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NURS 4211C Wk 1 COMMUNITY HEALTH ISSUES DISCUSSION

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In my community of Huntsville, AL, the incidence of osteomyelitis is on the rise. Osteomyelitis is an infection of the bone that is usually caused by a bacteria or fungus (National Organization for Rare Disorders, n.d.). Nationwide, the incidence of osteomyelitis is approximately 1 in 675 cases in hospitals, or about 50,000 per year (National Library of Medicine, 2022). Although osteomyelitis is considered a rare disease, it can have serious consequences such as sepsis, osteonecrosis, amputation, and death. Risk factors include surgery, other illnesses such as pneumonia or other bacterial infections, and diseases that cause circulation issues such as diabetes and peripheral vascular disease (Mayo Foundation, 2022).

In preparation for this course, I discussed with my mentor the age group that she is seeing the highest prevalence of osteomyelitis in. As an infectious disease nurse practitioner, my mentor is responsible for treating osteomyelitis, and therefore has real, relevant information regarding this disease in my community. She stated that the highest incidence was adults both male and female between the ages of 40 and 50. In addition to age as a factor, most patients that she sees with osteomyelitis have co-morbidities of obesity and/or diabetes. According to the CDC, Alabama has the third highest rate of obesity in the country (Alabama Public Health, 2022a). As of 2019, type 2 diabetes was the seventh leading cause of death in the state of Alabama (Alabama Public Health, 2022b).

One example of osteomyelitis as a result of several risk factors is a current patient of mine. This patient was at one time obese and had uncontrolled diabetes mellitus. As a result of her diabetes, she has very poor circulation to her lower extremities. What started as a dime-sized abrasion to her leg transformed into a severe case of osteomyelitis in less than one week, and the patient had a below the knee amputation as a result. Because of this amputation, she is now bedbound and has several stage three and stage four wounds. Unfortunately, because she and her family did not have the necessary education regarding management of obesity and diabetes, this patient now suffers from pain daily and the loss of a limb.

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As nurses, one of the most important things that we can do is educate our patients on how to manage disease. However, even more important is primary prevention. One of the most common complaints I get from patients as a nurse is they “just don’t know what to do”. Patients do not know how to eat well, they do not know the importance of exercise, and oftentimes may not have access to healthy foods. By providing health education, I strongly believe that we can decrease the obesity and diabetes rates both community-wide and nationwide, and therefore reduce the rates of complications such as osteomyelitis. As noted in the intervention wheel, health teaching can have far-reaching effects in the community (Schaffer et al., 2022).

References:

Alabama Public Health (2022a). Obesity.

https://www.alabamapublichealth.gov/obesity/#:~:text=CDC%20Data%3A%20Alabama%20Has%20Nation’s%203rd%20Highest%20Rate%20of%20Adult%20ObesityLinks to an external site.

Alabama Public Health (2022b). Diabetes.

            https://www.alabamapublichealth.gov/healthrankings/diabetes.htmlLinks to an external site.

Mayo Foundation for Medical Education and Research (2022). Osteomyelitis. Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/osteomyelitis/symptoms-causes/syc-20375913#:~:text=Osteomyelitis%20complications%20may%20include%3A,for%20antibiotics%20to%20be%20effective.

National Library of Medicine (2022). Osteomyelitis. National Institutes of Health.

            https://www.ncbi.nlm.nih.gov/books/NBK532250/Links to an external site.

National Organization for Rare Disorders (n.d.). Osteomyelitis.

https://rarediseases.org/rare-diseases/osteomyelitis/Links to an external site.

Schaffer, M. A., Strohschein, S., & Glavin, K. (2022). 

Twenty years with the public health intervention wheel: Evidence for practice

. Public Health Nursing, 39, 195– 201. https://doi.org/10.1111/phn.12941Links to an external site. 

   Some top health issues prominent in the community that have been discussed recently by my colleagues and I, are Covid-19 and respiratory syncytial virus (RSV). Working in a hospital setting, it is not surprising that respiratory illnesses would be one of the top causes of those admitted to the hospital at a time when respiratory illnesses are high. The peak of respiratory illnesses is typically late fall and winter (Perez et al., 2022). Of the respiratory illnesses noted recently however, the more surprising one has been RSV in adults, as there are those that believe adults do not get RSV.

