Preventing Pneumonia In Elderly Patients In Transitional Care: A Nursing Approach

Epidemiological Rationale for Topic

Pneumonia is the leading cause of death from an infectious disease in the United States. Prior to

 1936, it was the leading cause of death in the United States. Many patients die of pneumonia simply because of lack of education or unavailability of needed vaccines. In 2010, 1.1 million people in the United States were hospitalized with pneumonia, and about 50,000 people died from the disease (CDC, 2010).

Nursing diagnosis plays an important role in devising the prognosis for the patients and understanding the situation of the symptoms and the signs associated with the patient. These information will provide enough data for the health care professionals to arrive at a clinically reasonable judgment for the medical cause and the treatment pattern for the patients. In case for pneumonia in the elderly patients living in transitional care, a prevention plan is vital. Studies suggest that in transitional care the elderly acute patients often scum to pneumonia that further complicates their medical condition and diminishes their chance of recovery. Hence the nursing staff must ensure and comply with pneumonia prevention plan, so that the rate of elderly patients succumbing pneumonia can be prevented. however in order to ensure and facilitate more in depth learning experience some theoretical models and tools can be utilized (Bastable, 2016).

Readiness for Learning: Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn.

Readiness for learning is a famous topic in the discipline of teaching and education, which allows a very interactive and comprehensive learning experience to take place. Research has pointed out the capability of different individual to interpret what they are being taught can vary, while some may easily understand the concept very clearly while some of the students may easily interpret the actions to take to comply with the pneumonia prevention plan, while some might find it difficult to understand. On a similar note, readiness to learn concept is to gauge how willing one person is to learn and understood the contents being taught to him or her. According to this theory there are various factors associated with the readiness of the students to learn the contents and I tho0se factors that restrict the students from learning and addressing those factors can facilitate the learning progress significantly (Bastable, 2016).

The learning theory that is application to this scenario, is the social learning theory.teh social learning theory depicts that learning primarily is a cognitive process and is facilitated by learning processes like experience ad observation. In this case as well, if the learners can participate and observe the prevention plans being implemented in the practical real world scenarios, the factors that were restricting of how they can implement the plans (Cabana et al., 2014).

Goal: Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective from one of the 24 focus areas). If an HP2020 objective does not support your teaching, explain how your teaching applies to one of the two overarching HP2020 goals.

Nursing Diagnosis

The goal is to implement a succinct and effective prevention plan for the seniors in the transitional care and ensure that they understand and can implement the plan accordingly.

As acquired pneumococcal infection is a leading public health concern and contributes to more than 40000 deaths a year, educational plans about preventing this disease specially in the elder patients should be a global initiative,

Behavioral Objective and Domain Example – Third-grade students will name one healthy food choice in each of the five food groups by the end of the presentation. (Cognitive Domain)	Content   (be specific) Example – The Food Pyramid has five food groups which are…. Healthy foods from each group are…. Unhealthy foods containing a lot of sugar or fat are….	Strategies/Methods (label and describe) Example – Interactive poster presentation of the  Food  Pyramid. After an explanation of the poster and each food category, allow students to place pictures of foods on the correct spot on the pyramid. Also, have the class analyze what a child had for lunch by putting names of foods on the poster and discussing what food group still needs to be eaten throughout day.
1. The seniors in the transitional care will understand the symptoms o pneumonia	1. The major symptom of pneumonia is considered to be high fever with whole body pain and restlessness. Moreover frequent coughing with mucous secretion and extreme chest wall pain, increased by coughing can also be a trigger. Other symptoms include sudden drop in the body temperature and shaking and teeth chattering accompanied with it. Nausea, vomiting and diarrhea can also be accompanying the major symptoms (Domínguez et al., 2010).	1.interacticve presentation of the symptoms f pneumonia with easy to understand and catchy graphics. Comprehensive quiz session at the end to gauge the level of understanding for the learners.
2. The learners understand the adverse affects of succumbing to pneumonia.	2. In the last few years pneumonia coupled with other complicated diseases like influenza has been on e of the major causes of death in the senior population. Pneumonia is an inflammation of the lungs. Lack of treatment in case of pneumonia can give rise to shortness of breath and other health complexities that can be fatal. The more completed successors of untreated pneumonia in the seniors include bacteremia, ADRD, lung abscess, and Pleurisy and Empyema (Domínguez et al., 2010)	2. The seniors are demonstrated about the increasing risk of pneumonia in the elderly and how it contributes to morbidity rates. Explain to the senior the repercussions of a pneumonic infection and how it can turn to more fatal consequences.
3. The seniors understand the causes of pneumonia	3. Pneumonia is caused by more than a dozen or two of bacterial or viral strains, however in the elderly population Streptococcus is the most likely reason behind pneumonia. More than 40000detahs are caused due to this lethal infection according to the data of centre of disease control. Improper hygiene, lack of preventative measures and timely vaccinations are deemed to be the most likely cases behind this particular infection (Greer et al., 2014).	3. A easily comprehensible attractive poster about the causes of pneumonia and how it can be manifested. An animated video to facilitate better understanding.
4. The seniors have a clear understanding of preventative techniques for pneumonia	4. The pneumococcal vaccination can help in preventing more than 23 strains of bacteria and viruses that can cause pneumonia. Taking a new booster dose every five years can help the elderly prevent the risk of pneumonia infections significantly. Practicing good hand and oral hygiene can also reduce the risk of pneumonic infection radically. Having a healthy lifestyle with antioxidant risk light diet and good exercising regime can also boost the innate immunity of the body (Record et al., 2015).	4. Interactive presentation with involving the seniors to ensure that they understand the preventative techniques. A well articulated set of dos and don’ts provided t the seniors that they can flow (Griffin et al., 2013). A interactive group session to facilitate better and more succinct idea in them about the preventative techniques.

