Analyzing the National Action Plan for Antibiotic-Resistant Bacteria as a Policy

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National Action Plan For Combating Antibiotic-Resistant Bacteria

Introduction

Since the discovery of penicillin, Antibiotics continues to play a crucial role in the healthcare sector by saving millions of lives of over the world. It is therefore disturbing to realize that some bacteria are becoming drug resistant, punching a big hole to all the gains made in the past and leading to the limited, expensive, and sometimes nonexistent treatment to the bacterial infections. The centers for disease control and Prevention (CDC) state that the condition is so serious estimating the drug-resistant bacteria leads to over 23,000 deaths and two million illnesses every year in the United States alone. The purpose of this assignment is to discuss the national action plan for combating antibiotic-resistant bacteria as a policy at the national level, which addresses a specific health issue.

The loss of the gains leading to lack of bacteria to kill bacteria points to the need to seek faster and reliable bacterial treatment for bacterial infections such as food-borne diseases, bacterial pneumonia and other healthcare related infections(Schmidt & Brown, 2014). As more bacterial strains become antibiotic resistance, there is a possibility of losing some modern medical procedures whose treatment and safety relies on the ability to treat and manage the bacterial infections. The National Action Plan for Combating Antibiotic-Resistant Bacteria acts as a guide through which the nation could face the challenge of the antibiotic-resistant bacteria (House, 2014).

The action plan mainly involves the procedures necessary for the implementation of the National strategy for combating antibiotic-resistant bacteria. It also addresses the recommendations of the policy by the president’s council of advisors on science and technology. The main role of the policy is to guide the US. Government’s activities, but is also designed for the purposes of guiding the healthcare, public health and also the veterinary to urgently respond to the drug-resistant threats facing people in the United States and the entire world population.

The policy relies majorly on the collaborations between the U.S Government and foreign governments, organizations, and individuals who have the same desire of strengthening public health, healthcare, veterinary medicine, food safety, manufacturing, and research (Centner, 2016). Aggressiveness in these areas would ensure major steps towards the reduction of the drug resistance threats including the Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA) and carboapenem-resistant Enterobacteriaceae (CRE).

Significance Of The Policy To Nursing

The national policy provides a guide to all the professionals in the public health and healthcare sector. It affects the nursing programs dedicated towards the fight against the antibiotic-resistant bacteria.one such program is the antibiotic stewardship programs, which acts as the tool for nursing in fighting the healthcare threat. Through the antibiotic stewardship program, nurses engage successfully in ensuring that the effective implementation of such government policies(Schmidt & Brown, 2014). The policy motivates and calls upon the nursing fraternity to continue playing important roles in the antibiotic stewardship programs in their hospitals. The policy emphasizes the need to ensure safety in the administration of the antibiotics and effectiveness in the monitoring exercise and process.

The policy incorporates the nurse’s role by strengthening CDC’s core elements of hospital antibiotic stewardship programs. Through these programs, the policy aims to ensure the achievement of the best clinical outcomes in the administration of antibiotics while reducing the toxicity of the antibiotics among other adverse side effects. It also calls upon the nursing fraternity to reduce the number of adverse events resulting from the use of antibiotics, thereby limiting the occurrences of antibiotic-resistant bacterial strains. The CDC released the core elements to on the realization that antibiotic stewardship programs require the active participation of health care nurses in order to achieve optimal success.

Nurses play a significant role and have the largest influence on the patient outcome. They also form the largest part of the healthcare professionals, interacting most of the time with the patients. Therefore, nurses are in the middle of the patient care, hence cannot remain behind in the policy implementation process (Centner, 2016). They form the pillar of the patient-care team, ensuring coordination, continuity, and consistency of care.

The nurses in the frontline have the important duty of administering the antibiotics to the patients. In addition, most importantly, nurses are the last healthcare professionals to examine the suitability and appropriateness of the prescribed antibiotics medication before administering them to the patients (Schmidt & Brown, 2014). The national action plan for combating antibiotic-resistant bacteria outlines five main ways in which nurses contribute to antibiotic management and reduction of future emergence of antibiotic-resistant bacteria strains. The five points established through the policy influence the role of nurses significantly.

Ensure the Availability of Relevant Information Pertaining To Antibiotics At The Point Of Care

Some hospitals unnecessarily continue the use of antibiotics because the clinicians are not sure of the reason for the initiation of the antibiotic and the period of administration. The same applies to a direct-care nurse with no idea for the administration of the antibiotic. The nurse might have difficulty in suggesting a change or stoppage of the antibiotic administration. Access to the relevant information about the antibiotic therapy reduces the nurse’s reluctance to request for change or stop the use of antibiotics.

