Determinants of Pre-clerkship Medical Students’ Willingness to Work During Infectious Disease Outbreaks
Meghan M. Nahass1, Jaya Kanduri1, Parth Shukla1, Justin Oh1, Rima Patel1, Kapil Wattamwar1, Priya Patel1, Jennifer Yoon1, Clifton R. Lacy1
1Rutgers University Robert Wood Johnson Medical School, Department of Medicine
The authors have no conflicts of interest of sources of funding to disclose.
Corresponding author:
Clifton R. Lacy, M.D.
Director
Institute for Emergency Preparedness and Homeland Security
Rutgers, The State University of New Jersey
106 Somerset Street – 3rd Floor
New Brunswick, NJ 08901
Cell Phone: 732-977-7714
E-Mail: clifton.lacy@rutgers.edu
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Key Words: disaster medicine, pre-Clerkship medical students, role adherence, willingness to work, infectious disease outbreaks
INTRODUCTION
Infectious disease outbreaks greatly impact the responsibilities of health care workers (HCWs) including physicians, pharmacists, nurses, physician assistants and students of these disciplines. A study of the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic showed that HCWs were neither aware of nor prepared for the infection, contributing to its quick spread through various HCWs, with resulting morbidity and mortality. During the SARS outbreak, 21% of all cases worldwide were among HCWs (1). Following this, a number of studies were conducted to assess the degree of preparedness of HCWs for potential infectious disease outbreaks.
Hwang, S.W., Chambers, C., Chiu, S., Katic, M., Kiss, A., Redelmeier, D.A., & Levinson, W.
At the first possible outbreak of SARS, the nurse will need to follow protocol. The initiation of the protocol begins with an assessment of the patient. A doctor will determine if the patient is possibly infected with SARS by following the physical and epidemiologic criteria. The Center of Disease Control and Prevention mandates reporting to the all cases where the patient has pneumonia of an unknown origin, and could have recently been exposed of the SARS virus [ (Center of Disease Control, 2005) ]. Once the report has been made the community health nurse should have all hospitalized patients with respiratory symptoms questioned on their recent history and possibilities of contact with the virus. Next, the community health nurse needs to educate staff and the community about possible ways to contract SARS, and encourage behaviors such as, frequent hand washing, covering their nose and mouth while coughing or sneezing, and using and properly disposing of tissues for respiratory secretions. [ (Center of Disease Control, 2005) ] Once health care members and the public are educated on the route of transmission they can prevent being exposed. Confirmed infected patients would be transferred to Seattle, where they can be in isolation rooms, patients can be more critically monitored, and research centers can be of benefit to
What are standard precautions? How do they impact the nursing profession? These are all valid questions that need further investigation. Set forth by the Centers for Disease Control and Prevention (CDC), standard precautions are a set of practices that help guide nurses to prevent and control infectious diseases from spreading (Efstathiou, Papastavrou, Raftopoulos, & Merkouris, 2011, p. 1). There is no question that nurses are at a particularly higher risk of occupational exposure. Koutoukidis, Stainton, and Hughson (2016) explain that regardless of the patient’s diagnosis, presumed infectious status, and the setting in which the patient is in, nurses should always implement standard precautions (p. 483). The high stake profession leaves nurses
Hooton, T., Bradley, S., Cardenas, D., Colgan, R., Geerlings, S., Rice, J., Nicolle, L. (2010).
Schmidt, S. W., Shelley, M. C., Bardes, B. A., Maxwell, W. E., Crain, E., & Santos, A. (2010).
Health care governments have endorsed an assortment of vaccination policies and mediations to safeguard against the known dangers of influenza communication, with longer patient stays, absenteeism, intermissions in health care, and death. Studies assessing the consequence of health care workers vaccination found that health care workers influenza vaccination was linked with a decrease in patient death (Murana, 2014). Assessing the results of health care worker influenza vaccination on patient results anticipated that if all health care workers were vaccinated, patient influenza infections could be stopped.
Kangovi, ., MD, MS, Mitra, N., PhD, Grande, D., MPA, Huo, H., PhD, Smith, R,.A., BS, and Lon , J. A., MD. (2017).
Breiding, Matthew J., Sharon G. Smith, Kathleen C. Basile, Mikel L. Walters, Jieru Chen, and
CDC has a goal to reduce potential outbreaks of the preventable disease in a large group setting from the disaster with the use of vaccines (CDC, 2013). The public nurse is educating those communities regarding the importance of strengthening their immune system with receiving vaccines. The community and individuals will also be education on where to get the vaccines and how to manage themselves after vaccination for the event of the second complication. The community health nurses have a central role in providing prevention of disease and promotion health education after catastrophic like an earthquake.
“A disaster is an event that is a natural or man-made occurrence that can disrupt or destroy the lives of those it affects” (Stanhope & Lancaster, 2014). “Management of a disaster includes four phases; prevention, preparedness, response and recovery” (Stanhope & Lancaster, 2014). To date there have been 154 hospital-based shootings, which resulted in 235 dead or injured. (C.Catlett, 2012). The purpose of this paper is to identify emergency preparedness and response to hospital based shootings, and the role of the public health nurse in such a disaster.
In the medical thriller, The Hot Zone, Preston states that flawed decisions in outbreak situations are a threat to human survival. Ebola is known by many to be lethal and in recent years, has caused an interest within the public. Many in the United States have shown fear towards the threat of Ebola in the country, which has caused many to also research the effects of Ebola on the human body. Moreover, Ebola poses a threat to the safety of medical professionals; doctors must be able to safely help patients without high risk of exposure to the hot virus. Of equal importance, medical professionals involved with the treatment of hot viruses must be trained properly in order to effectively make decisions and protect all patients and
Preventing increase in epidemic: Training to “increase the capacity of healthcare providers to conduct patient screening, brief interventions, and
Many of the healthcare workers were volunteers and didn’t know what they were going to see when entering the hospital, increasing fears of how sick the patients were and heightening fears of making a mistake (14). Many workers were shocked by the conditions when they arrived in an infected area; often they were faced with a lack of running water, electricity, beds, and medical supplies (18). In addition to a shortage of supplies, there was also a shortage
The results of the study were summarized and the conclusion was clear. With the interventions provided, the vaccination rates did not have a significant spike until the time frame of the H1N1 and Avian flu threat. The study showed that the physician rates increased with the interventions but this was not the case with the nurse group. The vaccination rates were tracked from those that were vaccinated at that facility and did not take into account those who were vaccinated elsewhere. Fear of the side effects was the most common reason that the nurse group gave for not being
Lisa L. Sharma, MBA, MPH, Stephen P. Teret, JD, MPH, and Kelly D. Brownell, PhD