Discussion: Chapter 1 Pandemic Readiness Capstone

Discussion: Chapter 1 Pandemic Readiness Capstone ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Chapter 1 Pandemic Readiness Capstone Pandemic readiness in the acute health care setting Mariann England Aspen University Nursing Capstone Dr. Julie Kolde July 26, 2020 Chapter One Background to the study A pandemic is a global spread of a new ailment, one which traverses transnational borders and eventually affects a large proportion of the population. A pandemic is an unforeseen and unavoidable event, characterized by its indeterminate scope, length, and consequence. Besides posing a high morbidity and mortality rate threat, pandemics can overwhelm medical care structures and substantial societal and monetary disturbance (Bali et al., 2017). Pandemics result from the surfacing of an antigenically new microbe for which there is no erstwhile body resistance, usually with a reassortment of previously humanoid or animal microbial genomes. Readiness to pandemics comprises planning and organization, monitoring and evaluating circumstances, communication, continuity of medical care delivery, and curbing the disease’s spread. Pandemics, and their resultant effects, may persist for months to years. Therefore, a multi-disciplinary approach is imperative in the disease response strategies, particularly at the state and sub-state levels. Discussion: Chapter 1 Pandemic Readiness Capstone The threat of a pandemic or contagious illness vastly spreading skulks inaudibly beneath the surface of routine hospital operations and at the population in general. Instants of alarm instigate waves of preparedness as novel microbes and transmutations pose evanescent threats. Pandemic-preparedness needs to be founded on generic alacrity programs, resources, mechanisms, and approaches for crisis and disaster management (Shearer et al., 2020). Pandemic-preparedness is fundamental in ensuring that health and other indispensable structures continue to function during a pandemic, thereby decreasing the pandemic’s economic and social effects. Discussion: Chapter 1 Pandemic Readiness Capstone The effects of a pandemic, whether mild or severe, may affect a large population hence may require a response from multisector over several weeks, months, or years. Therefore, the health care sector needs to have strategies to assist in dealing with such incidences. Also, it is essential to have a clear plan for responding to a pandemic at the national and sub-national levels. A clear pandemic plan should be put in place to aid the health professions in developing response strategies in case it occurs. The pandemic plan, which is a written document, should be subjected to continuous reviews and revision based on the changes with the global changes on pandemic response guidelines. In the occurrence of an epidemic or pandemic, the healthcare professions have a moral obligation to take care of the community and the society against the adverse effects of the pandemic. In this regard, they ought to be adequately prepared to protect their lives while taking care of others. The nursing professions are particularly exposed to the pandemic effects as they take care of the affected population. As such, they need to have a well-documented plan and strategies that would be used to control the pandemic while safeguarding their health. This study is significant in the assessment of the preparedness of the healthcare professions in dealing with pandemics. Discussion: Chapter 1 Pandemic Readiness Capstone Purpose of the study Pandemic preparedness in the healthcare sector is an essential area of study, especially for the health care professions. This study plays a significant role in addressing the challenges encountered in the case of inadequate pandemic preparedness. The study is designed to investigate the pandemic preparedness in the acute care setting, focusing on personal protective equipment conservation, availability, and efficiency of the testing sites. The purpose of the study also aims at determining the levels of pandemic preparedness in acute care settings, with an emphasis on policy, planning and management efforts, and the ensuing modifications put in place to counteract future pandemics (Goniewicz & Goniewicz, 2020). This is important to the nursing profession as they will be able to identify the gaps that exist in the disaster response measures. Analytical data collected are essential in developing a pandemic response plan that will assist healthcare professionals in dealing with the gaps identified. This study will help policymakers and ground-level clinicians point out the gaps and insufficiency in the pandemic or crisis management protocols already in place. This study will outline the need for nurses’ integral involvement in collaboration with other professional teams towards pandemic preparedness. Project significance and rationale Pandemics are a significant challenge to policymakers, medical care professionals, legislators, and public health leaders. Any form of readiness plan should incorporate local and transnational harmonization to operate more proficiently with the limited means accessible. Whenever a significant fraction of the population is disease-ridden, the overall figure of the acute incidents can undoubtedly overwhelm the medical care systems available (Tsamakis et al., 2020). Consequently, critical care delivery is