Assessment Task Two: Critical Evaluation

Introduction

NRS328 – Professional Nursing: Evidence-Informed Practice

Assessment Task Two: Critical Evaluation of a Research Article

Due Date: 21^st Aug, 2020 [add approved extension if applicable]

Length: 2000 words

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[Subheadings are optional. You can use all or some of the suggested headings below to structure your paper.Please remember to delete all instructions in square brackets.]

Introduction

[Write your introduction here.]

Title

Educating patients, clients and the community on infection control in the era of COVID-19

Abstract

The outbreak of the coronavirus disease throughout the globe makes a clinical restriction in terms of the challenge to the discovery of the vaccine. Under the given context, it is of utmost important to teach the community as well as the patients and the client regarding the clinical manifestation and the limitation for this disease. The present reports documents some evidence based literature reports, the knowledge of which might lead to the following of better infection control as well as preventive protocol against the coronavirus disease.

Introduction250

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The outbreak of the recent disease, namely coronavrirus disease (COVID-19) is the one of the latest curse that the entire mankind of the world is facing (Chen et al., 2020). The various characteristics features and the peculiar behaviour of this virus make it extremely challenging for the entire clinical and the research community to prevent its spreading throughout the globe (Chen et al., 2020). Under this context of such a misfortunate situation, the better protocol to prevent the virus spreading is to take as many precautions of physical distancing as one can (Chen et al., 2020). The symptoms, the treatment protocol, the prevalence, etc are showing great deal of heterogeneity in the data from one country to the other. These create a sudden challenge of the prevention of the disease for the entire mankind. Under the condition of exposure to this virus, the unfortunate happening is the infection from this virus, which might lead to the hospital admission for critical patients under specific physiological problems (Huang et al., 2020). This is where the major role of the nurse is there to play. However, not only under the clinical status, but also it is the ethical and moral responsibility of the entire nurse community to teach the patients and the normal people about the clinical manifestations, symptoms, treatment challenges, etc (Jernigan et al., 2020). Therefore, under the given context it is worthy to go through the literature reports mentioning most of the clinical; manifestations, the data collection, data handling, etc. Further, these literature reports would help to elevate the degree of knowledge of the people so that the preventive protocol that they might adopt would follow a clinically and a scientifically treated procedures (Chen et al., 2019).

Literature Review

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The pioneer literature reports based on the number of clinically evidence helps to explore the clinical manifestation of the coronavirus disease. The most of the literature reports at the initial documentation followed the evidence based report, which then becomes a general characteristic of the patients in terms of the clinical manifestation, and also to a certain extent in terms of the treatment protocol throughout the globe (Kucirka et al., 2020). In terms of the clinical manifestation, the common scenario, as mentioned from the clinical evidence reports that the patients infected from coronavirus disease show the general expression of the symptoms (Wölfel et al., 2020). This includes the difficulty associated with the breathing, the pain in the area of the muscles, frequent headache. In addition to this, a number of clinical reports also suggest the symptoms of diarrhoea and the lost of taste of the tongue when got infected from the coronavirus disease. However, under the critical conditions, the inclusion of the sepsis and the pneumonia along with the other symptoms are also documented in the early literature reports. This expression and the documentation of the reports help the community of the doctors and the scientist to have adequate knowledge for the management of the disease. However, the normal people of the general community were not that much aware at least in the initial period of the time. In fact, in some of the developing countries and the under developing countries, the people of normal community is still not that much aware of the coronavirus disease (Talluri et al., 2020). The expression of these clinical manifestations of the patient of the cronavirus disease to the community people by the nurses therefore can help to spread the knowledge about the clinical manifestation and this severity of the coronavirus disease, which will help them to educate and to take adequate preventive protocol (Sanders et al., 2020). Now, in terms of the infection control for the patients as well as the clients, the regular washing of the hand is a mandatory step that needs to mention. In addition to this, practicing to maintain the social distancing is the other best protocol to be followed by the patients and the clients for the infection control in terms of the spreading. Wearing of face mask for the symptomatic patients is also being mentioned (Guan et al., 2020). However, in addition to this, the nurse community and the healthcare community need to follow addition preventive protocol (Patel et al., 2020). For this, the use of the personal protective equipments is the first and foremost important thing to be followed (Cao et al., 2020). In addition to this, the post duty protocol to wash the hand and the removing the personal protective equipments should also be according to the instructions, as mentioned by the World Health Organisation (WHO). Not to mention, the methodological protocol based on which such recommendations have been made is worth of mentioning, as described in the subsequent section.

