NR 503 Week 7 Discussion

NR 503 Week 7 Discussion

NR 503 Week 7 Discussion

This week you will share your findings from your problem paper. You will write up an abstract summarizing your findings. Your abstract should consist of 100 to 500 words. Keep in mind that an abstract should summarize your research, including its key themes and problems and providing your major conclusions. 

The United State is spending close to $16 Billion dollars annually on sexually transmitted diseases (STDs) (Centers for Disease and Prevention [CDC], 2017). Southern states, like Georgia, sees a large number of syphilis cases. Surprisingly, there was once a time where syphilis was at its lowest and was on the verge of elimination.  Now, the rates of syphilis have doubled, causing an incidence rate in the U.S of 5.5 cases per 100,000 (CDC). Men have the highest prevalence. Their rates have continued to climb. Men who have sex with men or MSM are at the greatest risk and have the highest rates of syphilis with 15.6 per 100,000 or 88.9% of all U.S. cases (CDC, 2017).

This has been termed a MSM epidemic. A rapid plasma regain (RPR) is the lab of chose to routinely screen for syphilis. Once diagnosed there are 3 main stages: primary, secondary, and latent. Treatment dosage varies but the treatment of choice is Penicillin Benzathine G given intramuscularly. Once there is a positive lab and confirmation lab, it must be reported by law to the state’s public health department. This is normally done by the laboratory and physician. There is an electronic system where this is transmitted through. After being reported, it is then used for surveillance. It is the goal of providers to help educate the community on syphilis awareness.

Patients must be open to talk about their sex health with their providers. Three ways to work towards the goal of syphilis prevention are: to provide information and encourage safe sex, screen for all STDs, and lastly, treat the patient and notify their partners. These actions will limit the exposure and transmission of syphilis; therefore, decreasing the rates of syphilis in Georgia and the U.S.  

Resource 

Centers for Disease and Prevention (CDC). (2017). Sexually Transmitted Disease (STDs). Retrieved from https:www.cdc.gov/std/syphilis/defualt.htm 

Thank you for sharing your abstract about syphilis! You’ve done a good job in providing an overview of the increasing incidence in the US and in Georgia.  STDs, such as syphilis, are multifactorial, with behavior and environment being significant factors. As you discuss, syphilis is on the rise in the US, which means it will be prevalent in many of our communities. Considering this information, it will be beneficial for ANPs to understand not only the disease process, but also the disparities impacting patient population. 

After I read your and Darnesha’s post, I looked up the statistics of syphilis in Georgia State. I found out that Georgia ranked 1 among 50 states at least one case of primary and secondary syphilis in the United States (CDC, 2013). In Georgia, African American had the highest incidence rates with 25.5 per 100,000 population, 34.1 among Native Hawaiian/Other pacific Islanders, and 5.1 among Hispanics/Latinos (CDC, 2013).

I was very surprised by these numbers and was reminded myself again that educating people who have lack of support and resources about the prevention disease are an important factor to reduce the incidence rate of STDs. In order to do that, healthcare providers at local and community center clinics should provide equal care to vulnerable and minority groups so everyone will get an equal chance to be healthy regardless of their background including religion, ethnicity, gender, income, disability, and sexual identity.  Enjoyed reading your post. Thank you !  

Centers for Disease Control and Prevention (CDC). (2013). Georgia, 2013. Retrieved from https://www.cdc.gov/std/syphilis2013/GA13.pdf  

I agree that it will be paramount for advanced practice nurses (APNs) to understand disease process so that they aid in decreasing transmission of disease. It will also be important that they understand the role disparities play in the epidemiological and disease process. Take for example, in a study conducted by Green, Levin-Rector, Hadler, and Fine (2015), 18 out of 41 communicable disease in New York City (NYC) were found to correlate with high poverty rates. This helps to demonstrate the effects poverty has on disease, supporting that disparities may have an instrumental impact on transmission of disease, as it may limit access to care, or places patients at higher risk for a disease. APNs will be leaders within addressing and revealing disparities so that they are decreased within the communities and populations they serve, seeking to increase the health and wellness of all individuals.

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During this week’s lesson measurements of outcomes were discussed. Through this I was able to learn key elements of measurable outcomes. The lesson also identified outcomes can be measured specifically both individually or within groups as they aid within development of patient care practices. It will be important for APNs to measure outcomes so that quality of care is maintained.

As the measurable outcomes now no longer revolve around mortality rates, but have shifted to a patient-centered care model. As the study by Rutten, van Vugt, Weerdt, and de Koning (2018) discovered, patients were more satisfied when the visits revolved around them and their thoughts on care, as well as sharing decisions with the physicians (2018). Comparison of outcomes will be paramount as they support patient care practices. APNs will need to also be knowledgeable about organizations that support comparison of outcomes so that patient practices and guidelines support evidence-based practice.

Take for example, the Patient-Centered Outcomes Research Institute (PCORI) is organization that seeks to support outcomes research in clinical practice take into account patient providers and perspective into research so that patient-centered outcomes can arise (Frank, Basch, & Selby, 2014).  Outcomes will seek to drive quality driven practices and aid in critical thinking so that patients receive optimal patient care and treatment. APNs will have the resources available to them to support them in measurement of outcomes. Measurable outcomes will be paramount as APNs appraise healthcare interventions so that they support safe healthcare practices. 

