Essay on Norovirus and Patient-Centered Care: Mr. Okafor's Case Study

This essay analyzes a case study of Mr. Abeo Okafor, an 88-year-old resident of a nursing home, who is experiencing symptoms of norovirus infection, including abdominal pain, diarrhea, and dehydration. The essay provides an in-depth overview of the norovirus, a highly contagious viral infection that causes vomiting and diarrhea, particularly affecting vulnerable populations like the elderly. It highlights the importance of understanding the virus's transmission, symptoms, and the specific challenges it poses in aged care facilities. The essay emphasizes evidence-based and person-centered care approaches, including hand hygiene, personal protective equipment (PPE), and environmental cleaning, to prevent the spread of the virus. It also discusses the need for comprehensive patient assessment, including pressure ulcer risk, fluid balance, and activities of daily living, to develop individualized care plans. Collaboration among healthcare professionals, including nurses, dieticians, and medical practitioners, is crucial for managing the patient's condition and ensuring a safe and supportive environment. The essay underscores the significance of infection control measures, patient exclusion, and cultural sensitivity in providing effective care for older adults affected by norovirus. This assignment, contributed by a student, is available on Desklib, a platform that provides all the necessary AI-based study tools for students.

Running head: NOROVIRUS
NOROVIRUS
Name of the student:
Name of the university:
Author note:

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Norovirus is a contagious disorder that causes vomiting and diarrhea. Children and
older patients have hard time as it affects them in much larger extent than the younger adults.
This assignment would be mainly describing the viral infection in details and will show how
older patients need to be cared when affected by the disorder (Petrignani et al., 2015). The
care should not only evidence based but should also ensure following a person centered
approach by professionals. It will also show the precautionary measures that need to be taken
when such outbreaks occur in aged care facilities.
Norovirus are a group of related, non-enveloped, single-stranded RNA. This virus is
highly contagious and spread through food and water that had been contaminated during
preparation and through contaminated surfaces. Diarrhea, vomiting and abdominal pain
typically begin 12 to 48 hours after exposure to the infection (Kambhampati et al., 2015). The
symptoms mainly last for one to three days and most of the people recover completely
without treatments. However, for specific cohorts of people like infants, people with
underlying disorders and older adults, this infection takes a toll on their health. In their cases,
diarrhea and vomiting results in severe dehydration and therefore require medical attention.
Some of the other symptoms are abdominal cramps, malaise, and muscle pain as well as low
grade fever. The patient named Mr. Abeo Okafor had similar complains of abdominal pain
and diarrhea. Another patient complained of suffering from abdominal pain and vomiting.
Norovirus mainly spread in public spaces like that of hospitals, schools, and even
nursing homes and aged care facilities. Small particles from vomit or the feces from the
infected person have the ability to infect a healthy individual. This infection may spread
through close contact with someone who are infected with Norovirus The virus can survive
outside the body for several days and therefore when a healthy individual touches
contaminated surfaces and objects, he or she might get affected with the infection (Lindsay et

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al., 2015). Moreover, eating contaminated food by the healthy individuals might lead to
infection as well.
Older adults seem to suffer more in comparison to that of the younger cohorts of
people when they get infected by Norovirus. The former suffer from a longer duration of
diarrhea ranging from 3 days to 9 days Therefore, Mr. Okafor might have to suffer because of
this infection in similar ways. Moreover, it results in even slower recovery from this infection
in the older cohort of people. Many of the studies have shown that older people have
increased susceptibility to the virus mainly due to age-related changes in B-cell as well as in
T-cell function (Metzelthin et al., 2017). They also have d immune-senescence or underlying
chronic conditions and co morbidities that make the older people vulnerable to more
suffering. Therefore, healthcare professionals need to plan a proper evidence based care to
ensure person centered care service to Okafor and help him get well soon.
Studies have found out important factors that explain why norovirus causes
challenging situations in nursing homes, aged care facilities and similar healthcare centers.
The infectious dose of norovirus is very low and this virus has multiple routes of
transmission. Hence, they can affect patients in various ways. Variety of norovirus is present
and hence infection with one strain does not confer immunity from other strains (Chen, Hall,
& Kirk, 2017). They can survive on any surface for days that even includes exposed and even
wrapped food items. Person to person outbreaks can take place in different types of semi-
closed setting. However, they are very difficult to control. This might be because the
infectious dose of Norovirus is small, or because that the infected patients excrete huge
amount of viable virus particles and even because of the widespread environmental
contamination that take place. Therefore, controlling the disorder in nursing homes and aged
care facilities is very difficult.

