Central Line-associated Bloodstream Infections.Walden UniversiMaximaSheffield592
Central Line-associated Bloodstream Infections.
Walden University
Dr. Linda Johanson
Francis Mercado
1
Identification and description of the clinical issue.
The clinical issue or problem identified for my study is the central line bloodstream infections (CLABSI)
Central line bloodstream infections(CLABSI) is a health condition that affects many people.
It occurs when pathogens such as bacteria and other germs invade the patients central line after which they get into the bloodstream.
CLABSI related infections are often serious but they can be successfully managed through appropriate treatment approaches.
Femoral central venous catheters and internal jugular along with subclavian central lines have high risk of getting infected.
As per the survey conducted in 2019 about the central line bloodstream infections, it was found that the infection ratio for the said infections was 0.8 per 1000 central line days. This means that over 250000 people across the world bloodstream infections occur yearly and most of them are associated with the presence of intravascular devices.
2
Identification and description of the clinical issue.
Cont.………
Risk factors for Central Line-associated Bloodstream Infections (CLABSI)
presence of gastrostomy tube.
ICU placement of central venous catheter.
Immunosuppression.
Antibiotic therapy(Steffens et al., 2019,).
Poor nutrition;
Multiple invasive procedures.
nonoperative cardiovascular disease.
Central line bloodstream infection is associated with numerous predisposing risk factors. From healthcare stats, it can be said that central line catheters are the common causes of health callings linked to CLABSI. However there are many other risk factors that predispose patients to contracting or developing central line bloodstream infections. Contamination may occur within the central line and this may cause central line related illness. Such contamination include; non interact dressing, contaminated infusion, central venous access devices as well as patient's skin flora.
3
How to develop PICOT question for CLABSI
By analyzing the major components of PICOT, that is P-population, patients, or problem at hand, I-interventions required to solve the issue, C- control or alternative interventions to be compared, O-outcome or the objective to be achieved and T-time framework required to achieve desired outcome(Steffens et al., 2019).
This will help formulate questions such as;
Who and what is the issues that need to be addressed?
What is the proposed intervention and actions to remedy the issue?
What is desired outcome?
How much time is required to realized anticipated results?
To come up with PICOT statement of question on the clinical issues that I had chosen I had to analyze all the components of PICOT to identify their meanings so as to develop a questions that meets PICOT guidelines. The analysis of the PICOT components will help develop questions about the what are kind of population or patients affec ...
Author: Dr Christa Maria Joel
Module: Principles of Infection and Disease Control
Supervisor: Dr William Mackay Gordie and Ms Fiona Hernandez
University of the West of Scotland
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv...CrimsonpublishersCJMI
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv-1 DNA Quantification by Tuofu Zhu in Cohesive Journal of Microbiology & Infectious Disease
Reducing Stroke Readmissions in Acute Care Setting.docxdanas19
Reducing Stroke Readmissions in Acute Care Setting
Contents
Introduction: 2
Objective of the study: 3
Readmission Factors: 3
Statins: 3
Long term care: 4
Demographics: 4
Personal Reflections: 4
Events: 4
Empirical Evidence: 6
Interventions for discharged patients: 6
TRACS: 7
COMPASS: 7
MISTT: 8
Clinical requirement: 8
Timeline: 8
Collaboration with the preceptor: 8
Proposed evaluative criteria: 9
Evaluative criteria discussed: 9
Conclusion: 9
Bibliography 10
Introduction:
Stroke refers to a cardiovascular disease which has been one of the leading reasons for deaths and long term disability. A stroke is an abrupt onset of a neurological deficit led by a vascular rupture or blockage that reduces the blood flow to brain. Subsequently, causing death to the tissue in the brain region if interruption of the blood flow persists. The indications of stroke vary, but may include the loss of function to one side of the body, the inability to speak or talk, and reduced vision or severe headache (Poston, 2018).
Issue: Discovery Research
Over time, the financial penalties on readmissions to the hospital have been taking place, which is promoting hospitals to take measures to reduce the instance of readmissions. A variety of interventions are taking place on different levels to ensure that pre and post discharge care is in place to avoid readmissions. The efficacy of interventions is dependent on the variety of components. Single component interventions are least effective and tend to have no effect on readmissions to the hospitals. Patients that are discharged to post-acute care accommodations are subjected to multi-component interventions and readmissions have dropped drastically. These interventions work through communication, advanced planning of care, and training to tackle simple medical issues that might cause readmissions. The availability of risk stratification methods have made it easier for the hospitals to give more care and attention to the patients that are more likely to get readmitted. Home based services are provided to ensure proper medical care for the patients.
This capstone project attempts to discuss the factors causing the readmissions of stroke patients to the hospitals. The past 20 years have proven to be important in acute and inpatient stroke care however, quality of post-acute care varies specially for the patients that are discharged to home. (Condon, Lycan, & Duncan, 2016). Different reasons for stroke readmissions are to be examined in this capstone project. Expected Outcomes: Discovery Research
This project aims to take into account the reasons of stroke and readmissions after being treated for stroke. Stroke is the second primary reason of readmissions in the hospital. Major readmissions comprise of elderly people. 20-70% people who survive stroke are readmitted in the first year of their treatment (Bravata, Ho, Meehan, & Brass, 2006). Poor health conditions and high treatment costs both account for the l.