faced with numerous challenges in terms of preparedness and readiness, surge capacity, management systems, contagion control, and clinical guidance. This study will help policymakers and ground-level clinicians point out the gaps and insufficiency in the pandemic or crisis management protocols already in place. This study will outline the need for the integral involvement of nurses, in collaboration with other professional teams towards pandemic preparedness. This study will also shed more light on nurses’ expanding role in the response and management of pandemics, which will significantly help advance nursing science. With all this information, it will be possible for the healthcare profession to provide adequate healthcare to the patients without putting their health at risk, given their role and professional obligation (Goniewicz & Goniewicz, 2020). Pandemic preparedness is vital for the nursing profession as it helps develop strategies that are important in dealing with the pandemic. Health care providers have a professional obligation to take care of the community at large. Nurses are required to provide direct care to the patients and sometimes expose themselves to the pandemic, which may be life-threatening to their personal life. It is crucial to be prepared more adequately when dealing with the effects of a pandemic. This study is of great importance to the professions as they assess their preparedness in dealing with any pandemic and how they can protect their health (Stephen, 2019). Taking the current pandemic of Covid-19 as an example, the pandemic has affected a significant number of the world’s population, including the healthcare profession. This is particularly the case since the healthcare profession is in direct contact with their patients and, therefore, more likely to contract the virus. With adequate measures to deal with this kind of a pandemic, the healthcare professions will be protected against its effects as they take care of the other patients. Studies indicate that any pandemic has significant implications in the healthcare system and the most affected being the caregivers. This is because they must take care of the community and place their health at risk. This study has a great significance to the health profession in addressing the gaps in the healthcare profession and the mechanism used to bridge the gaps that may be encountered. Discussion: Chapter 1 Pandemic Readiness Capstone Analysis of literature In the event of a pandemic, most of the population is exposed to the pandemic’s high rate, which remains at 40-60 % of the affected population. However, the lack of the necessary guidelines and standards in the fight against the pandemic can be the most critical failure in the acute healthcare setting. Therefore, it is essential for the healthcare setting to be ready and well prepared with measures and strategies to counter the effects of a pandemic. The world has witnessed different incidences of pandemics that remain a significant health burden to many different countries. One kind of pandemic is Influenza, which affects a large population of different countries. Due to the growth of urbanization and global transportation, it is evident that it is likely to spread rapidly across the world in the case of a pandemic. Therefore, Pandemic readiness in the acute health care setting remains an essential factor in the successful containment of these pandemics through proper planning. Preparedness is essential in minimizing the pandemic’s growth and spread, reducing the cases and incidences of a pandemic, preserving essential services, reducing hospitalization and deaths, and preventing the incidences of economic crisis. The management has a significant role to play when it comes to the fight against a pandemic. Research indicates that with poor planning, the effects of an infectious pandemic can be vital. Currently, most acute health care settings have inadequate accounting and interaction procedures, poor training on health care providers, poor programs on disaster preparedness, and inadequate essential preventive equipment such as ventilators and other essential health care equipment, including ventilators and hospital beds. Some of the plans in place have not yet been tested for their effectiveness, limiting the fight against a pandemic. Description of a pandemic Preparedness A pandemic is a global spread of a new ailment, one which traverses transnational borders and eventually affects a large proportion of the population. A is an unforeseen and unavoidable event, characterized by its indeterminate scope, length, and consequence. Besides posing a high morbidity and mortality rate threat, pandemics can overwhelm medical care structures and substantial societal and monetary disturbance (Bali et al., 2017). Pandemics result from an antigenically new microbe’s surfacing for which there is no erstwhile body resistance, usually with a reassortment of previously humanoid or animal microbial genomes. Readiness to pandemics comprises planning and organization, monitoring and evaluating circumstances, communication, continuity of medical care delivery, and curbing the disease’s spread. Pandemics, and their resultant effects, may persist for months to years. Therefore, a multi-disciplinary approach is imperative in the disease response strategies, particularly at the state and sub-state levels. The threat of a pandemic or contagious