Tuberculosis (TB) is a prevalent disease globally and is currently considered a significant challenge in correctional facilities. The living conditions of the inmates and the architecture are not meant to mitigate the spread of airborne diseases (Lambert et al., 2016). In correctional facilities, individuals from different backgrounds are housed in close proximity for various periods. Some of these individuals have active TB, and their housing situation in poor ventilation increases the likelihood of rapid spreading of the disease (Carbone et al., 2015). To mitigate this issue, there is a need for an intervention that will facilitate the early detection of the infection and timely treatment among inmates. Controlling the spread of TB is dependent on reducing the risk of transmission. The proposed solution to the problem is early detection and timely treatment to ensure that those diagnosed with the disease are treated to mitigate the disease's spread.
To facilitate early detection, these correctional facilities need to set up early identification procedures for people with TB. This can be done through screening every incarcerated individual and screening any incoming prisoners (Maitra et al., 2017). The facilities should also set up periodic follow-up screening sessions with the inmates to track the disease's spread. This will help mitigate the spread of the disease among the inmates while keeping data on infected patients to track reinfection prevalence rates. The management must also ensure they conduct efficient and thorough contact investigations in the facility once a TB infection has been identified (CDC, 2012). This ensures that all the exposed prisoners are identified and separated from the rest of the population. This helps to mitigate their interaction with others and thus controls the disease's spread in the facility.
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Timely treatment is another intervention that prison facilities can exploit in mitigating and controlling the spread of TB. Timely treatment will reduce patients' urge to self-medicate in these facilities. After early identification, prisoners must undergo successful treatment of the disease and latent TB infection (Maitra et al., 2017). Facilities can ensure this is done by enabling the appropriate use of airborne precautions such as respiratory protection and creating airborne infection isolation sections for the patients (CDC, 2012). Timely treatment of the prisoners should also be accompanied by comprehensive discharge planning. This ensures that cured prisoners are discharged and given the right guidelines recommended for extended treatment to prevent relapsing (Millet et al., 2013). Early screening in such facilities will help identify individuals suffering from LTBI as they are at a higher risk of developing TB (Dara et al., 2015). These prisoners should be exposed to isoniazid preventive therapy to mitigate their high risk.
My proposed solution has changed since I envisioned it as it has incorporated the education of patients to mitigate the spread of TB in the facilities. Initially, I had focused on interventions that healthcare providers could employ in the facility to mitigate the disease. I had not looked into how patient education could be effective in reducing relapse. Once the patients are cured, the guidelines that they will be provided with will help them are cured are discharged and given the right guidelines and recommendations for extended treatment to prevent relapsing. This will be used alongside the previously identified interventions to ensure TB prevalence rates in male correctional facilities are mitigated.
Response to Barbara Fink
Patients suffering from diabetes are likely to suffer from diabetic foot ulcers (DFU). Data shows that about fifteen percent of these patients will have an open sore at the bottom of their foot. Of this population, six percent will end up hospitalized, while 24 % of the patients with DFU end up having non-traumatic lower leg amputations. Holscher et al. (2018) conducted a study that found 17% of 206 patients with DFU ended up experiencing unplanned readmission within the first 30 days after discharge. This shows the need to come up with interventions that will mitigate the readmission rates in hospitals. The use of educational interventions to decrease these rates is beneficial as it enhances patients' chances of mitigating their risk of readmission. Having the language written in the sixth-grade reading level is essential as it ensures the patients comprehend the messages and information shared with them.
Response to Michele Aldridge
Covid-19 is a dire disease that has been declared a worldwide pandemic. Creating an evidence-based project that educates people on how to mitigate the spread, contain and reduce exposure to the disease in the school district is an innovative change project. Educational interventions are better at integrating the community or patients in disease prevention practices. Using simple language ensures that everyone can comprehend what they are taught. It is also important to be culturally sensitive when creating graphics, especially when dealing with racially diverse communities (Kaihlanen, Hietapakka & Heponiemi, 2019). Nurses must be culturally competent in their practice, and by being culturally sensitive, members of the community will feel included and participate in the change project. This will ensure the community's health improves, and Covid-19 spread will be mitigated.
Response to Tina Cox
The baby-friendly initiative is a WHO, and UNICEF initiative that supports protects, and promotes breastfeeding (WHO, 2020). Having a prenatal clinic that educates patients on the essence of breastfeeding their infants is essential. Data shows that only 84.1 % of the infants born are breastfed at birth, 19.2% are introduced to infant formula before their two days of age, while only 58.3 % are breastfed at six months (CDC, 2020). This shows the need to educate mothers on the importance of breastfeeding infants. Patients are more likely to accept intervention strategies when they play a significant role in it. I believe that using visual handouts and offering sensitization to the patients in English and Spanish increases the chances of patients understanding the initiative's steps, thus adhering to it.
References
Carbone, A. D. S. S., Paião, D. S. G., Sgarbi, R. V. E., Lemos, E. F., Cazanti, R. F., Ota, M. M., ... & Motta-Castro, A. R. C. (2015). Active and latent tuberculosis in Brazilian correctional facilities: a cross-sectional study. BMC infectious diseases, 15(1), 1-8. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-0764-8
CDC. (2012). Tuberculosis (TB); correctional facilities. https://www.cdc.gov/tb/topic/populations/correctional/default.htm#:~:text=TB%20in%20Correctional%20Facilities%20in%20the%20United%20States&text=Approximately%204%2D6%25%20of%20TB,TB%20than%20the%20overall%20population
CDC. (2020). Breastfeeding; facts. https://www.cdc.gov/breastfeeding/data/facts.html
Dara, M., Acosta, C. D., Melchers, N. V. V., Al-Darraji, H. A., Chorgoliani, D., Reyes, H., ... & Migliori, G. B. (2015). Tuberculosis control in prisons: current situation and research gaps. International Journal of Infectious Diseases, 32, 111-117. https://www.ijidonline.com/article/S1201-9712(14)01747-0/fulltext
Holscher, C. M., Hicks, C. W., Canner, J. K., Sherman, R. L., Malas, M. B., Black III, J. H., ... & Abularrage, C. J. (2018). Unplanned 30-day readmission in patients with diabetic foot wounds treated in a multidisciplinary setting. Journal of vascular surgery, 67(3), 876-886. https://www.sciencedirect.com/science/article/pii/S0741521417320803
Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC nursing, 18(1), 1-9 . https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-019-0363-x
Lambert, L. A., Armstrong, L. R., Lobato, M. N., Ho, C., France, A. M., & Haddad, M. B. (2016). Tuberculosis in jails and prisons: United States, 2002− 2013. American journal of public health, 106(12), 2231-2237. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5104991/
Maitra, A., Kamil, T. K., Shaik, M., Danquah, C. A., Chrzastek, A., & Bhakta, S. (2017). Early diagnosis and effective treatment regimens are the keys to tackle antimicrobial resistance in tuberculosis (TB): A report from Euroscicon's international TB Summit 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626228/
Millet, J. P., Shaw, E., Orcau, À., Casals, M., Miró, J. M., Caylà, J. A., & Barcelona Tuberculosis Recurrence Working Group. (2013). Tuberculosis recurrence after completion treatment in a European city: reinfection or relapse?. PloS one, 8(6), e64898. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679149/
WHO. (2020). Baby-friendly hospital initiative. https://www.who.int/nutrition/bfhi/en/
