Note: Sample below may appear distorted but all corresponding word document files contain proper formattingExcerpt from essay:
Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are not conscious or are in a comatose state, it becomes very difficult for the doctors and the nursing staff to make an early diagnosis of the aforementioned infections. By the time the doctors and the paramedics find out about the deteriorating conditions of the patients because of the opportunistic pathogens, it is usually too late to save the lives of the patients.
Definition of Important Terms
Before we start the discussion based on the PICO question, we will briefly define some of the key terms that will often be used in this paper. First of all, the term "adult patients" has been used in the question. It can be used in two different contexts. Firstly, it can be used in the sense that the adult patients are most prone to infections since they have a depressed immune system. Secondly, it can be implied in the sense that adult patients are the ones who are mostly admitted to the ICU ward of any hospital with usually a terminal disease or a very serious one.
The term "critically ill" would be used many times in this paper. It is used to refer to patients who have been admitted to the ICU with a potentially fatal disease or are in the terminal stages of any disease.
The second key term that has been used in the question is "bacteremia." Bacteremia refers to the presence of bacteria, of any strain or nature, in the circulating bloodstream that has the potential to cause systemic infections whose outcome is normally sepsis or what is commonly known as septic shock.
"Bacterial pneumonia" is basically the infection of the lungs or the lower respiratory tract. The causative agent has to be a bacterium, be it gram positive or gram negative.
The term "adjunctive measurement" has been used with respect to the measurement of pro-calcitonin in systemic infections. This implies that there are some diagnostic tools that have to be used to start treating patients who have developed bacteremia or bacterial pneumonia. However, there are some other diagnostic tools that are also sometimes referred to as the "surrogate markers" that can help the doctors and other nursing staff in the early diagnosis of a condition that can be potentially fatal for the patients who are critically ill.
The question on whose response this paper will be based on revolves around the adult patients that have been admitted in the ICU and are therefore terminally ill. These patients almost always develop bacteremia or bacterial pneumonia because of which their condition becomes worse and their survival rate also decreases. The purpose of this question is to figure out that whether or not the adjunctive measurement of pro-calcitonin levels can be helpful in the early diagnosis of bacteremia and bacterial pneumonia so that these patients could be promptly and appropriately treated so that their mortality/morbidity could be reduced. After reviewing the available literature, the question can be answered.
Researchers are working day in and day out to devise the tests or the assessment techniques that would make it possible for the clinical professionals to make an early diagnosis of such infections in these patients so that their lives could be saved and a reduction in morbidity could be made. One of such diagnostic criteria that the researchers have come up with is the adjunctive measurement of pro-calcitonin levels. In this paper, we shall discuss how this method and its alternatives can help save the lives of the patient. Apart from this, we shall also look at some of the statistics pertaining to the deaths of critically ill patients due to bacteremia. After analyzing the available data, we will make a conclusion that whether or not the measurement of pro-calcitonin levels is of benefit or whether the data is just inconclusive. At the end of the paper, we shall also answer the PICO question.
Relevance to clinical practice
As mentioned in first part of the paper, the doctors and the paramedic staff are quite concerned about the patients who are admitted in the ICU going into septic shock because of the opportunistic infections. Once the patients develop septicemia or bacteremia, it becomes very difficult to save their lives. In this part of the paper, we see why it is so important for the researchers and the doctors to find out a way through which an early diagnosis of the invasion by pathogens can be made so that the mortality and morbidity can be decreased and the lives of the patients can be saved.
Most of the patients that are admitted to the ICU are normally very old. This means that their immunity is extremely low. Moreover, since they are in the ICU, they are suffering from some serious disease for which they are receiving strong medications that further suppresses their immunity. Under such circumstances, the opportunistic bacteria invade the body and can potentially cause life threatening septicemia or bacterial pneumonia. It is indeed very difficult for the doctors to treat these patients if the diagnosis is not made in the very early stages. Even though fever and dropping blood pressure could be signs of developing bacteremia, these signs are not specific enough for the doctors to make a specific diagnosis. Therefore, the need of time is the development of specific methods for the early diagnosis of worsening health such as the measurement of the pro-calcitonin levels. The next step would be to appropriately treat the patients with bacterial pneumonia and bacteremia.
According to the theory, the automated continuous-monitoring systems allow the doctors and the nursing staff to detect the bacterial invasion just a few hours after the withdrawal of the blood sample. Nonetheless, in actual clinical practice, it takes at least 12 to 24 hours to obtain the result for Gram stain after the blood is drawn from the patient. This is one of the main reasons why the chances are high that the outcome could be worse and the patients have to stay longer in the hospital ICU. On the other hand, the new methods including the polymerase chain reaction allow the doctors to identify the bacteria reliably and quickly but unfortunately, the facility for conducting such tests is not available in most of the clinical centers. There is no doubt in the fact that the clinical manifestations are the best approach to make a diagnosis, but the recently discovered surrogate markers can offer great assistance in identifying the main human bacterial strains within the first few hours of management of patients who have developed bacteremia.