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Hand hygiene is the appropriate method of preventing spread of the virus. Cross
contamination by hands result in further propagation of the norovirus outbreak in nursing
homes and aged care facilities (Rajagopalan et al., 2016). Hence, hand hygiene needs to be
maintained by staff professionals. Nurses caring for Mr. Okafor need to maintain hand
hygiene before touching a patient, before a procedure, after touching a patient, after touching
patients’ surroundings and after a procedure or body fluid exposure risk are necessary.
Personal protective equipments should be used in the nursing home and aged care
facilities settings, as it would help in minimizing the infection risk. Splashing of feces or
aerosols from vomited particles has the potential for suspending the virus in the air and
thereby falling on food particles and surfaces. Hand hygiene needs to be carried after
removing PPE to reduce spread of virus. Disposable gloves, ace-shields or goggles, (surgical
type, fluid repellent paper filter mask) masks, and protective impermeable gowns or plastic
aprons need to be worn (Temime et al., 2018). These PPE can reduce the spread and hence
Nurses caring for Mr. Okafor need to utilize PPE and adopt the practice in their aged care
setting as well. All these will protect skin and clothing from being contaminated and thereby
prevent further spread.
Exclusion can reduce the chances of spread of infection to other patient in the nursing
homes and aged care facilities as it would reduce chances of sharing common bathrooms,
infecting common spaces and objects in the environment used or touched by many, infecting
food of healthy patients and others. Nurses caring for Mr. Okafor need to transfer him to a
separate room to reduce chances of affecting other asymptomatic patients. Environmental
cleaning with chemical agents, sterilizing cleaning equipments and agents, environmental
surfaces in the nursing home and aged care facilities are important to kill virus that may
survive on the surface of objects (McIntosh et al., 2018). Carpets, soft furnishings, and
laundries need to be properly disinfected.

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Mr. Okafor is quite aged and he might have limited mobility and restrictions in
movement. This results in risks of pressure ulcers when he is admitted to the ward. Nurses
need to identify the “at risk” patients and try to evaluate the ability of the patient in
repositioning himself on bed. Nurses attending Mr Okafor can utilize the risk assessment tool
of pressure ulcer namely Waterloo pressure ulcer prevention/treatment policy (White et al.,
2016). According to the score, they can identify the status and ability of the patient,
accordingly develop interventions, and care plans. This would include repositioning him
timely, proper mattress selection, assessing his nutritional status, maintaining correct
moisture level of skin and others.
Mr. Okafor had three episodes of diarrhea and therefore there may be high chance that
he might suffer from dehydration. Moreover, age related changes in the body’s ability for
balancing water and sodium might increase the danger (Pringle et al., 2015). Therefore,
nurses need to help the patient drink at least 6.5 liters of fluid every 24 hours to patients like
Okafor who have increased risk for becoming dehydrated after diarrhea. Fluid balance chart
needs to be maintained so as to assess whether management of dehydration was done
successfully or not.
Me.Okafor is quite old for about 88 years and he might face issues with activities of
daily living. Therefore, nurses caring for him need to use different assessment tools to assess
his capability in completing his activities of daily living and develop care plans accordingly.
They need to consider six important areas – movement in bed, transfers, locomotion,
dressing, person hygiene and feeding (Jump et al., 2018). They need to assess his capabilities
on these arenas and accordingly provide him services
Dietician is one of the professional who has the responsibility of working
collaboratively with the healthcare team members It has been found that the patient had

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several episodes of diarrhea resulting in loss of water and nutritional constituents from the
body. Hence, the dietician will advise the patient to drink lots of water that should be of the
optimum amount set for the patient and should be neither hot nor icy. He should advise the
patient to take clear liquids for the rest 10 to 24 hours as this helps the bowel to rest and
replace the important fluids lost during diarrhea. The dietician would offer him some good
choices of food like rice, potatoes, farina or wheat of cream, egg, white bread, canned peeled
fruits as well as well-cooked vegetables. He should be advised to prevent including foods like
fatty or fried foods, raw vegetables, and vegetables with lots of fiber like cabbage, peas, dried
beans and broccoli and others (Aliabadi et al., 2015
0).
The medical practitioner needs to work collaboratively with the nursing professionals
and act as the case manager for the patient named Okafor. He would continue assessing the
health of the patient from time to time ensuring his gradual recovery from the infection of
Norovirus (Temime et al., 2018). Accordingly, assessing the patient, identifying his altered
requirements from time to time would be his main responsibility. Moreover, guiding the
nursing professionals regarding the infection-control management-systems would be his
responsibility (Pringle et al., 2015).
In summary, it becomes clear that norovirus is a contagious viral
infection. Patients suffer from vomiting, diarrhea, dehydration, abdominal pain and many
others. Children and older patients suffer massively when infected. Different important
precautionary measures need to be taken by healthcare professionals once the outbreak takes
place like maintaining proper hand hygiene, personal protective equipments, excluding the
patients into separate rooms, environmental cleansing and others. The infection spreads
through oral and rectal routes and even through contamination of surfaces and food materials.
Older patients need to be assessed for their pressure ulcer status, fluid balance status,

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activities of daily living and cultural aspects before developing the care plans. Social workers
are helpful for older patients in such scenario and help the aged care facility staffs and the
patient to great extent.

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References:
Aliabadi, N., Lopman, B. A., Parashar, U. D., & Hall, A. J. (2015). Progress toward norovirus
vaccines: considerations for further development and implementation in potential
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