Necrotizing Enterocolitis in the Premature Infant

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Neonatal Nurses’ Knowledge and the Assessment of Necrotizing Enterocolitis (NEC) in the Premature Infant

This research project focuses on necrotizing enterocolitis (NEC) and how the web of causation relates to the development of this gastrointestinal emergency. NEC is one of the most common conditions seen in NICU’s per a study done by the Cleveland Clinic in 2015. To improve outcomes of these neonates, the web of causation was applied during research because it was determined that this process was not a result of a single causative factor, but a result from multiple factors (McEwen & Wills, 2019). The only known factor that attributes to NEC is premature delivery and other factors are added then leading to the development of NEC. A theory that has been proposed is the likelihood that a bacterial invasion has occurred is seen in NEC cases. The importance of this research study was to educate bedside nurses to know and understand the common signs that lead to NEC to prevent further progress of the disease. If bedside NICU nurses can identify the early signs of NEC, one or more factors may be prevented that will ultimately lead to improvement of care in these patients and prevention of NEC and the need for surgical intervention.Necrotizing Enterocolitis in the Premature Infant

Van Hoose, K. T. (2019). Neonatal Nurses’ Knowledge and Assessment of Necrotizing Enterocolitis (NEC) in the Premature Infant.

McEwen, M., & Wills, E. M. (2017). Theoretical basis for nursing (5th ed.) Wolters Kluwer Health.

A Review on Theories and Models of Disease Causation for COVID-19

This article describes the study of epidemiology and how it is used to determine a pattern of a specific area in regards to the spread of COVID-19. A discussion is provided about the origination of the novel coronavirus in Wuhan, China. It is a zoonotic disease that initiated in bats, jumped to an unknown host, suspected to be the pongolin, then was consumed by shoppers at the Huanan sea food market (Dangi & George, 2020). The epidemiological theory used in this article is the epidemiologic triangle. Our textbook describes this as “an interrelationship among the three essential components of host, agent, and the environment” (McEwen & Wills, 2019). The agent in this case of COVID-19 is a virus that originated in bats. The host is the bats that originally carried the disease that was then passed on to human hosts. The environment is that where the virus could incubate and spread. The seafood market in Wuhan was a breeding ground for the disease due to the population density and climate that promoted the virulence of COVID-19 (Dangi & George, 2020).

Dangi, R. R., & George, M. (2020). A Review on Theories and Models of Disease Causation for COVID-19. Available at SSRN 3584080.

McEwen, M., & Wills, E. M. (2017). Theoretical basis for nursing (5th ed.) Wolters Kluwer Health.

example 2

Oropharyngeal Decontamination with Antiseptics to Prevent Ventilator-Associated Pneumonia: Rethinking the Benefits of Povidone-IodineNecrotizing Enterocolitis in the Premature Infant

The article “Oropharyngeal Decontamination with Antiseptics to Prevent Ventilator-Associated Pneumonia: Rethinking the Benefits of Povidone-Iodine” focuses on how bacteria in the oropharynx can lead to ventilator-associated pneumonia. It is described that there are many techniques we use in in our everyday practice to prevent the decontamination of the oropharynx. These preventative strategies include; monitoring cuff pressures, hand washing, oral antibiotics, and oropharyngeal rinsing with antiseptics (Bassi, et. al., 2014). The research within this article is testing whether povidone-iodine should be used to prevent ventilator associate respiratory infections. This study used 3.3% solution of povidone-iodine or saline in patients that were intubated. The results showed that the povidone-iodine solution has a greater decrease in oropharyngeal colonization than saline but did not prevent VAPs (ventilator associated pneumonia). However, a similar study was conducted and did show a decrease in VAPs with the use of the povidone-iodine rinse. A theory was then created that the incidence of VAPs could have increased in the first study because of the incidence of pulmonary aspirate. The study then concluded that povidone-iodine solution only works in the oropharynx not in aspirated pathogens. Overall, the article concluded that povidone-iodine may not be the solution to preventing VAPs and Chlorhexidine should be considered as the first line approach.

Gene discovery: From biological plausibility to genetic evidence supporting disease causation

The article “Gene discovery: From biological plausibility to genetic evidence supporting disease causation”, introduces the idea of that genetic evidence can lead to certain diseases. It is noted that before we had DNA sequencing technology, the “diseases without genes” phenomenon was prevalent. With this new technology, we can now determine gene variations that may lead to some diseases. The article introduces the KCND3 gene that is present in arrhythmias, as the cause of early repolarization syndromes. This specific gene has a mutation that affects potassium channels in action potential. This makes the KCND3 patient vulnerable to ventricular fibrillation. Gollob states that the KCND3 gene has been prevalent in patient that have arrested due to VF. However, this gene is also present in some patients that have the gene mutation associated with intellectual disability and epilepsy but not arrythmias. Overall, the “genetic testing services routinely test these genes in patients, and allied professionals are tasked with interpreting genetic variants in genes that may not have clinical validity for disease, creating a risk of misdiagnosis and patient harm” (Gollob, 2019, p.1708). The study introduced how disease causation could be determined by a specific sequence of genes. However, the validity of the conclusion is variable and will continue to be researched.

References

Bassi, G.L., Rosa, F.D., Marti, J.D., Terraneo, S. (2014). Oropharyngeal Decontamination with Antiseptics to Prevent Ventilator-Associated Pneumonia: Rethinking the Benefits of Povidone-Iodine. Critical Care Medicine Journal. 42(1). DOI: 10.1097/CCM.0b013e3182a84bcb

Gollob, M.H. (2019). Gene discovery: From biological plausibility to genetic evidence supporting disease causation. Heart Rhythm Society. 16 (11). 

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