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Course Learning Outcomes for Unit VI Upon completion of this unit, students should be able to:

4. Summarize the differences between various health care providers. 4.1 Examine guidelines that health care providers need to follow. 4.2 Summarize various epidemics that health care providers have faced.

Course/Unit

Learning Outcomes Learning Activity

4.1, 4.2

Unit Lesson Chapter 9 Chapter 13 Unit VI Scholarly Activity

Required Unit Resources Chapter 9: Ethics and Safe Patient Handling and Mobility Chapter 13: The Ethics of Epidemics Unit Lesson In this unit, we will discuss problems and ethical concerns surrounding safe patient handling and mobility. We will also discuss health epidemics and various health care provider roles.

Health Care Provider Roles In the health care field, there are many different roles and responsibilities that make up a care team and help a health care organization function properly. Physicians play a pivotal role in the delivery of health care services and products. Physicians are trusted health care partners who are held to high ethical standards. However, physicians are often faced with making difficult health care decisions that may be outside of ethical norms. A primary care provider, also known as a PCP, is a health care provider who manages overall health; patients see their PCP for checkups and health problems. Within the PCP category are doctors of osteopathic medicine and medical doctors. Breaking it down further, PCPs include obstetrician/gynecologists, nurse practitioners, and physician assistants (MedlinePlus, n.d.). Outside of primary care providers, there are also several specialty care providers such as cardiologists, dermatologists, hematologists, and neurologists. As part of a health care organization and care team, there are also nursing professionals. There are licensed practical nurses, advanced practice nurses, registered nurses, certified registered anesthetists, clinical nurse specialists, and certified nurse midwives (MedlinePlus, n.d.).

UNIT VI STUDY GUIDE The Clinical Factor

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Safe Patient Handling and Mobility Safe patient handling and mobility causes professional, legal, safety, and ethical concerns for health care providers as well as patients and their family members (Morrison & Furlong, 2019). For example, associations like the National Institute for Occupational Safety and Health (NIOSH), the Nurses Strategic Action Team of the American Nurses Association, and regulations like the Occupational Safety and Health Act (OSH Act) have all created guidelines and standards to help diffuse health care provider concerns regarding safe patient handling (Morrison & Furlong, 2019). Musculoskeletal injuries from overexertion of health care providers are among the highest in the United States (Centers for Disease Control and Prevention [CDC], n.d.-e). For instance, NIOSH provides recommendations on a weightlifting limit of 35 pounds when transferring, repositioning, or lifting patients, and OSHA and NIOSH have both endorsed standards relating to ergonomic criteria (Morrison & Furlong, 2019). Various health programs and occupational safety organizations conduct research to identify safety interventions and risk factors to prevent injuries (CDC, n.d.-e). There are also assistive technologies that can help to ensure that patients be mobilized without harm and to avoid high risk manual patient handling.

Epidemics Plague: The Bubonic plague, also known as the Black Death, was an historic epidemic that affected mammals and humans. This occurred during the Middle Ages in Europe where millions of people died. The plague is caused by Yersinia pestis, which is a bacterium that is carried in a rodent flea. Rock squirrels, ground squirrels, chipmunks, wood rats, prairie dogs, mice, rabbits, and voles are examples of rodents that can be infected with the plague. If the rodent flea bites a human or mammal, the bacteria can be passed on. The last recorded urban outbreak of the plague in the United States was in Los Angeles in 1924–1925 (CDC, n.d.-f). The plague is still present in the western United States but more significantly in parts of Asia and Africa. The symptoms include fever, chills, headache, and weakness, along with at least one painful and tender swollen lymph node, called buboes (CDC, n.d.-f). The plague can be treated with modern antibiotics, but without treatment, the bacteria can cause serious illness and even death as the bacteria spreads throughout the body. Cholera: An estimated 95,000 deaths and 2.9 million cases of cholera occur around the world every year. Cholera is a bacterial infection caused by a toxigenic bacterium called Vibrio cholerae serogroup O1 or O139 (CDC, n.d.-a). Cholera is typically found and spread in regions with poor sanitation and inadequate water treatment and hygiene. The bacterium is typically found in food or water sources that are contaminated with feces from another individual that is infected with cholera; however, a person can contract it from eating or drinking contaminated food and water. Cholera is a diarrheal illness that can be mild, with little to no symptoms, or severe; about 10% of infected people will have a severe case (CDC, 2018a). Symptoms of cholera include vomiting, diarrhea, and leg cramps, which can lead to rapid loss of fluids, dehydration, and shock. If there is no treatment, death can occur rapidly within hours. Treatment for cholera includes the immediate replacement of the lost fluids and salts through methods of oral rehydration solutions and prepackaged mixes of salts and sugars with one liter of water that are ingested by the infected individual. Antibiotics can also diminish the severity of the sickness, but rehydration is the most important step (CDC, 2018a). Influenza: Influenza, also known as the flu, is caused by viruses: Types A and B. It causes a contagious respiratory illness. The flu viruses infect the throat, nose, and sometimes the lungs. The symptoms of the flu include fever, sore throat, stuffy or runny nose, body aches, cough, fatigue, headache, and sometimes diarrhea and vomiting (CDC, n.d.-c). Compromised health individuals, children, and the elderly are at highest risk of contracting the flu. The viruses can be spread through tiny droplets made when an infected person sneezes, talks, or coughs. Vaccination is the best way to prevent getting the flu as individuals may spread the flu because they may not even know that they are sick. Most cases of the flu can be treated at home, but a health care provider should be seen if an individual is at risk of complications (Mayo Clinic, 2019). Antivirals can also be taken within the first 48 hours after the onset of symptoms to try to reduce the length of the illness and to prevent further complications. Middle East Respiratory Syndrome: Middle East Respiratory Syndrome (MERS) is a respiratory illness caused by a coronavirus called Middle East respiratory syndrome coronavirus (MERS-CoV). It was first reported in 2012 in Saudi Arabia and has spread to several countries including the United States (CDC, n.d.- d). Individuals infected with MERS typically develop a cough, fever, and shortness of breath, and many