illness vastly spreading skulks inaudibly beneath the surface of routine hospital operations and at the population in general. Instants of alarm instigate waves of preparedness as novel microbes and transmutations pose evanescent threats. Pandemic-preparedness should be founded on generic alacrity programs, resources, mechanisms, and approaches for crisis and disaster management (Shearer et al., 2020). Pandemic-preparedness is fundamental in ensuring that health and other indispensable structures continue to function during a pandemic, thereby decreasing the economic and social effects of the pandemic The objective of planning and organization efforts is to offer direction and harmonization across all sectors involved in pandemics management. A collapse in disaster-response lags national and local efforts towards the control of a pandemic. As yet, exertions to boost testing has been directed on operational matters: adequacy of the testing capacity, the pervasive scarcities and supply-chain failures, and strategies to scale-up testing to the vast figures necessitated to ease the pandemic (Madhav et al., 2017). Availing additional tests is not an approach in and of itself. If sufficient tests were achieved, this question would still linger in our minds: What resolves are the outcomes intended to inform? Testing has numerous rationales other than diagnosis and ensuring safety for health care staff. Testing data is necessary for the management of all the features of a pandemic. For example, this data is the keystone of pandemic extrapolative models. That makes known the future demand for attention, the timing of surges, and the scale of the necessary emergency amenities. Devoid of reliable testing data, analysts depend on presumption and assumptions. The protocols of education in a pandemic aim at shrinking the contact and transmission rates of the infectious disease (Schneider, 2020). Educational strategies include encouraging respiratory propriety, basic hygiene, suitable aeration, social distancing, and disseminating appropriate and accurate health messages. Personal protective equipment, such as masks, gloves, and isolation gowns, help reduce the risk of exposure to an infectious pathogen for health care providers. The hastily flagging supply of such equipment, paired with the supply chain’s challenges, has triggered a high alarm and could significantly encumber the capability to ensure the safety to the care providers (WHO, 2020). This calls conservative approaches such as reducing access into the isolation settings, reducing the demand for personal protective equipment by temporarily doing away with elective surgical procedures and other unnecessary encounters, and reusing the material, which encompasses prolonging their use, decontamination with ultraviolet light and reusing some of the equipment up to several times. Importance of pandemic preparedness The impact of a pandemic in a nation or across the globe is severe and, therefore, needs to be well prepared in case it occurs. Currently, most healthcare facilities are not well equipped, so the acute pandemic’s impact is likely to strike hard. For instance, the current Covid-19 pandemic and the infrastructures used in the containment of the disease are the same infrastructures used in addressing pandemic and seasonal Influenza over the decades. This is an indication of the underfunding of the healthcare facilities that limit the ability to address pandemics. Research indicates that acute healthcare settings are not prepared to address the outbreak of pandemic or infectious diseases. There are outbreaks of acute pandemic almost every year that claims thousands of life almost every year. Some of the acute pandemics have similar symptoms and therefore making the containment and management process a challenge. However, with proper management, the healthcare setting may have the required infrastructure and machines to handle the pandemic. It is essential for all the health sector stakeholders to combine efforts in the fight against the pandemic that continues to affect the world every year. According to Goodman (2020), there is the need to have combined efforts in both the public and private sectors as a global partnership to succeed in fighting against the pandemic. Having preventive measures and being prepared will ensure that the global GDP is not severely affected by the pandemic as it has been the case every year. For instance, the current pandemic has severely affected the world’s economy, with the effect standing at 2% as of April in the United States alone (Goodman, 2020). The private sector can strengthen the health sector infrastructures as a vital part of fighting the pandemic. Also, the fight against the pandemic requires the collaboration of all the sectors, communities, families, and individual efforts to develop essential policies essential in fighting the pandemic. Discussion: Chapter 1 Pandemic Readiness Capstone Development of pandemic preparedness policies and strategies is vital in the acute health setting because it will help the health professionals have the required resources to fight the pandemic. Therefore, the fight against the pandemic becomes active, and the country can save as many lives as possible. Nurses are mostly exposed to the dangers as they take care of the patients. Therefore, with effective preparedness in the fight against a pandemic, there are less exposed