Reflective Journal of Improvement and Outcomes of Hepatitis C Therapy The purpose of this reflective journal is to determine the educational needs that the clinic needs in order to have 100 percent compliance with Hepatitis C (HCV) treatment. HCV is currently affecting millions of individuals who have no idea they have the disease. With a multi-disciplinary team who is dedicated to their jobs and successful in monitoring patients currently on treatment, the relapse rate is minimal and medication compliance will increase. In this journal, I will be discussing the issue of medication compliance, how the Pender’s Health Promotion Model and the use of multidisciplinary teams could be a benefit to the individuals pending or currently on HCV …show more content…
In the six years of nursing experience and the 18 years of pharmacy experience, I have been told by a number of individuals that the reason of noncompliance with their medications is: lack of funds, lack of support, no trust in their physician, side effects, forgetting about treatments, they feel better, lack of knowledge, no relationship with medical staff, and the duration of treatment (Ahmed et al, 2013). In the liver clinic that I currently work in, noncompliance is a vast problem, especially with the patients who experience hepatic encephalopathy.
Relevance of Medication Compliance As an HCV nurse in the liver clinic, I use the Pender’s Health Promotion Model, in my screening of the patient’s cognitive-perceptual factors of health, whether they have any barriers or modifying factors that may affect their treatment, and whether they are ready for the 12 to 24 week treatment. Every time a physician or nurse
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Through my years of being a nurse and a pharmacy tech, I have come in contact with individuals and realize that the number one reason for noncompliance of any type of medication regimen is because they feared the unknown. Education and social support are crucial for success in treatment. With an organized multidisciplinary team, patients will be able to demonstrate compliance with therapy, decrease the risk of treatment failure, have better outcomes, lessen the chance of the disease worsening, have less hospitalizations, and have a better outcome and/or life
Kanwal, F., Hoang, T., Kramer, J. R., Asch, S. M., Goetz, M. B., Zeringue, A., Richardson, P., & El-Serag, H. B. (2011). Increasing prevalence of HCC and cirrhosis in patients with chronic hepatitis C virus infection. Gastroenterology, 140(4), 1182-1188. doi: 10.1053/j.gastro.2010.12.032.
(Foster, 1998) The presence and severity of fatigue appears to correlate poorly with disease activity, although it may be more common and severe in HCV-infected individuals with cirrhosis. (Poynard, 2002a) Despite difficulties in separating fatigue symptoms associated with hepatitis C from those associated with other concurrent conditions (eg, anemia, depression), numerous studies have reported a reduction in fatigue after cure of HCV. (Bonkovsky, 2007) In the Virahep-C study, 401 HCV patients were evaluated for fatigue prior to treatment and after therapy using validated scales assessing presence and severity of fatigue. (Sarkar, 2012) At baseline, 52% of patients reported having fatigue, which was more frequent and severe in patients with cirrhosis than in those without cirrhosis. Achieving an SVR was associated with a substantial decrease in frequency and severity of fatigue. A recent analysis of 413 patients who achieved an SVR12 from the NEUTRINO and FUSION trials treated with a sofosbuvir-containing regimen demonstrated improvement in patient fatigue (present in 12%) from the pretreatment level. (Younossi, 2014) After achieving an SVR12, participants had marked improvement in fatigue over their pretreatment scores using 3 separate validated
The purpose of epidemiology is to better understand the burden and causes of health issues in humans. This helps decrease the risk of disease and improve health. Infectious diseases are caused by micro-organisms, transmitted to humans by humans, animals, or environment. Infectious disease usually follow a recognizable pattern. In this paper Hepatitis B also known as serum hepatitis will be discussed. Hepatitis B is a viral infection that can cause acute or chronic disease. Hepatitis B is a communicable disease. This paper will describe Hepatitis B, the demographic of interest, the determinants of health, the epidemiologic triangle, environmental factors, the role of community health nurse, and a national agency that addresses Hepatitis B.
Ask if the patient is experiencing other problems. If the patient reports other challenges, link it to poor adherence and encourage compliance.
As chronic viral hepatitis has a high prevalence in patients with HIV, clinicians should assess the risk of development of hepatotoxicity in these patients whenever HAART is initiated.7
Hepatitis A is a usually short acting virus that occurs in humans and monkeys. It is caused by the Hepatovirus and the species is Hepatitis A Virus. There are two major ways in which Hepatitis A can be transmitted. One way is from person to person. This transmission occurs when the fecal matter of an infected person gets ingested by another person. Other ways Hepatitis A can be transmitted from person to person are through direct contact with an infected person, such as sexual contact, and sharing of needles for intravenous drug use. Hepatitis A can also be transmitted through coming in contact with contaminated food or water. Also foods that are uncooked or undercooked and have been contaminated with Hepatitis A can transmit the virus. (Bennett,
Hepatitis A is a virus or an infection that causes liver disease and inflammation of the liver. According to Centers for Disease and Prevention, hepatitis A is a self- limited disease that does not cause a chronic infection and it is rarely fatal. The virus is an infectious disease of the liver which cannot be transmitted by sneezing and coughing. It is usually transmitted from person to person through the feces or the mouth, from consuming contaminated food or water. Many people do not experience any symptoms of hepatitis A, but if someone was to get it, then the symptoms could last from 2 weeks to 6 weeks. The blood is tested to determine how the liver is functioning. The blood is usually taken from the vein in the arm and
Hepatitis A is an acute infection of the liver that travels through your bloodstream and gastrointestinal tract (2). It is transmitted person to person through fecal contamination. Ingesting contaminated food and water is the main source, this usually occurs when an infected food handler prepares food without appropriate hand hygiene (3). Outbreaks are fairly common in institutions, prisons and military forces. An early infection of Hepatitis A can mimic the flu with symptoms such as being febrile, lethargy, nausea, anorexia, abdominal discomfort and eventually causing severe jaundice (1). This virus can progress and cause liver failure and even death if not treated promptly (3).