                One of the top health issues prominent in the community at this time is RSV. It is common knowledge that RSV is common in babies and children. What seems to be a common misconception of RSV is that only children can get RSV, or that it does not affect adults. This leads me to believe that education is needed at the community and system level to create awareness. Education is also needed on how to prevent the spread of RSV. It has become standard practice since the start of the Covid-19 pandemic to maintain a six feet distance from others, wear masks when ill, and to wash hands often. It would be beneficial to educate and encourage people to also clean surfaces thoroughly and to stay away from others when sick. Going Viral (Busack & Shorr, 2022), mentions that adults most vulnerable to RSV are those with previous heart and lung issues, the elderly and those that are immunocompromised. It would also be beneficial to educate patients at a heightened risk of getting RSV or being seriously ill with RSV, the signs, symptoms, and what to do if symptoms occur. Nurses could also help prevent the spread of RSV by testing those that have respiratory illnesses for it, so they can isolate themselves.

               In conclusion, respiratory illnesses like RSV have been prominent in my community lately. One aspect about RSV that has been surprising to the community has been the fact that RSV can affect adults and make them ill as well as children. Education would be extremely beneficial in preventing the spread of RSV in adults and even children, as adults could be unaware that they could have it to spread.

References

Bethany Busack, & Andrew F. Shorr. (2022). Going Viral—RSV as the Neglected Adult Respiratory

                 Virus. Pathogens, 11(1324), 1324. https://doi.org/10.3390/pathogens11111324

Perez, A., Lively, J. Y., Curns, A., Weinberg, G. A., Halasa, N. B., Staat, M. A., Szilagyi, P. G., Stewart, L. S.,

                 McNeal, M. M., Clopper, B., Yingtao Zhou, Whitaker, B. L., LeMasters, E., Harker, E., Englund, J.

                 A., Klein, E. J., Selvarangan, R., Harrison, C. J., Boom, J. A., & Sahni, L. C. (2022). Respiratory Virus

                Surveillance Among Children with Acute Respiratory Illnesses – New Vaccine Surveillance

                Network, United States, 2016-2021. MMWR: Morbidity & Mortality Weekly Report, 71(40),

                1253–1259. https://doi.org/10.15585/mmwr.mm7140a1

 A top public health issue in Atlanta is opioid overdoses. According to the Georgia Department of Public Health (2022), the number of opioid deaths in Georgia in 2020 rose 207% over a 10-year period. But this isn’t just a Georgia problem; it is a nationwide problem. The U.S. Department of Health and Human Services (2017) declared the opioid crisis a public health emergency. Colleagues across metro Atlanta are describing similar rises in patients with substance abuse disorder and overdoses and have also shared how the crisis has affected them personally within their families.

            There are many ways that a nurse can help to improve the crisis at a population level. One way that nurses can focus on is primary prevention within a specific community. A public health nurse can identify specific populations at risk (Stanhope, 2020, pp. 5). Once those populations have been identified, the nurse can target education at those specific groups. For example, the public health nurse can provide education about the opioid crisis to children in school to help prevent them from ever starting to take drugs.

            Secondary prevention is another level that nurses can participate in within the community. Secondary prevention involves finding people and treating them early in the disease process (Stanhope, 2020, pp. 11). Nurses can offer information on where to get help and connect people with the appropriate resources for them to try to stop using drugs. Nurses can also provide information to families about keeping Naloxone, an opioid antagonist, on hand for overdoses.

            One of the most impactful ways a nurse can help to improve addiction treatment is to help get rid of the stigma around addiction. The National Institute on Drug Abuse (2020) defines addiction as a chronic brain disease. Dr. Attia describes his transition from judgmental thinking and how he learned that everything he thought he knew about a disease process was possibly wrong (Attia, 2013). People with addiction are not bad people. They are sick people. Changing that thought process can allow nurses to give more compassionate care on a personal level and benefit the community because people living with addiction may be more likely to seek help.

Attia, P. (2013). Is the obesity crisis hiding a bigger problem? Links to an external site.Links to an external site. [Video].

           TED conferences. https://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes

Georgia Department of Public Health. (2022, November 7th). Opioid and Substance Misuse

            Response.https://dph.georgia.gov/stopopioidaddiction#:~:text=Visit%20the%20Georgia

            %20Crisis%20%26%20Access,overdose%2C%20and%20how%20to%20respond.

National Institute on Drug Abuse (2020, July). Drugs, Brains, and Behavior: The Science of

            Addiction. https://nida.nih.gov/publications/drugs-brains-behavior-science-Links to an external site.

            addiction/drug-misuse-addiction

Stanhope, M., & Lancaster, J. (2020). Public health nursing: Population-centered health care in

            the community (10th ed., pp. 5-11). Elsevier.

U.S. Department of Health and Human Services (2017, October 26th). HHS Acting Secretary

            Declares Public Health Emergency to Address National Opioid Crisis.

            https://public3.pagefreezer.com/browse/HHS.gov/31-12-Links to an external site.

            2020T08:51/https://www.hhs.gov/about/news/2017/10/26/hhs-acting-secretary-declares-

            public-health-emergency-address-national-opioid-crisis.html

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