Biological Weapons and Bioterrorism - Essay Example

 Biological Weapons and Bioterrorism Introduction: Bioterrorism is an intentional attack using weapons of bacteria, viruses and other germs. The act of using diseases as a weapon of Bioterrorism is not something that is new. One significant potential health problem today is an attack of Bioterrorism on our country. One of the earliest use of Biological weapons occurred in the 6th century BC when the Assyrians used rye ergot to poison the wells of their enemies. Nelson Mandela too was a victim of Bioterrorism, while he was serving his sentence in a South African prison. Ricin was used to put an end to Georgi Markov in London, while anthrax laden envelopes were sent to media organizations and politicians in the United States of America. (Cummings 1996, Miller et. al, 2001). In response to the increasing threat of Bioterrorism, the medical fraternity are undertaking to equip their nurses in dealing with this problem by making them aware and improving their knowledge against such attacks. By Nursing Bioterrorism Preparedness we mean that nurses have to be continually educated and updated on the current patters and methods of Bioterrorism to be able to meet any such crisis in case it occurs. It is essential to include Bioterrorism preparedness into the Nursing curriculum from the very start. If this is done, then nurses would be better equipped to face any eventuality by way of Bioterrorism. A Teaching module for nurses…3 Nurses are one of the largest groups of health professionals and as such, form a major institution in their response against Bioterrorism. It is now the time for nurses to don the role of a Bioterrorism responder. Bioterrorism is come as a deep scar on the face of society. None can ever forget the September 11th attacks that killed thousands of innocent people. Nurses selflessly answered the call of duty and battle with the suffering people. It is during such moments of crisis, we need to have thoroughly skilled hands to meet or take up the challenge of the growing number of casualties and deaths. Hence it is exceptionally essential to have trained and especially skilled nurses to meet this criteria. Therefore it is inevitable that Nursing Bioterrorism Preparedness should be part and parcel of each and every qualified nurse. In its war against Bioterrorism, the United States has what is called a bio-weapons program whereby it denounces the use of any kind of deadly biological weapon and has stopped the production of dangerous toxin weapons. It has also now turned its focus towards giving quality training to nurses on how to face and handle Bioterrorism attacks. A Teaching module for nurses….4 A Literature Review The article titled “Arming for an Emergency” states that the United States is not ready for a bioterrorism attack. The article also suggests that New York City may be involved in such attacks due to the fact that it has a major port of entry into the United States and also because of its dense population. It also points out that it faces another major drawback which is scarcity of nurses in the medical profession. It also went on to say that many hospitals did not have enough medical equipment such as ventilators etc. which are very essential in case of an emergency in case of a bioterrorism attack. Based on the above article, it is inevitable that nurses should be given thorough training on the subject of bioterrorism, so that they would be able to manage the sick and injured during any such attack. Another article titled, “Hospital preparedness for victims of chemical or biological terrorism”, states that there is a growing concern that terrorist may be using chemical or biological weapons against the civilian population. Therefore the need of the moment is for the US to prepare its nurses through training and educating them to meet such an A Teaching module for nurses…5 eventuality if it happens. The article clearly suggests that there is an urgent need for health care providers/nurses in hospitals to better their responses when covering critical areas of a bioterrorism attack. The article made use of a cross sectional questionnaire survey of all the hospitals emergency departments in the US Public Health Service Region X. The survey included a self administered questionnaire, a cover letter and a postage- paid self addressed envelope which was mailed to around 224 hospitals that were eligible. The questionnaire consisted of six questions that assessed the availability of medical resources that were available in the event of a Bioterrorism attack. The findings from this survey indicated that most of the hospitals were not well equipped with medical instrument, nurses or care providers. The nursing staff and the care providers showed signs of secondary exposure. This literature review stresses the need and importance for bioterrorism preparedness at all levels of nursing so that they would be in a position to counter these attacks. The article, “What we need to know about Bioterrorism Preparedness”, shows us results from focus groups conducted at “APIC 2000”. The article laid stress on Bioterrorism as we see it today and discussed the biological agents that were most likely to be used during an attack. The information collected from the questionnaires of the focus groups A Teaching module for nurses…6 determined that there should be a priority for educating nurses on Bioterrorism preparedness by using both audio and video technology, and other self learning packages, so they could meet any eventuality when it occurs. The comments made by the participants suggested that there was a general lack of awareness among them on the issues of Bioterrorism in the United States and the consequences leading to such attacks. The first and foremost step taken towards beating this problem would be to educate the medical fraternity of doctors, nurses and other health care givers on this issue. Steps to beat the issue of Bioterrorism: In collaborating a plan for education in Bioterrorism is to first become aware of the threat that faces