Scenario
1. Excessive drinking of alcohol has been associated with different problems to workers .Excessive consumption of alcohol has resulted a lot of physical and mental harm to the workers. Excessive drinking also results to distress and different illness to the drinker and this reduces their productivity at the workplace. In order to reduce this habit, it has been recommended that regular screening can be of benefit. However, screening is associated with both numerous benefits and downsides as will be discussed in the essay. Some of the benefits include providing an avenue for education on alcohol and drug abuse, formulating intervention measures and encouraging those who do not use the drugs to shy off. The disadvantages include wasting resources and the invalid results that might be produced by the measuring equipment.
Screening can help in educating workers on the benefits of low alcohol consumption. Screening involves handling one patient at a time to determine their level of alcohol as well as drug consumption. This sessions can be very beneficial since the healthcare providers get that chance to have that oral conversation with some of the addicts and convince them or rather educate them the importance of low consumption of alcohol. Alcohol consumption generally reduces the productivity of workers (Jackson, Felstead, Bhowmik, Avery, & Nelson-Hearity, 2016). The healthcare providers can therefore take advantage of the interactive screening sessions to provide such crucial information to the alcohol dependents. This would generally reduce alcohol and other drug abuse by the workers.
Screening assists practitioners to take the necessary preventive measures. Screening can be used as the best tool in coming up with the best interventions because it involves finding out the level of drug and alcohol abuse of each worker .Different workers or individuals have different levels of dependency and this therefore makes it quite difficult to provide nursing interventions in general. With screening however, the practitioners can learn the dependency of each worker and this makes it easier to offer interventions at a personal level.
Screening makes it possible for people who are not alcohol dependent shy off from the habit. Screening makes it possible to find out those workers who depend on alcohol and other substances as well as those that do not (Magar, 2015) .This is the best opportunity for the healthcare providers to assist or encourage those who are not dependents of the drug and alcohol abuse to keep off by telling them the negative implications of the habits.
Benefits of Drug and Alcohol Screening
False positive results. There are chances that the equipment to be used in the screening are obsolete. Obsolete equipment would in return lead to false positive results that would need necessary interventions for a condition that is absent. This would in return further complicate the health condition of the person who is subjected to such interventions would will adversely affect the persons output at the place of work.
It is an expensive exercise. Screening 3000 workers on a monthly basis is quite expensive whose results might not be reliable to some extent. The company should therefore reconsider this exercise and invest the money to a more productive venture within the organization. Besides, the exercise also wastes a lot of time. Screening of 3000 workers would take quite some time (“Prevalence of fetal alcohol syndrome (FAS) in a population based sample of children living in Australia: The Lililwan project,” 2015). The company should therefore consider investing that precious time to other productive time within the organization.
Some workers work well under the influence of alcohol. According to some studies, it has been established that close to 25% of workers who are alcohol addicts perform better after alcohol intoxication. Screening of such workers would force them to quit their habit and this would generally affect their productivity. The company should therefore weigh out the two options before deciding on the way out.
2. The company that would be doing the screening claims that there accuracy is 95%.This therefore means that in every 100 people that are screened using the test kit,95 of the results would be correct while the remaining 5 would be false or unreliable. This therefore still means that it would be very difficult for the organization to get the true picture of alcohol prevalence within the organization .If we calculate the percentage using the whole population of 3000 workers ,only 2850 results would be correct while the remaining 150 would be false. I would therefore recommend that the CEO looks for a company that has 100% accuracy.
3. a) Sensitivity is defined as the chance of a test result being positive when the subjects have been affected in real sense. Specificity on the other hand refers to the probability of getting a negative result in subjects who are actually not affected by the disease.
In this case for example, 95% sensitivity means that there is 95% chances of a positive result in subjects that are dependent to alcohol and other drugs. A specificity of 86% in this case implies that there is a likelihood of 86% negative results in individuals who actually don’t have the disease. It is very advisable to have both high sensitivity and specificity.
Downsides of Drug and Alcohol Screening
b)
|
Disease Number |
NonN Disease |
Total |
|
|
Positive Number |
2(True positive) |
2577(False positive) |
2579 (Total Test Positive) |
|
Negative Number |
1(false negative) |
420(True Negative) |
421 Total Test Negative |
|
3(Total Disease) |
2997 (Total Non-disease) |
3000 (Total) |
Working with a prevalence of 0.001% this means that the total population with disease is 0.001 ×3000=3
So 3 is the number with disease.
To get the remaining values, we already have sensitivity at 95% and specificity of 86%.
95%=True positive/ (Total disease) ×100
86%=true negative/ (Total Negative) ×100
So the true positive was 2 while the true negative were 420.
To calculate the positive and negative predictive values:
Positive predictive value=2/2597 × 100
=0.08%
The negative predictive value=420/421 × 100
=99%
A positive predictive value means the likelihood of getting a positive result during the test which is 0.08% while the negative predictive value means the chance of getting a negative result during the test which is 99% in this case.
C). In this case, I would advise the CEO not to use the monthly screening test. This is because the test or technique has a very high negative predictive value. As described earlier, the predictive value represents that likelihood or probability of an outcome .In this case, having a negative predictive value of 99% means that the results are likely to be 99% negative. This means that the test would really miss out on most of the positive cases and this therefore means that there will be little or no intervention measures .This would also imply that the workers who are alcohol addicts will go on with the habit since the tests cannot recognize them.
However, the positive predictive value is usually influenced by both the specificity, sensitivity and prevalence of the condition .In this case, the prevalence was quite low at only 3 out of a possible 3000.The positive predictive value in this case is actually too low at 0.08% because of the low prevalence .As the disease becomes more prevalent, the diseased column will have more figures and this means that the disease subjects with positive tests will also increase .It is therefore very important to assess both the positive and negative predictive values of any test kit before it is incorporated.
References
Jackson, L., Felstead, B., Bhowmik, J., Avery, R., & Nelson-Hearity, R. (2016). Towards holistic dual diagnosis care: physical health screening in a Victorian community-based alcohol and drug treatment service. Australian Journal of Primary Health, 22(2), 81. doi:10.1071/py15097
Magar, V. (2015). Gender, health and the Sustainable Development Goals. Bulletin of the World Health Organization, 93(11), 743-743. doi:10.2471/blt.15.165027
Prevalence of fetal alcohol syndrome (FAS) in a population based sample of children living in Australia: The Lililwan project,” (2015). Journal of Pediatrics and Child Health, 51, 4-5. doi:10.1111/jpc.12913_12https://onlinelibrary.wiley.com/doi/abs/10.1111/jpc.12814
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