Case Study on Immunisation for Healthcare Laws- myassignmenthelp

Question: Discuss about theCase Study on Immunisation for Healthcare Laws. Answer: It is the legal and professional responsibility of all healthcare providers to obtain appropriate informed consent of individuals, prior to immunization or vaccination. Vaccinating a child is one of the most essential things that can be done to protect their health. Young children and infants are particularly vulnerable to a range of vaccine preventable diseases, owing to the fact that their immune systems do not attend enough maturity (Gostin 2015). Hence, vaccination is considered as a legal right of all children and is the most effective measure, related to primary prevention of a range of diseases. Consent refers to the principles where the individuals are required to give their permission before a medical intervention, or procedure related to immunization is implemented. Owing to the fact that in most legal systems existing across the world, the legal age at which an individual can provide consent coincides with age of majority (18 years), consent regarding vaccination is genera lly taken from the legal guardian, or parent for minors. In the above case scenario, Albert cannot provide the sole consent regarding Mias vaccination, without the consent of her mother. This can be attributed to the fact that most healthcare laws and governmental guidelines suggest that the only person, who can provide consent for their child to have vaccinations, is the mother. A father can only provide his consent, if he has parental responsibility.Policies and legislation also state that both parents of a child, aged less than 8 years, share equal parental responsibility for the child, following their separation (Gilmor 2017). Hence, it is presumed that separated parents will have equal responsibility and role, in making decisions about major issues that can create adverse effect on the health of the child. Taking into consideration the fact that Mia lives with her father and mother for equal time span every month, it is of utmost importance to seek consent from her mother, before any vaccination for purposes or influencer is administered upon her (Kabakama et al. 2016). Therefore, following completion of the brief explanation assessment, and obtaining consent from her father, it is imperative to establish contacts with her mother Rose and provide her sufficient information about the immunization, to assist her to make an appropriate decision. This would include providing her information on the type of vaccine that is proposed to be administered, and the reasons for immunization (recent outbreak of pertussis and a family all history of influenza). Moreover, the risks and benefits of vaccination will also be explained to her mother in order to help her gain a deeper understanding of the adverse health impacts that can affect Mia in the long run. Hence, an informed and open decision making partnership will be created with both the parents that will form the basis of informed consent, which is required prior to administration of the vaccines (Brunson 2013). Disclosure of the vaccine risks and benefits will be essential in avoiding confusion, and promoti ng the overall integrity of the consent process. It will also help in building trust of both the parents in the immunisation program. Despite the huge body of scientific research that has been done to evaluate the benefits of immunization and the overwhelming effects of vaccination that support its effectiveness and safety, there are various parents who so hesitant in having their child immunized (Jung, Lin and Viswanath 2013). The reasons that make parents hesitant regarding vaccination range from fear about allergic reactions or hypersensitivity, autism, or concerns about their safety. In this case scenario, ignorance or deficiency in knowledge of Mias mother regarding the contraindications, and adverse effect of the proposed vaccine might lead to several immunization error. She considers mild illness and allergic reactions as the primary reason for not giving her consent to up to date immunizations (Brunson 2013). She should be provided with correct information about the benefits and risks of vaccine. Although she would like to know about the adverse effects more, health benefits of immunization should be emphas ised during the discussion, without comparing it to the major risks that might be involved. Communication with the parents, and delivery of appropriate sources of information about major factors that might affect parental practice regarding vaccination is essential. Engaging in an effective communication will improve her perception on the potential benefits. This will make her more likely to continue with the proposed immunization programme. While counselling her mother about the safety of vaccines, it is required to uniformly state that there is no association between development of autism with vaccination. A discussion regarding the common misconceptions about immunization needs to be initiated, to change her attitudes and beliefs (Nyhan et al. 2014). Moreover, it needs to be evaluated whether Mias mother has distrust in government sponsored information, regarding immunization. There is a need to show empathy to the parent, to demonstrate a willingness of protecting the child. Empathy will be displayed by addressing the concerns of the parent directly and demonstrating active listening skills. This will make her perceive that her concerns are being noted and respected. Follow up time will be set aside, on a regular basis to receive feedback from the parent regarding her opinion on vaccination. Such a partnership should be established much prior to the immunization visit. In addition transparency should be maintained regarding the decision making process. Displaying honesty about the risks and uncertainty of immunization will help in motivating and engaging the parents during dialogue. Motivational interviewing will also be adopted to change her behaviour. Respecting the differences that exist in opinion about immunization and dete rmining the origins that lead to vaccine hesitancy will help in providing a clear understanding about perceptions (Mergler et al. 2013). Using of a non-confrontational and non-judgmental tone will also demonstrate patience, and provide support to her mother for deciding to immunize her. The level or type of vaccine related information that is wanted by the parent will be assessed, followed by presentation of evidence that is understood (Sadaf et al. 2013). Immunization will also be framed in terms of positive benefits. Providing easily available information in audio, printed or visual format that tailors to her perceptions and