Investigate the high incidence of sickle cell anaemia, in African and Caribbean population in the UK from birth to 20 years.

Task LO1

Research Title
A critical review of Sickle Cell Anaemia population in the UK

Research Aims
I am going to investigate the high incidence of sickle cell anaemia, in African and Caribbean population in the UK from birth to 20 years.

Research Objectives
1. To examine the etiology of SCD
2. Evaluate the incidence rate of SCD
3. To explore what treatments are given
4. To evaluate the impact on Health and social care and family members

Research project background:
My research is about Sickle Cell Anaemia – Sickle cell disease, commonly abbreviated as SCA or SCD is a serious infectious inherited condition which affects the blood of the individual and various vital organs in the body. I am researching this topic because I have few friends whose children have the condition. They got it from their parents, through genetics and how it affects the family. SCD mainly affects the red blood cells – In the process, it causes episodes and the episodes will eventually cause pain amongst other various symptoms. Some of the children develop severe crisis and take medication to help calm the pain whilst others get admitted in hospital to receive treatment for the pain or infections.

There are certain conditions which influence and trigger sickle cell disease such as lack of fluid in the body, infection and cold. Low oxygen also triggers SCD. Sickle cell anaemia is a complicated set of condition which causes the erythrocytes to be sickle-shaped. SCD has over the years affected a lot of people (Sullivan, 2000, pg48). While there is medical advancement aimed at treating the patients, SCD is still an obstacle in different parts of the world. Sickle cell is not curable but managed with medicine and good diet. I am going to find out how this group are supported within their community i.e. the NHS, specialist or health professional and especially by their family members.

Research Project Review
My research is about Sickle Cell Anaemia (SCA) – Sickle cell disease, commonly abbreviated as SCD is a serious, infectious inherited conditions which affects the blood of a patient and various vital organs in the body. SCD mainly affects the red blood cells. In the process, it causes episodes and the episodes will eventually cause pain amongst other various symptoms. There are certain conditions which influence and trigger sickle cell disease such as lack of fluid in the body, infection, and cold. Low oxygen also triggers SCD. Sickle cell anaemia is a complicated set of condition which causes the erythrocytes to be sickle-shaped. SCD has over the years affected a lot of people (Sullivan, 2000, pg48). While there is medical advancement aimed at treating the patients, SCD is still an obstacle in different parts of the world.

Research Methodology
The study seeks to adopt a cross-sectional survey research design to help in showing trends in attitudes and behaviours and allow generalisation of the outcome of the investigation of the high incidence of sickle cell anaemia in African and Caribbean population in the UK. According to Wiersma and Jurs (2009, pg14), this design is appropriate for this study because it utilises a questionnaire as the data collection tool which saves time, expenses and ensures information yielded is of quality and valid. The bias of interviewer is minimised because participants complete similar report measures.

The target population will be drawn from a population frame collected from about 10 Hospital Management Team Members. This study’s population consists of various management staff from Level IV health care facilities. These include; medical superintendents, administrative officer and other heads of departments such as accounts, supply chain office, nursing services, physiotherapy, laboratory services, mother and child health, nutrition, clinical services, public health, biomedical engineering office and accommodation, medical records, and radiology (Agarwal, 2009, pg124).

Zikmund et al. (2010, pg86) posit that a sample should be representative of the population, with a very minimal sampling error. From the target population of 180 Hospital Management Team Members, all constituents will be taken into consideration in the census. This size is perceived representative and comprehensive for the study objectives and economical in terms efficiency. The study will examine 36% of the target population as a sample representing the entire population.

A questionnaire is a tool for data collection whereby participants provide written answers to given questions (Gilham, 2008, pg12). The questionnaires collected from secondary data of the Hospital Management Team Members and used for this data. The secondary data to be used for this study will be obtained from the documented files in the Hospitals departments.

Data analysis is defined as the ordering and organising of raw data to extract useful information from it (Saunders, Lewis, and Thornhill, 2009, pg18). The gathered data will be analysed to ascertain the effect of sickle cell anaemia on the independent variables: causes of sickle cell anaemia, the incidence rate and handling of the SCD, and the impact of anaemia on HSC and family members. Quantitative data will be used to compare and contrast irregularities and inconsistencies to justify measures.. It will then be summarised and coded for easy classification to enhance interpretation. Descriptive statistics will be used in projecting the sample to portray the actual respondent and to show the response pattern. Analysing of the qualitative data will involve the use of frequency distribution and cross tabulation in describing and explaining the information from views, ideas, feelings and opinions. Through content coding, a list of the main ideas and themes for each variable will be generated which will guide the nature of integration needed for both qualitative and quantitative data. The statistics will be produced which will help provide elaborate data handling capability and various statistical analysis ways (Zikmund, 2010, pg145).

Literature Review
This literature review investigates the condition of SCA, in African and Caribbean population in the UK. Little is known about the origin of sickle cell anaemia. However, a comprehensive study reveals that the disease originated from Africa some millions of years ago. In 1910, J. Henrick, a medical officer, admitted a patient in his clinic which had similar conditions like sickle cell anaemia. According to Burch-Sims and Matlock (2005, pg 322), the disease was found its way to the UK through immigrations of the slaves to the country.

