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As we move forward into developing ways to
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As we move forward into developing ways to combat diseases and conditions, It’s important to understand how prevalent and deadly they can be. This can be seen in the form of preventative care whereby health is promoted and disease is angry or even disability occurrence is prevented. There are different levels, primary, secondary and tertiary. Primary focus on interventions before disease or pathological process occurs add a group of individuals who may be healthy or at risk, meanwhile secondary prevention is aimed at individuals who have the disease but at its early stages compared to tertiary prevention which is aimed at limiting The severity of a disease (Stanhope & Lancaster, 2022). In order 2 assess what groups of individuals or population is important for public health nurses and the like to find ways to measure the prevalence of disease. Epidemiologists examine morbidity and mortality. For morbidity, there are different ways to measure, such as prevalence, occurrence of a disease, and incidence, occurrence of new cases of a disease. For example, the prevalence of people who have been diagnosed with diabetes is 29.7 million people which represents about 11.5% of the population in the United States, or 115 per 1000 (CDC, 2023). There are estimates, by the CDC, of 1.5 million new cases of diabetes, thus an incidence of 5.5 per 100 people. And like many other diseases, people die from diabetes. In 2021, there were 103,294 deaths from diabetes, making the mortality 31.1 per 100,000. These statistics are important as different levels of prevention would target different populations within a disease. Going back to diabetes, primary prevention would target the population of people who are pre-diabetic or healthy with a family history of diabetes through the use of lifestyle changes, such as diet, weight loss and physical activity (Uusitupa, 2019). The long term goal being to lower new cases of diabetes, which have been seen by a lower incidence of diabetes and lower mortality. Secondary prevention, through screening and education, would help delay the occurrence of secondary conditions while teritarty would help in treating patients with diabetes and minimizing the severity. These levels would help in reducing the mortality of diabetes. In order to ensure the effectiveness of interventions and prevention, data must be accurate. Much of this data has been collected from multiple agencies and institutes, such as the CDC or World Health Organization, in the pursuit to combat varying diseases and conditions. It helps that there is cooperation between hospitals and health departments in obtaining the data.
Nurses have to take care of patients when they are sick with diseases. In ACE units the elderly is the population of focus. Many of them come with varying medical issues and have comorbidities. Once it’s the thing I see how my unit is the amount of patients admitted with either influenza pneumonia or covid 19, exacerbating one of their chronic conditions such as COPD, CHF or dementia. In particular with dementia, I had one patient admitted with covid-19, which increased the severity of his dementia, causing him to be uncooperative and combative to the point where he needed restraints. Further, patients with COPD are more likely to have severe pneumonia, increased hospital admissions and worse outcomes (Restrepo et al 2018). These patients,at their baseline, have trouble breathing and when they come with the sickness they deteriorate rapidly. I see my patients prescribed multiple medications that help with their respiratory distress. This includes steroids like solumedrol, or nebulizers like Ipratropium or albuterol. Recently, we have been seeing many patients deteriorating. We have to call RRT to prevent Code Blues, eventually transferring them to the CCU, as they need to be ventilated and closely monitored. Prevention of disease for the 65 year old and over population is important due to the 30-day mortality rate being up to 25%, depending on the severity and comorbidities (Aydin et al, 2022). And as we deal with the elderly, many of them reside in LTC facilities, resulting in a high incidence and mortality rates of pneumonia (Henig & Kaye, 2017). We have to focus on ways to care for these patients, thus, when they come in we try to assess their home baseline by asking the patient or their families. Further , we ensure that the patient is aware of the causes of their admission such as when they have influenza. Some patients don’t understand the necessity of being vaccinated for influenza or pneumonia, while others delay medical help. There was one patient who came in for pneumonia which if he caught it early enough would have been prescribed solumedrol by his primary physician. However, due to the holidays he decided to wait a couple days more than he would, endangering himself as he had a severe exacerbation of respiratory failure.
REFERENCES
Aydin, M., Şaylan, B., & Ekiz İşcanlı, İ. G. (2022). Factors associated with mortality in younger and older (≥75 years) hospitalized patients with community-acquired pneumonia. Annals of Saudi medicine, 42(1), 45–51. https://doi.org/10.5144/0256-4947.2022.45
CDC. (2023). National diabetes statistics report. CDC. https://www.cdc.gov/diabetes/data/statistics-report/index.html
CDC. (2023). FastStats – Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/fastats/diabetes.htm
Henig, O., & Kaye, K. S. (2017). Bacterial Pneumonia in Older Adults. Infectious disease clinics of North America, 31(4), 689–713. https://doi.org/10.1016/j.idc.2017.07.015
Restrepo, M. I., Sibila, O., & Anzueto, A. (2018). Pneumonia in Patients with Chronic Obstructive Pulmonary Disease. Tuberculosis and respiratory diseases, 81(3), 187–197. https://doi.org/10.4046/trd.2018.0030
Stanhope, M. & Lancaster, J. (2022). Foundations for population health in community/public
health nursing (6th ed.).
Uusitupa, M., Khan, T. A., Viguiliouk, E., Kahleova, H., Rivellese, A. A., Hermansen, K., Pfeiffer, A., Thanopoulou, A., Salas-Salvadó, J., Schwab, U., & Sievenpiper, J. L. (2019). Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis. Nutrients, 11(11), 2611. https://doi.org/10.3390/nu11112611
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