Community-based nursing care is referred to as the provision of ensurance of personal care to individuals and families in the community”(Lancaster, Stanhope, 2000).” Community Health Nursing Practice is the synthesis of nursing theory and public health theory applied to promoting, preserving, and maintaining the health of populations through the delivery of personal health of individuals, families, and groups”(Lancaster, Stanhope, 2000).
Los Angles times on November fourth edition reports that in Chicago consumer advocate group suggests to test all new hospital patients for dangerous ‘super bug ’, staph would help out to wipe out the germs which kill more American’s than aids. The irony is that only few hospitals in America are doing test to find out the staph germs. Jeanne Thomas, a patient who was almost died due to drug resistant staph bugs. The reason is doctors reluctant to do test for dangerous staph strains in the hospital.
“The Chicago suburban residents pressure led the state of Illinois to become the first state in the country to issue guidelines to test high-risk hospital patients and to isolate those who carries the staph germ called MRSA”(USA Today). Similar measure has been passed in Pennsylvania and New Jersy.Thomas’s personal crusade for testing MRSA germs gained more importance due to the death of teenager in Virginia who was affected by MRSA last week. Government report points out that MRSA infections makes 90,000 sick each year and kills close to 19,000.
Staphylococcus Aureus bacteria cause methicillin Staphylococcus Aureus (MRSA). Decades ago in hospitals an antibiotic resistant MRSA has emerged. The MRSA was one of the methicillin-resisting germs, which can be very fatal to patient. Staph bacteria ate normally found in about one third of the general population on their skin or in the nose. Those people carrying staph germs in their skin but not infected are known s colonized, but with no MRSA infection. These carriers can pass the germs to those patients who do not carry the germ.
Staph bacteria are harmless till they enter into human body through a cut or wound and can cause only minor skin problems. In older adult, children or those whose immune systems are weak due to illness, diseases even ordinary staph infections can inflict serious health problems. In 1990’s a type of MRSA, which is not known previously, started to show in wider community, which is known as CA-MRSA.
MRSA, and CA- MRSA cause many serious soft tissue infections. These germs could also cause pneumonia in a dangerous from. The only antibiotic effective against hospital strains of MRSA is Vancomycin. Several drugs works against CA-MRSA and both strains are rapidly evolving bacterium. It is only matter of time these drugs also become resistant to antibiotics. The news article is mainly referring about MRSA strains related to hospitals. Article has given stress to people who are in the healthcare settings like hospitals and nursing homes, Not following the strict adherence of personal hygenity by doctors, nurses and other hospital staffs leads to the spread of MRSA from patients to patients. Improper sanitation, germ contained medical devises without proper sanitation using on patients who is undergoing dialysis or other medical procedures is another serious concern by the hospital staff which spreads the germ.
Concerned people says that MRSA amounts only one among other dozens of risky germs that often infect people in hospitals, which causes serious harm particularly to those who are with weak immune systems or with open wound. The director of consumer union says “ to eradicate hospital is going to take a comprehensive effort, that should include testing hospital patients”(USA Today).
MRSA infections have logged attention due to recent issues. Center of disease control recommends testing for MRSA resisting germ is an option to contain it. However CDC opines that it is not sure that testing hospitals for MRSA works better than other measures. Other measures like preventative hygenity like hand washing, wearing gloves and other preventatives combined with using antibiotic judiciously.
Joint commission, an independent joint organization that set standard for the nations hospitals do not set a preventative rules to prevent MRSA.The commissions wants to see evidence that testing for the germs and other measures works. Commission is expecting to have an answer soon and will decide to set standards and rules if necessary. Veteran’s hospital in Pittsburgh tested new patients using a nose swab and isolated those patients from those who do not have MRSA. This action has resulted infection rates from 60% TP 18%. Dr.Rajiv Jain says the commission should look into the experiment done by Pittsburgh veteran’s hospital.
The news article did not pay any highlights with regards to the general public other than patients and medical staff in a hospital atmosphere. Another web article narrates, a Nine year old boy’s survival of staph infection .A small bruise on his left knee happened while riding his bike last October caused infections spread throughout his body, lungs riddled with holes. The child managed to survive. The bacteria infected the knee became resistant to most common antibiotics used across America. The germs are spreading rapidly throughout Texas, Illinois, California and Alaska. The germ started to show up in Pennsylvania and New York. The most concerning fact is that the germs have rapidly spread by close contact, if it gets in to any closely knit community it can spread like an epidemic. The germs can be contacted from play gorunds, gym and meeting rooms. Germs can be carried on anything from laundries or from shared towel. Community based MRSA can even alter the other bacteria, and DNA can mix together also match genetic information by exchanging DNA short strips, which is known as cassettes. Some of these cassettes can make the infections more dangerous.
Articles posted in Mayo clinic site shows that the main reason for drug resistant MRSA is due to decades of overuse of unnecessary antibiotics in humans. Antibiotics were prescribed for cold, flu and viral infections, which do not respond to these drugs. Simple bacterial infections normally clear as their own. Poultry and cattle meet contains antibiotics, the way they are raised in America. Some of these bacteria, which survive antibiotics lives in a fast, track way and learns to resist other drugs. Prevention is better than cure, the best way to prevent MRSA is to wash the hands frequently, disinfect hospital surfaces, use mask and other preventative measures. Hospitals need to use surveillance systems to track bacterial outbreaks and isolate the patients colonized with MRSA.
“ Orem’s Theory of nursing is referred to as the self-care deficit theory of nursing, and it consist of the articulation of the theories of self-care, self-care deficit, and nursingsystems”Alligood, Tomey, 2002). In Orem’s nursing model self-care describes activities that individual initiate and perform on their own behalf to maintain life, health and well being. Individuals are always not able to perform their self-care, so the nurses should assess the capability of individuals and provide the care accordingly. It can vary from total care, to partial care; to education and supporting individuals to assist them increase their self-care capability.
To prevent or control the MRSA infection educating the public is the primary concern. Community at large should be educated on personal hygenity, washing hands with soap and water, keep personal items, towel, razor, sheets, clothing athletic equipments personal and not share personal items with others. Keep wounds covered with sterile bandages, and sanitize linens with hot water, bleach and dry them with hot dryer. Wash gym clothes after each use. Get tested for germs if the person has any skin infections. Education should be done in school, churches, public places. The education can be done by passing out simple brochures, giving lectures in the community, school, churches etc. Health care workers should wash their hands before and after each patient contact. Nurses have a critical role in educating people to care for themselves.
Alligood, M.R&Tomey, A.M (2002). Nursing Theorists and their work (5th ed). St.Louis, Mosby Inc.
Gorman, C, U.S.A Today: New Killer Bug (October 25,2007). Retrieved on Sunday, November 4,2007 from http://www.usatoday.com
Lancaster, J&Stanhope, M. (2002). Community & Public Health Nursing.St.Louis, Mosby Inc
Tanner, L.Los Angeles Times: Staph screening may wipe out germ, (October 24,2007). Retrieved on Sunday, November 4,2007 from http://www.latimes.com