The Effectiveness of Personal Care in the Management of Corona Disease - Research Proposal Example

Concept Plan Name Registration No: Institution Date 1. Introduction Corona disease is an example of diseases that continue to affect people in various ways. It is a disease that is associated with negative impacts on the respiratory system as well as its ability to spread easily from one person to another. Health personnel have also experienced difficulties in implementing measures that can contribute to prevention of the spread of corona disease among patients (Alagaili et al. 2014). However, it has been suggested that personal hygiene can contribute significantly towards a reduction of infection of healthy people in a number of ways. The use of personal protective equipment has been identified as a method that can contribute towards prevention of the disease in a significant manner.This paper presents an investigation of the effectiveness of personal care in the management of corona disease. Specifically it focuses on the practice of washing hands using personal protective equipment (PPE) as a method of reducing the spread of corona disease. 1.1. Research Question: The research question for this study was: What is the effectiveness of personal protective equipment (PPE) in self-care management in the effort to prevent the spread of corona disease among the populations of Saudi Arabia? 1.2. Aim The aim of this study was: To determine how self-care can be implemented in controlling the spread of corona disease among health care workers in Saudi Arabian health institutions. 1.3. Objectives The objectives that this paper tries to achieve include the following: I. To establish various personal care methods that can enable prevention of the spread of corona infection II. To establish signs and symptoms or corona disease III. To promote good hygiene practices that prevent corona disease infections IV. To determine the effectiveness of hand washing using personal protective equipment (PPE) in preventing corona infection 2. Literature Review 2.1. Corona disease Corona disease is a respiratory disease that affects the various parts of the respiratory system such as the nose, sinuses and upper sections of the throat (Azhar EI et al, 2014). The virus is mainly spread in a similar manner that cold-causing viruses are spread from one person to another such as through coughing, touching an infected person or touching things such as knobs that have been touched by infected people and sneezing. Some forms of the disease are serious and it has been reported that more than 100 people have died as a result of Middle East respiratory syndrome (MERS), which was reported initially in Saudi Arabia followed by other countries in the Middle East as well as in Europe and Africa (Bermingham et al, 2012). The first American to be infected with the disease was reported in April 2014 in Indiana. The patient had just arrived from Saudi Arabia (http://www.who.int/csr/disease/coronavirus_infections/en/). There have also been increased cases of deaths as a result of respiratory syndromes. 2.2. Patient under investigation definition Clinical definition: An individual with acute respiratory syndrome may experience fever up to 30oC as well as coughing. This may result into the need for hospitalization. Epidemiological criteria: Contact should be made within the previous 10 days before the illness occurs when a person travels to an area that has been subjected to infection or an area where it is suspected that the infection could have occurred. Probable novel coronavirus case: A person that needs to be defined to have clinical and epidemiological definition explained above but does not have laboratory confirmation. Symptoms of Corona According to WHO The main symptoms include shortness of breath, infection of organs such as lungs that can result into renal failure or severe systemic bleeding. The affected person may also experience fever and diarrhoea. Positive diagnosis tests may include: Positive polymerase chain reaction (PCR) which is an implication that there is no presence of the virus. Positive antibody tests results which are an indication of previous infection with SARS-CoV and Seroc conversion from positive to negative. Negative diagnosis tests may include: PCR results that do not exclude SARS-CoV PCR due to the infection of the patient with coronavirus or illness from another infection or incorrect test results. Negative antibody result may include no detection of antibody in the next 1 days after the onset of the illness showing that there is no infection with SAR-CoV. 2.3. Symptoms of corona disease The symptoms of corona disease are similar to those that affect upper respiratory section and include coughing, running nose, and sore throat and in some cases fever. A person who is affected by the disease may not have information about the disease until after sometime when the symptoms become severe (Cox, Posner & McPheeters M et al. 2006). A person who wants to establish whether he or she is suffering from corona disease can get tests such as nose and throat cultures in order to determine whether the cold resulted from coronavirus, but it is not necessary. However, when there is a spread of the infection to the lower respiratory tract, pneumonia can be experienced, particularly among old people who have heart diseases as well as those who have weak immune systems. 