DASHBOARD BENCHMARK
Miatta Teasley
Capella University
Running Head: DASHBOARD BENCHMARK
DASHBOARD BENCHMARK
April 19,2022
DASHBOARD BENCHMARK
Second Quarter Hypertension Intervention Compliance at Med for adults presenting with Diabetes
Intervention
Needed
Completed
Compliance Percentage
Initial Lactate within 3 hours
30
30
100%
Blood cultures were drawn before antibiotics
22
17
77%
Antibiotics administered within 3 hours
22
20
91%
Fluid resuscitation if in septic shock within 2hours
19
12
63%
Vasopressors if hypertension persists after fluid or lactate >4mmoL/L within 6 hours
12
7
58%
Overall
105
86
82%
Second Quarter Dialysis Intervention
Compliance and Inpatient Mortality
Patient ID
Number of Interventions needed
Number of Interventions completed
Inpatient Mortality
2000
4
2
0
2014
3
3
1
2098
2
1
0
2134
5
4
0
2156
3
4
1
2245
4
2
0
2345
3
3
1
2567
5
4
1
2676
4
1
1
2935
3
2
0
Note: The Staffing benchmark for the nurse staffing unit is 3 patients per nurse. The average monthly staffing for the unit is 3 nurse workloads. The average number of patients in the unit per month in the third quarter was 5.75.
The data above is a review regarding the compliance of Dialysis measures and interventions compliance and the sample of the second quarter inpatient mortality. The information below entails evaluating the data, which indicates that various departments need to be improved, and a proposal for a specific area and target for improvement.
Evaluation of Dashboard Metrics
There are several inefficiencies in regards to dialysis measures at Med. From the dashboard concerning the compliance of executing the arranged measures and procedures, the two stand out at the 77% compliance rate on drawing blood cultures before running antibiotics and 58% compliance rate on administering vasopressors for those patients that require them. As per Medicare.Gov (n.d), the national average for meeting dialysis guidelines is 72%, and the state of Minnesota is 60% which indicates that Med is performing at 82% overall testing. Higher percentages are required to ensure the advanced quality of life for residents of the healthcare institution (Morfín et al., 2018).
Failure to complete blood draws for cultures before running broad-spectrum antibiotics; there will be an incapability to authorize contamination and the responsible pathogen. This can result in an inefficient or ineffective intervention for aiding a patient. Moreover, by failing to confirm infection from the start, unnecessary and wasteful care interventions could be performed or ordered for patients (Morfín et al., 2018). As per the failure to administer vasopressors, the institution is gambling with the patient's life. As the reinforcement for the dialysis unit states, vasopressor therapy is needed to sustain and uphold perfusion in the wake of life-threatening hypertension. The needed nature of compliance concerning administering this intervention can be seen in the samp.
Central Line-associated Bloodstream Infections.Walden UniversiMaximaSheffield592
Central Line-associated Bloodstream Infections.
Walden University
Dr. Linda Johanson
Francis Mercado
1
Identification and description of the clinical issue.
The clinical issue or problem identified for my study is the central line bloodstream infections (CLABSI)
Central line bloodstream infections(CLABSI) is a health condition that affects many people.
It occurs when pathogens such as bacteria and other germs invade the patients central line after which they get into the bloodstream.
CLABSI related infections are often serious but they can be successfully managed through appropriate treatment approaches.
Femoral central venous catheters and internal jugular along with subclavian central lines have high risk of getting infected.
As per the survey conducted in 2019 about the central line bloodstream infections, it was found that the infection ratio for the said infections was 0.8 per 1000 central line days. This means that over 250000 people across the world bloodstream infections occur yearly and most of them are associated with the presence of intravascular devices.
2
Identification and description of the clinical issue.
Cont.………
Risk factors for Central Line-associated Bloodstream Infections (CLABSI)
presence of gastrostomy tube.
ICU placement of central venous catheter.
Immunosuppression.
Antibiotic therapy(Steffens et al., 2019,).
Poor nutrition;
Multiple invasive procedures.
nonoperative cardiovascular disease.
Central line bloodstream infection is associated with numerous predisposing risk factors. From healthcare stats, it can be said that central line catheters are the common causes of health callings linked to CLABSI. However there are many other risk factors that predispose patients to contracting or developing central line bloodstream infections. Contamination may occur within the central line and this may cause central line related illness. Such contamination include; non interact dressing, contaminated infusion, central venous access devices as well as patient's skin flora.
3
How to develop PICOT question for CLABSI
By analyzing the major components of PICOT, that is P-population, patients, or problem at hand, I-interventions required to solve the issue, C- control or alternative interventions to be compared, O-outcome or the objective to be achieved and T-time framework required to achieve desired outcome(Steffens et al., 2019).
This will help formulate questions such as;
Who and what is the issues that need to be addressed?
What is the proposed intervention and actions to remedy the issue?
What is desired outcome?
How much time is required to realized anticipated results?
To come up with PICOT statement of question on the clinical issues that I had chosen I had to analyze all the components of PICOT to identify their meanings so as to develop a questions that meets PICOT guidelines. The analysis of the PICOT components will help develop questions about the what are kind of population or patients affec ...
Author: Dr Christa Maria Joel
Module: Principles of Infection and Disease Control
Supervisor: Dr William Mackay Gordie and Ms Fiona Hernandez
University of the West of Scotland
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv...CrimsonpublishersCJMI
Comparison of Ultrabio HIV DNA PCR and Gag Real-Time PCR Assays for Total Hiv-1 DNA Quantification by Tuofu Zhu in Cohesive Journal of Microbiology & Infectious Disease
Reducing Stroke Readmissions in Acute Care Setting.docxdanas19
Reducing Stroke Readmissions in Acute Care Setting
Contents
Introduction: 2
Objective of the study: 3
Readmission Factors: 3
Statins: 3
Long term care: 4
Demographics: 4
Personal Reflections: 4
Events: 4
Empirical Evidence: 6
Interventions for discharged patients: 6
TRACS: 7
COMPASS: 7
MISTT: 8
Clinical requirement: 8
Timeline: 8
Collaboration with the preceptor: 8
Proposed evaluative criteria: 9
Evaluative criteria discussed: 9
Conclusion: 9
Bibliography 10
Introduction:
Stroke refers to a cardiovascular disease which has been one of the leading reasons for deaths and long term disability. A stroke is an abrupt onset of a neurological deficit led by a vascular rupture or blockage that reduces the blood flow to brain. Subsequently, causing death to the tissue in the brain region if interruption of the blood flow persists. The indications of stroke vary, but may include the loss of function to one side of the body, the inability to speak or talk, and reduced vision or severe headache (Poston, 2018).