Methodology

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In order to extract the clinical manifestation data regarding the pre and post condition of the coronavirus disease patient, the Wei et al. reported a methodological treatment in his study on the corononavirus patients (Wei et al., 2020). The cases for four patients from the coronavirus disease were collected and analysed under the clinical context. The method was consisting of the continuous monitoring of the four mentioned patients for around two months of the time under the clinical observation. Now, in terms of the infection treatment protocol, the patients were administered ritonavir-boosted danoprevir (DNVr, 100/100 mg, once daily). However, the administration of this drug was resulted in the introduction of the negative coronavirus result. The tests were repeated for the couple of times, and finally confirmed when the repeated result of negative report was mentioned due to the administration of this drug. The patients were then discharged from the hospitals, and this drug, namely, ritonavir-boosted danoprevir (DNVr, 100/100 mg, once daily), has been recorded as one of the infection preventive protocol, the administration of which has been proved to prevent the virus, as mentioned based on this evidence based case study. This ray of hope further urges the detailed documentation of the sampling and the ethical protocol that was followed in doing the job (Wei et al., 2020).

Sampling & Ethics

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In terms of sampling the data, four individual cases of four specific coronavirus patients were admitted to the hospital and kept under the clinical observation (Wei et al., 2020). In these evidence based report, in case of case 1, the patient was a fifty years old man who got admitted to the Wuhan medical hospital after suffering from the cold and cough with fever for a long period of forty seven days. The patient was found to be tested covid-19 positive. In addition to this, post admission to the hospital, the oxygen saturation of the patient was found to be decreased to a value of 96%. The clinical symptoms of these along with the physical status of this patient were documented, where the breathing for this patient was below enough. On the other hand, the data collected from the patient 2 was for a 81 years old man, who got admitted to the Huoshenshan medical hospital after suffering from the fever for around fifty days of time with similar clinical symptoms like the patient 1. The patient 3 was similarly tested positive after the hospital admission when he suffered for 30days from the cough and the fever. The data corresponding to patient 4 was for a 32 years old male, who was admitted to the Huoshenshan medical hospital with the symptoms of cough, backache along with cold and fever for around sixty four days. The standard ethical protocol was followed prior to the publishing the data corresponding to these four cases (Wei et al., 2020).

Data Analysis/Results/Findings [Use one term appropriate to your chosen article]

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Under the given clinical symptoms for the clinical cases, on analysis of the data, the common clinical manifestation was found among the patients suffering from the coronavirus disease. All of them had the symptoms of cold, cough, mild to severe fever, and headache. One of them was found to report the backache too. Later on, these symptoms were found to be general in nature, where the clinical symptoms were mild to severe depending on the previous medical history of the patients. In the below figure, the detailed about the data collection followed by the analysis is being provided for the four cases (Wei et al., 2020).

Not to mention, the presence of previous medical complicacies were also taken into the consideration prior to the administration of the drug, as mentioned in the study. The report further emphasizes on the presence of diabetes and the hypertension as two co-morbidity factor in a large number of literature studies, which makes another complicacy for the treatment protocol of the coronavirus patient (Wei et al., 2020). The analysis also took into consideration of the IgM and IgG level for the respective SARS-COV-2 sample of the four individual admitted to the hospitals for the four cases, as mentioned in the prior section of the report.