2.4. Various methods of personal care that prevent the spread of corona disease Due to contagious nature of corona disease, it has been necessary to ensure people are protected from the disease. Personal care has been identified as an example of the best strategies that facilitate prevention of the disease. For instance, some people have ensured they are protected from the disease by not sharing personal items such as clothes, food, cups and drinks with those who have the symptoms of the disease. Another strategy has been isolation of a person who has been infected so that the person gets treatment first before being allowed to associate with healthy people. Since dust is a major contributing factor to this disease, people have ensured rooms are kept free from dust while children have been isolated from dusty environments. In addition, facilities such as utensils and chairs in rooms have been kept far away from dust so that people who use them do not get infected with corona disease. 2.5. How to promote hand washing using PPE in prevention of corona disease Since the discovery of the outbreak of corona disease in Saudi Arabia, it has been recommended that health professionals should use personal protective equipment at all time while attending to patients affected with the illness so that they are not infected with the disease (Tran et al. 2012). In addition, Occupational Health and Safety Act requires that employers must ensure employees are provided with personal protective equipment PPE so that they are protected from hazards at work place such as dust that may contain corona virus that is highly infective. The equipment should be subjected to constant inspection to determine whether there is any damage or worn out part as well as ensuring they are effectively maintained in order to prevent virus penetration in case a person comes into contact with the virus (Krumkamp, Duerr & Reintjes R et al. 2009). Workers are expected to use personal protective equipment during hand washing according to the instructions of the seller and workers are required to follow instructions and training provided on the use of PPE (Oboho et al. 2014). When health workers establish that they are exposed to a person being investigated, they are required to report the exposure to their seniors at the workplace so that measures can be taken to prevent exposure to the virus (Svoboda et al 2004). If the person under investigation is established to pose high risk of infecting health professionals risk assessment has been suggested as a method of determining the next step (Madani et al. 2014). This involves establishing gaps and determining areas where improvements can be implemented to prevent the spread of the virus to healthy people. Table of Sources Study country Study Design Research question Sample Measures Control variables Results Bermingham et al. (2012) Saudi Arabia Retrospective cohort What are self management strategies for prevention of corona disease? Public health care workers Independent variables: health management practices Dependent variables: number of sick people Rate of infection reduced by 20% for areas where self care was implemented Madani T.A, Althaqafi A. &, Alraddadi B.M. (2014). Saudi Arabia Qualitative Research What measures can enable prevention of corona infection? Patients with corona disease Independent variable: Number of health providers Dependent variable: Number of recovered patients Unattended coronary patients High rates of reduction of corona infections Azhar EI et al. (2014) USA Qualitative What methods of transmission are involved in camel-human corona transmission? Patients with corona disease Independent variable: Number of infected camels Dependent variable: Infected humans Patients not in contact with infected camels Reduction of corona infection by 37% for patients who are not in contact with infected camels Alagaili AN et al. (2014) Saudi Arabia Retrospective cohort What is the method of camel-human corona infection? Camels and patients with corona infections Independent variable: Infected camels Dependent variable: Patients with corona infection in contact with camels Camels and patients without corona infections An increase in infection of people who are in contact with infected camels by 28%. Madani, Althaqafi &, Alraddadi, (2014) Saudi Arabia Qualitative Research What factors contribute to corona disease? Residents of Jeddah with corona disease Independent variable: body contact, personal hygiene Dependent variable: Time of infection Residents without corona infection Increase in corona infection for those who were in contact with infected people by 30% Jefferson T, Del Mar CB, Dooley L et al. (2011) Saudi Arabia Qualitative Research What are physical intervention methods for preventing corona infection? Residents of Saudi Arabia Independent Variable: Number of households Dependent variable: Number of intervention strategies Uninfected persons Decrease in corona infection for people who have access to physical interventions by 54% Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. (2012 Saudi Arabia Qualitative Does the use of aerosol transmissions contribute to increase respiratory infections among health workers? Employees of health care institutions in Saudi Arabia Independent Variable: The use of aerosol transmissions Dependent variable: Number o infected employees Hospitals that do not use aerosol procedures Increase in respiratory infections by 23% in hospitals where health workers use aerosol transmissions. Dolan GP, Harris RC, Clarkson M et al. (2012) Saudi Arabia Mixed Research What is the effect of vaccination in preventing respiratory diseases Residents of Saudi Arabia Independent variable: Amount of vaccine Dependent variable: Number of infected individuals Areas where vaccination is not provided Infected vaccinated people were 30% less compared to those who are not vaccinated Krumkamp R, Duerr HP, Reintjes R et al. (2009) Saudi Arabia Mixed Research What is the effect of public health interventions in preventing respiratory diseases infections? Residents of