Issue: Discovery Research
Over time, the financial penalties on readmissions to the hospital have been taking place, which is promoting hospitals to take measures to reduce the instance of readmissions. A variety of interventions are taking place on different levels to ensure that pre and post discharge care is in place to avoid readmissions. The efficacy of interventions is dependent on the variety of components. Single component interventions are least effective and tend to have no effect on readmissions to the hospitals. Patients that are discharged to post-acute care accommodations are subjected to multi-component interventions and readmissions have dropped drastically. These interventions work through communication, advanced planning of care, and training to tackle simple medical issues that might cause readmissions. The availability of risk stratification methods have made it easier for the hospitals to give more care and attention to the patients that are more likely to get readmitted. Home based services are provided to ensure proper medical care for the patients.
This capstone project attempts to discuss the factors causing the readmissions of stroke patients to the hospitals. The past 20 years have proven to be important in acute and inpatient stroke care however, quality of post-acute care varies specially for the patients that are discharged to home. (Condon, Lycan, & Duncan, 2016). Different reasons for stroke readmissions are to be examined in this capstone project. Expected Outcomes: Discovery Research
This project aims to take into account the reasons of stroke and readmissions after being treated for stroke. Stroke is the second primary reason of readmissions in the hospital. Major readmissions comprise of elderly people. 20-70% people who survive stroke are readmitted in the first year of their treatment (Bravata, Ho, Meehan, & Brass, 2006). Poor health conditions and high treatment costs both account for the l.
DASHBOARD BENCHMARK
Miatta Teasley
Capella University
Running Head: DASHBOARD BENCHMARK
DASHBOARD BENCHMARK
April 19,2022
DASHBOARD BENCHMARK
Second Quarter Hypertension Intervention Compliance at Med for adults presenting with Diabetes
Intervention
Needed
Completed
Compliance Percentage
Initial Lactate within 3 hours
30
30
100%
Blood cultures were drawn before antibiotics
22
17
77%
Antibiotics administered within 3 hours
22
20
91%
Fluid resuscitation if in septic shock within 2hours
19
12
63%
Vasopressors if hypertension persists after fluid or lactate >4mmoL/L within 6 hours
12
7
58%
Overall
105
86
82%
Second Quarter Dialysis Intervention
Compliance and Inpatient Mortality
Patient ID
Number of Interventions needed
Number of Interventions completed
Inpatient Mortality
2000
4
2
0
2014
3
3
1
2098
2
1
0
2134
5
4
0
2156
3
4
1
2245
4
2
0
2345
3
3
1
2567
5
4
1
2676
4
1
1
2935
3
2
0
Note: The Staffing benchmark for the nurse staffing unit is 3 patients per nurse. The average monthly staffing for the unit is 3 nurse workloads. The average number of patients in the unit per month in the third quarter was 5.75.
The data above is a review regarding the compliance of Dialysis measures and interventions compliance and the sample of the second quarter inpatient mortality. The information below entails evaluating the data, which indicates that various departments need to be improved, and a proposal for a specific area and target for improvement.
Evaluation of Dashboard Metrics
There are several inefficiencies in regards to dialysis measures at Med. From the dashboard concerning the compliance of executing the arranged measures and procedures, the two stand out at the 77% compliance rate on drawing blood cultures before running antibiotics and 58% compliance rate on administering vasopressors for those patients that require them. As per Medicare.Gov (n.d), the national average for meeting dialysis guidelines is 72%, and the state of Minnesota is 60% which indicates that Med is performing at 82% overall testing. Higher percentages are required to ensure the advanced quality of life for residents of the healthcare institution (Morfín et al., 2018).
Failure to complete blood draws for cultures before running broad-spectrum antibiotics; there will be an incapability to authorize contamination and the responsible pathogen. This can result in an inefficient or ineffective intervention for aiding a patient. Moreover, by failing to confirm infection from the start, unnecessary and wasteful care interventions could be performed or ordered for patients (Morfín et al., 2018). As per the failure to administer vasopressors, the institution is gambling with the patient's life. As the reinforcement for the dialysis unit states, vasopressor therapy is needed to sustain and uphold perfusion in the wake of life-threatening hypertension. The needed nature of compliance concerning administering this intervention can be seen in the samp.
REVIEW CENTRAL LINE-ASSOCIATED BLOODSTREAM2REVIEW CENTRAL .docxzmark3
REVIEW: CENTRAL LINE-ASSOCIATED BLOODSTREAM2
REVIEW
CENTRAL LINE-ASSOCIATED BLOODSTREAM2
Central Line-Associated Bloodstream Infections
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM 2
October 9, 2018
CLABSI Supporting Literature
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter (CVC), refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. There were 200 articles that were established to talk about the CVCs, CLABSIs, risk factors, intervention, and benefits of preventive measures. Through inclusion and exclusion criteria many journal articles were left out because of being written in other languages rather than English. Therefore, the use of the English language index the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was used to search related journal articles. Other search tools includeThe National Center for Biotechnology Information (NCBI) – PubMed. Studies older than five years were excluded to ensure that the research remained current and up to date. Using real-time cases or conditions helps to improve the quality and validity of the resulted research.
Questions Posed in the Studies
Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
Education, Simulated Training, Experience, and Knowledge
Kadium (2015) inquired into how the education program for one month, based on the evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care? Other researchers that focus on how education, experience, and workshops enhance prevention or reduction of CVC infections include; El-Sol & Badawy, (2017), Leistner, Thürnagel, Schwab, Gastmeier, & Geffers (2013), and Soffle, Hayes, & Smith (2018). Dougherty (2014) questions the potential solutions in reducin.
