Saudi Arabia Road Traffic Crashes & TB Prevention PDF

Describe the contribution of road traffic crashes to injury related death and disability and prevention strategies in Saudi Arabia and internationally. Describe the extent to which motor vehicle accidents contribute to injury-related death and disability. 1.35M deaths annually 34 injur...

Describe the contribution of road traffic crashes to injury related death and disability and prevention strategies in Saudi Arabia and internationally. Describe the extent to which motor vehicle accidents contribute to injury-related death and disability. 1.35M deaths annually 34 injuries in 100,000 Describe the trend in injury related death and disability that has occurred in Saudi Arabia and internationally over the last three decades. Young and economically productive males are most affected 80% of hospital deaths are due to RTI 20% of hospital bed occupancy is related RTI Explain the respective roles of human and vehicle factors along with physical and social environmental factors in the causal pathways for motor vehicle accident and injury. Human: young, speeding, reckless driving Vehicle: doesn’t factor in much Environmental: weekday rush hours, weather has minimal influence Outline the difference between passive and active safety strategies Active: main prevention o Blind spot detection within the driver’s side and rear o Road sign recognition o Lane departure warning Passive (active during collision): minimize damage o Airbags o Seatbelts o Whiplash protection o Pedestrian safety Use the Haddon Matrix to identify strategies for primary, secondary and tertiary prevention of motor vehicle accident and injury List the evidences for the effectiveness of these strategies Haddon matrix: A conceptual model for the systematic exploration of countermeasures Provides an integrated approach to injury control Helps in developing new laws and enforcement mechanisms Describe the myths and taboos related to TB in Saudi Arabia and the counseling strategies to patients and families Describe the myths related to spread and control of TB in Saudi Arabia Myths about TB: TB is hereditary TB leads to death TB treatment is expensive You get TB only once All patients are contagious TB transmission is airborne. It does NOT spread through: Food, water, sharing plates, or utensils Kissing or skin contact like handshakes or hugs Sharing a toothbrush (ew don’t do this with ANYONE cuz that’s nasty!) or clothes Toilet seats Describe the importance of counseling for families of TB patients, especially by health workers for alleviating fears of TB infection Providing TB patients and their families with knowledge on TB Disposing of common myths Increasing support within families TB patients are at higher risk for depression, thinking of themselves as burdens, and questioning “why me?” Acknowledge all of that and work with it not around it. Also, it’s important to talk about medications and side effects. TB drugs can change a person. It makes their family feels helpless and powerless. So, an honest open discussion with the family on what to expect and what’s likely to come is extremely imperative. Critically analyze the taboos related to TB infection common in Saudi Arabia HIV Substance abuse: o Drugs o Smoking: 20% of TB worldwide is attributed to smoking o Alcohol Describe methods of dealing with the sensitive issues related to TB A focus on social justice means caring for the most vulnerable and marginalized and addressing the social determinants which underly the TB endemic: Poverty Immigrants: providing treatment is ethical and of the interest of the host country Prisoners TB research: is underfunded and needs better attention Confidentiality: can be violated only if patient consents or there’s a direct danger to patient or someone else Discrimination: putting signs and warnings on the doors of TB patients rooms Describe the screening, control and preventive methods of tuberculosis and the role of the community. Describe methods of TB screening relevant to Saudi Arabia Mantoux (TST), IGRA, MTB culture and microscopy Describe the Infection control issues related to spread of TB in the communities Describe the TB control programs in Saudi Arabia National tuberculosis control program (NTP): Aims: o Decrease incidence rate to 1/100,000 o Treat > 85% of TB patients o Detect > 70% of estimated TB cases Strategies: o Diagnose and treat all people who have active tuberculosis. o Test high-risk groups for LTBI and offer therapy as appropriate. o Provide BCG vaccination for all children. o Implementing Directly Observed Treatment,Short Course (DOTS). o Health education. Elements: o Central unit: in the public health agency o TB control manual: reference o Lab services: 3 levels: peripheral at hospitals, intermediate/regional, central/national o Treatment services: provided through the whole period of treatment o Training: for all members working with NTP o Supervision and evaluation: evaluate implementation and manage obstacles o Surveillance system: identify and register cases and notify authorities Explain the role of family in the management of TB patient using “Directly Observed Therapy Short Course” (DOTS) Nutrition support provided by families to meet