Riyadh, Saudi Arabia Independent variable: Personal hygiene, protective equipment Dependent variable: Number of infected persons Those who were not provided with intervention programs Those who implemented self-care programs had 25% decrease in infections compared to an increase by 23% for those who did not Cox S, Posner SF, McPheeters M et al. (2006) Saudi Arabia Qualitative Research What is the rate of infection of pregnant women during influenza outbreak? Saudi Arabian pregnant women with influenza Independent variable: Number of infected women Dependent variable: Number of pregnant women Infected women who are not pregnant The number of infected pregnant women was 47% higher than those who were not pregnant Davis MM, Taubert K, Benin AL et al. (2006) Saudi Arabia Mixed Cohort research What is the effect of vaccination on prevention of respiratory infections? Saudi Arabian residents Independent variable: Number of vaccination centres Dependent variable: Number of infected people People who are infected but not vaccinated An increase in number of infections by 17% when there is no vaccination Svoboda T, Henry B, Shulman L et al.(2004) Canada Mixed Cohort research What are public health care measures to be implemented during an outbreak of respiratory diseases? Toronto residents Independent variable: Role of education, personal care Dependent variable: Number of infections People living in areas where public health care measures have not been implemented. Those wo lie in areas where public health care measures were not implemented had a higher number of infections 35% compared to areas where health care measures were implemented (13%) Methods This section involves a study that will be conducted to determine the effectiveness of personal care by use of personal protective equipment (PPE) in preventing the spread of corona disease in the population of Saudi Arabia. The following are the main concepts of this research: Hypothesis: Personal care using personal protective equipment contributes to prevention of corona disease infection Variables: Independent variables: These are variables that do not change with the change in responses provided by participants in the research. The main independent variables will be types of personal protective equipment and Personal care strategies. The results of the study will be dependent on these variables. Dependent variables: These are variables that change with the change in responses provided by participants during a research. Examples of dependent variables during this study will be number of infected people and number of recovery cases Type of sampling bias to be used: Bias refers to the emphasis put by a researcher during a particular research. This study will implement omission bias. This is a situation where particular groups of people are eliminated from the study. In this study, people who do not live in areas where corona disease has been reported will not be included in this study. Design of the questionnaire The questionnaire will be designed in such a way that all the research questions are addressed. This will involve formulating questions related to the views of respondents with regards to the effectiveness of personal care activities that enable prevention of corona disease among the patients. In addition, the questionnaire will be designed in a manner such that respondents will be able to provide demographic information such as age, gender and employment status. This will enable making of comparison regarding the responses with demographic characteristics of respondents. Study design The study design will involve observation of the ability of respondents to implement various techniques of personal care as well as the use of personal protective equipment in performance of their tasks. Research Strategy The research strategy will be a qualitative research strategy will be used during this process. Qualitative research is a research strategy that involves collection such as ideas, opinions and views regarding a particular activity during a research. During this research, qualitative data collected will be the views and ideas of health personnel in health care facilities in Saudi Arabia bout various characteristics of corona disease. In addition, qualitative data collection will involve collection of views, ideas and opinions about the methods of intervention they have put in place to enable them control impacts of corona disease among the population. In addition, the health professionals will be asked to explain the effectiveness of hand washing using PPE as a method of preventing corona infection and spread. The PICO concept will be implemented as follows: P- The problem or population of interest will be health professionals as well as residents of Saudi Arabia. The study will involve investigation of the level of the use of hand washing practice in protecting the health professionals and residents of Saudi Arabia from corona disease. It will also involve investigation of the methods used by Saudi Arabian residents to perform self care practice of hand washing to prevent the spread of corona disease among them. I- Intervention in this case will involve determining various methods of hand washing using PPE that can be implemented by residents of Saudi Arabia and health professionals so that they control the spread of corona disease among them. C- The comparison in this case will be determination of alternative strategies of preventing the spread of corona disease infection apart from hand washing using PPE O-The outcome in this study will be the effects of interventions such as the use of PPE during hand washing on rates of recovery among patients such as the percentage reduction in cases of corona infection as a result