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2CENTRAL LINE-ASS.docxsleeperharwell
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature Review
Kerry S. Murphy
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Dr. Kari Lane
September 26, 2018
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature ReviewComment by Microsoft Office User: The heading of introduction is inferred in APA format
I. Introduction
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.
II. Questions Posed in the Studies
a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the
evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?
c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?
d. Srinivasan, Wise, Bell, Cardo,Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.
e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.
f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva.
Background & Objective: Worldwide, nearly 350 and125 million persons have chronic hepatitis B &C virus (HBV& HCV) infections, respectively. This study aimed to bridge the gap between knowledge of HBV & HCV infections and theirs prevalence among pregnant women, through assessing the impact of an educational intervention on knowledge of pregnant women toward HBV & HCV infections.
Methods: The study was a quasi-experimental one, 100 pregnant women were enrolled in the study they were in third trimester. Structured interviewing sheet, laboratory investigations, educational interventions and pre & posttest formats were utilized for the study.
Hepatitis C elimination in HIV-infected men who have sex with men: reality and challenges
Edward Cachay MD, MAS
February 23rd, 2018
UCSD HIV & Global Health Rounds
Evaluation of the Awareness about Hepatitis among Ardabil Medical University ...asclepiuspdfs
Introduction: Hepatitis is one of the five infectious diseases in the world that yearly one million people die and nearly 2 million sufferers from it. Hepatitis B virus (HBV) is the most important cause of liver disease and the major cause of death from hepatitis in Iran. The purpose of this study was to investigate the knowledge about hepatitis among medical students of Ardabil University of Medical Sciences in 2016. Methodology: This study was a descriptive cross-sectional study that has been done on 150 students were selected randomly from Ardabil University of Medical Sciences students in 2016. The data collected by a questionnaire consisted of 25 questions. The collected data were analyzed using statistical methods in SPSS version 16. P < 5% was considered significant. Results: Of all students, 56% were female, and the rest of them were male with an average age of 20 years. The average of student knowledge was 11.06. Nursing and health students had the highest and IT students had the lowest level of knowledge. 61.3% of students referred to the use of a common syringe as an agent for the transmission of hepatitis and 62% believed that the level of knowledge of people in the community could prevent the transmission of HBV infection to individuals. Conclusion: The results present study showed that students’ knowledge about HBV was moderate and because of medical personnel is at high risk of infection due to their occupational status. Hence, promoting their level of knowledge about HBV is essential.
Adherence to Antiretroviral Therapy among HIVPositive Patients in Central Hos...Efe Clement Abel
Abstract: Adherence is the quantified level to which an individual follows a prescribed treatment and a low level of adherence to antiretroviral therapy(ART) adversely affects a patient’s treatment outcome and results in a rebound of plasma viraemia, development of resistant strains of HIV, more rapid immune deterioration, development of AIDS and death. This study is aimed at assessing the level of adherence to ART among HIV-positive patients assessing care in Central Hospital, Warri, Delta State, Nigeria. A descriptive cross-sectional study. Data were obtained using a semi-structured, interviewer-administered questionnaire and analysed using SPSS version 23. A total of 303 persons were recruited for the study. The mean age of respondents was 36.2±10.8years. Less than half of the subjects (45.5%) were adherent to their ART. Among the non-adherent subjects, the common reasons reported for missing doses of ART were forgetfulness (50.9%), too busy with other things (43.6%) and away from home (35.8%). This study showed that adherence to ART among the study population was poor. Forgetfulness, too busy with other things and being away from home were the most common reason for non-adherence. It is, therefore, recommended that; regular health education should be organised for HIV patients on ART on the importance of being adherent to their ART, regular assessment of adherence to ART should be carried out and a method of reminding patients who are non-adherent to ART on the need to take their ART as at when due should be considered as part of the routine services provided by ART centres.
Role of Biostatistician and Biostatistical Programming in Epidemiological Stu...PEPGRA Healthcare
Pepgra experts provide regulatory biostatistics and epidemiology statistical programming support to all phases of clinical trial process development and commercialization. Our Epidemiological statistical services is are located globally & trained in current methods and standards to support the successful execution of your projects.
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1
2
Quality Improvement Project - Sepsis
Student’s Name:
Course Name:
Institution Affiliation:
1.
Identify the clinical issue that will be the focus of your Quality Improvement project.
The importance of undertaking and implementing quality improvement project in the healthcare environment cannot be understated. It would serve to boost the performance in a specific healthcare environment. Optimization of sepsis care is the first clinical issue that the quality improvement project would focus on. Sepsis is becoming a major health concern globally as there is high risk of death when one gets it. Specifically, delayed sepsis identification has been one of the biggest impediments to achieving desirable health outcomes among patients. However, integrating an analytical system as part of the quality improvement project will help in optimizing sepsis care. Specifically, this will involve early identification of sepsis through use of a robust data-driven approach. Developing this type of analytical system such as machine learning would help clinicians to have real-time actionable data that will then aid in boost early detection of sepsis (Klompas et al., 2020). Consequently, requisite health interventions would be implemented. On top of this, there would be rapid intervention concerning severe sepsis and this will help reduce mortality and improve health outcomes among patients. One of the most significant challenges when dealing with sepsis is that scientists have not been able to come up with an approved medicine that can help in targeting the impaired or aggressive immune system. For this reason, the need for clinicians to have access to high quality and robust analytical systems aimed at detecting sepsis would be crucial.
2.
Provide rationale for the need to change the status quo.
