Role of community health nursing in pandemics

Role of community health nursing in pandemics

1. Seminar on Role of community health nurse in managing pandemics Presented by: Nisha Yadav M.Sc. Nursing 2 nd year NINE, PGIMER Chandigarh

2. At the end of class, students will be able to: Understand the background and introduction to pandemic and nursing Understand the important factors in a successful response Describe key issues in managing pandemics Describe the role of community health nurse in managing pandemics Learning objectives

3. Background Introduction Important factors in a successful response Key issues in managing pandemics Role of community health nurse Role of CHN to maintain and surge existing services Role of CHN to shield the vulnerable outline

4. Infectious diseases constitute the third leading cause of death worldwide (WHO, 2017). Emerging global pandemics pose high risks for individuals and communities. International mobility contributes to the promulgation of new and reemerging pathogens that frequently are resistant to current form of treatment ( Morens & Fauci , 2013). BACKGROUND

5. Nurses, the largest sector of healthcare workers in every country, play a pivotal role in preparation for a possible pandemic. According to World Health Organization (WHO), the American Nurses Association (ANA) and other healthcare organizations nurses’ role in a pandemic begins even before a disease has an opportunity to cause widespread devastation. CONT..

6. When a pandemic occurs community health nurses at the local, state and federal levels have multiple roles in: Assessment Planning Implementing Evaluating needs and resources for the different populations being served. Community services play an important role in the provision of palliative care during pandemics, such as COVID-19. INTRODUCTION

7. It is important for community health nurses to practice confidentially when they have knowledge about an individual, family, communicable disease outbreak, community level problem or any special knowledge obtained in community health work setting. Cont..

8. Important factors in a successful response include

9. KEY ISSUES IN MANAGING PANDEMICS

10. Delay in Early identification A key issue is the time delay in the early identification of infections that pose a threat to potential epidemics/pandemics. Unable to recognize pattern A delay in such identification may lead to the development of epidemics/pandemics and be an impediment to the prompt initiation of treatment for the infected individual, appropriate interventions and protective devices, and efforts to curtail the spread of the epidemic. Key issues in pandemics

11. The World Health Organization Department of Pandemic and Epidemic Diseases (PED) brochures note that their work is implemented through a multidisciplinary team that includes disease-specific and public health experts with field experience responding to outbreaks and emergencies under the International Health Regulation, it is not clear how nurse input is provided and communicated with the team. Responses and Policy Options

12. RESULTS: Three interplaying themes were identified as follows: personal resources, workplace resources and situational influences. The findings suggest that an effective epidemic outbreak response would require further effort to reinforce the interplay between individual nurses, healthcare institutions and the governments.

13. Early identification To mitigate the delay, it is essential that the health care professional who is the initial point of contact with the infected person, likely the Community health nurse in many global settings, communicate with the appropriate provider or agency to initiate the next steps including following: Role of community health nurse

14. Recognition of pattern Recognition of a pattern, alerting others as to the emerging disease, and preventive services will aid in preventing further diffusion of pathogens from isolated cases. Community health nurse Play a vital role in recognition of pattern of pandemic

15. Role of community health nurse in managing pandemics

16. Responses and Policy Options The World Health Organization Department of Pandemic and Epidemic Diseases (PED) develops strategies, initiatives, and mechanisms to address emerging and re-emerging epidemic diseases to reduce impact on affected populations and limit international spread. Community health nurse act a liaison in implementation of these responses and policy actions

17. Role of CHN IN MANAGING PANDEMICS

18. Immediate investment in community health systems will help achieve the following goals: Achieving these goals will require targeted actions at different stages of the pandemic

19. Anticipation/early detection/containment 1. PROTECT health workers. CHN will Coordinate with partners and invest to rapidly produce, deploy and restock PPE, including masks, gloves, goggles, gowns, hand sanitiser , soap and water, and cleaning supplies. Ensure community health workers are included in PPE projections.

20. 2. INTERRUPT the virus. CHN will Standardise and endorse a staffing and readiness protocol for CHWs responding to pandemic Engage with governments to quantify training needs and invest to rapidly train existing CHWs to Prevent Detect and Respond.

