The main purpose of this essay is to discuss influenza and what is the mode of action and risk factors for the older person and how to prevent the spread of infection in a residential aged care facility. This essay will discuss the risk assessment needed for a person who suffering from influenza and what nursing care is required following cultural safety and how multidisciplinary team help to assess the patient. Influenza spreads very quickly, and it may lead to severe mortality and morbidity in the residential aged care facility.
Influenza caused by the influenza virus and is the most common and highly contagious respiratory disease. Influenza spreads anywhere and can cause seasonal outbreaks. The main symptoms of influenza are high fever, cold, runny nose, headache, body ache, and loss of appetite. (Bullock & Manis, 2014). People over the age of 65 are more vulnerable to get influenza because of low immunity and, chronic condition such as respiratory, endocrine, and chronic cardiac disease, renal failure, and sometimes, it creates complications and may lead to death. Three different types of virus infect humans, which are type A, B, and C, but only type A and B mainly causes major influenza outbreaks. There are three subtypes of influenza A such as H1, H2, and H3 but only H1, and H3 cause seasonal influenza in humans (Ghebrehewet, Macpherson, & Ho, 2016).
Influenza is transmitted via three modes, such as contact, droplet, and airborne transmission. In contact transmission, infectious particles are transferred to the mucous membrane to the upper respiratory tract by touching the patient or through break skin or person comes in contact of a susceptible host with a contaminated object such as needles or sharps. In droplet transmission, when an infectious patient sneeze or cough, they generate a large particle, and it travels up to 1 meter and comes in contact with a susceptible host. Large droplets deposited in upper airways can directly entre the recipient's mouth via droplet infection (Tang et al., 2014). Airborne transmission occurs when virus carried on dust particles or in small respiratory droplets become aerosolized when infected person talks, coughs, sneeze, and laugh (Crisp, Taylor, Douglas & Rebeiro, 2013).
Older people are more likely to get an infection due to chronic conditions such as diabetes, chronic obstructive pulmonary disease, cardiac arrest, and low immunity. Older people may decline in their physical functions, for example, mobility due to influenza. Influenza is the most common infection that causes death in an aging society (Shobugawa, Fujiwara, Saito & Kondo, 2018).“World health organization (WHO), one billion people are infected, and around 500,000 people die from influenza each year” (Ghebrehewet, Macpherson, & Ho, 2016, p.1). Research shows that the efficacy of the influenza vaccine is less in older people than younger adult due to their chronic condition (Yang et al., 2017).
Residential aged care is a more vulnerable place to spread a virus due to older age and chronic diseases. All staff responsible for providing care to residents should control and prevent the spread of infection. First step to reduce the spread of germs is hand hygiene. It is essential to perform hand hygiene before touching a resident, before a procedure, after a procedure, after touching a resident and after touching the resident’s surroundings and use alcohol-based hand rub (Sundal, Aune, Storvig, Aasland, Fjeldsæter, & Torjuul, 2017). It is necessary to use personal protective equipment (PPE), such as gloves, apron, mask, and goggles, to prevent the potential spreading infection. The purpose behind using gloves is to reduce the spread of infectious agents that may carry on hands. Aprons are used to protect against contamination. Face masks and goggles are used to protect a care worker's mouth and nose from exposure to infectious agents through splashing vomits (Akagbo, Nortey, & Ackumey, 2017). It is important to clean frequently touched hard surfaces, such as doorknobs, bedside tables, light switches, tabletops and wall areas around the bathroom with detergent followed by a disinfectant solution to prevent spreading infection (National Health and Medical Research Council, 2013).
Nursing home are more vulnerable places to the spread of influenza because of increased contact between people. A person who struggles with their activities of daily living (ADL) are more prone to get infected. In the nursing home, residents and care workers are more susceptible to infectious agents. Mainly, the care worker’s hands are a possible source of transmission of contagious agents to residents (National Health and Medical Research Council, 2013). Patients who required precautions should be isolated in a single-patient room, and staff needs to perform hand hygiene’s five steps with using PPE such as gloves, gown, mask, goggles to prevent contact with the contaminated patient's environment. Try to restrict the visitors during the period of an outbreak to prevent further spreading of infection. (Gothenburg & Barron,2016). Staff should wear PPE when they enter a room and take off the PPE when they leave the room and, dispose it in a clinical waste box, and perform the hand hygiene (Baek et al., 2014).