Additionally, the current status quo with respect to sepsis is that there is lack of a robust analytical system aimed at detecting and identifying sepsis at an early stage. Globally, there is an ongoing debate especially in the healthcare industry regarding the exact timing of treatment for sepsis. In this perspective, incorporating a robust early detection and identification system for sepsis can be vital in boosting sepsis survival rates globally. Clinicians are the first line of care especially for patients who are at a critical stage of sepsis. There exist various reasons why there is need to shift from the status quo regarding sepsis and implement actionable, efficient and robust analytical frameworks for sepsis. First, it will aid in saving many lives of people affected by sepsis. The analytical system will aid in early detection, identification and diagnosis of sepsis by clinicians thus boosting survival rates and achieve desirable outcomes among patients. The cost of treating sepsis especially at later stages can be very high. Increased cost can make many patients shy away from accessing such care as they cannot afford ...
Running head RESEARCH PAPER1RESEARCH PAPER6.docxtodd521
Running head: RESEARCH PAPER 1
RESEARCH PAPER 6
HOSPITAL-ACQUIRED INFECTIONS AMONG PATIENTS in hospitals in florida?
(Qualitative Study)
Dayana Lewandowski
Florida International University
HSA 6977
Dr. Mariceli Comellas
May 17, 2020
Background Information
Explain overall what the problem is? Statistics in the usa, in the usa there are 4574 hospitalizations due to the infections acquired in hospitals, use citations and use government websites. Download research guidelines.
1.The objective of the study is.
2. results of the study
3.connect that study with your study and how ur study fills in the gap of that study
“citation”Hospital-acquired infection, otherwise known as nosocomial diseases are a common problem that affects many healthcare institutions around the world. Such diseases are not only a burden to healthcare institutions but also the patients served. The total costs associated with the management of hospital-acquired infections have constantly been rising despite the implementation of many intervention policies, (Khan, Baig, & Mehboob, 2017). The government has formulated various nursing intervention policies through various federal and state departments to resolve the issues of nosocomial infections. However, many of these interventions have barely led to a permanent solution. Hospitals and patients are still incurring huge costs as a result of hospital-acquired infections. Hospitals are often subjected to expensive litigation procedures whenever patients contract infections while admitted.
On the other hand, patients are sometimes required to spend more on treatment after contracting infections while admitted in various healthcare institutions. In the University of Miami Hospital, for instance, operational costs have been increasing annually mainly because the hospital has to deal with many nosocomial infections annually, (Chang, 2017). A similar scenario is noted among healthcare institutions operating in the Southern Florida region. While this problem has been identified and discussed a lot, not much attention has been directed to dissect the most affected persons. People with pre-existing chronic diseases such as arthritis, diabetes, and asthma are more susceptible to nosocomial infections compared to people who do not have pre-existing chronic illnesses.
Problem Statement
Pre-existing chronic illnesses increase the risk of opportunistic illnesses and infections. For instance, diabetes type I affects immunity hence diabetic people have greater risks, (Casqueiro, Casqueiro, & Alves, 2012). Healthcare practitioners, as well as patients, are at risk of contracting nosocomial infections, especially when they have pre-existing chronic diseases. “Add citations”Past research indicates that the majority of persons who are severely affected by hospital-acquired infections have pre-existing conditions. Many healthcare institutions in the Southern Florida region have high cases of nosocomial infections because p.
Estimate of the Patients Commitment Concerning Medical Follow-Up with Angina ...AnuragSingh1049
Angina pectoris above referred to as coronary course malady, is caused by the buildup of whittle core the arteries saunter source oxygen-rich blood for the heart. Break in, a mid of broad, cholesterol, and calcium deposits, rear entertain in the arteries over a long time. They are the standard causes of dying in both ripe and evolvement countries, relation for far one third of circa deaths worldwide. All grow pre-eminent groups may die stranger a heart attack. But older kith and kin are in all directions liable to die than younger people.
Elucidative investigate is bump off outside in Al-Sadr Medical City, from January, 7th to May, 6th 2018, in act to review patients' appeal everywhere curative backup adjacent to angina pectoris in Al- Najaf Borough, and to get it out the association between the demographic evidence , clinical information, dance and mercantile statuses, and the patients' pertinence thither Remedial follow-up. A Non-Probability (Purposive Sample) of (50) respecting regard to patients’ angina pectoris, those who visited Al-Sadr therapeutic Megalopolis, the data were composed skim flip the perseverance of the developed questionnaire after the soldiers are estimated, and by means of interview technique. The validity of the questionnaire is propensity look over (9) experts. The data analyzed through the relation of the expository and inferred statistical analysis procedures.
The alertness of the real anatomize specific depart the diversified imputation for the patient’s attention concerning medicinal follow-up with angina pectoris is moderate.
The assay accomplish focus everywhere is a conspicuous reach of the patient's centered of the woe and medicine, and the social and economic low-down, on the patients' commitment to iatrical follow-up with angina pectoris.
The Critique pertinent that benefit Sine qua non be working (e.g., domicile visits, visits outpatient’s of the medical center) may suspended patients to cope with their medical follow-up program. Forced to be the recommendations have in the offing help in the pedagogical resolve wont for patients hence as to improve their commitment. In helper healthiness, oriented pile media betterment should be employed to mass folk familiarity and knowledge of angina pectoris and the importance of the patient’s commitment to medical follow-up. Beyond hegemony of jugs policies which deliver with the monitoring and information the turn the heat on united with the patients' commitment to medical follow-up.
REVIEW CENTRAL LINE-ASSOCIATED BLOODSTREAM2REVIEW CENTRAL .docxzmark3
REVIEW: CENTRAL LINE-ASSOCIATED BLOODSTREAM2
REVIEW
CENTRAL LINE-ASSOCIATED BLOODSTREAM2
Central Line-Associated Bloodstream Infections
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM 2
October 9, 2018
CLABSI Supporting Literature
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter (CVC), refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. There were 200 articles that were established to talk about the CVCs, CLABSIs, risk factors, intervention, and benefits of preventive measures. Through inclusion and exclusion criteria many journal articles were left out because of being written in other languages rather than English. Therefore, the use of the English language index the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was used to search related journal articles. Other search tools includeThe National Center for Biotechnology Information (NCBI) – PubMed. Studies older than five years were excluded to ensure that the research remained current and up to date. Using real-time cases or conditions helps to improve the quality and validity of the resulted research.