the nutritional needs of tuberculosis pa[ents and increase endurance. Informational support given by families in caring for TB pa[ents, such as reminding to take medications and accompanying control to health services. Emotional and psychological support to motivate the pa[ent during the treatment process. Describe the preventive measures for family and health care workers Administrative control: reduce exposure to patients with infectious TB Environmental control: reduce concentration of infectious droplet nuclei Respiratory control: use of personal protective equipment Describe the importance and method of contact tracing used in Saudi Arabia All persons who are close contact of a confirmed infectious MTB will be investigated A close contact is defined as person who had close, regular, prolonged contact with MTB patient while he or she was infectious without wearing proper PPE in a small poorly ventilated place After screening all other close contacts of the index case, the public health nurse will refer them to the public health clinic to rule out active MTB or LTBI The public health nurse will provide education regarding the signs and symptoms of the disease and the need for screening Describe the nature and mechanisms of action of vaccines, their effectiveness, impact on the health of population and the vaccination program in Saudi Arabia (children and adults). Describe the nature and mechanisms of action of vaccines; their effectiveness and impact on the health of populations Nature and mechanism of action: Live attenuated vaccine: weakened pathogen; chickenpox, yellow fever, MMR, sputunik Inactivated vaccine: dead pathogen, needs booster shots; hepatitis A, rabies Subunit/conjugate vaccine: pieces of pathogen; pneumococcal, HPV Toxoid vaccine: toxin of pathogen; tetanus mRNA vaccine: leading the body to synthesize the foreign protein; COVID-19 Pfizer Viral vector vaccine: antigen similar to target pathogen; COVID-19 AstraZeneca Impact of vaccines: Protection of unvaccinated population (herd immunity) Extending life expectancy Promoting economic growth Protection against bioterrorism and equity enhancement Control of morbidity and mortality Mitigation of disease severity Prevention of infection List the range of vaccines that are available in Saudi Arabia and the vaccination schedule for children and adults Vaccination program for children and adults: DTaP: diphtheria, tetanus, and pertussis (at age 7) o Tdap: the booster shot at age 11 MMR: measles, mumps, and rubella Polio Influenza Additionally: o Meningitis, pneumococcal pneumonia, varicella influenza, HPV, herpes zoster, HiB Understanding how systemic thinking can improve healthcare and minimize adverse events Adverse events: An adverse effect is an undesired harmful effect resulting from a medication or other intervention. An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. The occurrence of adverse events due to unsafe care is likely one of the 10 leading causes of death and disability in the world. In high-income countries, it is estimated that one in every 10 patients is harmed while receiving hospital care. The harm can be caused by a range of adverse events, with nearly 50% of them being preventable. Serious adverse events include: death, disability, permanent damage, congenital anomalies Difference between adverse events and medical errors Errors are planned sequences of mental or physical activities that fail to achieve their intended outcomes, when these failures cannot be attributed to the intervention of some chance agency. Errors may occur by doing the wrong thing (commission) or by failing to do the right thing (omission). Iatrogenesis: medical errors defined as mistakes, inadvertent occurrences, or unintended events in healthcare delivery that may result in patient injury. Preventable causes of medical errors: Fatigue. User error. Inexperience. Human errors. Most common preventable medical errors: Misdiagnosis. Delayed diagnosis. Faulty medical device. Infection Who is responsible? The systems approach requires a shift from a blame culture which encourage people to cover up, to an ethos of safety management in the context of a just culture to avoid future adverse events. lack of standard procedures for storage of medications that look alike poor communication between the different providers lack of verification before medication administration lack of involvement of patients in their own care might all be underlying factors that led to the occurrence of errors. How can the system minimize adverse events A mature health system takes into account the increasing complexity in health care settings that make humans more prone to mistakes. Physicians should disclose adverse events to their patients and report promptly to institutions. Institutions must make sure that patients harmed by adverse events do not face additional financial burdens; conduct a root cause analysis, and develop an action plan if necessary. If an actual error transpired, the appropriate physician or institutional representative should apologize to the patient. Institutions should also adopt policies that encourage smooth transitions to new technologies, and foster communication as the key to improving patient safety.