Applications of Epidemiology-A case study
Analyze Good Health Hospital’s records and itemize recent nosocomial infections that occurred within the past year. In your report, categorize the different parameters (i.e. person, time, place and ethnicity and gender) used in the compilation of data into the information summative. Hypothetically, Good Health Hospital is assumed to have possessed nosocomial infections as in any real hospitals where patients seek admission for treatment. According to Center for Disease Control and prevention (CDC), and Pennsylvania Department of Health (PADOH), a healthcare associated infection (HAI) which is also known as nosocomial infection is an infection that a person gets while staying as a patient in a hospital or other health care facility (PADOH, 2008). Hence, it is clearly understood that patients always acquired nosocomial infections during the process of receiving health care services from health professionals in any hospital or healthcare setting. PADOH has also confirmed that HAIs are the primary contributors of most sicknesses and mortalities in the world. For example, in American hospitals alone, HAIs account for about 1.7 million infections causing 99,000 deaths each year. Therefore, based on the analysis of Good Health Hospital records, research had shown that a great number of recent nosocomial infections that had happened before were identified. Among the different kinds of nosocomial infections verified, few infection type have been listed as followed:
1. Surgical site infection (SSI).
2. Urinary tract infection (UTI).
3. Gastrointestinal infection (GI).
4. Blood stream infection (BSI).

5. Pneumonia infection (PNEU).
6. Lower respiratory tract(LRI)’
7. Skin and soft tissue (SST).
8. Eye Ear Nose and Throat (EENT).
9. Cardiovascular system(CVS). Categories of different parameters
Case Episodes per
Person Time Place Ethnicity Gender Age
Skin and soft tissue infection 10,000 2009-2011 Northern California Asisn,African American, Hispanic, Native American and White Female and male Under age 5, 18,50,65 and 65+