Questions Posed in the Studies
Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
Education, Simulated Training, Experience, and Knowledge
Kadium (2015) inquired into how the education program for one month, based on the evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care? Other researchers that focus on how education, experience, and workshops enhance prevention or reduction of CVC infections include; El-Sol & Badawy, (2017), Leistner, Thürnagel, Schwab, Gastmeier, & Geffers (2013), and Soffle, Hayes, & Smith (2018). Dougherty (2014) questions the potential solutions in reducin.
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2CENTRAL LINE-ASS.docxsleeperharwell
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature Review
Kerry S. Murphy
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Dr. Kari Lane
September 26, 2018
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature ReviewComment by Microsoft Office User: The heading of introduction is inferred in APA format
I. Introduction
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.
II. Questions Posed in the Studies
a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the
evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?
c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?
d. Srinivasan, Wise, Bell, Cardo,Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.
e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.
f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva.
Background & Objective: Worldwide, nearly 350 and125 million persons have chronic hepatitis B &C virus (HBV& HCV) infections, respectively. This study aimed to bridge the gap between knowledge of HBV & HCV infections and theirs prevalence among pregnant women, through assessing the impact of an educational intervention on knowledge of pregnant women toward HBV & HCV infections.
Methods: The study was a quasi-experimental one, 100 pregnant women were enrolled in the study they were in third trimester. Structured interviewing sheet, laboratory investigations, educational interventions and pre & posttest formats were utilized for the study.
Hepatitis C elimination in HIV-infected men who have sex with men: reality and challenges
Edward Cachay MD, MAS
February 23rd, 2018
UCSD HIV & Global Health Rounds
Evaluation of the Awareness about Hepatitis among Ardabil Medical University ...asclepiuspdfs
Introduction: Hepatitis is one of the five infectious diseases in the world that yearly one million people die and nearly 2 million sufferers from it. Hepatitis B virus (HBV) is the most important cause of liver disease and the major cause of death from hepatitis in Iran. The purpose of this study was to investigate the knowledge about hepatitis among medical students of Ardabil University of Medical Sciences in 2016. Methodology: This study was a descriptive cross-sectional study that has been done on 150 students were selected randomly from Ardabil University of Medical Sciences students in 2016. The data collected by a questionnaire consisted of 25 questions. The collected data were analyzed using statistical methods in SPSS version 16. P < 5% was considered significant. Results: Of all students, 56% were female, and the rest of them were male with an average age of 20 years. The average of student knowledge was 11.06. Nursing and health students had the highest and IT students had the lowest level of knowledge. 61.3% of students referred to the use of a common syringe as an agent for the transmission of hepatitis and 62% believed that the level of knowledge of people in the community could prevent the transmission of HBV infection to individuals. Conclusion: The results present study showed that students’ knowledge about HBV was moderate and because of medical personnel is at high risk of infection due to their occupational status. Hence, promoting their level of knowledge about HBV is essential.
Adherence to Antiretroviral Therapy among HIVPositive Patients in Central Hos...Efe Clement Abel
Abstract: Adherence is the quantified level to which an individual follows a prescribed treatment and a low level of adherence to antiretroviral therapy(ART) adversely affects a patient’s treatment outcome and results in a rebound of plasma viraemia, development of resistant strains of HIV, more rapid immune deterioration, development of AIDS and death. This study is aimed at assessing the level of adherence to ART among HIV-positive patients assessing care in Central Hospital, Warri, Delta State, Nigeria. A descriptive cross-sectional study. Data were obtained using a semi-structured, interviewer-administered questionnaire and analysed using SPSS version 23. A total of 303 persons were recruited for the study. The mean age of respondents was 36.2±10.8years. Less than half of the subjects (45.5%) were adherent to their ART. Among the non-adherent subjects, the common reasons reported for missing doses of ART were forgetfulness (50.9%), too busy with other things (43.6%) and away from home (35.8%). This study showed that adherence to ART among the study population was poor. Forgetfulness, too busy with other things and being away from home were the most common reason for non-adherence. It is, therefore, recommended that; regular health education should be organised for HIV patients on ART on the importance of being adherent to their ART, regular assessment of adherence to ART should be carried out and a method of reminding patients who are non-adherent to ART on the need to take their ART as at when due should be considered as part of the routine services provided by ART centres.
Role of Biostatistician and Biostatistical Programming in Epidemiological Stu...PEPGRA Healthcare
Pepgra experts provide regulatory biostatistics and epidemiology statistical programming support to all phases of clinical trial process development and commercialization. Our Epidemiological statistical services is are located globally & trained in current methods and standards to support the successful execution of your projects.
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1
2
Quality Improvement Project - Sepsis
Student’s Name:
Course Name:
Institution Affiliation:
1.
Identify the clinical issue that will be the focus of your Quality Improvement project.
The importance of undertaking and implementing quality improvement project in the healthcare environment cannot be understated. It would serve to boost the performance in a specific healthcare environment. Optimization of sepsis care is the first clinical issue that the quality improvement project would focus on. Sepsis is becoming a major health concern globally as there is high risk of death when one gets it. Specifically, delayed sepsis identification has been one of the biggest impediments to achieving desirable health outcomes among patients. However, integrating an analytical system as part of the quality improvement project will help in optimizing sepsis care. Specifically, this will involve early identification of sepsis through use of a robust data-driven approach. Developing this type of analytical system such as machine learning would help clinicians to have real-time actionable data that will then aid in boost early detection of sepsis (Klompas et al., 2020). Consequently, requisite health interventions would be implemented. On top of this, there would be rapid intervention concerning severe sepsis and this will help reduce mortality and improve health outcomes among patients. One of the most significant challenges when dealing with sepsis is that scientists have not been able to come up with an approved medicine that can help in targeting the impaired or aggressive immune system. For this reason, the need for clinicians to have access to high quality and robust analytical systems aimed at detecting sepsis would be crucial.