Africans and Caribbean populations living in the United Kingdom have been mainly affected by sickle cell anaemia. Studies show that sickle cell anaemia is usually characterised by various complications which affect functionality of organs in the body. Apart from chronic anaemia which is often experienced by the patients, there are serious manifestations of the patients such as sexual menstruation delays, pulmonary infections, abdominal pain osteocartilaginous pain episodes and chronics of various organs, body, systems or body apparatuses (Juwah, Nlemadim , Kaine 2004, pg122).

Sickle cell anaemia is characterised by hearing impairment. Series of research (between 1988 and 2004) used various methods to establish the hearing impairment to patients of patients who suffered from sickle cell anaemia. Some of the most common methods which have been used for years include otoacoustic emissions, brain auditory evoked potential, central auditory processing assessment and vocal audiograms (Embury, Hebbel, Mohandas and Steinberg, 2005, pg58). The result which was obtained varies significantly, and it was established that 12 to 66 percent of the victims had suffered from sickle cell anaemia. One of the commonly affected groups was children who were between 15 years and below. The children of the stated age range were 50 percent more likely to suffer from hearing as compared to the adults.

The World Health Organisation report reviews that every year in the United Kingdom, there are over 3000 children in the African and Caribbean population who suffer from the disease. 20 percent of the children will eventually die before they reach five years because of the adverse effect of the disease. However, the disease can be treated if early diagnosis is carried out. Appropriate measures have been taken in the recent years in the UK to deal adequately with the disease so as to avert more loss of lives (Embury, Hebbel, Mohandas and Steinberg, 2005, pg49).

The Sickle Cell Anaemia Program, a body which was developed by Department of Health, with activists in UK, suggested collaboration by all the relevant organisations to fight the disease. For instance, the body urges the governmental and non-governmental organisation to join hands together and create public awareness, establish long-term solutions to the problem and serve the victims of the disease diligently. While a lot is being set up to seek the long-term remedy of the disease in the UK, other countries too are striving to eradicate the disease. For example, in Brazil, the body known as Brazilian Public Health System remains committed to ensuring diagnostic tests for hemoglobin diseases for all newborn babies in the country, as well as free treatment for disease (Amayo, Owade, Aluoch and Njeru, 2002, pg 182)

What you must do, 900 words
LO2 Be able to implement the research project within agreed procedures and to specification
2.1 Based on the methodology you described in your proposal (Task LO1), carry out the primary research, and match the resources efficiently in your research.
2.2 Undertake the proposed research investigation in accordance with the agreed specification and procedures.
2.3 Record and collate the data based on the research question. Use appropriate research techniques to analyse your data.

As stated above, within the methodology, you should briefly explain qualitative and qualitative methods and their advantages and disadvantages. Each method has its own techniques, for example, interviews and observations for qualitative methods. Similarly, quantitative methods include surveys (questionnaire) and experiments. Social Science use the survey, so you should justify the use of any of the survey techniques (postal, telephone, Internet and personally administered survey). Remember to justify your use of a particular method and technique and the sampling technique (random or non-random). The last part of methodology wants you to explain how you collected the data using the chosen technique (interview or any of the four survey techniques).

In preparation for Task LO3, you should present your results using appropriate tables, charts, graphs and statistics in order to evaluate these results. Each diagram should have a title and number; for example, Fig 1: Rate of hospital admissions due to air pollution. You should also include an interpretation of what the results mean for the benefit of the reader.

LO3 Be able to evaluate the research outcomes(900Words)
3.1 Match resources efficiently to the research questions or hypothesis.
3.2 Interpret and analyse the results of the data analysis in LO1 in terms of the original research proposal (research objectives and/or hypotheses). Using the appropriate structure and statistical techniques to analyse your data).
3.3 Make recommendations to solve the research problem identified in Task LO1. You should also justify areas for further consideration. (Ideas have been generated and decisions taken when evaluating the research outcomes). It is important that you refer to my LO1 to completed this work. This project is a based on a secondary data analysis, for referencing use 7 Journals and 3 Textbooks in the UK.

Outline the causes, incidence and risk factors of the identified condition and how it can impact on the patient and family

Case study is provided below. Please answer the associated questions. The assignment is to be presented in a question/answer format NOT as an essay (i.e. no introduction or conclusion).
The following questions relates to the patient within the first 24 hours since admission to the emergency department (ED):
1. Outline the causes, incidence and risk factors of the identified condition and how it can impact on the patient and family (400 words)
2. List five (5) common signs and symptoms of the identified condition; for each provide a link to the underlying pathophysiology (350 words)
a. This can be done in the form of a table – each point needs to be appropriately referenced
3. Describe two (2) common classes of drugs used for patients with the identified condition including physiological effect of each class on the body (350 words)
a. This does not mean specific drugs but rather the class that these drugs belong to.
4. Identify and explain, in order of priority the nursing care strategies you, as the registered nurse, should use within the first 24 hours post admission for this patient (500 words).

