Assignment 1: Applications of Epidemiology – A Case Study
Landon Hazel
Dr. Cynthia Davis
HSA 535
October 22, 2014

Introduction
The Good Health hospital has a minor 6 person nosocomial infection of E. coli. The role of the social science researcher is to investigate dissimilar patterns and causes of the E. coli and its bearing on the patients. The science researcher also understands that litigation issues are also in question because the hospitals are anticipated to safely inhibit the spread of any diseases from patient to patient. In many cases Good Hospital could be held liable for negligence. By contacting the DOH and CDC for data related to nosocomial diseases, the researcher can gain valuable information about different ways to contain the spread. After the data is gathered, the researcher can effectively prepare an evaluation report. This report will include information in detail about nosocomial infections as well as considerations for Good Hospital to handle the problem effectively.

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, ethnicity, and gender) used in the compilation of data into the information summative.
In an evaluation of the information that we do recognize about Good Health Hospital is that the outbreak of E. coli was triggered in fact by spoil food from the cafeteria. The E. coli outbreak has six known cases. Four of the confirm cases are described as such: Case | Age | Gender | 1 | 23 years old | Male | 2 | 21 years old | Female | 3 | 15 years old | Male | 4 | 42 years old | Female |

As a scientific researcher, there is a necessity to realize what E. coli is and how it can spread. According to the CDC, “Escherichia coli (abbreviated as E. coli) are bacteria found in the environment, foods, and intestines of people and animals.” E. coli can have symptoms of diarrhea, urinary tract infections, respiratory illness, and even pneumonia. Analyzing the confirmed cases underneath certain categories will always serve as a great tool to begin research in this matter. These categories are person, place, ethnicity, and gender.
In all of the four identified cases, the “place” of the E. coli infection is Good Health Hospital. This centralized location makes the disease easier to contain and also suggests that the hospital itself is the infected area. Each “person” that are displaying symptoms are confirmed cases. These cases are broken down into case numbers. The ethnicities or the race of the individuals are unidentified so that will not play as a factor in this case. If this information was known, the data would recommend that the certain ethnicities would be more susceptible than others.
The genders of the patients are expressed as two males and two females. Being that there are four cases being compared, that is an even split. This case shows that a male is no further at risk than a female and visa-versa.
The other category that is shown here is age differences. The data expressed here is a 23 year old, a 21 year old, a 15 year old and a 42 year old. The 42 year old is the age that stands out the most. Based on this information it proposes that the younger age group is more like to become infected with E. coli.

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.

1. What measures are being taken to monitor the condition of the food that is being served?
The condition of the food was the source of the E.coli outbreak initially. The food should be tested and inspected methodically prior to serving it in the hospital cafeteria. Meats should be specifically paid close attention to since they are the most common way for the disease to be contracted. The spread of this kind could have been worse than just six people because all patients eat cafeteria food during any length of stay which is a massive legal responsibility. 2. What measures are being taken to prevent the spread of diseases from patient-to-patient?
Patients that become infected can spread the disease to other patients. The patient may be unaware of the contracted disease if it is nosocomial, however the patient should be closely supervised for signs and symptoms of other diseases. The patient is still under hospital care, so the hospital could be held liable. 3. What measures are being taken to ensure that health care staff are healthy so that they do not spread diseases to patients? Hospital staff should continuously be up-to-date on immunizations and current flu shots. Caring for patients makes them a higher risk to contract a disease. Staff needs to be carefully checked out periodically to make certain they are healthy for their own benefit, but more importantly the patient. Even if the patient contracts a disease from a staff member, the hospital is still held responsible. 4. What types of procedures are in place to ensure the proper sanitation of operating equipment, utensils, and other medical supplies? Medical supplies that are used during surgeries, needles, IV’s, and any other piece of medical equipment would need to be properly sanitized. There are several types of infections that can happen after surgeries, knee-replacements, hip-replacements, and other types of implants. It is very common for a surgery or other procedure to go wrong. Patients that experience malpractice will more than likely sue the hospital and staff involved. 5. Is the hospital up-to-date with the safety procedures from the state or CDC standards?
In a case of negligence, the proper use of standards and safety procedures will be audited. It is imperative for the hospital to remain in compliance with current standards within that particular state and also the CDC. Hospitals can be fined if violations are found out about, and a violation can help to prove negligence in a court. 6. What types of measures are taken to quarantine highly contagious patients if necessary?
The hospital needs to be in compliance with the CDC to have quarantine measure in place. The hospital must take any necessary measures to ensure that infected patients, as well as patients with unconfirmed cases. Patients that become infected can all hold the hospital liable for negligence. Quarantines can be considered inhumane in some cases, but the spread of diseases has to be contained until the infected patients are treated.
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.
Four steps that are useful in the final implementation plan would cover all bases of compliance, prevention, containment, and treatment. These are four very important elements to consider when developing a good plan. (1) Compliance- Ensure that the hospital is compliant with all procedures and up-to-date with all standards at all times, especially disease control (2) Prevention- ensuring that standards are in place for inspecting food items that are served in the cafeteria, making sure that staff members are up-to-date on immunizations, and ensuring that all medical equipment is properly sanitized to prevent infections. (3) Containment- once the disease has spread, it should be kept from spreading to other patients and staff members. (4) Treatment- Patients should be quarantined if necessary until vaccines or medicines can be administered. Also patients need to be checked to ensure that they are cleared of the disease prior to discharge.
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 department head can put the implementation plan into action by making sure that certain changes are made to the policies and procedures. These suggestions that are being made help to support the implementation plan. 1. Suggest that there is a weekly meeting on proper standards. Compliance guarantees that the hospital is properly following current procedures and standards. A weekly meeting ensures all staff members are familiar with procedures. 2. Suggest that a staff member be assigned to inspect food items as they come in on the delivery truck prior to being used and included into the kitchen inventory. Prevention of infectious diseases in food items served in the cafeteria is the goal. 3. Suggest that all medical equipment be sanitized after use, and again before use to be extra safe to ensure supplies are not causing infections 4. Suggest that patients be kept in the same room regardless of conditions. This prevents patients from spreading any unknown disease from floor to floor. 5. Suggest that patients be quarantined only as a last resort. That should be preserved for deadly diseases like Ebola.
Using these approved recommendations, design a safety protocol itinerary that must be placed in public access areas of the hospital. * Pay attention to signs and do not walk into restricted areas, could be a quarantine area * If you ever begin to feel sick, especially different symptoms, let a member of staff know * If you notice anything strange in the cafeteria or different about the food, let a member of staff know * Wash hands and use hand sanitizer after going to the bathroom * If you see any suspicious activity or any serious concerns, do not hesitate to let a member of staff know * If there is an emergency call 911

References
Friis, R. H., & Sellers, T. (2014). Epidemiology for public health practice (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Macera, C. A., Shaffer, R., & Shaffer, P. M. (2013). Introduction to epidemiology:
Distribution and determinants of disease (1st ed.). Clifton Park, NY: Cengage Learning
CDC website: E. coli (Escherichia coli) Retrieved on October 22, 2014 from http://www.cdc.gov/ecoli/index.html
South Carolina DHEC website: E. coli Retrieved on October 22, 2014 from http://www.scdhec.gov/