2.
Provide rationale for the need to change the status quo.
Additionally, the current status quo with respect to sepsis is that there is lack of a robust analytical system aimed at detecting and identifying sepsis at an early stage. Globally, there is an ongoing debate especially in the healthcare industry regarding the exact timing of treatment for sepsis. In this perspective, incorporating a robust early detection and identification system for sepsis can be vital in boosting sepsis survival rates globally. Clinicians are the first line of care especially for patients who are at a critical stage of sepsis. There exist various reasons why there is need to shift from the status quo regarding sepsis and implement actionable, efficient and robust analytical frameworks for sepsis. First, it will aid in saving many lives of people affected by sepsis. The analytical system will aid in early detection, identification and diagnosis of sepsis by clinicians thus boosting survival rates and achieve desirable outcomes among patients. The cost of treating sepsis especially at later stages can be very high. Increased cost can make many patients shy away from accessing such care as they cannot afford ...
Running head RESEARCH PAPER1RESEARCH PAPER6.docxtodd521
Running head: RESEARCH PAPER 1
RESEARCH PAPER 6
HOSPITAL-ACQUIRED INFECTIONS AMONG PATIENTS in hospitals in florida?
(Qualitative Study)
Dayana Lewandowski
Florida International University
HSA 6977
Dr. Mariceli Comellas
May 17, 2020
Background Information
Explain overall what the problem is? Statistics in the usa, in the usa there are 4574 hospitalizations due to the infections acquired in hospitals, use citations and use government websites. Download research guidelines.
1.The objective of the study is.
2. results of the study
3.connect that study with your study and how ur study fills in the gap of that study
“citation”Hospital-acquired infection, otherwise known as nosocomial diseases are a common problem that affects many healthcare institutions around the world. Such diseases are not only a burden to healthcare institutions but also the patients served. The total costs associated with the management of hospital-acquired infections have constantly been rising despite the implementation of many intervention policies, (Khan, Baig, & Mehboob, 2017). The government has formulated various nursing intervention policies through various federal and state departments to resolve the issues of nosocomial infections. However, many of these interventions have barely led to a permanent solution. Hospitals and patients are still incurring huge costs as a result of hospital-acquired infections. Hospitals are often subjected to expensive litigation procedures whenever patients contract infections while admitted.
On the other hand, patients are sometimes required to spend more on treatment after contracting infections while admitted in various healthcare institutions. In the University of Miami Hospital, for instance, operational costs have been increasing annually mainly because the hospital has to deal with many nosocomial infections annually, (Chang, 2017). A similar scenario is noted among healthcare institutions operating in the Southern Florida region. While this problem has been identified and discussed a lot, not much attention has been directed to dissect the most affected persons. People with pre-existing chronic diseases such as arthritis, diabetes, and asthma are more susceptible to nosocomial infections compared to people who do not have pre-existing chronic illnesses.
Problem Statement
Pre-existing chronic illnesses increase the risk of opportunistic illnesses and infections. For instance, diabetes type I affects immunity hence diabetic people have greater risks, (Casqueiro, Casqueiro, & Alves, 2012). Healthcare practitioners, as well as patients, are at risk of contracting nosocomial infections, especially when they have pre-existing chronic diseases. “Add citations”Past research indicates that the majority of persons who are severely affected by hospital-acquired infections have pre-existing conditions. Many healthcare institutions in the Southern Florida region have high cases of nosocomial infections because p.
Estimate of the Patients Commitment Concerning Medical Follow-Up with Angina ...AnuragSingh1049
Angina pectoris above referred to as coronary course malady, is caused by the buildup of whittle core the arteries saunter source oxygen-rich blood for the heart. Break in, a mid of broad, cholesterol, and calcium deposits, rear entertain in the arteries over a long time. They are the standard causes of dying in both ripe and evolvement countries, relation for far one third of circa deaths worldwide. All grow pre-eminent groups may die stranger a heart attack. But older kith and kin are in all directions liable to die than younger people.
Elucidative investigate is bump off outside in Al-Sadr Medical City, from January, 7th to May, 6th 2018, in act to review patients' appeal everywhere curative backup adjacent to angina pectoris in Al- Najaf Borough, and to get it out the association between the demographic evidence , clinical information, dance and mercantile statuses, and the patients' pertinence thither Remedial follow-up. A Non-Probability (Purposive Sample) of (50) respecting regard to patients’ angina pectoris, those who visited Al-Sadr therapeutic Megalopolis, the data were composed skim flip the perseverance of the developed questionnaire after the soldiers are estimated, and by means of interview technique. The validity of the questionnaire is propensity look over (9) experts. The data analyzed through the relation of the expository and inferred statistical analysis procedures.
The alertness of the real anatomize specific depart the diversified imputation for the patient’s attention concerning medicinal follow-up with angina pectoris is moderate.
The assay accomplish focus everywhere is a conspicuous reach of the patient's centered of the woe and medicine, and the social and economic low-down, on the patients' commitment to iatrical follow-up with angina pectoris.
The Critique pertinent that benefit Sine qua non be working (e.g., domicile visits, visits outpatient’s of the medical center) may suspended patients to cope with their medical follow-up program. Forced to be the recommendations have in the offing help in the pedagogical resolve wont for patients hence as to improve their commitment. In helper healthiness, oriented pile media betterment should be employed to mass folk familiarity and knowledge of angina pectoris and the importance of the patient’s commitment to medical follow-up. Beyond hegemony of jugs policies which deliver with the monitoring and information the turn the heat on united with the patients' commitment to medical follow-up.