Examine the Antibiotic Administration Route

Switching a patient early from the I.V to the oral therapy reduces the number of days they stay in the hospitals and minimizes the risk of infection from the I.V catheter access. The nurses would assess their patients daily to establish the appropriateness of the I.V antibiotics. Discussion of any doubt or inconsistency with the physicians and other members of the team should follow immediately to allow switching to oral therapy when necessary.

Reevaluation of the Antibiotic Therapy in 2-3 Days

Normally, the administration of the antibiotics occurs before the physicians achieve the full picture of the patient’s clinical condition (House, 2015). After 2-3 days, the doctors obtain the report on the patient’s clinical and microbiology status. The physicians must discuss this report with the nurse, who should seek further information in cases she does not fully understand the report (Schmidt & Brown, 2014). The nurse should hold further consultation with the physician or ask other members of the healthcare team to establish if the antibiotic is still effective or relevant to the illness. If the available information shows that the patient still requires the antibiotics, the nurse should advocate for the narrow-spectrum antibiotic therapy and request for further clarification on the duration of the treatment. During this time, the nurse would keenly monitor the patient’s condition to establish any potential side effects.

Reassess the Antibiotics Treatment In Case Of C. Difficile Infection

When a patient develops the C. difficile, the first step is to evaluate the antibiotic therapy of the patient and put a stop to all the unnecessary antibiotic drugs. If the patient requires the C. difficile diagnosis then the nurse should review the antibiotics prescribed for the patient and have a discussion with the physician whether all the recommended antibiotics still exist.

Merge the Antibiotics during Patient Care Shifts

The patient care involves regular shifts among the healthcare providers and healthcare stations. To minimize inappropriate use of antibiotics during the shifts, nurses evaluate the relevance and requirements of the antibiotic therapy at the care transition points(Schmidt & Brown, 2014). The most significant transition points include the hospital and outpatient and between facilities such as the general care and intensive care unit. The direct care should have a discussion on the duration and indication of the antibiotic therapy with other team members such as fellow nurses during their change of shifts. The discussions should appear on the change-of-shift report.

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How the Health Policy Eradicates the Problem

The foundation of the national health policy is on the understanding of the factors that promote the emergence of antibiotic-resistant bacteria. Misuse or overuse of the antibiotic drugs is one of the reasons behind the faster emergence of the antibiotic-resistant bacteria strains. The practice hastens the development of such bacteria leading to reduced or loss of efficacy of the drugs (DeNisco & Barker, 2013). One health approach is important for the detection and controlling of the antibiotic-resistance. Evidence-based control practices help in preventing the spread of antibiotic-resistant strains. Interventions are crucial to enhance the investment of private sector since the current interest for the private sector is low(Schmidt & Brown, 2014). Researchers could use new technologies and innovations to develop health tools for next generations, which aim to strengthen human health. From these points, the policy aims to eradicate the problem by its five main goals:

Slow the emergence of resistant bacteria and prevent the spread of resistant infections

Careful and appropriate use of the antibiotics in agriculture and healthcare settings is important in slowing down the emergence of the antibiotic-resistant strain while extending the duration of antibiotic effectiveness. The antibiotics have an important use in healthcare hence their preservation would require collaborations from healthcare professionals, leaders, patients, agricultural sector, pharmaceutical organizations and the veterinarians.

The activities under this goal include the careful use of vaccines in the prevention of infections, implementing antibiotic stewardship programs and healthcare policies, and reduce the development of antibiotic-resistant strains (Grove, Burns & Gray, 2014). The policy aims to ensure that every patient under antibiotic therapy receives the right kind of antibiotic, at the appropriate time, at the right dose and duration. The policy promotes faster detection and controls disease outbreak and regional coordination as measures of preventing the resistance.

Strengthen national one-health surveillance efforts to combat resistance

The policy advocates for improved control and detection of the antibiotic-resistant strains through an exclusive “one-health” approach that comprises measures to enhance and integrate information from the health surveillance system responsible for observing the human pathogens(Schmidt & Brown, 2014). The established systems that serve this purpose include the national healthcare safety network, the emergency infection programs, and the national microbial resistance monitoring. The policy aims to integrate data from these systems with data from other surveillance systems such as the national animal health monitoring system, the national animal health laboratory network, and veterinary laboratory investigation and response network.

The activities under this goal would entail the creation of the regional public health laboratory network responsible for the provision of a standardized avenue for the testing of resistance and capacity advancement for the bacteria genetic characterization. Through this goal, the policy would also ensure keen observation of the antibiotic use, sale, management, and resistance at different points within the food-production chain, from farmers to the processing factories and to the supermarkets.

Advance Development And Use Of Rapid And Innovative Diagnostic Tests For Identification And Characterization Of Resistant Bacteria.