Creativity: How was creativity applied in the teaching methods/strategies? 

Creativity is a majorly important part in case of any interactive learning procedure and is considered to be a key step in generating interest and sense of pull in the learners to understand the topic more clearly. In this preventative teaching plan as well a few creative measures were applied. for instance the interactive and playful demonstrative session were the nurses explained to the senior patients about the preventative measures using a dummy got the seniors very excited. The animated videos were very successful in generating interest in the patients as well (Record et al., 2015).

Planned Evaluation of Objectives (Outcome Evaluation): Describe what you will measure for each objective and how.

The first outcome will be to measure the level of understanding in the senior patients about pneumonia, how it occurs and what can be done to prevent it.

This will be done by distributing a questionnaire to the seniors about the different aspects of pneumonia followed by an interactive question answer session that will elicit important information about their level of knowledge (Roquilly et al., 2014).

The next outcome will be explaining to them all the preliminary knowledge about pneumonia, its causes and symptoms and clarify any misconceptions that they seniors may have.

This will be achieved by having a presentation and then having a open question answer session, the questionnaires provided to the seniors will help them clarify any question they might have.

The next outcome will be explaining to them the preventative measures and demonstrating the benefits of incorporating them in their lifestyles.

This will be done by interactive presentation and learning session using animated interfaces and videos (Sharma, 2016).

The last outcome will be to ensure that the seniors understood the contents of the pneumonia prevention plan and they will be able to implement the in their lifestyle?

By circulating informative manuals and sets of dos and don’ts to ensure that they understood the details.                       

Planned Evaluation of Goal:  Describe how and when you could evaluate the overall effectiveness of your teaching plan.

The overall effectiveness can be evaluated by having a demonstrative preventative session after the completion of preventative teaching program using dummies, where the senior one by one will carry out the steps demonstrated to them in the prevention plan (Tomczyk et al., 2014).

Planned Evaluation of Lesson and Teacher (Process Evaluation):

The process evaluation will be done by the health care professionals in a manner that will generate accurate results about how effective the plan was.

Barriers: What are potential barriers that may arise during teaching and how will those be handled?

Readiness for Learning

The barriers or challenges to the success of this teaching plan that can present itself are the resistance in the seniors to participate in the program, this barrier can be overcome by persuading them to participate with some complementary gifts or souvenirs.

Another risk that may come up can be the sensory disabled seniors that cannot participate in the usual manner to the session, alternative communication measures can be taken in this case.

In case of dialect related barrier for ethnic communities an interpreter can be employed (Urden, Stacy & Lough, 2015).

Communication: How will you begin your presentation (hook them in)? How will you end your presentation (go out with a bang)? What nonverbal communication techniques will you employ?

The presentation will start with a interactive animation video about health care teaching plans and its benefits to captivate the audience.

The ending of the presentation will be with a powerful statement about the importance of preventative strategies in avoiding the risk of diseases.

The nonverbal communication strategies that will be used are sign language, gestures, paralinguistics and proxemics (Wroe et al., 2012).

References:

Amir, O., Grosz, B. J., Gajos, K. Z., Swenson, S. M., & Sanders, L. M. (2015, April). From care plans to care coordination: Opportunities for computer support of teamwork in complex healthcare. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (pp. 1419-1428). ACM.

Bastable, S. B. (2016). Essentials of patient education. Jones & Bartlett Publishers.

Cabana, M. D., Slish, K. K., Evans, D., Mellins, R. B., Brown, R. W., Lin, X., … & Clark, N. M. (2014). Impact of physician asthma care education on patient outcomes. Health Education & Behavior, 41(5), 509-517.

Domínguez, A., Izquierdo, C., Salleras, L., Ruiz, L., Sousa, D., Bayas, J. M., … & Carratalà, J. (2010). Effectiveness of the pneumococcal polysaccharide vaccine in preventing pneumonia in the elderly. European Respiratory Journal, 36(3), 608-614.

Greer, A. G., Clay, M., Blue, A., Evans, C. H., & Garr, D. (2014). The status of interprofessional education and interprofessional prevention education in academic health centers: a national baseline study. Academic Medicine, 89(5), 799-805.

Griffin, M. R., Zhu, Y., Moore, M. R., Whitney, C. G., & Grijalva, C. G. (2013). US hospitalizations for pneumonia after a decade of pneumococcal vaccination. New England Journal of Medicine, 369(2), 155-163.

Record, N. B., Onion, D. K., Prior, R. E., Dixon, D. C., Record, S. S., Fowler, F. L., … & Pearson, T. A. (2015). Community-wide cardiovascular disease prevention programs and health outcomes in a rural county, 1970-2010. Jama, 313(2), 147-155.’

Roquilly, A., Marret, E., Abraham, E., & Asehnoune, K. (2014). Pneumonia prevention to decrease mortality in intensive care unit: a systematic review and meta-analysis. Clinical Infectious Diseases, ciu740.

Sharma, M. (2016). Theoretical foundations of health education and health promotion. Jones & Bartlett Publishers.

Tomczyk, S., Bennett, N. M., Stoecker, C., Gierke, R., Moore, M. R., Whitney, C. G., … & Centers for Disease Control and Prevention (CDC). (2014). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged≥ 65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep, 63(37), 822-5.

Urden, L. D., Stacy, K. M., & Lough, M. E. (2015). Priorities in critical care nursing. Elsevier Health Sciences.’

Wroe, P. C., Finkelstein, J. A., Ray, G. T., Linder, J. A., Johnson, K. M., Rifas-Shiman, S., … & Huang, S. S. (2012). Aging population and future burden of pneumococcal pneumonia in the United States. Journal of Infectious Diseases, 205(10), 1589-1592.