beliefs might also help in improving her decision. Anaphylaxis refers to serious allergic reactions that occur rapidly and are often triggered by immunologic mechanism. The signs and symptoms of the concerned person will be evaluated for diagnosing anaphylaxis. Symptoms of anaphylaxis will usually involve more than one organ of the body, such as, the mouth, skin, lungs, eyes, brain, heart, and gut (Song, Worm and Lieberman 2014). It will be identified based on the following symptoms: Spelling of the tongue throat or the lips Itching, skin rashes, and hives Trouble breathing, shortness of breath, and whistling or wheezing sound Stomach pain accompanied with diarrhoea and vomiting Fainting or dizziness Presence of low blood pressure at levels 30%, below the normal might also indicate onset of anaphylaxis. Skin tests and other in vitro tests that determine presence of IgE antibodies will help in providing a positive diagnosis for anaphylaxis. Initial measures will be taken to identify the agent that triggered an anaphylactic reaction. Diagnostic tests will help in identifying triggers among food, medication, insect sting and latex that is found in disposable gloves (Clark et al. 2014). Management of this medical emergency might require measures that involve resuscitation or chest compression and artificial ventilation. Use of airway management techniques, intravenous administration of fluids, and supplemental delivery of oxygen, while closely monitoring the patient, are some of the major steps taken for management of this condition. Epinephrine or adrenaline is regarded as the primary treatment, owing to the fact that there are no absolute contraindications for them. Epinephrine solutions will be administered intramuscularly in the mid anterolateral thigh, upon receiving positive results for the diagnosis (Dennerlein 2014). The injection will be repeated on a time interval of 5-15 minutes, following insufficient response from the patient. Preference of intramuscular route of administration over subcutaneous injection route can be attributed to the fact that the latter often results in delayed absorption of the fluid in the body. Minor adverse effects related to headache, anxiety, tremors and palpitation might arise in the patient, following epinephrine administration (Campbell et al. 2014). Corticosteroids can also be considered as a second form of treatment, with the objective of reducing risks of biphasic anaphylaxis. In cases where epinephrine fails to resolve bronchospasm, administration of nebulizer salbutamol might be considered essential (Choo, Simons and Sheikh 2013). An allergy action plan will also be formulated for the patient, prone to anaphylaxis. The plan will include utilisation of epinephrine autoinjectors, in addition to recommendations for wearing bracelets, with medical alert for avoiding triggers. Future episodes of anaphylaxis can be prevented by immunotherapy. Reviewing all labels present in food ingredients, will also help in uncovering potential illusions that might worsen the condition. Efforts will also be taken to avoid the patient from getting bitten by insects or bee stings. The caregivers and teachers shall also be informed about patients, at an increased susceptibility for anaphylaxis. Measures will be taken to prevent the patient from dri nking beverages from soft drinks can, walking barefoot in grass, wearing bright colored clothing with floral prints, or using hair sprays, hairspray, lotion for perfumes during early fall and late summer. Adverse event following immunization (AEFI) refers to medical incidents, which take place after an immunization or vaccination program and cause major health concerns. Five major types of AEFI are grouped as vaccine reactions, program error, coincidental occurrences, injection reaction, and unknown events (Tozzi et al. 2013). Initially Rose will be informed about reporting cases of AEFI, immediately to the concerned healthcare agency under two conditions, such as, isolated and cluster events. An isolated event is a solitary medical incident that might take place after immunization, and cause concern in the patient. Occurrence of true or more similar events that are related in time, and have occurred within the same geographic region, are associated with same immunisation programme will be considered as clustered event. Rose will be informed about the necessity of identifying and reporting all forms of serious and non serious adverse events, following immunization of her child. She wi ll be provided information on two channels of reporting. Monthly reporting- This will make her report all forms of adverse event, related to immunization and the monthly progress of her child. Events related to high grade fever, seizure, hypotonicresponsive episode, inconsolable screaming, and other complications such as BCG infection, thrombocytopenia, or local reactions must be reported to the immediate medical officer, responsible for the immunization programme (Breugelmans et al. 2013). She will also be asked to report any untowards medical occurrences in the district or community that has resulted in prolonged hospitalization, significant disability, or death of an individual or group of individuals. She will be asked to notify the case to the nearest primary healthcare centre, or district immunization officer by the quickest means of communication. Rose will also be provided adequate information regarding the statutory requirements regarding notification of adverse events that occur following and immunization. Guidelines and rules from the Public Health Regulations Act 2017 and Public Health Act 2016 will be adequately sent to her. She will also be recommended to take her child to visit the doctor on an annual basis, till 3 years of age. Between 4-6 years of age Rose will be instructed to take Mia for a visit to the doctor, during which she will receive vaccine for polio, diphtheria tetanus and whooping cough, chicken pox, influenza (annual), and measles mumps and rubella (MMR) (Harris et al. 2014). Additionally, she will also be recommended to let her child receive flu vaccination at every flu season. Further vaccines will be recommended for Mia during her pre-teen years. Recommendations regarding administration of flu vaccine, HPV vaccine, Tdap, and meningococcal conjugate vaccine during the preteen years will be made. In addition to providing appropriate training on ways of reporting AEFI, efforts will be taken to provide the parent with appropriate information and management plan, regarding the adverse event that is experienced (Alicino et al. 2015). This will also include information on implications for the subsequent recommended vaccinations. 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