Case person time place ethnicity gender age
Surgical site infection per 1,000 2009-2011 all states all ethnics’ men, women American
Urinary tract infection
Pneumonia
Bloodstream infection
Propose at least six (6) questions for the health care administrator at Good Health Hospital, regarding potential litigation issues with infections from the nosocomial diseases. Rationalize, in your report, the logic behind your six (6) questions. There is no doubt that healthcare providers and their facilities have some obligations to legal duty of the care they provide their patients. As a result, they must execute such a degree of care and professional skill which could necessarily be anticipated of a standard wise experts. According to (Beckmann, 1998), “nosocomial infections poses a major threat for hospitalized patients, and if failed to provide a safe environment for your patient, it could become a legal threat to your facility”. For example, Ms. Summers sued, contending that proper care of the I.V. insertion site would have prevented the infection and subsequent amputation of her leg if the nurses had not failed to assess her infected arms and leg systematically (Beckmann, 1998).It is important for every leader in the healthcare setting to be aware of nosocomial infections which are a major source of morbidity and mortality in hospital settings afflicting an estimated 2 million patients in the United states each year. Therefore, it is very important for the health care administrator at Good Health Hospitals to be provided with the below listed questions concerning possible lawsuit matters in connection to infections from the nosocomial diseases.
1. As health care administrator what experienced have you had about nosocomial infections considering the economic burden it imposes on health care system?
2. As health care administrator of Good Health Hospital, how do you plan to prevent your organization from lawsuit cases with infections from health associated infections?
3. Outline strategies that will be used to minimize the frequency of the following nosocomial infections: a. bloodstream infections, b. urinary tract infections, c. surgical site infections and d. ventilator –associated pneumonia.
4. State your primary goal of nosocomial infections control and explain how you will implement your plans to achieve your goal and avoid legal action against your organization for nosocomial diseases?
5. What protocols must be available to assist in the management of patients with suspected or confirmed viral infections in the health care facility? Why hand hygiene is the most important defenses against nosocomial transmission of viruses and must be based on continuing education of staff and strict adherence to infection control policies?
6. Name the main courses that you would like for all your staff to be trained against nosocomial infections and that which will enable them to prevent future lawsuit.
7. What policies would you create and distribute for all staff members to implement without excuse considering potential litigation problems with infection from the HAIs?
The important reason for these questions is that so many writers have reported the negative impacts of nosocomial infections on health care providers and the health care settings. According to Thomas, Rial and Rouge (2002), “Infections acquired in health care institutions are a topic of which professionals and the general public are becoming increasingly aware of the growing number of lawsuits relating to nosocomial infection increases the anxiety felt professionals in this domain”. Moreover, the Administrative case law approved from 1988 onwards a system which is more favorable to the victims than the civil courts which deal with litigation against private health care institutions”(Thomas, Rial,& Rouge, 2002). Hence, these questions are there to help the health care administrator at Good Health Hospital educate his or her staff about the legal circumstances surrounding the nosocomial infections.
Identify a targeted audience within Good Health Hospital, and prepare an implementation plan based on your hypothetical meeting with the hospital health care administrator. Propose four (4) steps that will be useful in the final implementation plan. The target audience for nosocomial infections within Good Health Hospital include patients who have been taken to severe care units due to shortage of consciousness, distress, and main surgical challenges. In addition, patients with bloodstream infections, pneumonia infections, surgical site infections, urinary tract infections and patients with other HAIs infections are considered targeted audience (Celike, 2004). Nosocomial pneumonia is reported to be the most commonly infection to attack the elderly or the young. For example, “Among all age groups, the elderly are at greatest because aging can impair normal pulmonary defense mechanisms” (Galliano, 1996). For surgical site infections, the aim audience consists of more men than women, the normal age ranges from 58 to 68 year and surgical site infections and hospital developed pneumonia lead among hospital infections within patients undertaking vascular surgery procedures (Bulanda, 2008). Nosocomial infections is said to develop after 48hours of hospital admission. In 1985, the center of Disease Control in the United States reported that 2.7% of all hospital patients acquired nosocomial infections and yearly expenditure for management of nosocomial infections was about $ 1billion. Presently, the projected costs of treatment had intensified to between $5 and $10 billion, and more than 80, 000 are reported deaths per year with direct link to the development of nosocomial infections” (Celik, 2004). The implementation plan prepared based on the hypothetical meeting with the hospital health care administrator for the prevention of nosocomial infections.
Prevention of nosocomial infections in Good Health Hospital implementation plan:
1. Appoint a team head to coordinate the implementation plan for the prevention of nosocomial infections
2. Propose a budget
3. Provide formal prevention orientation to all hospital staff on the prevention intervention
4. Provide prevention training to all hospital staff.
The four steps that will be used in the final implementation plan are as follows:
Discuss:
• Prepare and distribute handouts to all participants about nosocomial infections to educate staff on how to prevent the HAI diseases.
• The risk of infection – provide lecture and video show on nosocomial infection risk factors against the health of patients, health providers, lawsuits and financial burden risk the health care organization faces with nosocomial diseases
• Type of patients- help participants identify the various kinds of nosocomial diseases and how patients acquire nosocomial from health care professionals after admission.
• Type of procedures-teach hand hygiene as when to wash hand. Promote hand hygiene before and after every patient contact, duration, how to wash antisepsis and hygiene agents, use of alcohol based hand rubs, hand hygiene after glove removal and so on (Kilbride,Wirtschafter, Powers & Sheehan, 2003).
Suggest at least five (5) recommendations to your department head based on the steps taken in the implementation plan. Provide rationale for your suggestions.
The five recommendations to the department head regarding the steps taken in the implementation plan of nosocomial infection prevention.
1. Wash your hands before touching a patient when approaching him or her. This step will prevent the patient against from any harmful germs on your hands.
2. Clean your hands immediately before performing a clean or aseptic process. By doing this you are saving the patient against getting infectious disease, including the patient’s own infection from entering his or her body.
3. Wash and sanitize your hands immediately after an exposure risk to body fluids and after glove removal. This will protect yourself and the health –care environment from harmful patient bacteria.
4. Clean your hands after touching a patient and his or her immediate surroundings when leaving the patient room. The reason is to protect the health care environment and yourself from destructive patient diseases.

Using these approved recommendations, design a safety protocol itinerary that must be placed in public access areas of the hospital This safety protocol itinerary is designed for hospital staff and the public in general to access evidence based information in the prevention and control of infection. For this aim to be accomplished a hospital infection control committee has been formed that will look after the infection control needs of the hospital. It is very important for all the staff including physicians, nurses, other clinical professionals and administrators working within the hospital to assist in fulfilling their professional obligations with regard to both communicable diseases and infection control. The function of hospital control team is to implement the recommended plan of nosocomial infection prevention, policies, and provide infection control advice on a 24-hours basis. Hence, the team is responsible to execute the following:
• Surveillance of infections and monitoring methods of control
• Constant verification and investigation of infection cases or possible risky procedures
• Giving advice on the management of patients with infection, mainly those in isolation
• Providing a straining activity in infection control and auditing compliance
• Preparing yearly infection control program and monthly infection control reports
• Producing and maintaining up-to-date hospital infection control policies
• Helping various departments within the hospital in their endeavors to reduce healthcare associated infections and implement compulsory hand washing policy.