New Best Practice Implementation
Providing the best and most up-to-date care is the duty of every practicing health care professional, especially nurses. Since the time of Florence Nightingale, nurses have been showing excellence in nursing care regardless of a patient’s social, political, or religious backgrounds. This standard of unbiased nursing excellence carries on today by the nurses who work with underserved populations, such as those who are incarcerated. The purpose of this paper is to link best practice with the benefits of offering Hepatitis C treatment to those who are incarcerated and how this practice would be implemented by the Ohio Department of Rehabilitation and Corrections.
Best Practice to Implement
According to the
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If it is not written in a policy, it is simply not done. Security driven, correctional nursing presents unique challenges in relation to evidenced based research influencing policy changes. Monitored by quality improvement teams, reginal directors, and facility health care administrators, nursing practice and health care practices undergo close analysis. To successfully progress and perfect nursing practice evidenced-based research must be recruited and implemented (LoBiondo-Wood & Haber, 2013). According to Vanessa Sawyer, Health Care Administrator at Noble Correctional Institute (2017), nurses typically do not have a part in changing policy or procedures. Changes typically occur if reported nursing errors are linked to a faulty procedure or if a lawsuit uncovers a faulty policy. To change an official policy, such as extending Hepatitis C antiviral treatment to more inmates, a reginal directors or administrators must present the proposed change at the semi-annually meeting. All the pros and cons are discussed and if agreed upon, the policy would be created or amended (Sawyer, 2017)
Literature to Support New Practice Often dubbed as “the silent disease”, 80-90% of people with acute Hepatitis C do not initially experience symptoms (Center for Disease Control and Prevention [CDC], 2016). Because symptoms are not experienced until the disease has already cause irreversible liver damage, many who are effected with Hepatitis C are unaware.
Many people don’t understand how dangerous Hepatitis C is because it is not commonly known about as much as Hepatitis A or B. This disease is however very serious. Although frequently asymptomatic in time the virus can lead to cirrhosis, liver cancer and liver failure. Symptoms of HCV are jaundice (yellowing of the eyes), stomach pain, nausea and fatigue. Treatment options for the disease, if caught early enough is a combination of medications or depending on the degree of damage, a liver transplant. ”For some people, hepatitis C is a short-term illness but for 70%-85% of people who become infected with
About 4.1 million people in Americans have the positive antibody for hepatitis C virus (HCV), and about 75% of them are persistently infected and most of the infections happened d 20 to 40 years ago, before the finding of HCV. Hepatitis C increased from 7,000 to 13,000 deaths in 2005. Furthermore, HCV develops slowly which increases the risk for severe complications in the infected people. Identification, death, and treatment is predicted to affect 35,000 by 2030. The Center for Disease Control (CDC) used antiviral therapy with PEGylated in clinical trials. The CDC recommends a HVC one time test for people born between 1945 and 1965.They observed testing by birth. The objective of this study was to thoroughly evaluate the amount of substance abuser infected with hepatitis C in the United States. Additional to observe the treatment of HVC. Currently Medicaid and Medicare repayment standards for sofosbuvir were calculated in all states including the District of Columbia. Medicaid and Medicare covered the drug based on the following classes liver disease stage, HIV, and drug use. Approximately 42 states reimbursed the following criteria up to 74% for the drug sofobuvir. About two thirds of the United States restricted the treatment centered on prescriber type. About 88% included drug abuse in their sofosbuvir admissibility measures. Finally 50% required a dated of abstinence and 64% required drug test. The latest drug to HVC is called Sovaldi and it costs $84,000 for the 12
In time the virus can lead to cirrhosis, liver cancer and liver failure. Symptoms of HCV are jaundice (yellowing of the eyes), stomach pain, nausea and fatigue. The main problem is that many people don’t have symptoms until they already have some sort of liver damage. Treatment options for HCV include a combination of medications or depending on the degree of damage, a liver transplant. Given that HCV it is a blood disease that is spread through contact with an infected person’s blood, there are many ways to contract this disease. Injection drug users, physical altercations, sexual contact and mother to infant infection are just some of the ways this disease is spread.
Hepatitis C is a prevalent health care problem. According to the Centers of Disease Control and Prevention (CDC, 2016), approximately 2.7-3.9 million of the adult population in the United States is infected with hepatitis C virus (HCV). Some groups of people are at risk for Hepatitis C infection, including current injection drug users, people who received the blood transfusion before 1992, organ recipients from a donor who tested positive for hepatitis C virus, hemodialysis patients, and children born to a hepatitis C mother (CDC, 2016). Hepatitis C causes embarrassment and isolation from the society. Self-esteem and understanding of the family, friend and community will motivate the patient to have a good quality life in society. This
From fever to loss of appetite, there is a range of symptoms that come along with Hepatitis C. The most common symptoms are flu-like, for example a fever, fatigue and stomach pain are expected ("Hepatitis C Treatment"). Although these symptoms are common, Hepatitis C usually goes unnoticed until serious damage has occurred ("Hepatitis C Treatment"). Considering this disease affects the liver directly, the digestive system is the main system effected. However, it can alter the central nervous system and the circulatory system. The liver filters toxins out of the blood and when it is not functioning correctly the buildup of toxins can cause forgetfulness, poor concentration and personality changes (Kahn). Also, there can be an increase in blood pressure and an increase of sugar in the blood, which can lead to Diabetes (Kahn). There are numerous symptoms that are observed with Hepatitis C that can be present in more than one body
Hepatitis C is a blood transmitted virus that has been know for substandard therapies/ drug treatments. When Mr. Parish commented that currently, there is no absolute cure to HCV, my mind immediately shifted to “cancer”. People often think of cancer as the most severe illness someone can get, because there is no cure. However, we forget that in actuality, there are numerous
Chronic hepatitis C virus (HCV) causes inflammation of the liver, eventually leading to tissue damage. Cirrhosis is the result of extensive scarring of the liver. The Centers for Disease Control and Prevention state that HCV typically causes cirrhosis in 5 to 20 percent of infected people over a period of 20 to 30 years. Overall, cirrhosis develops 20 to 30 percent of the time. Progression to cirrhosis may be accelerated in people who are older, obese, drink alcohol, or are immune-suppressed (such as people who are coinfected with HIV).