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1. The Future of Nursing Theory Discussion
The Future of Nursing Theory DiscussionORDER HERE FOR ORIGINAL, PLAGIARISM-FREE
PAPERS ON The Future of Nursing Theory DiscussionThis assignment is a discussion board
Post which requires the use of APA 7 for reference and citation. I will be attaching the
documents needed for this assignment. This assignment is the concluding part of the
semester work hence information used prior in the semester is needed to answer some of
the questions.The Future of Nursing Theory
Discussionattachment_1attachment_2attachment_3Unformatted Attachment
PreviewAssignment Instructions Discussion Board: The focus of this assignment is to
prompt you to reflect on your learning this term. You will demonstrate your understanding
of the interplay among research, theory, and practice through your critical thinking
evidenced in your responses to the discussion board items. You will also investigate
examples of the globalization of nursing. 1. Describe what the following quote means to you.
“Theory without practice is empty and practice without theory is blind” (*Cross, 1981, p.
110). 2. Explore the Sigma website. o Based on your exploration of the Sigma Theta Tau
International website, provide 3 specific examples of the globalization of nursing. At least
one example must include an example of an internationally written article from the most
recent issue of the Journal of Nursing Scholarship. o You can access this journal from the
Sigma website.
(https://sigmapubs.onlinelibrary.wiley.com/journal/15475069#pane01cbe741-499a-
4611-874e-1061f1f4679e01 (Links to an external site.)). ▪ It will only give you the title of
the articles in the journal and abstracts. If you want to read the articles, you will need to go
to the online library and look at them there. 3. Share the three most important concepts that
you learned this 7-week term. 4. The Future of Nursing Theory DiscussionWhat were the
two most challenging activities for you confronted in this course? What suggestions do you
have related to addressing those challenges? *Cross, P. (1981). Adults as learners.
Washington, DC: Jossey-Bass. Liver Health Literacy and Health Status Among Adults With
Hepatitis C: Implications for the Nursing Profession as Part of the 2030 Global Elimination
Goal Yu-Chih Lin, MD1, Wen-Nan Chiu, MD2, Te-Sheng Chang, MD, PhD3, Tung-Jung Huang,
MD, PhD4, & Mei-Yen Chen, PhD, RN5 1 Department of Family Medicine, Chang Gung
Memorial Hospital, Yunlin, Taiwan 2 Department of Hepato-Gastroenterology, Chang Gung
Memorial Hospital, Yunlin, Taiwan 3 Division of Gastroenterology and Hepatology,
Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, and
Assistant Professor, College of Medicine, Chang Gung University, Taoyuan, Taiwan 4
4. Administration, 2019). Community health nurses are responsible for the provision of
frontline care as well as adequate information to residents with HCV infection and their
families, and transferring them for the reception of DAA treatment (Shiffman & Gunn,
2017). However, few nursing studies have focused on community-based screening of anti-
HCV antibodies, further HCV RNA confirmation in endemic rural areas, and the association
between health-related behaviors and health status in adults with HCV infection. Methods
Design, Sample, and Setting This study is the first phase of a nurse-led community health
development program that is being established to reduce the rates of HCV infection in
endemic rural areas. Working with a local hospital, the research team held annual
community health screenings between July 2018 and March 2019 in coastal southern
Taiwan. The inclusion criteria were (a) area of residence being in one of five designated
townships in Yunlin County and age 20 years or older, 129 Hepatitis C Elimination (b)
ability to sign an informed consent form, (c) ability to walk to the community centers, and
(d) ability to complete the questionnaire. Those who are unable to answer questions or
have any limitations in cognition were excluded from this study. Procedure and Ethical
Considerations We did not conduct the research until the institutional ethical committee
review board had approved the study (No. 201800428B0). The local hospital and the leader
of each community activity center used broadcasting material on free health screening to
invite people with HCV infection and their family members to walk to a community center
located in each of 30 villages, on a Monday or Tuesday morning every week during the
study period. The purpose of the study was described by the research assistants to all
participants, such as supplying information on the risks of HCV and liver cancer, describing
the procedure for drawing blood samples after an overnight fast of 8 hr from midnight, and
posing health-related questions before study initiation. Measurements Demographic
characteristics included sex, age, education level, serum anti-HCV antibody status (positive
or negative), and comorbidities (participants were asked to answer if they had been
diagnosed with diabetes mellitus, hypertension, heart disease, or other chronic conditions
by a doctor). Cardiometabolic risk factors and liver and renal function. Cardiometabolic risk
factors were determined by the national standard (HPA, 2019), including (a) waist
circumference > 90/80 cm for male or female participants, respectively; (b) systolic or
diastolic blood pressure > 130/85 mmHg; (c) high-density lipoprotein-cholesterol (HDL-C)
level < 40/50 mg/dL for male or female participants, respectively; (d) fasting blood glucose
level > 100 mg/dL; and (e) triglyceride level > 150 mg/dL; metabolic syndrome (MetS) was
defined as the presence of three or more of these risk factors. (f) Glutamic-oxalocetic
transaminase (GOT) and glutamic-pyruvic transaminase (GPT) levels were used to detect
liver inflammation status, and (g) the estimated glomerular filtration rate (eGFR) was
indicative of renal health. Liver health literacy and healthy lifestyle. Participants were asked
to answer if they (a) were aware or unaware of their HCV infection status; (b) had received
screening for hepatitis; and (c) were informed of the new free drugs available for hepatitis
treatment. The 130 Lin et al. participants’ lifestyle status, pertaining to liver health, was
determined as previously described (HPA, 2019; Wang, Li, Chang, & Chen, 2015).
Participants were asked to respond to the following five behavior questions with
“never/seldom” or “usually/always”: (a) Vegetable intake: “Do you consume three portions