Sickle Cell Disease Teaching Presentation


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This is a powerpoint presentation I did for my Vulnerable Communities class in nursing school.

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  • Health disparities refer to gaps in the quality of health and healthcare across racial, ethnic and socioeconomic groups (U.S. Department of Health and Human Services [HHS], January, 2000, p. 2). The Healthy People 2010 initiative, a set of health promotion and disease prevention objectives for the nation, aims to eliminate health disparities by the year 2010 (Goldberg et al., 2004, p. 2). Populations with SCD are at risk for disparities primarily because of the lack of knowledge on the part of the healthcare providers regarding the disease; inadequate pain management and prejudice among the staff (Tanabe & Myers, 2007). This presentation will attempt to bridge those barriers by providing education regarding SCD, eliminating prejudice and increasing awareness of the practitioner to this particular vulnerable group.
  • Sickle Cell Disease Teaching Presentation

    1. 1. Assessment & Vulnerability Protection of Patients with Sickle Cell Disease By Tosin Ola, RN
    2. 2. What is Sickle Cell? <ul><li>Inherited disease </li></ul><ul><li>Genetic mutation against malaria </li></ul><ul><li>Defective hemoglobin in red blood cells </li></ul><ul><li>Under stress, cells assume inverted C (sickle), rigid shape </li></ul><ul><li>This leads to blockage of veins/arteries </li></ul><ul><li>Blockage causes excruciating pain </li></ul>
    3. 3. Genetics and the Transmission of SCD
    4. 4. Who Does it Affect? <ul><li>85,000 people in the United States </li></ul><ul><li>4 million people worldwide </li></ul><ul><li>Affects mostly those of African descent in the US </li></ul><ul><li>Also found in African, Caribbean, Middle Eastern, Indian, Latin American, Native American and Mediterranean heritage </li></ul>
    5. 5. Sickle Cell Variations <ul><li>All forms of SCD can exhibit the complications associated with the disease (OHSU, 2008). </li></ul><ul><li>Sickle cell trait (HbAS) </li></ul><ul><li>Sickle cell anemia (HbSS) </li></ul><ul><li>Hemoglobin C disease (HbSC) </li></ul><ul><li>Hemoglobin E disease </li></ul><ul><li>Hemoglobin S-beta thallasemia </li></ul>
    6. 6. Assess Patient For <ul><li>Anemia </li></ul><ul><ul><li>Syncope, dizziness </li></ul></ul><ul><ul><li>Shortness of breath </li></ul></ul><ul><ul><li>Pallor, cold extremities </li></ul></ul><ul><ul><li>Headache, chest pain </li></ul></ul><ul><li>Pain </li></ul><ul><li>Infections </li></ul><ul><li>Jaundice </li></ul><ul><ul><li>yellowing in skin, mouth, eyes </li></ul></ul><ul><li>Respiratory distress </li></ul>
    7. 7. Complications of SCD <ul><li>Stroke </li></ul><ul><li>Gallstones </li></ul><ul><li>Splenic Sequestration </li></ul><ul><li>Avascular Necrosis </li></ul><ul><li>Leg ulcers </li></ul><ul><li>Priapism </li></ul><ul><li>Renal failure </li></ul><ul><li>Acute chest syndrome </li></ul><ul><li>Pulmonary hypertension </li></ul><ul><li>Retinal damage </li></ul><ul><li>Opioid tolerance, addiction or pseudoaddiction </li></ul>
    8. 8. Hospital Management <ul><li>Oxygenation </li></ul><ul><li>Pain management </li></ul><ul><li>Hydration </li></ul><ul><li>Blood transfusions </li></ul><ul><li>Antibiotics </li></ul><ul><li>Bone marrow transplants & gene therapy </li></ul><ul><li>Medications given: </li></ul><ul><ul><li>NSAIDS </li></ul></ul><ul><ul><li>Opioids </li></ul></ul><ul><ul><li>Hydroxyurea </li></ul></ul><ul><ul><li>Folic acid </li></ul></ul>
    9. 9. Complementary & Alternative Therapies <ul><li>Herbal remedies </li></ul><ul><li>Alternative therapy </li></ul><ul><ul><li>Sauna/Heat therapy </li></ul></ul><ul><ul><li>Reiki </li></ul></ul><ul><ul><li>Acupuncture </li></ul></ul><ul><ul><li>Yoga </li></ul></ul><ul><ul><li>Massage </li></ul></ul><ul><ul><li>Prayer </li></ul></ul><ul><ul><li>Meditation </li></ul></ul><ul><ul><li>Breathing </li></ul></ul>