It is essential to perform Mr. Holden's risk of assessments such as pressure injury, falls risk assessment, pain assessment, and fluid balance chart because he suffers from influenza. A pressure injury can be caused by many factors such as age, poor nutrition, mobility, and faecal and urine problems (Han, Kim, Hwang, Lee, & Song, 2018).To prevent the risk of pressure injury, inspect skin every day and reposition every two hours, maintain skin integrity, hydration and prevent from shear and friction. Document skin assessment using a validated assessment tool such as Water low and Bardon assessment tool to communicate between health professionals (Crisp, Taylor, Douglas & Rebeiro, 2013). The second assessment is falls risk assessment, and many factors are affected to mobility, medication, nutritional status, gait and balance abnormalities, frailty, and medical condition (Kwan & Straus, 2014). Falls risk assessment tool was developed to do a quick assessment for those people who are at high risk falls and it is used in hospitals and residential aged care facility by healthcare workers (Crisp, Taylor, Douglas & Rebeiro, 2013).
The third assessment is pain assessment, and many factors affected to the pain such as sleep disturbances, impaired mobility, decreased appetite, constipation, falls, and cognitive impairment. Nurses play a crucial role in pain assessment, and as a nurse, it is essential to assess how pain is affecting their ADLs (Gregory, 2015). There are three ways of measuring pain self-reports, physiological, and behavioral changes. To assess pain, the main pain assessment tool is used Wong-Baker faces pain scale and Abbey pain scale (Crisp, Taylor, Douglas & Rebeiro, 2013). The fourth assessment is a fluid balance. Water is essential for the body; therefore, enough fluid balance is necessary to maintain metabolic processes. A subsequent level of fluid imbalance can cause a severe effect. Appropriate use of fluid balance monitoring is required to determine hydration. A decline in urine output may indicate symptoms of renal failure. If a person reduces their fluid intake shows changes in consciousness level, gastrointestinal-related problems (Pinnington, Ingleby, Hanumapura, & Waring, 2016).
Nurses need to be aware and respect the Aboriginal culture and provide a humble environment and patient-centered care. As a nurse, consider involving Aboriginal patients and their families in decisions regarding their care. As a nurse, we need to be aware of a patient’s cultural and spiritual, emotional, physical wellbeing (Department of Health, 2014).
As we know, Mr. Holden is underweight, and he had influenza, and it reduces his appetites. It is essential to involve a dietitian to review him. Dietitian provides information related to nutrition and diet. It is essential to involve a dietitian to review him. By involving dietitians, it plays an important role to increase food intake and reduce the risk of developing malnutrition in older adults. It is essential to communicate between dietitians and chef successfully to reduce malnutrition (Farrer, Sasanelli, Matwiejczyk, Yaxley, & Miller, 2019). Consider involving a physiotherapist, who helps Mr. Holden with mobility because he is unsteady while walking. A physiotherapist provides treatment through massaging and exercise. Physiotherapists provide treatment for people suffering from physical problems caused from injury, diseases, illness, due to aging. Physiotherapists aim to improve the quality of life by improving mobility, alleviating pain, improving balance, and to build strength (Baert, Gorus, Guldemont, Coster, & Bautmans, 2015).
The main purpose of this essay is to focus on influenza and how it is transmitted through contact transmission, droplet transmission, and airborne. Older people are more likely to get an infection due to chronic conditions such as diabetes, chronic obstructive pulmonary disease, congestive heart failure, renal failure and low immunity. Hand hygiene is an essential factor to prevent spreading infection as well as it is necessary to use personal protective equipment (PPE) such as apron, gloves, mask, and goggles to avoid spreading flu and cross-contamination. As a nurse, we need to be aware of and respect the patient’s culture and consider involving them in decisions regarding their care. This essay also includes the involvement of other health professionals, such as dietitians and physiotherapists.
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