us and an understanding of the importance of such learning. Nurses should be taught the different biological agents such as anthrax, botulism, plague, small pox, tularemia, filoviruses and arena viruses. Tips and guides could be taken from reliable sources to understand the signs and symptoms of each and every component of Bioterrorism warfare. Another important factor to be considered is that the plan of action to be taken during an occurrence should be made very clear to nurses and other medical personnel. The first thing that would happen would be a mass panic attack, therefore if A Teaching module for nurses…7 they are well trained they would be able to deal with the situation by communicating and educating the people who are affected. Well trained and skilled nurses would be able to actively participate and undertake important decision making in alleviating the problems faced by those attacked. The worst scenario in an event is lack of information and knowledge and therefore it is imperative that nurses have a thorough understanding on the various medicines and know how to administer them. The main idea of having a workout plan is to be able to meet the situation and contain it in the shortest possible time so that it is not widespread. Another important step to be taken towards this issue is to educate the general public through public awareness programs and through literature such as handouts, brochures and through the media. Dealing with this issue, an article titled, “Are you prepared for a Bioterrorist attack?” discusses certain strategies on how to respond if the community was under attack. It says that an action plan should not be made up during an occurrence but it should have already been in place before the attack and which helps us to systematically put an end to the problem quickly without getting it blown out of proportion. Ever since the deadly anthrax Teaching module for nurses…8 was stealthily passed through envelopes, the problem of Bioterrorism has been taken seriously. Planning therefore, is the most important step towards preparedness that should be done thoroughly in order to prepare nurses and other professionals in handling the situation with ease and calm. The next step would be reviewing and understanding the matter already taught so that the nurses would be familiar with the various signs and symptoms of people who are attacked and hence able to render quality treatment in relieving them of pain and stress. The third important step would be to accurately identify the relevant agents and give the correct medication quickly in order to save lives. The next important step in preparedness would be to explore epidemiology. Knowing and understanding the seasonal changes would help nurses go a long way in identifying the disease and knowing what is normal and what is abnormal. Nurses should follow both the universal precautions as well as the standard precautions which would help them to protect not only themselves but also their patients and the community at large. Teaching module for nurses…9 The fifth step of preparedness for nurses is assessing their patients by documenting the signs and symptoms of the patient and the history of the sick individual. In case of a contagious disease, they should isolate the patient and keep a close check on the progress. Nurses should have a good understanding on the nature of the role they play in moments of disaster. They should exhibit a holistic attitude towards treating a patient by administering the right medicines at the right time and reducing a patient’s discomfort. This literature review acts as an eye opener and a guide that educates us on the effectiveness and importance of response on our part towards Bioterrorism. The article on concept analysis helped to define the concept of Bioterrorism preparedness for nurses by making use of a systematic literature review. One hundred and eighteen references were identified, 41 of which were deemed relevant. The 41 relevant articles were used to develop a theoretical definition, defining attributes, antecedents, consequences and related concepts. These definitions were all defined using the methodology process to evaluate a concept. This method helps in picking out the right concepts and eliminating the poor ones. The right choice of these concepts is very essential for use in research studies and for framing new theories. Teaching module for nurses…10 In the following article, “The Role of an advanced practice of a Public Health Nurse in Bioterrorism Preparedness”, states that in order for health care professionals to be able to handle a Bioterrorism attack effectively, they have to be prepared to manage the situation well using unprecedented and cooperative measures at the National, state and Local levels. The article highlights the use of the Los Angeles County Health Nursing Practice Model which says that nurses can be easily and effectively trained to deal with incidents of Bioterrorism. This model will help assist nurses on planning their response in case of such an attack. In this study, six specific interventions are implemented to ensure the nursing practice is effective at the community level during a Bioterrorism attack. Biological agents are very readily and easily available and it doesn’t need much knowledge on how to handle or use them. These agents however are noted to have a delayed onset of symptoms giving time for the terrorist to make good his escape. These biological agents are not just recently used but it was used years ago as a means of warfare in ancient times. Recently in the 2001, the deadly anthrax was used by sending the anthrax spores in envelopes to 22 different people that resulted in 22 identified cases of anthrax between October and November 2001. Teaching module for nurses…11 Biological Agents: The Center for Disease Control and Prevention have categorized these biological agents into three groups – A, B and C. The agents in category A are the most dangerous and harmful of the whole lot. The Category “A” agents include Variola Major, Bacillus