    10. 10. Health Disparities in SCD Patients <ul><li>Structural barriers </li></ul><ul><li>Socio-economic </li></ul><ul><li>Patient-provider communication problems </li></ul><ul><li>Provider discrimination and lack of cultural competency </li></ul>
    11. 11. Vulnerability Assessment <ul><li>Demographics </li></ul><ul><li>Learning method </li></ul><ul><li>Medical history </li></ul><ul><li>Pain assessment </li></ul><ul><li>Financial barriers </li></ul><ul><li>Transportation </li></ul><ul><li>Sickle cell risk factors </li></ul><ul><li>Lifestyle factors </li></ul><ul><li>Sex and genetic counseling </li></ul><ul><li>Personal safety </li></ul><ul><li>Mental health </li></ul>Please see Appendix A Vulnerability Assessment for SCD Patients
    12. 12. Action Plan <ul><li>Do a thorough and proper assessment of all SCD patients </li></ul><ul><li>Develop an individualized care plan focusing on their vulnerabilities and pain issues </li></ul><ul><li>Communicate this plan to help increase their self-care management ability </li></ul><ul><li>Develop a caring relationship while focused on enhancing trust, cultural competency and support </li></ul>
    13. 13. Conclusion <ul><li>Assess vulnerabilities </li></ul><ul><li>Manage pain </li></ul><ul><li>Avoid stereotyping & bias </li></ul><ul><li>Practice cultural competency </li></ul><ul><li>Provide compassionate care </li></ul>
    14. 14. References <ul><li>Dorsey, C. J., & Murdaugh, C. L. (2003). The theory of self care management for vulnerable populations. The Journal of Theory Construction and Testing , 7 (2), 43-49. </li></ul><ul><li>Fiaskerud, J. H., Kim, S., Strehlow, A., Tullman, D., Verzemniek, I., & Koniah-Criffin, D. et al. (2002). Health disparities among vulnerable populations: Evolution of knowledge over five decades in Nursing Research publications. Nursing Research, 5 (2), 74-85. </li></ul><ul><li>Goldberg, J., Hayes, W., & Huntley, J. (2004, November). Understanding Health Disparities . Retrieved from Health Policy Institute of Ohio: </li></ul><ul><li>Healthy People (n.d.). What are the Leading Health Indicators? Retrieved November 30, 2008, from </li></ul><ul><li>Lusher, J., Elander, J., Bevan, D., Telfer, B., & Burton, P. (2006). Analgesic addiction and pseudoaddiction in painful chronic illness. Clinical Journal of Pain , 22 (3), 316-24. </li></ul><ul><li>Massers, L. J. (November 18, 2008). Willamette Falls Hospital Merges with Providence Health System. Clackamas Review . Retrieved from http:// </li></ul>
    15. 15. References cont. <ul><li>National Heart, Lung and Blood Institute (2007). Sickle Cell Anemia . Retrieved November 8, 2008, from </li></ul><ul><li>Steiner, C., & Miller, J. (2006, December). Sickle cell disease patients in U.S. hospitals, 2004 (Agency for Healthcare Research and Quality). Rockville, MD: HCUP. </li></ul><ul><li>Strickland, O. I., Jackson, G., Jilead, M., Mcguire, D. B., Quarles, S., & Douglas, P. et al. (2001). Use of focus groups for pain and quality of life assessment in adults with sickle cell disease. Journal of the National Black Nurses Association , 12 (2), 36-43. </li></ul><ul><li>Tanabe, P., & Myers, R. (2007). Emergency department management of acute pain episodes in sickle cell disease. Emergency Medicine , 14 (2), 419-425. </li></ul><ul><li>U.S. Department of Health and Human Services (January, 2000). Healthy People 2010: National Health Promotion and Disease Prevention Objectives . Retrieved November 29, 2008, from </li></ul><ul><li>Watson, J. (1985). Nursing: The philosophy and science of caring (2nd ed.). Boulder: Colorado Associated Press. </li></ul><ul><li>Weissman, D. E., & Haddox, J. D. (1999). Opioid pseudoaddiction--an iatrogenic syndrome. Pain , 36 (3), 363-366. </li></ul>