Position about Specific Healthcare Issue 

NURS FPX 6026 Assessment 1 Attempt 1 Analysis of Position Papers for Vulnerable Populations KP

The challenge of diverse population of pateints and employees is always hard to meet by the professionals. Regarding elderly health issues in Vila Health Hospital, the researchers have observed that the common variable deficiency disease (CVID) is the primary immune deficiency errors in old-age people. According to a recent estimate, the prevalence of CIVID disease can be determined by the fact that it is increasing by one in 25,000 people in the United States. This position paper aims to address the particular and vital issue of CVID disease patients’ population rising in the Vila Hospital the adversely impacting the outcomes of the hospital. This report aims to analyze the current available evidence to support the practices and policies of healthcare professionals in Vila System. Moreover, the report will help professionals to explore different opposing viewpoints of professionals and researchers to help the organization improve its outcomes. Since the Common Variable Immunodeficiency in elderly people is also described by the Food and Drug Administration as a complex healthcare issue in the country, medical professionals have rare and limited knowledge of the deficiency of antibody that causes this disease in elderly people. 

Most of the patients in Vila Health Hospital suffering from CVID disease fall into the range of 50 to 65 years. This area of study is the most important and profound because of its health implications. In Vila System the analysis of the patients reveals that many old-age patients admitted in the emergency department ED show symptoms such as neoplasia. The veteran patient in the scenario is Carl who shows heterogeneous group of disorders that occurs due to failure of antibody in the human body (Zheng et al., 2022). The patient like other CVID patients has a polygenic disorder as well as a humeral immune defect. The patient’s tests showed the identification of a single gene defect that removed that patient from the umbrella diagnosis of CVID disease. In his population health activity, the patient named Carl at 61 years of age suffers from the rare CVID who shows symptoms of increased rate of mortality. CVID is a rare case for Carl as his blood shows the autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Moreover, there is lack of knowledge of CVID in patient who was also complaining about a respiratory tension. The nurses are able to protect the wellbeing of Carl who shows no significant history of CVID infection and aim to receive the best treatment. The previous treatment given to the patient using rituximab and prednisone. Moreover, there were no signs of protein losing enteropathy while the patient’s test results show B cell lymphopenia with low absolute lymphocyte count of 190. 

The Role of Interprofessional Team in Supporting Improvements and Challenges Faced 

Teams working together in an interprofessional setting can promote and produce more positive outcomes than individuals. The patient’s relatives had shown an unsatisfactory response due to ineffective performance of nurses and physicians related to this healthcare issue in Vila Hospital. They wish to discontinue the further treatment in the absence of positive results that requires providing adequate and serious care of the CVID patient. According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), CVID causes can range from various genetic abnormalities and imbalances in the body; especially in elderly patients also suffering from type 2 diabetes and other liver and cardiovascular complications, the nurses need to properly understand the importance and the nature of real CVID treatment and diagnosis to make an early impact on the family of the patient. The patient also felt gastric trouble in the form of diarrhea and was unable to absorb nutrients properly. CVID can also cause spleen to enlarge in the stomach. This is also argued and favored by our senior gerontologist Dr. Hagen who has consulted many research studies such as Yoong et al. (2018). This confirms that Carl can also have different complications such as swollen glands and lymph nodes as a result of CVID in old age. This can also result in swelling in his knees and can also cause cancer. 

The American Nursing Association ANA suggests Provides guidelines for nurses to play their role in improving the health of the patient by helping him change his adverse lifestyle. Our master’s prepared nurses are advised to reduce health-hurting strategies including late diagnosis of CVID. Through the guidelines of the ANA, nurses in Vila System can facilitate positive conversations among stakeholders related to CVID risks in older people, especially in those who are addicted to alcohol and smoking. Therefore, the nurses can help pateints and mentally empower them to quit bad habits like smoking and tobacco addiction to promote better lifestyle. The good news is that it is possible nowadays to make use of many latest tools and sources of knowledge online to help the professionals to increase their= knowledge and learn to fight the menace of CVID.  

The Evidence and the Position of Others to Support a Team’s Approach 

A limited number of scholars have published research literature to help physicians explore the critical issue of CVID disease. The study by Yoong (2018) reveals that intravenous immunoglobulin infusions can cause this disease in elderly people. The study argues that a lower number of immunoglobulin levels are responsible for the disease and this issue can be mitigated by professionals by giving patients an injection that increases the level of immunoglobulin. The immunoglobulin can be given to Carl as well using antibodies from the blood of a healthy individual not showing signs of CVID. Furthermore, the evidence-based study by   Shin et al. (2020) also reveals that CVID can also occur in patients as a result of bacterial infections which require immediate medical attention. The treatment of CVID in this case is possible for achieving positive results by increasing the number of antibiotic medications for the patient (Le Saos-Patrinos et al., 2020). Because the CVID treatment is not yet discovered significantly, it still remains a daunting task for the medical healthcare professionals to understand its treatment. In the absence of a universal treatment, doctors can treat bacterial infections within time by incorporating additional tailored strategies related to specific pateints. 