to the dangers as they handle the patients. Therefore, it is crucial to have continuous pandemic preparedness training for the health care providers and especially the nursing profession, to successfully counter the pandemic’s effects. This ensures that the providers of essential services are not affected. Provision of necessary equipment such as personal protective equipment and other training on how to provide essential services in the acute healthcare setting is essential as the professionals are better equipped with the needed knowledge and skills in the fight against infectious pandemics (Carbell & Christian, 2011). Studies recommend that preparedness acute healthcare settings against a pandemic is an integral part of a successful fight against pandemic (Goodman, 2020). There is the need to have well-documented policies in disaster preparedness at all levels of acute health care, which provides room for effective containment of the pandemic. Combined efforts of all the stakeholders in the acute health care setting play a vital role in the success of pandemic containment, which includes measures to have all the essential procedures being up to date in pandemic preparedness. Essential pandemic preparedness measures Health care providers in the acute healthcare setting should be well prepared in the containment of acute pandemics that strike the world every year. Most acute pandemics are infectious diseases that spread from one person to another, and the rate of spreading is high. Given that it requires much time to understand the epidemiology of any infectious disease, it is equally essential to have adequate procedures and strategies to contain it. This involves international and national level planning to take care of the high number of patients expected to flood in the hospital in case of a pandemic (Stephen, 2019). Most healthcare facilities have the inadequate infrastructure required to contain a pandemic with hospitals operating at near or in full capacity (Stephen, 2019). The infrastructures currently used are the same used in decades, limiting the effectiveness in the fight against a pandemic. There is a shortage of health care providers, while emergency preparedness is always crowded. Many healthcare facilities lack enough hospital beds, while the emergency room is not well equipped with required materials such as the ventilators, which are vital in pandemic management. The healthcare workers are also at risk of being exposed to the pandemic as they care for the patients due to the lack of enough personal protective equipment. Therefore, there is the need to have all these issues being addressed to successfully contain the pandemic (Carbell & Christian, 2011). The following are essential emergency preparedness requirements in a successful fight against the pandemic. Airborne isolation capabilities in acute health care There is the need to have enough airborne isolation capabilities with all the required materials and equipment to address the pandemic. This may include acute inpatient beds in national and regional hospitals. The preparedness ensures that the hospitals are in a position to handle the high cases of infected people effectively. With proper measures in isolation capacity, acute health care can have an interim emergency plan that will address the needs in the event of an outbreak. Therefore, the health care facilities will be able to house the patients safely in their isolation rooms. Necessary equipment required in the isolation room should be availed, such as ventilators required for success in the fight against a pandemic. Staffing The successful control of a pandemic requires adequate staffing of health care providers to take care of the infected persons. Therefore, hospitals need to have adequate staff required to take care of the patients. There should also be measures to ensure that health care providers are well prepared and adequately trained to address the needs of the patients while protecting themselves against infectious disease. Vaccine Most important is the preparedness in protecting the healthcare providers against a pandemic, which is possible through vaccination. There is a need to have a well-structured strategy to quickly research the disease’s epidemiology and develop a vaccine. Most important is to front the healthcare professionals in receiving the vaccine in the event of a pandemic. This will motivate the workers in providing patients with the care they need effectively. Discussion: Chapter 1 Pandemic Readiness Capstone Preparedness in the event of a pandemic is essential in the acute healthcare setting as it ensures that health care facilities can handle the infections successfully. This requires combined efforts of all the stakeholders for the successful containment of the pandemic. METHOD Procedure This study uses a cohort study design to establish the cause of the ailment and identify links between risk factors. Local hospitals with an operational intensive care unit and emergency department will be recognized and contacted via telephone to help identify the emergency management coordinators in charge of emergency management, planning, and operations. A structured questionnaire was prepared based on an existing pandemic management plan. The survey has its main sections as facility planning data, workforce glitches and structure, and surge capacity. The questionnaire was piloted using a representative