References:                                

Frank, L., Basch, E., & Selby, J. V. (2014). The PCORI perspective on patient-centered outcome research. Journal of the American Medical Association, 312(15), 1513-1514. doi:10.1001/jama.2014.11100 

Greene, S. K., Levin-Rector, A., Hadler, J. L., & Fine, A. D. (2015). Disparities in reportable communicable disease incidence by census tract-level poverty, New York City, 2006-2013. American Journal of Public Health, 105(9), 27-34. doi:10.2105/ajph.2015.302741 

Rutten, G. M., van Vugt, H. A., de Weerdt, I., & de Koning, E. (2018). Implementation of a structured diabetes consultation model to facilitate a person-centered approach: Results from a nationwide Dutch study. Diabetes Care, 41(4), 688-695. doi:10.2337/dc17-1194 

I was shocked to read these statistics regarding syphilis and the fact that an almost extinct disease now has a doubled rate and is considered an epidemic among MSM men. Dr. Anttila, I couldn’t agree more that although it is very important we have an advanced level of knowledge regarding syphilis and other STD’s it is crucial that we understand how disparities among different populations can impact their risk for contracting a STD. Darnesha you had great suggestions on reducing the incidence of syphilis. First and foremost, education is key. This education needs to be targeted at the population most at risk and provide resources for further information, counseling, etc.NR 503 Week 7 Discussion

You mentioned screening for all STD’s and I think this is also crucial.  The CDC’s current recommendations for different STD’s are not as inclusive as they should be, in my opinion, and this hinders physicians in asking the right questions, offering the right screening, and appropriate counseling. Providing easy access screening or even screening drives in impoverished or high risk areas would be very beneficial. Also, in my experience with my own teen, she did not realize that partners can be anonymously treated (Katz, 2014).

Through this option partners of those who test positive can receive medication anonymously without ever having to be tested or see a physician. Of course this brings up the issue of antibiotic allergies or overuse but when considering the pros and cons of treating even a possible STD far outweighs the possible negative implications. 

Katz, A. R. (2014). Insights in public health: The hidden epidemic: sexually transmitted diseases in 2014. Hawai’i Journal of Medicine & Public Health: A Journal of Asia Pacific Medicine & Public Health, 73(8), 265-267. 

 Katz, A. R. (2014). Insights in public health: The hidden epidemic: sexually transmitted diseases in 2014. Hawai’i Journal of Medicine & Public Health: A Journal of Asia Pacific Medicine & Public Health, 73(8), 265-267. 

It was very interesting to read your thoughts regarding sexually transmitted diseases (STDs) and their impact within the United States (US). It is important that we as future advanced practice nurses (APNs) seek to educate about STDs so that their transmission is reduced. With me being within the same geographical location as you, the large number of syphilis cases is alarming. Education will be of utmost importance as we move forward. Specifically, syphilis presents itself as a chronic infection that is the result of Treponema pallidum and is often acquired sexually.

Syphilis has many stages and its affects are often systemic in nature. Syphilis has also been known to correlate with Human Immunodeficiency Virus (HIV) infections, as it heightens one’s risk for developing or extending HIV to others. High prevalence of this disease is seen in men; specifically, men of younger age, African American males, men of homosexual orientation, and those with promiscuous sexual habits (Cantor, Pappas, Daeges, & Nelson, 2016). Georgia currently is 4th in the United States (US) for primary and secondary syphilis as of 2016 (Georgia Department of Public Health, 2017). The prevalence of syphilis within the US has maximized by 18% solely within the years of 2015 to 2016 (Centers for Disease Control and Prevention [CDC], 2017).

Given this, it will be import for APNs to thoroughly screen patients, as rates are on the rise both locally and nationally, so that there is a decreased transmission of the disease. Education will be key to aid in decreased transmission. Education points can include maintaining an exclusive relationship with someone who has been verified to not have syphilis and wearing condoms will aid in prevention, supporting safe sex practices (CDC, 2017). As you discussed by notifying partners if one is diagnosed with syphilis will remain influential as well as adequate screening, specifically for the at-risk population.

As of 2004, the US Preventative Task Force (USPTF) only supports regular screening for at risk populations and does not support them for populations who are not at risk (Cantor et al., 2016). By being knowledgeable about current screening guidelines and safe practices will seek to decrease the incidence and prevalence of syphilis at local, state, and national levels, specifically for those most at risk, including the state of Georgia. 

References: 

Cantor, A. G., Pappas, M., Daeges, M., & Nelson, H. D. (2016). Screening for syphilis: Updated evidence report and systematic review for the US Preventive Services Task Force. Journal of The American Medical Association, 315(21), 2328-2337. doi:10.1001/jama.2016.4114 

Centers for Disease Control and Prevention. (2017). Syphilis & MSM-CDC fact sheet. Retrieved from https://www.cdc.gov/std/syphilis/stdfact-msm-syphilis.htm 

Georgia Department of Public Health. (2017). Information about STDs. Retrieved from https://dph.georgia.gov/information-about-stds 

See  Also: NR 451 Week 4: Capstone Project: Milestone 2: Design Proposal (graded) Assignment