Moreover, the American Academy of Allergy and Asthma Immunology AAAI also advises medical professionals regarding change in physical states of a CVID patient. In case of sever bacterial problems, the patients may not be able to bear the disease and never recover. This implies that the medical professionals must take immediate action and must not show negligence or laziness before the threshold of infections reach a dangerous point to adversely affect the ears and other vital organs of elderly patients (Guevara-Hoyer et al., 2020). The disease can damage respiratory tract of the patient and doctors must make sure that the disease is curable and treatable after performing an early diagnosis. A consensus has been found regarding this issue in Vila Hospital among nurses and senior physicians. 

The Position of Professionals contrary to Team’s Approach  

CVID often shows a heterogeneous group of medical disorders in patients due to antibody failure. The disease is diagnosed in several individuals over the year; however, the genetic reasons are not found in all the patients (Gereige et al., 2019). This means that a large number of CVID patients in Vila Hospital are found to have polygenic disorders. Hormonal immune defect occurs mainly due to immune defect in pateints. Which is why some physicians are supporting the thought that instead of causing CVID, C104R and TACI gene mutations are predisposing CVID instead of giving rise to it. The European Society of Immunodeficiency’s also published position papers in 1999 in addition to the Pan American Group of Immune Deficiency. The experiments show that patients who are treated with IVIG/scLG are likely to have significant improvement regarding their CVID conditions. Therefore, some physicians are in the favor of using the ESID/PAGID criteria for the preliminary diagnosis of CVID. 

The disease can cause many gastrointestinal issues in elderly patients such as causing vomiting and chronic diarrhea. However, a number of DNP nurses also found evidence those conflicts with the other professionals. For example, nurses explore that CVID patients have also been observed to have weight loss and nausea issues during their hospital stay. This was observed in the patient Carl that reduces the consensus on the fact that in some forms of CVID, granulomas sing in patients’ lungs are shown. This leads nurses to disagree on the treatment that only involves medication and antibiotics. A study published by Akhter (2018) also states that treatment through antibiotics is less likely to reduce blood count; this shows that the patient Carl can have less white blood cells in his body which can delay his cure and healing. Therefore, if the treatment is discontinued, this issue can go away by itself. But not many professionals are able to accept this argument due to lack of observation of real-time CVID patients and the similar results. 

References 

Akhter, J., Lefaivre, C. A., Saltines, C., DiGirolamo, M., & Warnatz, K. (2018). Immunologist’s perspectives on assessment and management of lung disease in CVID: a survey of the membership of the Clinical Immunology Society and the European Society for Immunodeficiencies. Journal of Clinical Immunology, 38(3), 237-246.

Gereige, J. D., & Maglione, P. J. (2019). Current understanding and recent developments in common variable immunodeficiency associated autoimmunity. Frontiers in Immunology, 10, 2753.

Guevara-Hoyer, K., Saz-Leal, P., Diez-Rivero, C. M., Ochoa-Grullo, J., Fernández-Arquero, M., Pérez de Diego, R., & Sánchez-Ramón, S. (2020). Trained immunity based-vaccines as a prophylactic strategy in common variable immunodeficiency. A proof-of-concept study. Biomedicines, 8(7), 203.

NURS FPX 6026 Assessment 1 Attempt 1 Analysis of Position Papers for Vulnerable Populations KP

Le Saos-Patrinos, C., Luzon, S., Blanco, P., Villard, J. F., & Duluc, D. (2020). Functions of Tph cells in common variable immunodeficiency. Frontiers in Immunology, 11, 6.

Shin, J. J., Leeuw, D., Siddiqui, S., Lee, J., Chung, E. J., Steele, R., … & Kang, I. (2020). Immunological and clinical phenotyping in primary antibody deficiencies: a growing disease spectrum. Journal of Clinical Immunology, 40(4), 592-601.

 Tithonian, A., & Talbot, P. (2011). Electronic nicotine delivery systems: is there a need for regulation? Tobacco Control, 20(1), 47-52.

Yoong, S. L., Stockings, E., Chai, L. K., Telepic, F., Wiggers, J., Old meadow, C., … & Wolfenden, L. (2018). Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta‐analysis of country level data. Australian and New Zealand Journal of Public Health, 42(3), 303-308.

NURS FPX 6026 Assessment 1 Attempt 1 Analysis of Position Papers for Vulnerable Populations KP

Zheng, B., Artin, M. G., Chung, H., Chen, B., Sun, S., May, B. L., … & Kong, X. F. (2022). Immunogenetics of gastrointestinal cancers: A systematic review and retrospective survey of inborn errors of immunity in humans. Journal of Gastroenterology and Hepatology.