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Related Concept Videos

Pneumonia V: Nursing management and Prevention01:30

Pneumonia V: Nursing management and Prevention

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Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
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Rheumatic Heart Disease IV: Nursing Management01:20

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Related Experiment Video

Updated: Aug 23, 2025

Experimental Human Pneumococcal Carriage
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Implementing a Nurse-Driven Protocol for Pneumococcal Vaccination in an Academic Rheumatology Clinic.

Elena K Joerns1, Nagendra Pokala2, Bonnie Bermas2

  • 1E.K. Joerns, MD, N. Pokala, MD, B. Bermas, MD, P. Bajaj, MD, MPH, Division of Rheumatic Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center; elena.joerns@utsouthwestern.edu.

The Journal of Rheumatology
|November 1, 2022
PubMed
Summary

A nurse-driven protocol successfully increased pneumococcal vaccination rates in rheumatology patients. This initiative improved coverage of both PCV13 and PPSV23 vaccines in immunosuppressed individuals.

Keywords:
pneumococcal vaccinesquality improvement

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Area of Science:

  • Immunology
  • Public Health
  • Rheumatology

Background:

  • Rheumatology patients face elevated risks of pneumococcal infections.
  • Adherence to pneumococcal vaccination guidelines is crucial for this vulnerable population.

Purpose of the Study:

  • To evaluate the feasibility of a nurse-driven protocol for pneumococcal vaccination in an academic rheumatology clinic.
  • To enhance vaccination rates for pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23) in immunosuppressed patients aged 19-64.
  • To increase the proportion of fully vaccinated immunosuppressed patients by at least 10% over two years.

Main Methods:

  • Eligible patients were identified via electronic medical records using medication-based criteria.
  • Baseline vaccination rates (unvaccinated, partially, fully vaccinated) were established in 2019.
  • A protocol based on 2012 ACIP guidelines was implemented by nursing staff.
  • Post-intervention vaccination rates were monitored monthly and analyzed for statistical significance.

Main Results:

  • Monthly vaccination rates for PCV13/PPSV23 rose from 4.3% in 2019 to 12.6% in 2021.
  • The proportion of fully vaccinated patients increased from 14.6% in 2019 to 26.2% in 2021.
  • Both increases were statistically significant.

Conclusions:

  • A nurse-driven vaccination protocol is a feasible strategy to improve pneumococcal vaccination rates in immunosuppressed rheumatology patients.
  • The protocol demonstrated success despite challenges, including disruptions from the COVID-19 pandemic.