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infected people die from the infection (3 out of 4 infected individuals). The illness is spread from an infected person through close contact, but because of the new nature of this illness, not much is known about the exact way the virus spreads. Currently there is no vaccine or specific antiviral treatment recommend for a MERS-CoV infection (CDC, n.d.-d). Medical care can be given to help relieve symptoms of the infection. Ebola: In 1976 near the Ebola River, Ebola virus disease (EVD) was discovered. Ebola is a deadly and rare disease that can infect nonhuman primates and people. Ebola in humans is caused by a group of viruses with the genus Ebolavira: Ebola virus, Sudan virus, Taï Forest virus, and Bundibugyo virus. These viruses are mainly located in sub-Saharan Africa; however, scientists do not know the origins of the viruses (CDC, n.d.-b). Ebola can be spread through direct contact with bodily fluids of a living or deceased infected individual or an infected animal like a bat or nonhuman primate. Initially, an infected person does not show symptoms or signs of having the virus. During this time, the virus cannot be spread to others until the signs and symptoms develop; however, an infected individual will continue to be contagious after signs and symptoms subside. Currently, there is no treatment or vaccine for Ebola, but blood transfusions from survivors is being explored (CDC, n.d.-b). In a health care setting, Ebola can spread very quickly; therefore, health care personal need to practice caution and use dedicated medical equipment for treatment of Ebola-infected individuals. The proper cleaning of instruments and the use of a U.S. Environmental Protection Agency (EPA)-registered hospital disinfectant is important to kill the virus (CDC, n.d.-b). Zika: In 1947, the Zika virus was first discovered, and in 1952 the first human cases were detected. In 2015, there was a widespread epidemic of Zika virus in Brazil, which spread to other parts of North America and South America (CDC, 2014). Zika is a virus that is spread by several means: the bite of an infected Aedes species mosquito, from a pregnant woman to her fetus, through sexual intercourse, or through a blood transfusion. Infected individuals may not have symptoms or may experience mild symptoms such as a rash, headache, fever, joint and muscle pain, or red eyes that may last for several days to a week (CDC, 2014). Infection of a pregnant woman can cause serious birth defects, including microcephaly, stillbirth, or miscarriage. Zika is diagnosed via a blood or urine test through a health care provider. Currently, there is no vaccine or medicine to treat the Zika illness. In the health care field, there are many different roles and responsibilities that make up a care team and help a health care organization function properly. It is important for these health care providers to work together, and follow safe patient handling and mobility practices when caring for a patient. Such guidelines also come into play when epidemics occur.

References

Centers for Disease Control and Prevention. (n.d.-b). Ebola (Ebola virus disease): Treatment. https://www.cdc.gov/vhf/ebola/treatment/index.html

Centers for Disease Control and Prevention. (n.d.-a). Cholera – Vibrio cholerae infection: General information.

https://www.cdc.gov/cholera/general/index.html Centers for Disease Control and Prevention. (n.d.-c). Influenza (flu): Key facts about influenza (flu).

https://www.cdc.gov/flu/about/keyfacts.htm Centers for Disease Control and Prevention. (n.d.-d). Middle East respiratory syndrome (MERS): Prevention

& treatment. https://www.cdc.gov/coronavirus/mers/about/prevention.html Centers for Disease Control and Prevention. (n.d.-f). Plague: Ecology and transmission.

https://www.cdc.gov/plague/transmission/index.html Centers for Disease Control and Prevention. (n.d.-e). The National Institute for Occupational Safety and

Health (NIOSH): Safe patient handling and mobility (SPHM). https://www.cdc.gov/niosh/topics/safepatient/default.html

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Centers for Disease Control and Prevention. (2014). Zika virus: Overview. https://www.cdc.gov/zika/about/overview.html

Mayo Clinic. (2019). Influenza (flu): Overview. https://www.mayoclinic.org/diseases-conditions/flu/symptoms-

causes/syc-20351719 MedlinePlus. (n.d.). Types of health care providers. https://medlineplus.gov/ency/article/001933.htm Morrison, E. E., & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning.