Analysis of TB Treatment & Prevention in Prisons: EBP Report

This report examines the application of evidence-based practice (EBP) in addressing tuberculosis (TB) within a healthcare organization, specifically focusing on its implementation in a nursing home and the challenges posed by TB outbreaks in prisons. The report details the healthcare organization's strategies for enhancing patient safety through effective communication, multidisciplinary collaboration, and readiness for positive change. The core problem identified is the increasing number of TB cases in prisons, necessitating the development of EBP strategies for treatment, prevention, and control. The report outlines a comprehensive approach involving stakeholder collaboration (state government, ministry of health, prisoner community, and hospital administration), identification of infected individuals through culture testing, and the use of expert consultation to determine the appropriate treatment and prevention methods. The plan for knowledge transfer involves educating both prisoners and the healthcare team on TB treatment, hygiene, and the importance of medication adherence. The expected outcomes include increased patient awareness, acceptance of treatment, reduced transmission rates, and timely completion of treatment. The report also includes a critical appraisal of peer-reviewed articles, highlighting the importance of evidence-based nursing practices and the use of evaluation tables to ensure unbiased and reliable conclusions. The references include key sources on EBP and clinical respiratory medicine.

Essentials of Evidence Based Practice
Student’s Name
Institution
Date

Description of my healthcare
organization
It is called mercyline nursing home, which has a capacity of 6o
beds for inpatients and deals with cases of outpatients as well.
There is a clear culture of enhancing patients safety through
various clear strategies from the administration. The strategies
show creativity, effective communication and multidisciplinary
collaboration. Everyone is ready for a positive change there
through readiness to accomplish tasks, using the available
resources and implementing all the situational factors.

Description of my healthcare organization
 The hospital has been receiving increased number of TB patients from the
nearest prisons.
 This has led to increased number of admissions of prisoners in the hospital.
 The issue prompted the need to create a change in the prisons to reduce the
number of people suffering from TB.
 This can be done through evidence based practice to identify the right
treatment options for TB and the right practices to prevent its transmission and
infection rate.

The current opportunity for change
 There is the problem of tuberculosis in the American prisons
 The circumstances include the high number of patients suffering from
tuberculosis in the prisons.
 The scope of this issue is that there are many case of deaths through increased
infections amongst the prisoners. There is the need to control and prevent TB
in the prisons via various strategies. This shall involve intensifying the current
treatment mechanisms, carrying out research , eliciting systematic support and
involving stakeholders.

The current opportunity for change
 Stakeholders to be involved includes the state government , ministry of health,
the prisoners community and the hospital administration.
 Change would start by teaching the patients the need to receive TB treatment,
identifying the suffering people and those at high risk, vaccination and
enhancing good hygiene and sanitation amongst the prisoners.
 The risk factors include high transmission rate in the institution and other
complications associated with TB.

Evidence Based Idea for Tuberculosis change
 One of the ideas involves identification of individuals suffering from TB in the
prison.
 This can be done through culture testing using trained health professionals, a
functioning healthcare system and enough healthcare facilities (Spiro, Silvestri,
& Agustí, 2012).
 The available evidence is used and expert consultation to carry out culture
isolates and test directly the smear – positive sputum specimens.
 Carrying out a test on susceptibility of conventional drugs is needed for
confirmation of XDR- TB.
 These tests shall help in coming up with the right numbers to treat, the right
drugs / vaccination and other strategies needed for change.

The plan for knowledge transfer for this
change
 To facilitate this change, the stakeholders should create lessons to teach the prisoner
and the healthcare team on the need for compliance.
 The healthcare team are advised on the need to give patients the right medications
that are recommended through EBP to successfully treat tuberculosis.
 They are also taught on how to carry out the smear tests to verify the number of
patients suffering from TB, those at high risk for vaccination purpose and how to use
fixed drugs combinations.
 The patients are taught on the need to adhere to medications given and are led on
how to practice good hygiene to avoid further suffering and the spread of the disease.
 This is done through direct communication to the patients by the health professionals
and holding seminars to teach the transmission course of TB.

The plan for knowledge transfer for this
change
 The organizational adoption of the knowledge to enhance change involves
proper sanitation and hygienic measures in every corner of the organization
i.e. the prison (Hoffmann, Montori, & Del Mar, 2014).
 Implemented by multidisciplinary team cooperation in the healthcare to
perform smear tests to identify those suffering and offer the right medications.
 It is also implemented through encouraging the EBP vaccinations to avoid
transmissions.
 Ongoing internal monitoring and timely external valuations are other ways of
change implementation.

Measurable outcomes to achieve
 Outcomes include increased awareness towards TB by the patients.
 After the education offered, it is expected that the patients shall accept the TB
treatment.
 Patients are can identify contacts and practice the right hygiene practices.
 The other outcome includes subjecting the patients to the right tests, giving
them the right treatment and adhering to the medications given.
 Another outcome involves timely completion of treatment, reduced number of
patient cases admitted in hospitals and less transmission rate of TB.

A summary of the critical appraisal of the
peer-reviewed articles
 I peer reviewed the articles on the American Journal of infectious diseases.
 The aim of the study provided was scientifically relevant.
 Its aim is provision of all academicians and scientists with a platform in which
they can learn various infectious diseases and various methods of the diseases
control based on evidence.
 Methodology used is well designed and the primary outcome variable well
evaluated.
 Large sample size was used hat provided reliable data that made it impossible
to doubt the present infectious diseases, treatment options and how the
diseases can be prevented.

Lessons learnt on creating evaluation table.
 I learnt how to rely on evidence when it comes to nursing practices.
 Every practice carried out in the medical field should be associated with
procedures followed to reach to a particular conclusion based on the research
carried out.
 Creating a critical appraisal is important because one is able to identify the
best practice .
 Creating evaluation table helps a person follow all the procedures needed to
critically review a nursing practice activity to avoid bias and unreliability.

References
 Hoffmann, T. C., Montori, V. M., & Del Mar, C. (2014). The Connection
Between Evidence-Based Medicine and Shared
Decision
Making. JAMA, 312(13), 1295. doi:10.1001/jama.2014.10186
 Spiro, S. G., Silvestri, G. A., & Agustí, A. (2012). Clinical Respiratory
Medicine E-Book: Expert Consult - Online and
Print. St. Louis, MO: Elsevier Health Sciences.