of implementation of the intervention strategies. The research strategy is summarised in the following flow chart. Figure 1. Flow Chart of the research strategy to be implemented Sample Selection Sampling goal: The sampling goal will be to collect a range of samples of the population that demonstrate personal care techniques in prevention of corona disease among them. Sampling frame The following sampling frame will be used to collect samples of participants during the study Target Populations Those with shortness in breathing Those that do not use PPE Those that work in hospitals Those that are within the age group of 18-45 years Table 1. Sampling frame to be used Sampling outcomes to be achieved include: To collect as many samples as possible within the sampling frame To record observations of the application of PPE in prevention of corona infection To establish any malpractices in personal care among the samples collected. Data analysis tools to be used: The main data analysis tools to be used include validity and reliability analysis. Validity is the extent to which the data collected represents the true findings of the study. This will be achieved by establishing the extent to which the data collected follow a particular pattern or the rate at which respondents from a particular health care setting provide similar responses. Reliability analysis is the extent to which the data collected provide answers to the research questions. This will be determined by establishing the number of research questions that are answered by the data collected. Justification Corona infections have been reported to result mainly from contact with animals such as camels. This is because it has been established that those who are infected with the disease are mainly people who are in contact with camels and do not practice good personal hygiene. This is based on the fact that a number of people in the Middle East own camels. Consequently, this study enables understanding of the populations that are mostly affected by corona disease and identifies the solutions that have been implemented in order to prevent corona disease in health institutions such as hand washing using PPE. This study is highly significant in areas where people get infected with corona disease due to contact with infected people or animals by elaborating the effectiveness of personal protective equipment (PPE) in achieving this objective. In addition, it tries to establish alternative methods of preventing infection of people through contact with camels based on the fact that a number of people in the Middle East own camels. This study also tries to identify possible outcomes that can be expected in the spread of corona disease if intervention measures are implemented. References Alagaili AN, Briese T, Mishra N, Kapoor V, Sameroff SC, Burbelo PD, de Wit E, Munster VJ, Hensley LE, Zalmout IS, Kapoor A, Epstein JH, Karesh WB, Daszak P, Mohammed OB, Lipkin WI. (2014). Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia.;5(2):e00884-14. Azhar EI, El-Kafrawy SA, Farraj SA, Hassan AM, Al-Saeed MS, Hashem AM, Madani TA. (2014) Evidence for camel-to-human transmission of MERS coronavirus. New England Journal of Mediciine; 370 (26):2499-505. Bermingham A, Chand MA, Brown CS, Aarons E, Tong C, Langrish C, et al. (2012). Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, Euro Surveill. 2012;17(40):pii=20290. http://www.eurosurveillance.org/images/dynamic/es/v18n02/v18n02.pdf Cox S, Posner SF, McPheeters M et al. (2006).Hospitalizations with respiratory illness among pregnant women during influenza season. Obstetrics and Gynecology, 107(6):1315–1322 (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids =16738158). Davis MM, Taubert K, Benin AL et al. (2006). Influenza vaccination as secondary prevention for cardiovascular disease: a science advisory from the American Heart Association/American College of Cardiology. Journal of the American College of Cardiology, 48(7):1498–1502 (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids =17010820). Dolan GP, Harris RC, Clarkson M et al. (2012).Vaccination of health care workers to protect patients at increased risk for acute respiratory disease. Emerg Infect Dis, 18(8):1225- 1234 (http://www.ncbi.nlm.nih.gov/pubmed/22840895). Jefferson T, Del Mar CB, Dooley L et al. (2011). Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database of Systematic Reviews, 2011, 7:CD006207. Available at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006207.pub4/abstract;jsessionid=074644E776469A4 CFB54F28D01B82835.d03t02. http://www.who.int/csr/disease/coronavirus_infections/en/ Krumkamp R, Duerr HP, Reintjes R et al. (2009). Impact of public health interventions in controlling the spread of SARS: modelling of intervention scenarios. International Journal of Hygiene and Environmental Health, 212(1):67–75. Oboho IK, Tomczyk SM, Al-Asmari AM, Banjar AA, Al-Mugti H, Aloraini MS, Alkhaldi KZ, Almohammadi EL, Alraddadi BM, Gerber SI, Swerdlow DL, Watson JT, Madani TA. (2014) Outbreak of MERS Coronavirus in Jeddah: A Link to Healthcare Facilities. New England Journal of Medicine 2014, in press. Madani T.A, Althaqafi A. &, Alraddadi B.M. (2014). Infection prevention and control guidelines for patients with Middle East Respiratory Syndrome Coronavirus (MERS- CoV) infection. Saudi Med Journal 2014 Aug;35(8):897-913. Svoboda T, Henry B, Shulman L et al.(2004). Public health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto. New England Journal of Medicine, 350(23):2352–2361. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. (2012). Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PloS One;7:e35797. Available at http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0035797 Read More