number of individuals. Data was collected and computed for univariate and bivariate analysis. A qualitative approach is then used for text responses (Edwards & Brannelly, 2017). The cohort study method applies to this research as a non-experimental study. The participants included in the study are selected based on the interests in the research outcome. The study uses the study design to assess preparedness in a pandemic in the acute healthcare setting. The cohort study involves local hospitals designed to handle intensive care to patients affected by a pandemic. Subjects and participants The research focused on local hospitals with intensive healthcare facilities and emergency departments contacted on the research via telephone. The selected hospitals were subjected to the research. The management in the emergency department and the management in intensive care will be required to fill a pre-prepared questionnaire. These are the most important sources of information on how their health facilities are prepared to fight against a pandemic. The research design requires that the participants be subjected to training on how the response should be made (MacKay et al., 2020). Collection of Data Primary and secondary data were collected in the research in which the participants provided the primary source of data. In contrast, the qualitative approach to a review of past research works on pandemic preparedness was used. The primary data involved the use of a prepared questionnaire based on past research work on pandemic preparedness. Besides, interviews were also good sources of information on how acute healthcare facilities are prepared for the pandemic’s management. The interviews involved 20 healthcare professionals in the emergency and intensive care unit based on their roles in healthcare facilities. A qualitative case study was used to collect secondary data on the preparedness of healthcare facilities in the fight and management of the pandemic in the acute health care setting. There was a need to prevent biases. Therefore, the information was sourced from two independent sources: the information provided by the ministry of health and the internet, which provided reviewed articles on the readiness of the acute health care setting in containing a pandemic. The internet database provided such materials from Google Scholar. Did it include search terms such as pandemic readiness in the acute healthcare setting, and how are health care prepared in the fight against the next pandemic? Information provided by healthcare facilities included their procedures in handling the infected patients at the emergency department and the intensive care unit (Edwards & Brannelly, 2017). In the qualitative research methods, the case study approach was more effective in collecting data through a literature review of previous studies on the same topic. This provided valuable information required in the research on the preparedness in the event of a pandemic. Advantage of the data collection strategy The strategy used in collecting data has its advantages over the other methods in the study and therefore considered the most appropriate research method for the study. This is because the cohort study method provides an opportunity to have clarity of the temporal sequence, which determines whether the exposure preceded the expected outcomes. The cohort study method indicates the temporal sequence in the outcome and the exposure. The study also provides an opportunity to calculate incidences of the likelihood of a disease, which can be grouped as absolute risk, relative risk, attributable proportion, and risk difference. The multiple outcomes of the study can also be determined simultaneously. Discussion: Chapter 1 Pandemic Readiness Capstone Qualitative data collection is also crucial in research given that the researcher can be more speculative on the interest areas of research and how the investigation is to be done. The research is also more targeted in the whole process, which improves the data collection process while minimizing the cost of the data collection process. Limitations Despite the advantages of the cohort study strategy, some limitations may make the research process a challenge. For instance, a researcher is expected to conduct a follow up of a vast subject over a long period, the study method may be expensive and also consumes much time, may introduce bias as a result of differential loss of participants follow up, data may be of poor quality if the data used was not designed for this type of study (Sedgwick, 2013). In qualitative analysis, the limitation of the study method is that the strategy may be time-consuming, which remains a significant drawback in a research method. The interpretation of the data may also be limited. This is because; qualitative methods may take between weeks and months and given that the data collection may deviate from the main study question. The process is also labor-intensive due to the analysis process, such as recording and categorization, and requires a very experienced researcher to obtain the required information. Finally, the research strategy is not representative statistically. This is because the strategy is based on perspectives, and the responses given are not measured. Also, the research may result in comparison, which may lead to duplication. Therefore, there is a need to cross-examine the data collected