The policy aims to improve the diagnostic procedure for detecting the resistant bacteria strains and characterization of their resistance patterns to assist healthcare providers in making treatment decisions (Chism, 2017). The improved diagnostic procedure helps in reducing the inappropriate use of antibiotics in the hospitals. The activities include under this goal include the acceleration of the development of new diagnostic procedures and expansion of their use and availability to enhance treatment, improve infection control, and achieve rapid response to outbreaks and infections resulting from resistant bacterial pathogens with the hospital settings or the community.

Accelerate basic and applied research and development for the new antibiotics, other therapeutics, and vaccines

The current number of research and projects aimed towards drug development remains small lack significant commercial interest, despite the great need for new antibiotics in the healthcare sector. The policy aims to promote awareness and advocacy on the need to have more efforts directed towards the improvement of drug development including the traditional treatment methods (Cherry & Jacob, 2016). The efforts would focus on improving the scientific research, attracting investment from the private sector, and facilitation of clinical trial of the new drug. The policy supports these objectives by providing support to basic and applied research initiatives, providing the necessary scientific services to the scientists and promoting public-private partnership leading to stronger frameworks for clinical trials and reducing the possible risks, obstacles, and uncertainty by organizations that develop new antibiotics and other vaccines that could lead to development of resistance.

Improve international collaboration and capacities for antibiotic-resistance prevention, surveillance, control and antibiotic research and development

The health concern of antibiotic resistance is a global problem that the U.S Government cannot handle alone without collaboration with other governments(Schmidt & Brown, 2014). The activities under this goal include close collaborations with foreign ministries of agriculture and health, food and agriculture organizations, world health organization, world organization for animal health, among other multinational organizations to promote detection, analysis, reporting antibiotic resistance, and use all over the world.

The activities also include the prevention and control of antibiotic-resistance, and the creation of incentives to promote the development of diagnostics and therapeutics(Schmidt & Brown, 2014). Promotions of these objectives require that the U.S governments support the developments of WHO global actions on antimicrobial resistance, improve international associations including close collaborations with the European Union- United States Trans-Atlantic Task Force On Antimicrobial Resistance (TAFTAR), and mobilizing the universal health resources through the Global Health Security Agenda.

Nurse’s role in the Health Policy advocacy as a Professional Nurse

The nurses have great influence both in the formulation and in the implementation of the health policies (Brownson, et al., 2017). This policy provides a platform for the nurses to engage actively in the development of the national health policy and effectively control their nursing practice. In this manner, the nurses have a critical role to play in ensuring the success of the health policy. The nurses need to develop necessary policy-making skills to tackle the professional challenges that might arise from the policy. The nurses also have valuable and unique perspectives because of their diverse values, experience, advocacy skills, and professional ethics.

The policy would require increased nursing presence, influence, and role in the process of its implementation. They would identify the issues that affect the smooth implementation of the policy and work closely with other healthcare professionals to promote the principles of the national health care policy (Arabi, et al., 2014). In this process, the nurses must understand power levels involved in the policy implementation as well as the people who control the resources in their respective healthcare organizations and facilities. This goes without saying that the nurses’ involvement would affect patients and their families as well as the nurses themselves. Their role is to ensure the protection of the patient’s safety, enhanced quality of care and facilitation of access to these resources, as well as promoting quality of healthcare in their organizations.

Most primary healthcare providers consult with the local nurses to ensure effective service delivery. It is therefore clear that the nurses are at the forefront of promoting the principles of any particular health policy (Schmidt & Brown, 2014). The role of nurses also comes out clearly as of great importance in ensuring the success of the policy and ensuring that the masses reap the benefits of the policy. The policy challenges the nursing fraternity to take up active roles in ensuring its success in their workstations. It also challenges other healthcare professionals to improve their collaboration with the nurses in their healthcare facility. Nurses have the most interaction with the patients hence should assist other professionals to achieve higher patient outcomes.

Conclusion

The discussion demonstrates that the national action plan for combating antibiotic-resistant bacteria is an important healthcare tool. The policy includes the various measures and strategies through which the government and other healthcare organizations and personnel can improve health care status of the population. The four main goals of the policy cover all the necessary steps involved in eradicating the emergence of the antibiotic-resistant bacteria. The aspect of close collaboration with other entities comes out clearly from the health policy. The collaboration among the healthcare entities is important for effective implementation of such health care policies. The article also highlighted the importance of intergovernmental collaborations in combating global health problems.

In the recent times, there are calls to have antibiotics dropped as measures of treating bacteria. Some of these argument states that the use of the antibiotics is the cause of the résistance. While this could be true, a proper use and the measures recommended in this policy would be the best solution to stopping resistance. However, this remains a question for every medical student to ask himself or herself. Let every student find out for herself or himself the best way to take regarding the use of antibiotics.

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