In several clinical cohorts, it has been shown that chronic hepatitis C is a main leading cause of cirrhosis and HCC, which is the third cause of cancer deaths worldwide (EASL Clinical Practice Guidelines, 2011).
Hepatitis C is a liver disease caused by the Hepatitis C virus. The disease can be either acute or a chronic infection, which can be mild or a lifelong disease. This disease also is the major cause of cirrhosis and liver cancer. The disease is slow moving and sometimes take up to thirty years to damage the liver. In the United States there are an estimated three to four million people with the disease and are not even aware. Approximately thirty percent of the individuals infected within six months have no symptoms and will not even be aware that they have the disease. In the remaining seventy percent infected the disease will become chronic. According to statics one hundred and seventy million people are chronically infected worldwide.
In this article, the authors identify the problem of access due to affordability of the curative and transformative therapies including the most recently found Hepatitis C therapy and a gene therapy for the highly rare disease lipoprotein lipase deficiency. The authors provide two approaches such as short-term and long-term approach that would increase the accessibility to transformative drugs. The authors suggest providing health care loans (HCL) to the consumers to help finance the expensive treatments to increase affordability. To make them affordable rapidly they provide a short-term approach which suggests financing HCLs with establishment of the special purpose entity (SPE). The SPE will be financed by a pool of investors who
Acute HCV usually presents with little to no symptoms and goes undiagnosed.1 The Hepatitis C RNA can be seen after 1 to 2 weeks of exposure and the levels increase at a fast rate in the first weeks. Another level that can be detected is the rise in ALT, this shows hepatic trauma and cell death. Infected individual’s ALT levels may be 10 times the higher normal limits. Symptoms of acute HCV, if seen, are usually mild such as fatigue, weakness, abdominal pain, or jaundice and develop 2-12 weeks after exposure.2 Most people (85%) with acute infection will end up with a chronic HCV infection, which is when HCV RNA is detected for 6 or more months. Like acute HCV, most chronic infections present as asymptomatic, but the most common symptom is continual fatigue. As a result of chronic HCV infection, 20% of patients will get cirrhosis which usually takes 20-25 years to develop.1, 2 The HCV virus itself is not lethal, but the progression to the other diseases it causes like cirrhosis of the liver is lethal.
Hepatitis C typically has a slower and more insidious onset. The preicteric phase, the first of three phases, precedes jaundice that last from 1 - 21 days. When symptom do occur they can be so vague that people often don't realize what is truly going on. People actually may mistake these symptoms as a mild case of the influenza virus as the symptoms of this phase often mimic the symptoms of the flu. The interic phase is characterized by the onset of jaundice that last 2 - 4 weeks. Urine often becomes dark and stool may be a abnormally light color, this is cause by the absence of bile in the stool. Bile pigment deposits in the skin can cause pruritus to occur. The liver often becomes enlarged and tender. During the third phase, the posticteric
Hepatitis C has been referred to as a "Silent Epidemic," since it usually progresses slowly over many years. Most people who are infected with hepatitis C are not aware of any noticeable symptoms for as long as one to two decades after they are infected. In fact, by the time symptoms appear, the virus has probably already begun to damage the liver. If the liver is injured and stops functioning, death will always be the outcome (Lieber). Liver failure from chronic hepatitis C is one of the most common causes of liver transplants in the United States.
Hepatitis A is a liver disease caused by the Hepatitis A virus. It may cause fever, malaise, anorexia, nausea, and abdominal discomfort, followed within a few days by jaundice the disease ranges in clinical severity from a mild illness lasting 1–2 weeks to a severely disabling disease lasting several months. Good personal hygiene and proper sanitation can help prevent Hepatitis A. Transmission may occur by direct person-to-person contact; or from contaminated water, ice, or shellfish from contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked, but which may become contaminated during handling. Hepatitis A can affect anyone
Hepatitis C is a liver disease that is spread from one person to another by the contact of uninfected blood with that of someone who is infected. After having the disease for a number of years, someone who is infected with Hepatitis C is likely to have liver problems in the future, which could lead to cirrhosis and liver cancer within twenty years of being infected. Over the years, many infectious disease specialists have found treatments that manage the disease, but, in 2013, Gilead Sciences created the medicine by the name of Sofosbuvir (Sovaldi). The difference between Sovaldi and other hepatitis C treatments that have been used over the years is that Sovaldi is the only treatment that cures the disease rather than managing its symptoms in order to decrease the severity like the other treatments do. For this reason many physicians desire to prescribe Sovaldi to suffering patients, but often times cannot do so because the drug is not covered by all State Medicaid policies; therefore, many of these patients are left to suffer with the disease as they do not have the means to find the curing specialty drug. State Medicaid covers many health plans, but some states neglect to cover the specialty drug, Sovaldi; although the addition of coverage for this treatment will have short term negative impacts, the long term effects will overshadow the initial issues.