21. PREVENT

22. PREVENT

23. CHN must ensure that all are subordinates are following protocols designed to ensure the physical safety and health of CHWs. Identify signs and symptoms in community members, support safe collection of samples in communities and health facilities. Facilitate rapid transport of samples to laboratories for analysis, thus reducing risks of nosocomial transmission. DETECT

24. ► CHN must ensure CHWs should only be tasked with responsibilities if they can be regularly supplied with the key materials necessary to conduct those tasks and protect themselves. ► Enter alerts into community events-based surveillance systems DETECT

25. ► Communicate rapidly and effectively to residents in pandemic areas, including delivering health information in a tailored, context-specific and relevant way while combating the spread of misinformation. ► Support contact tracing, symptom reporting and monitoring of contacts of patients with infectious disease to ensure access to testing and treatment for those who develop signs and symptoms. Respond

26. 3. MAINTAIN health services while surging their capacity. Work with governments to ensure Community health nurses are designated as part of the essential workforce. Invest in the national supply chain to quantify demand and coordinate distribution of essential commodities and surge supplies.

27. Sustain routine primary healthcare services, for example, vaccinations and integrated community case management of young children with malaria, pneumonia or diarrhoea . Codesign workflow modifications necessary to continue primary healthcare delivery while being responsive to changing pandemic conditions and patient and health worker safety. Role of CHN to maintain and surge existing services

28. Introduce safe means of requesting and accessing care in the event of community-level pandemic spread. Postpone non-essential services to alleviate capacity constraints on existing health workforce. Monitor patients for clinical deterioration and support rapid referral of individuals who require hospitalisation , reinforcing links between the health system and communities Cont.

29. Harness digital technology to receive requests for care, proactively check in with families, follow up with patients, assess symptoms and establish care plans. Support preparation of health systems and communities for the eventual introduction of vaccines and treatments, including outreach to high-risk groups. Implement or support disinfection of high-risk surfaces in communities using appropriate infection prevention and control supplies and procedures. Cont.

30. 4. SHIELD the vulnerable. ► Support immediate cash injections at the household level and the creation of neighbourhood plans to protect the most vulnerable. ► Work with governments and funding partners to ensure that budgets for CHWs incorporate holistic support.

31. Support self-isolation and monitor patients in the community while ensuring delivery of food, social and medical support. Combat misinformation, fear and mistrust by acting as a bridge to the formal health system and national authorities. Role of CHN to shield the vulnerable

32. Inspire positive behaviour change and collective action. Identify and educate at-risk populations (elderly, immuno - compromised, those with underlying conditions) to reduce their exposure to infectious disease leading to pandemic

33. Other roles of CHN in managing pandemics

34. Role of chn cont.. Pandemic or spread of communicable disease represent an imbalance in the harmonious relationship between the human, host and the environment. This state of imbalance provides the infectious agent an opportunity to cause an outbreak. So to disrupt the agent host environment relationship, a multisystem approach to be used by community health nurse

35. Improve host resistance to infectioous agents and other environmental hazards Role of chn cont.. improved hygiene, nutrition, and physical fitness Increased immmunization coverage Provision of prophylaxis Stress control and improved mental health

36. Improve safety of the environment Improved sanitation Provision of safe water and clean air Proper cooking and storage of food Control of vectors and animal reservoir hosts

37. Improve public health system Increased access to health care Adequate health education Improved surveillance system Facilitate social and political changes to ensure better health for all people Individual , organisational and community action legislation

38. Any doubts

39. Community health nurse has a important role in managing pandemics through education , prevention, surveillance and outbreak investigation Community health nurse can find infected individuals; notify contacts; refer; administer treatments; educate the individual, family community, professionals and population; act as advocates and in general be state-of-the-art resources to reduce the impact of pandemic in community. Conclusion

40. World Health Organization ( n.d. ) Pandemic and epidemic diseases. Retrieved from: http://www.who.int/csr/disease/en/ . Edmonson, C., McCarthy, C., Trent-Adams, S., McCain, C., & Marshall, J. Emerging Global health issues: A nurse’s role. OJIN: The Online Journal of Issues in Nursing, 22, doi:10.3912/OJIN. EIDR. Emerging infectious disease repository. EcoHealth Alliance U.S. Department of Health and Human Services (n.d.) Office of Global Affairs, Office of Pandemics and Emerging Threats (PET). http://www.hhs.gov/about/agencies/oga/about-oga/what-we-do/policy-and-program-coordination/pandemics -emerging-threats.html . REFERENCES