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community health lecture notes
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Chapter 15 Surveillance and Outbreak Investigation Objectives
-Collaboration among Partners A quality surveillance system requires collaboration among a number of agencies and individuals. Such collaboration promotes the development of a comprehensive plan and a directory of emergency responses and contacts for effective communication and information sharing. Nurses are often in the forefront of responses to be made in the surveillance process. The type of information to be shared includes the following: How to use algorithms to identify which events should be investigated (i.e., using a precise step-by-step plan outlining a procedure that in a finite number of steps helps to identify the appropriate event) How to investigate Whom to contact How and to whom information is to be disseminated Who is responsible for appropriate action -Nurse Competencies Core Competencies include: Analytic assessment skills Communication Community dimensions of practice Basic public health science skills Leadership and systems thinking A hospital is a system-own unique way of doing business. Nurse needs to look at system and leadership and see how we can positively impact it Introduction Disease surveillance has been a part of public health protection since the 1200s. The Constitution of the United States provides for “police powers” necessary to preserve health safety as well as other events. These powers include public health surveillance. State and local “police powers” also provide for surveillance activities. Disease surveillance has been a part of public health protection since the 1200s during the investigations of the bubonic plague in Europe. Wanted to see what was happening and why people were sick The Constitution of the United States provides for “police powers” necessary to preserve health safety as well as other events (see Chapter 7). These powers include public health surveillance. State and local “police powers” also provide for surveillance activities. Health departments usually have legal authority to investigate unusual clusters of illness as well. Global Infectious Disease Surveillance Frameworks (framework/model for global surveillance) -Uses of Public Health Surveillance Public health surveillance can be used to facilitate the following: Estimate the magnitude of a problem (disease or event). Determine geographic distribution of an illness or symptoms. Portray the natural history of a disease. Detect epidemics; define a problem. Generate hypotheses; stimulate research. Think of causal plausibility of why a problem is happening. Statistics do not improve causation, they link things together. They don’t ever cause it. That happens when we have documentation of records, specific things happening, we’ve observing this. That’s plausibility. Plausability can generate a hypothesis that stimulates research. Evaluate control measures. Monitor changes in infectious agents. Detect changes in health practices. Facilitate planning. Minnesota Model of PH Interventions: Applications for PHN practice Public Health Nursing Section: Public Health Interventions–Applications for Public Health Nursing Practice. St. Paul: Minnesota Department of Health, 2001. NATIONAL NOTIFIABLE DISEASES Box 15-3 shows the national notifiable infectious diseases National Notifiable Disease Surveillance System (NNDSS) Reporting of disease data is essential if trends are to be accurately monitored. Morbidity and Mortality Weekly Report Summary of Notifiable Diseases – United States (annual report) State Notifiable Diseases Requirements for reporting diseases are mandated by law or regulation. Each state differs on the list of reportable diseases. http://www.healthy.arkansas.gov/programsServices/epidemiology/Documents/ReportableDisease.pdf Not all nationally notifiable diseases are legally mandated for reporting in a state. National Electronic Telecommunications System for Surveillance (NETSS) National Electronic Disease Surveillance System (NEDSS) Follow-up to NETSS When reporting nationally, all automated systems can communicate with each other. Also, throughout the world. Before using the National Electronic Disease Surveillance System (NEDSS), CDC developed and used the National Electronic Telecommunications System for Surveillance (NETSS). NETSS is a computerized public health surveillance information system that provided CDC with weekly data regarding nationally notifiable diseases. NETSS continues to be used by reporting
Standard Precautions Response to bioterrorism or large-scale infectious disease outbreak may require the use of Protecting health care providers from exposure including use of standard precautions when coming in contact with broken skin or body fluids, use of disposable nonsterile gowns and gloves followed by adequate handwashing after removal, and use of a face shield Summary Surveillance is practiced at local, state, regional, national and international levels Many uses for public health surveillance that are very similar to the steps in the epidemiology process. According to S and L ( 2014), surveillance system evaluate the effectiveness of PHP (public health programs), Monitor and decrease incidence of chronic diseases, and note and help prevent occupational exposure and diseases. What is the difference between Active and Passive Surveillance? Passive: Building a database Active: Nurse seeks out investigation Patterns of occurrence are important to the Surveillance Investigation. Ex: Common Source, Point source, mixed… WHY? Important to prevent spread by knowing where it started. You can go back and decide how to prevent it and see if interventions worked or not. Active is imitated by a nurse to identify an event ( timing, geographic distribution, susceptible populations) look at unusual incidence of diseases… example common source bronchitis in school system.