to avoid duplication (Sedgwick, 2013). Ethical Issues on Collection Upon the participants Ethical consideration that was considered in the research study includes informed consent, voluntary participation, confidentiality, and anonymity. Information consent ensures that the participants in the research are fully aware of the project. In this regard, the participants were briefed on the study’s expectations to make an informed decision on their participation. Participation in the research was voluntary, and they were allowed to withdraw from the research without discriminations. Finally, the participants’ confidentiality was maintained, and their information was to be confidential only to the program coordinator, and therefore no use of names was done. This ensures that participants remain anonymous (Velip, 2018). Data Analysis The collected data were subjected to statistical analysis, which included collecting the data, analysis, interpretation, and modeling. The analysis involved a descriptive analysis of a set of collected samples and data. The analysis involved statistical tools in computing the data collected from the participants. Chapter 4: Results and Recommendations Health care Workforce Response Twenty-three hospitals were involved in the research project and gave their responses to the questionnaire provided with a response rate of 55%. This involved private and public hospitals, and the hospital size ranged from 40 to 800 hospital beds for inpatient. The hospital beds’ median for the public hospitals being 352 and private hospitals at 101 (median= 260). An equivalent of 180 to 5000 health care professionals and a median of 2370 were identified in both public and private hospitals, while the hospital beds stand at a median of 44 beds in both emergency department and intensive care units. The percentage of the emergency department participants was 41%, respondents from infection control were 23 %, and finally, the percentage of Acute Services and nursing was 14%. Group Frequency Count Control of infections Occupational Health & safety Medical and medical staff Emergency management committee Nursing Director and Staff Emergency Department Quality and Risk ICU 80% 42% 37% 30% 25% 25% 15% 6% 18 8 8 7 6 6 4 2 Table 1: frequency of individual hospital departments in preparing pandemic preparedness and emergency plans Medical staff and hospital executives were cited as the staff members commonly involved in planning the occupational health and safety departments, emergency department, and intensive care units in the infectious departments. The hospitals had a higher planning and preparedness rate in some private hospitals and public hospitals, while some required additional improvement. Therefore, in the case of a pandemic, the respondents indicated that the hospitals would handle the pandemic at a good point, with the variable being the workforce’s availability and how severe the pandemic is likely to be. The respondents reported that the hospital needs in the acute health care setting would not be met adequately due to the high rate of healthcare professional absenteeism. The survey also indicated that some hospitals had achieved the overall guidelines on hygiene standards and precautions training on managing the pandemic. However, the hospitals needed to have an additional provision of personal protective equipment to protect themselves from the infections. When it comes to the health care workers on the preparedness to report to in the wake of a pandemic, many workers were willing to report. Anxiety was evident in the interview, but they were willing to report to the health care facilities. This is based on the hospitals’ preparedness in the reduction of the chances of infections to occur in the hospitals as they attend to the patients. The health care workers reported that appropriate measures were put in place to identify health workers infected and isolation procedures to handle the case, hence preventing other staff infection chances. However, the health care professionals were unwilling to attend to the patients in the next pandemic due to fear of personal and family safety. This is because the workers are expected to be infected first as they are in direct contact with their patients, which would then be transmitted to their family members. Therefore, when healthcare professionals consider themselves at a higher risk of a pandemic in the middle of a pandemic, their chances of reporting to their work station are low. However, according to the respondents, the hospital management was putting measures to ensure that the health care professionals were well taken care of. This includes educational training on how to protect them adequately against the pandemic. The move would prepare the healthcare workers on the protocol update on pandemic preparedness, which would reduce uncertainties.Discussion: Chapter 1 Pandemic Readiness Capstone The respondents viewed the preparedness of the hospital’s capacity to meet the infrastructure required in the fight against a pandemic as a mixed one. The preparedness in the infrastructure was weak, with little pandemic infrastructure presentation hence a potential challenge in addressing the pandemic in case of an increase in the number of cases. As an essential part of the fight against a pandemic, the emergency department was identified as lacking essential facilities to care for the patients. Based on