Discussion200/162

In terms of the clinical manifestation, it has been observed the generic trend of the symptoms of the four patients in these discrete four cases. As mentioned in the analytical part, all of them were found to have mild to cold fever with the cold and cough. The report regarding the headache and the backache was also found to present. This leads to the report for the documentation of the general clinical symptoms for the patients of corornavirus disease. Again, the ray of hope is that the drug (DNVr) alone (100/100 mg, one tablet twice daily) or (DNVr) alone (100/100 mg, one tablet once daily) was found to prevent the symptoms of the patients. The all of the four patients after administration of this drug was found to test negative after certain period of time. In all these cases, the damage of the immune system by the coronavirus was reported. Further, the viral infection might lead to the damage of the tissue (Wei et al., 2020).

Conclusion

In conclusion, the clinical manifestation including the symptoms and the treatment protocol to prevent the coronavirus disease is being reported in the present contribution. However, the administered drug still has not found wide application throughout the globe. This leads to the fixing of the restriction and following of the preventive protocol against this virus. It is true that a number of vaccines are recently in the trial mode; however, until it is safely reached to the every persona after the successful trial, the keeping of the physical distancing and the hygienic habit is must. This information along with the clinical limitations is worth of describing to every type every community of the people. This lies in the moral as well as ethical perspective from the point of the nurses’s view.

References

Chen, Y., Feng, Z., Diao, B., Wang, R., Wang, G., & Wang, C. (2020). The Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Directly Decimates Human Spleens and Lymph Nodes. J medRxiv, 20045427.

Chen, H., Guo, J., Wang, C., Luo, F., Yu, X., Zhang, W., & Zhang, Y. (2020). Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: A retrospective review of medical records. The Lancet, 395(10226), 809–815.

Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., & Zhang, L. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. The Lancet, 395(10223), 507–513.

Chen, J., Lau, Y.F., Lamirande, E.W., Paddock, C.D., Bartlett, J.H., & Zaki, S.R. (2019). Cellular immune responses to severe acute respiratory syndrome coronavirus (SARS-CoV) infection in senescent BALB/c mice: CD4+ T cells are important in control of SARS-CoV infection. J Virol.84(3), 1289-301.

Cao, Y., Li, L., Feng, Z., Wan, S., Huang, P., & Sun, X. (2020). Comparative genetic analysis of the novel coronavirus (2019-nCoV/SARS-CoV-2) receptor ACE2 in different populations. Cell Discov. 2020(6), 11.

Guan, W.J,, Ni, Z.Y., Hu, Y., Liang, W.H., Ou, C.Q., & He, J.X. (2020). Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497–506

Jernigan, D. B., CDC COVID-19 Response Team. (2020). Update: Public health response to the coronavirus disease 2019 outbreak—United States, February 24, 2020. Morbidity and Mortality Weekly Report, 69(8), 216–219

Kucirka, L.M., Lauer, S.A., Laeyendecker, O., Boon, D., & Lessler, J. (2020). Variation in False-Negative Rate of Reverse Transcriptase Polymerase Chain Reaction–Based SARS-CoV-2 Tests by Time Since Exposure. Ann Intern Med., M20-1495.

Patel, A., Jernigan, D. B., & 2019-nCoV CDC Response Team. (2020). Initial public health response and interim clinical guidance for the 2019 novel coronavirus outbreak—UnitedStates, December 31, 2019–February 4, 2020. Morbidity and Mortality Weekly Report, 69(5), 140–146.

Sanders, J.M., Monogue, M.L., Jodlowski, T.Z., & Cutrell, J.B. (2020). Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020.

Talluri, S. (2020). Virtual High Throughput Screening Based Prediction of Potential Drugs for COVID-19. Preprints 2020

Wei, B. (2020) Long-term positive severe acute respiratory syndrome coronavirus 2 ribonucleic acid and therapeutic effect of antivirals in patients with coronavirus disease: Case reports. Revista da Sociedade Brasileira de Medicina Tropical, 53(July), p. e20200372. doi: 10.1590/0037-8682-0372-2020.

Wölfel, R., Corman, V.M., Guggemos, W., Seilmaie,r M., Zange, S., & Müller, M.A. (2020). Virological assessment of hospitalized patients with COVID-2019. Nature. 581(7809), 465-469.