According to a study that was based on 147 patients admitted in five different ICUs, it was found out that the most common source of infection was that of the lower respiratory tract. This implied that 32.0% of the patients who were infected with opportunistic pathogens developed lower respiratory tract symptoms. Some of the drugs that were tested for the treatment of these infections included ceftazidime, imipenem and cirpfloxacin. The aforementioned were the drugs that were found to be the most effective against the bacteria that were isolated from the blood cultures of the patients admitted in the ICUs. The independent risk factors pertaining to mortality were considered to be the development of septic shock and fatal underlying conditions. According to the results, treatment with the appropriate antibiotic did not prove to be of significant help in increasing the survival of these patients. The findings of this study suggested that the prevention of bacterial pneumonia and lower respiratory tract colonization are very critical for decreasing the incident of hospital acquired gram negative septicemia in the ICU patients. The most significant risk factors for death are the underlying disease and septic shock (Jang et. al, 1999).
Effectiveness of Evidence
Serum pro-calcitonin, also known as PCT is a peptide based on 116 amino acids. There has been a strong association between elevation of PCT and systemic bacterial infections. The measurement of serum PCT depends upon a fast and routine laboratory test that has the documented ability to distinguish between non-infectious acute inflammatory conditions and systemic bacterial infection (Digiovine et. al, 1999). On…[continue]
"Treatment To Patients The Main Objective Of" (2013, July 19) Retrieved October 23, 2016, from http://www.paperdue.com/essay/treatment-to-patients-the-main-objective-97688
"Treatment To Patients The Main Objective Of" 19 July 2013. Web.23 October. 2016. <http://www.paperdue.com/essay/treatment-to-patients-the-main-objective-97688>
"Treatment To Patients The Main Objective Of", 19 July 2013, Accessed.23 October. 2016, http://www.paperdue.com/essay/treatment-to-patients-the-main-objective-97688
They added newer constructs to a PSC model developed earlier by Gershon and his colleagues (2000), which unveiled the relationship of safety and security aspects and linked it with work performance. They found that when hospital staff used the Gershon tool there was considerable increase in the patient safety culture. They concluded that the health care decision makers when using Gershon safety tools, which appear to have sufficient reliability
Post Bariatric Surgery Outcomes Importance of Patient Education: Deciding When and Improving Post Bariatric Surgery Outcomes Obesity is one of the national and international problems affecting growth and development of the economies because of its influence on the health conditions of society members. Obesity and overweight contribute significantly to number of death cases in the context of the United States and across the global under the influence of globalization. There are various
Staffing in Nursing Staffing and Other Nursing Issues The main topic of this paper is staffing related to the field of nursing, here it is very important to realize a correct balance between the demand of nurses and available nurses at any medical facility. Since the duty of any medical professional like a doctor requires much assistance from a subordinate such as nurse therefore it is vital for any organization to fulfill
Healing hospital provides its patients with a safe environment in terms of healing qualities that are related with interpersonal care and healthy interaction between health care providers and patients. It creates an environment that recognizes, supports and promotes the self healing abilities of the patients. A healing hospital helps the patients to achieve physical, mental, emotional and spiritual well being. In addition to technical competency such a hospital provides its
Service Learning Observation of Psychiatric Patients Patients with normal health problems behave in a different manner as compared to patients with psychiatric problems. It has always fascinated me that psychiatric patients have an ability to look normal as compared to the patients with other health problems despite the fact that they are suffering from what can be in a longer term a fatal mental disease. My interest in psychiatric patients encouraged
Ulcerative Colitis Initial presentation The patient is an 18-year-old of the Filipino-American origin. He has no known family history of ulcerative colitis or chronic illnesses similar to colitis. He is a high school senior student. Historical information The patient complains of diarrhoea 3-4 times a month although it has been on and off for one year. There is no known allergy that the patient experiences. Presenting Symptoms He experienced rectal bleeding, rectal pain and often had
Antipsychotic Medication and the Physical Health Problems of the Patient With Mental Illness More and more attention is now being given to the mental disorders especially in U.S. And due to this increase in attention an increase has also been noticed in the treatment of these mental health issues (Zuvekas, 2005). About 30% of the total U.S. population that is between the ages of 18-52 is being affected by mental health