MENINGITIS Joe Bachelder

INTRODUCTION  Provide Understanding of Meningitis  Evidenced Based Research Summary  TRUEPIC case study  Nursing Care and Advocacy

UNDERSTANDING MENINGITIS

EVIDENCE FOR CARE  At Risk Population – Freshman College Students  Nursing Theory – Dorothea Orem’s Self Care Theory  Treatment and Prevention Programs

EVALUATION OF EVIDENCE  Review of research study  Systematic reviews of electronic databases and bibliographies reviewed for further evidence not identified  Inclusion and exclusion criteria  Data extraction and synthesis  Comparison of studies identified  Interventions and outcomes not clearly defined

LIMITATIONS AND CRITIQUE OF STUDY  Limited published literature on prevention programs  One Study performed in the United Kingdom  Potential for bias identified  Critical need for further controlled studies

COLLABORATION OF PATIENT CARE  Nurse  Patient  Family  Health Care Team  District Health Department  University Health Department

TRUEPIC A twenty-one year old male college student living on campus. Arrives at the emergency department (ER) with a 24-hour history of chills, stiff neck, and headache. Clinical examination reveals he is experiencing a severe headache, nausea, and vomiting. When asked to move his neck he complains of pain in the cervical area of the spine. Patient (Pt) has no history of previous illness, and patients mental status is normal. 1. IDENTIFY… 2. RELATE… 21 year old male Primary Position: Patient it at risk for bacterial 24 hour history of stiff neck, and severe headache meningitis Pt has nausea, and vomiting Possible Assumptions: Patient is aware of his Pt has normal mental status symptoms but may not understand them Possible Confounding Variables: Patient needs counseling on meningitis and treatment plan to follow for expected positive outcomes

TRUEPIC CONTINUED 3. Understand… 4. EXPLAIN…  Proposition: Patient understanding of condition Proposition: Educate the patient on behaviors will allow for positive outcomes associated with meningitis along with any tests and treatments expected with this diagnosis  Significance of Assumptions: Patient outcomes will be negative if the patient does not adhere with Assumptions: Educate the patient on the benefits of proposed treatment plan following the treatment plan to a full recovery, and that this should prevent meningitis from happening  Possible Confounding Variables: Patient is in the future aware of treatment and should comply accordingly Confounding Variables: All treatment will be explained, allowing for questions to be answered

TRUEPIC CONTINUED 5. PREDICT… 6. INFLUENCE…  Proposition: Patient has an understanding of Proposition: Include family in the education and the disease and is ready for treatment treatment of meningitis. Educate patient on the  Assumptions: With the patients cooperation importance of following medication protocol treatment will begin immediately Assumptions: Explain to the patient associated risks  Confounding Variables: Patient understands involved with this disease as well as his treatment his risk and their disease. Patient should expect regime to follow favorable results Confounding Variables: Patient verbalizes risk and treatment plan related to his disease 7. CONTROL… Patient will verbalize an understanding of his disease, treatment plan, and medication plan prior to discharge

NURSING DIAGNOSIS  Acute pain related to headache, fever, neck pain secondary to meningeal irritation  Interrupted Family Process related to critical nature of situation and uncertain prognosis

PATIENT ADVOCACY  Advocate on behalf of patient  Quality of Patient Care  Striving for Positive Outcomes  Care Specific to Disease  Educating Incoming College Students

REFERENCES Allison, S. (2007). Self-care requirements for activity and rest: an Orem nursing focus. Nursing Science Quarterly, 68 thru 76. Butler, K. (2006). Meningococcal Meningitis prevention programs for college students: A review of the literature. Worldviews on Evidence-Based Nursing, fourth quarter, 185 thru 193. Centers for Disease Control (CDC). (2013). Bacterial Meningitis. Retrieved from:// World Health Organization (WHO). (2012). Meningococcal Meningitis. Retrieved from://