Summary
Despite advances in treatment, hepatitis C virus (HCV) infection continues to be a major global health concern. It is projected that a significant portion of the population of the world is chronically infected by the virus, with many of those affected developing liver cancer or liver cirrhosis. Despite the fact that the disease is treatable, Lee et al. (2020) found that neglecting Hepatitis C symptoms and disregarding therapeutic recommendations led to an acute state. Hepatitis C is caused by a contagious virus that is primarily transmitted through exposure to infectious people’s blood. Hepatitis C infection is more common in individuals who work in hemodialysis units, hematology and physiological (tuberculosis) units, receive organ transplants, give blood, and are blood donors. This PICOT study examines the effect of timely testing among patient populations on the earlier detection of infection spread.
PICOT Question: Is mandatory hepatitis C screening better than no screening in terms of detecting the virus within 12 months for patients with immune problems?
Background
Patients who have long-term immune issues are the ones most susceptible to contracting hepatitis C. They tend to have very weak immune systems thus, it is easier for them to contract hepatitis C compared to others. Koniares et al. (2020) conducted a study with an aim to find out whether universal Hepatitis C screening is more impactful than risk-based screening in pregnant women. From the study, they realize that patients with immune issues contact hepatitis C easily when compared to others. As a result, the study wonders if risk-based screening is as impactful as universal screening. Pregnant women, kids, the elderly, and those who have had liver transplants, for instance, are some of the most vulnerable demographics (Koniares et al., 2020). Regular hepatitis C testing can lower the number of people who have undiagnosed chronic liver infections. Regular screening may also affect the overall success of hepatitis C treatment. Universal screening can help prevent the spread of hepatitis C, advance early infection diagnosis, and streamline efficient treatment strategies.
The study was conducted to investigate the efficacy of hepatitis C screening in populations with compromised immunity. The study was done by Lee et al. (2020), and they wanted to see if community-based hepatitis C screening among drug addicts could help reduce infection spread. The study’s goal is coherent with nursing research because drug abusers are among those with immune deficiencies. Further, despite the fact that the disease is easy to treat, found that neglecting Hepatitis C symptoms and disregarding therapeutic recommendations led to an acute state.
The importance for nursing is that such a system can be incorporated into the regular operations of a medical facility without adding to the workload of the staff. Park et al. (2021) sought to investigate the effects of the created risk-based screening and treatment program, which enables a medical facility to carry out the required tests to identify hepatitis C. The goal of the study is to determine how well the risk-based screening test works in preventing infections so that they can be treated quickly.
The relevance of nursing is found in the development and application of a program and system aimed at substantially enhancing the process and system that can impact medical practices infection. Patel et al. (2020) investigate various HIV prevention and treatment systems to determine barriers to the spread of this contagious diseases. The study’s goal is to highlight innovative HCV care models. The same procedure can be used in developing and implementing a program that can be used in screening the contagious hepatitis C virus.
How do these four articles support the nurse practice issue you chose?
My PICOT question is focused on mandatory hepatitis C screening. Whether it is better than no screening in terms of detecting the virus within 12 months for patients with immune problems. To support this PICOT question, Koniares et al. (2020) focus on screening expectant mothers to provide the response to the question. The expectant mothers are part of vulnerable patients who have a high risk of hepatitis C contamination. Inconsistencies among healthcare professionals in determining risk factors for hepatitis C virus infection are highlighted by the study intervention. Similar to this, Lee et al. (2020) assessed the efficiency of hepatitis C screening among populations with immune system issues. The articles support my research PICOT question that screening in high-risk environments revealed a significant hepatitis C stigma and the importance of reflex testing.
To find out whether mandatory hepatitis C screening is better than no screening, it is better to understand the effects of the risk-based screening program. Park et al. (2021) sought to investigate the effects of the created risk-based screening and treatment program, which enables a medical facility to carry out the required tests to identify hepatitis C. The goal of the study is to determine how well the risk-based screening test works in preventing infections so that they can be treated quickly. The article will answer the PICOT question by determining how the program works for ease in treatment of hepatitis C.
Method of Study
The four research papers used various methodologies to evaluate hepatitis C virus screening processes in high-endemic populations. Lee et al. (2020) used the experimental approach method, whereas Koniares et al. (2020) used the survey method. Inhabitants and physicians who provide obstetrical care were sent a 10-question electronic survey (Koniares et al., 2020). Between 2016 and 2018, the experimental research was carried out in shelters, drug treatment facilities, and Federally Qualified Health Centers that participated in the screening. A coordinator was required to assist people in confirming their viremia and connecting with treatment for substance abuse or primary care practitioners who administer hepatitis C treatment (Lee et al., 2020). The results of all stations’ experiments were evaluated to assess the effectiveness of screening in high-risk settings.
Results of Study
According to the study’s findings, screening and the detection of Hepatitis C in vulnerable populations are strongly correlated. For instance, the Koniares et al. (2020) survey revealed that because medical providers are conflicting in identifying risk factors, risk-based testing for the Hepatitis C virus may be less effective than universal screening. The number of hepatitis C virus infections that go unrecognized during pregnancy could be lowered with universal screening. The discovery is important for nursing practice because it sheds light on the necessity of prenatal screening for all women.