as 3.5 million people are believed to be carriers which means that they have the
Nurse’s should have a strong pharmaceutical knowledge background and be aware of the potential harm a medication could cause. In the process of medication administration, registered nurses are responsible to “determine that each medication order is clear, accurate, current and complete”. Medications should be withheld when a medication order is incomplete, illegible, ambiguous or inappropriate; with concerns being clarified with the prescriber (CNO, 2015)”. The critical care nurse demonstrated ineffective communication, which was shown by failing to ask the physician for clarification. Another instance of miscommunication is during medication reconciliation, which is a formal process in which healthcare providers work together to ensure that patient medication information is communicated consistently and accurately across transitions of care (Etchells, 2012).
This service is experienced, documented, evaluated and paid for as Pharmaceutical Care. Pharmaceutical Care consists of a philosophy of practice, patient care process as well as a patient management system. Pharmaceutical Care has common integrated vocabulary consistent with other patient care practices such as medicine, dentistry and nursing. Philosophy of pharmaceutical care consists of a description of the social need for the practice, a concise and clear statement of individual practitioner responsibilities to meet this social need, the expectation to be patient-centered and the requirement to function within the caring paradigm. This philosophy of practice is expected and practiced by all health care professionals. The patient care processes must be consistent with the patient care processes of all other health care providers. These processes include the assessment of the client’s pharmaceutical needs, a health care plan that is constructed to meet the specific needs of the client and a process in which evaluates the health care plan to gauge the efficacy of decisions made and actions taken. Pharmaceutical care management system includes all resources needed to manage the client’s needs, which include the space provided, such as a clinic or hospital, an appointment system for patients, appropriate and ethical documentation, reporting of patient care, evaluation of decisions made and actions taken and payment of service
...any APIs are not tested for Hepatitis B and are unaware of their infection. As a result, chronic Hepatitis B and associated liver cancer in APIs is one of the most serious health disparities in the United States. In the United States, nearly 70% of APIs were born or have parents born in countries where Hepatitis B is common. Hepatitis B-related liver cancer incidence is highest among APIs and is a leading cause of cancer deaths in this population. The death rate from Hepatitis B among APIs is 7 times greater than deaths among whites. Knowledge of Hepatitis B varies greatly in the API community and many misconceptions exist. The lack of knowledge and awareness of the disease significantly contributes to the low testing rates in the API population. Limited English proficiency can be a significant barrier to seeking and receiving Hepatitis B related care and services.
Health promotion consists of all actions that encourage maximum spiritual, mental and physical functions despite of whether an individual is ill or well. Most of these plans are aimed at bringing positive lifestyle changes (Van Leuven, & Prion, 2007). A major core competency for all NPs is health promotion. Through regular screening, immunizations and counselling, NPs can guide their patients towards the goal of health promotion and disease prevention. As a future NP, my goal is to provide patient-centered, holistic care focusing on health promotion and sickness prevention. I also believe that an understanding of practice models like Pender’s Health Promotion Model will enable me to empower patients to obtain self-efficacy and behavior specific changes.
A patient’s treatment needs may differ widely based on stage of their illness experience. Treatment for a newly diagnosed, moderately ill patient may be very different than the treatment of an end stage, seriously ill patient. In addition, working with patients in various settings as a part of their multi-disciplinary team requires an added consideration of the approach to the staff in the setting. Each patient care setting has a culture of it’s own and requires that a clinician be mindful of how to work with the staff as well as the patient in that particular
Standards of practice for LTCP have evolved over several decades in response to a complex set of Federal and state regulations governing the provision of prescription drugs in the LTC setting (CMS, 2014). The law that regulates the practice of pharmacy in nursing facilities are developed to safeguard the health and well being of nursing facility residents. This group of population have atypical care needs that would require alternative forms of medication or more intensive medication management. Federal law regulation mandates LTC facility in conjunction with LTCP to develop a system to decrease medication errors and adverse drug events; assure proper medication selection; monitor drug interactions; assess for over-medication, and under- medication; improve medication documentation (CMS, 2014). In order to be compliance with the federal law, it is imperative that the pharmacy and nursing facility work collaboratively to develop policy and procedure that meet the regulations.