Case Study 1: Myocardial infarction with history of stable angina and mitral valve stenosis Mr Tupa Savea is a 54 year old male who has been transferred to the coronary care unit (CCU) from the emergency department for management of episodic chest pain. He has a history of stable angina and mitral valve stenosis. Mr Savea is of Samoan background and has lived in regional Queensland for the last 20 years with his wife and children. He was brought in by ambulance having had chest pain and shortness of breath. He reports having similar symptoms on and off for the past two months but did not visit his GP as he assumed the discomfort was due to indigestion. Mr Savea is an ex-smoker, tobacco free for the last six months and a social drinker (approx. 10 units/week). He works full-time as an orderly at a local hospital and is active in the Samoan support community.
On assessment Mr Savea’s vital signs are: PR 90 bpm and irregular; RR 12 bpm; BP 150/100mmHg; Temp 36.9°C; SpO2 98% on oxygen 8L/min via Hudson mask. He has a body mass index (BMI) of 35 kg/m2 indicating clinical obesity. Blood test results show elevated cardiac enzymes and troponin levels and cholesterol level of 8.9mmol/L. His ECG indicates that he has a ST segment elevated myocardial infarction. Mr Savea was administered sublingual glyceryl trinitrate followed by morphine 2.5 mg IV for pain in the emergency department. He reports being pain free on admission to CCU.

Impending obligations to Continuing Professional Development (CPD) and the use of Portfolio in achieving that.

Topic:
Impending obligations to Continuing Professional Development (CPD) and the use of Portfolio in achieving that.
INSTRUCTION:

  1. Define CPD
  2. Discuss specific requirements for professional development either by Nursing and Midwifery
    Board of Australia or Paramedics Australasia.
    N/B: Please focus on your discipline of study. FOCUS ON NURSING
  3. Explain the importance of portfolios and how they can be used as evidence of CPD.
    HOW TO ANSWER
    – Avoid plagiarism
    – Support your arguments with references
    – APA style of referencing
    – Use credible primary sources such as text books no older than 5 years and peer-reviewed
    journal articles within the last 5 years . Avoid consumer brochures, websites or hospital
    consumer leaflets.
    – Three (3) references are adequate for this section of the assignment.

Discuss the role of the RN in the medication management related to the ongoing nursing management

Case Report:

Based upon the Horizons Hospital & Health Service (HHHS) Mary Young, construct a case report. The case report will draw upon your knowledge of pathophysiology and relevant academic literature to support an evidence-based plan of care.

Headings and a description of the content for each section of the report have been provided. These serve as a guide for how you will present your case report; however, it is important that all sections of the report are conceptually connected. For example, your knowledge of pathophysiology and your understanding of this particular client should underpin the nursing problems that you identify which should, in turn, drive the nursing management that is relevant for this clinical situation.

The case report should include the following:

Introduction (150 words)

Introduce the client and provide a brief overview of their case. Provide an outline of the purpose and structure of the report.

You might like to think about the overview of the case study like a verbal clinical handover: what is the key information from the HHHS patient information, progress summary and medication chart that would be relevant for the plan of care for this client?

Primary admission diagnosis (200 words)

Identify the primary diagnosis for the client (i.e. the reason the client was admitted to the HHHS). Provide a brief description of the pathophysiology for the primary diagnosis.

As part of this discussion, it is important to relate the pathophysiology to client’s risk factors and relevant previous medical history.

Nursing problems (200 words)

Use your knowledge of pathophysiology and the subjective and objective data provided in the HHHS progress summary notes to identify five (5) nursing problems that may arise as a result of the client’s primary diagnosis. These problems may be actual or potential nursing problems. Provide a brief description for why these problems may arise for this client.

From these, select two (2) nursing problems as the focus for the remainder of the case report. Provide a rationale for your selection.

Nursing Management (600 words)

The nursing management should focus on the nursing assessment, nursing interventions and the role of the Registered Nurse (RN) related to medication management for this client and will address the two (2) selected nursing problems.

Nursing Problem 1: Nursing assessment, nursing intervention, medication management.

Discuss one (1) method of nursing assessment that would need to be performed related to the ongoing

nursing management of this nursing problem. Provide a rationale for this type of assessment and briefly

describe how this assessment would be conducted in this case.

Discuss one (1) nursing intervention that you would need to implement related to the ongoing nursing

management of this nursing problem. Provide a rationale for the intervention.

Discuss the role of the RN in the medication management related to the ongoing nursing management

of this nursing problem.

Nursing Problem 2: Nursing assessment, nursing intervention,medication management.

Discuss one (1) method of nursing assessment that would need to be performed related to this nursing problem. Provide a rationale for this type of assessment and briefly describe how this assessment would be conducted in this case.

Discuss one (1) nursing intervention that you would need to implement related to the ongoing nursing management of this nursing problem. Provide a rationale for the intervention.

Discuss the role of the RN in the medication management related to the ongoing nursing management of this nursing problem.

Discharge planning (250 words)

Identify five (5) issues/challenges that you may need to address for this client prior to discharge home. Discuss how you would facilitate discharge planning for this client, with consideration to two (2) of these concerns?