The results obtained show that the novel method of hepatitis C diagnosis is promising. Consequently, 4525 individuals underwent a screening test; of these, 131 (2.90%) tested positive for HCV antibody and 43 (0.95%) for HCV RNA, showing that only 33% of those with a favorable screening test had a chronic infection (Park et al., 2021). With an LTC rate of 60.5%, 26 out of 43 chronic hepatitis C patients who were diagnosed showed up for their initial consultation with specialists.
The efficiency of community-based testing programs for patients at drug treatment facilities was assessed in the second study. The findings showed that drug users are at a high risk and should be examined for Hepatitis C when they enter healthcare centers (Lee et al., 2020). The findings increased nursing practice’s awareness of the significance of concentrating on high-risk populations (drug users), which are typically disregarded by public health. In their efforts to eradicate Hepatitis C from society, nurses should bear in mind these weak patients.
Increased funding for caring services reimbursement, the ability to bill and compensate for outpatient HCV therapy in society settings, the removal of DAA restrictions, and innovative payer models may all help to promote greater adoption of HCV care (Patel et al., 2020). Effective national models have expanded DAA coverage, mobilized political action, controlled costs, decentralized treatment delivery by removing prescription restrictions, and transferred obligation from specialists to primary care.
Ethical Considerations
One example of an ethical consideration in any studies involving the collection of data from people is getting permission and approval for your study. The research goals and design must be evaluated by review boards or other responsible authorities to see if they are morally righteous or adhere to your institution’s code of conduct. Following this rule, Koniares et al. (2020) submitted their request for approval to the Tufts Medical Center Institutional Review Board. Similar to this, Lee et al. (2020) submitted their research for the University of Alabama at Birmingham (UAB) review board’s approval. These studies obtained approval from the appropriate authorities in accordance with the right procedure.
Another important ethical factor in subject-based research is voluntary participation. Without any coercion or pressure, research participants are free to decide whether to participate (Kaewkungwal & Adams, 2019). Frontline staff were mandated by Lee et al. (2020) to let patients know that they would be offered a free, private HCV antibody test unless they objected. Similar to this, Koniares et al. (2020) sent the surveys via email to the attending physicians and residents with their consent. As a result, both study participants were aware of their options for stopping or continuing participation.
Outcomes Comparison
The primary goal of the PICOT question is to determine whether requiring hepatitis C screening improves upon not requiring screening in terms of diagnosing the virus in patients with immune issues within a 12-month window. Both studies’ findings exactly match the PICOT question. Through various analyses, the four studies come to the anonymous conclusion that hepatitis screening is crucial for patients. As a result, both articles demonstrated significant implication to the PICOT question and also came to the same conclusion.
Proposed Evidence-Based Practice Change
The PICOT study aims to identify the relationship between hepatitis C screening and immune-related patient within a 12-month window. The question seeks answers to whether requiring hepatitis C screening improves upon not requiring screening in terms of diagnosing the virus in patients with immune issues within a 12-month window. Koniares et al. (2020) conducted a study with an aim to find out whether universal Hepatitis C screening is more impactful than risk-based screening in pregnant women. According to the study, patients with immune disorders are more likely than others to contract hepatitis C. Hepatitis C infections are thus a threat to patients with weakened immune systems and to public health, making them an important topic in the nursing profession. Community nursing careers therefore need to be aware of the consequences of hepatitis C and how it spreads. The studies will be substantial in helping prove the importance of hepatitis C screening to patients who have immune related issues. The significance of this research in clinical practice is aiding in the prevention of possible spread of the infection to patients.
References
Kaewkungwal, J., & Adams, P. (2019). Ethical consideration of the research proposal and the informed-consent process: An online survey of researchers and ethics committee members in Thailand. Accountability in Research, 26(3), 176-197. Web.
Koniares, K., Fadlallah, H., Kolettis, D., & Vindenes, T. (2020). Hepatitis C virus screening in pregnancy. American Journal of Obstetrics & Gynecology MFM, 2(3), 100-123. Web.
Lee, A., Karumberia, S., Gilmore, A., Williams, E., Bruner, N., Overton, E., Saag, M, & Franco, R. (2020). Hepatitis C among high-risk Alabamians: Disease burden and screening effectiveness. The Journal of Infectious Diseases, 222(5), 365-375. Web.
Park, J. S., Wong, J., & Cohen, H. (2021). Hepatitis C virus screening of high-risk patients in a community hospital emergency department: Retrospective review of patient characteristics and future implications. PLOS ONE, 16(6), e0252976. Web.
Patel, A. A., Bui, A., Prohl, E., Bhattacharya, D., Wang, S., Branch, A. D., & Perumalswami, P. V. (2020). Innovations in hepatitis C: Screening and treatment. Hepatology Communications, 5(3), 371–386. Web.
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