Anthrax, Yersinia Pestis, Clostridium botulinum, Francisella, Filoviruses and Arcnaviruses. Category “B” is found in polluted or contaminated food and water and possesses a very low mortality rate. The agents in Category “C” are easily available, are easily produced and have a great potential for high morbidity, mortality and major health problems. Advanced Practice Nurses are well skilled in these specific areas of study such as epidemiology, Community Health Planning, Public Health policies and the collaboration of intermediary teams. Advance Practice Nurses build upon the strength of the current public health nursing workforce by expanding the knowledge base and skills required to deal effectively with contemporary and emerging issues (Quad Council of Public Health Nursing Organizations, 1999) Advanced practical nursing is not clearly defined in Bioterrorism, but the use of nurses to assist in a bioterrorism attack is essentially defined. Teaching module for nurses…12 The Los Angeles Count (LAC) Department of Health Services (DHS) Public Health Nursing developed the Public Health Nursing (PHN) practice model to describe the building blocks of public health nursing practice and correlate their relationship with one another. The model consists of a strong framework for collaborating with a public health interdisciplinary team to develop necessary skills to be used during a Bioterrorism attack on the community. This practice model consists of assessment, diagnosis, outcome identification, planning, surveillance, collaboration, coalition building, health teaching, consultation, policy development and enforcement, assurance and evaluation. Based on the theoretical framework and the literature review of the Practice model, this study identifies the model as an effective tool as a guide to guide learning and preparedness efforts so that public health nurses would be always alert and responsive to Bioterrorism attacks. Bioterrorism attacks are intentional, using viruses, germs and bacteria as weapons. This is stated in the article, “Update on Bioterrorism Preparedness”. The article goes on to say that the rapid detection of the disease – producing agents would be mainly up to the public/health nurses response to Bioterrorism. In order to achieve the rapid detection of the Teaching module for nurses…13 biological agents, the CDC Plan calls to increase the surveillance of epidemiology and the distribution of pamphlets with accurate information. The Federal Government too has stated an urgent need for an action plan for preparedness in case of a biological attack. It has emphasized the importance on the medical community to takes important measures especially where the Category “A” agents are concerned because they cause the most number of disease and deaths. The article concludes that the best defense against biological attacks would be the extent of preparedness on the part of the medical fraternity. After the September 11th attacks there is a general feeling that other attacks are soon to follow. A study conducted on biological warfare by the centers for Disease Control and Prevention perceived the risks bioterrorism attacks in the future. Reviewing this piece of literature Medical Professionals felt that they needed a stronger action plan in order to meet the situation and felt that their present set up did not have much of a standardization which is the most essential component to any good medical institution. Teaching module for nurses…14 Bioterrorism Preparedness I, states that the ability to effectively and accurately respond to bioterrorism attacks will depend largely on the extent of preparedness of the medical practioners and other staff. In many hospitals, excess staff have been eliminated in emergency rooms and hence it becomes very difficult during an actual attack. The article states that emergency response plans should be incorporated and integrated into the daily operation procedures. The Joint Commission too, has given full support by establishing a baseline prerequisite for all emergency rooms dealing with Bioterrorism attacks. A management plan should be instituted to deal with any kind of emergency before and after a terrorist attack. An action plan has to be drawn up for decontamination of the whole facility after a biological attack. Supplies and logistics have to be taken into account before an after an eventuality. Command and control over things needs to have a strong and trained management staff for things to be carried out in a smooth manner. Therefore, education and training are crucial and rapid diagnosis and treatments are indispensable in order for effective command over the situation. Teaching module for nurses…15 The threat of Bioterrorism is a known fact and its dangers are best avoided than undergone. It is vital to know the threats they pose and the nature with which they may occur. Nurses who take part in decision making and planning have better capacity to think and act rationally to ensure protection to themselves as well as others around them. One of the most important principles in the practical guide for nurses is to ensure the trust of the health care provider. In many cases, during a biological attack, trust has been replaced with suspicion. Trust can be regained once again by allowing the people to take part in the decision making process and giving them accurate information so that they can understand the seriousness of the problem which would help and encourage them to deal with it in a better manner. Conclusion: In conclusion it could be said that it is not enough if one studies the principles in the practical guide for nurses, but it is even more important to put every single principle into practice when a disaster occurs. Taking the public into confidence helps to build trust in the medical fraternity which makes it even much easier in the treatment process. Strictly following a good action plan and having a strong management force would help to put an end to poor decision making, thus helping the medical personnel to act promptly and effectively. Read More