubMed, and Cochrane library" will be used as a database, and with the use of appropriate keywords, resources will be collected. “Boolean operator” will be used as the search strategy of the research which helps to select both quantitative and qualitative research (Devezer et al. 2021, p.200805). In the selected database a huge number of articles, and journals will be identified, therefore; the “PRISMA framework” will be used for screening of the data. The use of the selected framework will be appropriate for the development of the research in a systematic way and mitigate the objectives of the study through appropriate data (D?wigo? and D?wigo?-Barosz, 2018, p.425). Therefore, after the application of screening a total of 8 articles will be selected where 4 of the papers will be qualitative and the other 4 will be quantitative.
The selected article of the research will be analyzed with the use of the quality appraisal tool “CASP” and extracted data relevant to the role of nurses in infectious disease management will be hated.
The collected data of the quantitative research will be analysed with the use of a secondary data analysis process in a systematic way. Therefore, the “Thematic data analysis” process will be appropriate for the analysis of the findings of the research paper relevant to the role of nurses (Cr, 2020). All the themes will be developed based on the objectives of the present research to fulfil the research aim and question to meet actual findings.
PEO
P (Patient or Population): Nurses
E (Exposure): Management of infectious diseases
O (Outcome): Development of best practices for the reduced spreading of infection
The use of the PEO table is appropriate for the identification of the main outcome along with the targeted population of research. PEO table is used for the analysis of the likelihood of a pre-existing exposure which applies to the present study as a result this framework is chosen.
Ethics
In a study, ethical implications are identified as the issues that may arise with the development of the research and the rise of risk of bias. Development of the research is based on some ethical considerations which are developed with some appropriate principles such as “anonymity, confidentiality, the potential for harm, and results in communication” (Ienca et al. 2018, p.e0204937). Rise issues in those principles are identified as the implications of the research which may not be present in the present study. It is estimated that the research will be completed ethically as “The data protection act, 2018” will be considered (Gov.uk, 2021). The selected act will help to follow the ethical manners in the development of the research.
All the data used in the research need to be collected ethically to reduce the “risk of bias” and for maintaining the authenticity of the research. In the same context as the present research, all the data will be collected from secondary sources therefore appropriate ethics will need to be maintained for reduced bias. The ethical consideration of the research principle of ethics will be followed which may help to complete the research ethically. The data transfer will be done in password secured folders.
Conclusion
Infectious diseases or communicable diseases need much more protection and safety for both the patients and the care person. Therefore, based on the above context that is identified research will be developed on the management aspects of the nurses along with their role in such disease management. It is concluded that infection control nurses or ICN are the nurses with special care plans for the effective management of infectious diseases in patients. During the management of the Covid pandemic, situation nurses play an effective role in the management of such infectious diseases. It is concluded that the identified methodological framework will be appropriate for the analysis of present topics where appropriate data collection processes will be delivered.
References
Baker, R.E., Mahmud, A.S., Miller, I.F., Rajeev, M., Rasambainarivo, F., Rice, B.L., Takahashi, S., Tatem, A.J., Wagner, C.E., Wang, L.F. and Wesolowski, A., 2022. 'Infectious disease in an era of global change'. Nature Reviews Microbiology, 20(4), pp.193-205. Available at: https://www.nature.com/articles/s41579-021-00639-z (Accessed: 29 December 2022)
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Chew, Q.H., Wei, K.C., Vasoo, S., Chua, H.C. and Sim, K., 2020. 'Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic'. Singapore medical journal, 61(7), p.350. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926608/ (Accessed: 29 December 2022)
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Devezer, B., Navarro, D.J., Vandekerckhove, J. and Ozge Buzbas, E., 2021. 'The case for formal methodology in scientific reform'. Royal Society open science, 8(3), p.200805. Available at: https://royalsocietypublishing.org/doi/abs/10.1098/rsos.200805 (Accessed: 29 December 2022)
D?wigo?, H. and D?wigo?-Barosz, M., 2018. 'Scientific research methodology in management sciences'. Financial and credit activity problems of theory and practice, 2(25), pp.424-437. Available at: https://fkd.net.ua/index.php/fkd/article/view/1769 (Accessed: 29 December 2022)
Fu, S., Chen, D., He, H., Liu, S., Moon, S., Peterson, K.J., Shen, F., Wang, L., Wang, Y., Wen, A. and Zhao, Y., 2020. 'Clinical concept extraction: a methodology review'. Journal of biomedical informatics, 109, p.103526. Available at: https://www.sciencedirect.com/science/article/pii/S1532046420301544 (Accessed: 29 December 2022)
Greco, S., Ishizaka, A., Tasiou, M. and Torrisi, G., 2019. 'On the methodological framework of composite indices: A review of the issues of weighting, aggregation, and robustness'. Social indicators research, 141(1), pp.61-94. Available at: https://link.springer.com/article/10.1007/s11205-017-1832-9 (Accessed: 29 December 2022)
Houghton, C., Meskell, P., Delaney, H., Smalle, M., Glenton, C., Booth, A., Chan, X.H.S., Devane, D. and Biesty, L.M., (2020). 'Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis'. Cochrane Database of Systematic Reviews, (4). Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013582/abstract (Accessed: 29 December 2022)
Ienca, M., Ferretti, A., Hurst, S., Puhan, M., Lovis, C. and Vayena, E., 2018. 'Considerations for ethics review of big data health research: A scoping review'. PloS one, 13(10), p.e0204937. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204937 (Accessed: 29 December 2022)
Lee, N. and Lee, H.J., 2020. 'South Korean nurses’ experiences with patient care at a COVID-19-designated hospital: Growth after the frontline battle against an infectious disease pandemic'. International Journal of Environmental Research and Public Health, 17(23), p.9015. Available at: https://www.mdpi.com/911492 (Accessed: 29 December 2022)
Lotfinejad, N., Peters, A. and Pittet, D., 2020. 'Hand hygiene and the novel coronavirus pandemic: the role of healthcare workers'. The Journal of hospital infection, 105(4), pp.776-777. Available at: https://archive-ouverte.unige.ch/unige:144293/ATTACHMENT01 (Accessed: 29 December 2022)
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Websites
Gov.uk, 2021. Data protection. Available at: https://www.gov.uk/data-protection#:~:text=The%20Data%20Protection%20Act%202018%20is%20the%20UK%27s%20implementation%20of,used%20fairly%2C%20lawfully%20and%20transparently [Accessed on: 28th December 2022]
Cdc.gov, 2022, a, Infectious diseases, Available at: https://www.cdc.gov/nchs/fastats/infectious-disease.htm (Accessed on: 28 December 2022)
Cdc.gov, 2018, b, Standard precautions, Available at: https://www.cdc.gov/oralhealth/infectioncontrol/summary-infection-prevention-practices/standard-precautions.html (Accessed: 28 December 2022)
Wellcome.org, 2018, The cost of not preparing for infectious diseases, Available at: https://wellcome.org/news/cost-of-not-preparing-for-infectious-diseases (Accessed: 28 December 2022)
Usa.edu, 2020, what is the Role of an Infection Control Nurse? Available at: https://www.usa.edu/blog/infection-control-nurse/ (Accessed on: 28 December 2022)