Using an Epidemiological and Public Health Approach to Managing a Foodborne Outbreak
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Using an Epidemiological and Public Health Approach to Managing a Foodborne Outbreak
Nurses working in schools, daycare centers, camps, and other facilities where food is served must be cognizant of safe food-handling principles. Furthermore, they must be aware of the potential for transmitting disease if proper procedures are not followed.
Outbreaks of foodborne illness must be assessed and managed, and often it is the community health nurse who initiates and participates in this process. The following is a scenario in which the nurse utilized the nursing process to analyze and intervene in such an epidemic.
Assessment
On Wednesday, October 4, the school nurse at Greenly Elementary School saw eight students who complained of abdominal cramping, diarrhea, and fever. Parents of the sick students were called, and the students were sent home. On Thursday, the nurse was alerted to a large number of absent students and teachers.
Specifically, 62 students and 10 teachers were absent. Most reported diarrhea symptoms. Because the absentee rate of 10% exceeded the average daily rate of 4% for the 620-student school and because the nurse determined that the large number of diarrhea cases suggested an epidemic, the local public health department was notified.
Public health officials arrived at the school and began to assess students still at school and those who were recovering at home. Stool culture specimens were collected and sent to the state laboratory. Results indicated that the organism causing illness was in most cases Shigella sonnei, the most commonly found form of the bacteria.
Persons with severe symptoms were referred to their physicians for possible antibiotic therapy. Food histories of meals eaten both at school and outside of school were taken.
Friday saw a continuing increase in absenteeism of students and staff reporting gastrointestinal illness. Public health specialists defined the criteria for identifying cases on the basis primarily of positive laboratory results, symptoms of diarrhea or vomiting, fever with nausea or abdominal pain, or all of these.
Cafeteria staff were interviewed, and it was determined that one staff member had had diarrhea over the previous weekend but had returned to work on Monday. Public health staff continued to take dietary histories of affected and unaffected persons and constructed rates of illness for all foods served in the cafeteria beginning on Friday of the previous week. These data are displayed in the following table.
From the data, it can be seen that students who ate lunch at school on Tuesday and ate fajitas and salad had higher rates of illness than those who did not. Therefore it was concluded that the outbreak of Shigella could be attributed to a food source.
Diagnosis
Determining the likely cause of the outbreak was important in specifying a diagnosis and directing the planning of an intervention. The following diagnosis was formulated:
Increased risk for infectious diarrhea among elementary school children related to inadequate hygiene and food-handling practices as evidenced by a 19% increase in reported cases within a 4-day period.
Planning
The school nurse, in conjunction with public health specialists, determined that several groups should be targeted in order to eliminate the further spread of disease. They identified a need to assist families in understanding the nature of the disease, how to care for their children who were ill, and how to prevent the spread at home.
Within the school, there was a need to review food-handling practices and the training that cafeteria workers received. Staff, including teachers, also required information about Shigella and how it should be prevented in the everyday lives of students. Needs of special ages and developmental levels of children were also important.
A formal plan of what needed to be done, by whom, and when was drawn up. Research into the nature and prevention of Shigella was gathered from the CDC and the local health department, among other sources. Health department staff developed a plan to release information to the public about the prevention of gastrointestinal illnesses, as many of these diseases are easily spread and so many students were already ill.
Long-Term Goal
- An absence of cases of infectious diarrhea
Short-Term Goals
- Treatment and recovery of all identified cases of diarrhea
- Implementation of an effective program of hygienic practices among students and staff
- Implementation of a food-handling program for all cafeteria workers
- Adequate informing of the larger community in order to prevent spread of the epidemic
Intervention
The school nurse took a central leadership role, directing action within the school aimed at staff, students, and student families. Teaching of appropriate hand washing was stressed. Hand-washing facilities were inspected for soap, paper towels, and running water. Food preparation guidelines were reviewed with staff, and policies regarding remaining at home when ill were reiterated. The health department staff provided technical assistance and made recommendations.
They informed community physicians about surveillance and reporting requirements and provided information regarding case identification and treatment regimens. Daycare centers and preschools were advised to watch for diarrhea outbreaks and to adhere to strict hand-washing and diaper-handling practices, as these facilities tend to be high-risk areas for the transmission of organisms such as Shigella. The media were contacted to elicit their help in disseminating correct and useful information to the community.
Evaluation
Immediate evaluation involved monitoring the decline in Shigella cases both within the school and in the larger community. The school nurse noted that rates of absenteeism returned to normal on the following Monday. She determined that all classes had received hygiene instruction within the following 2 weeks and that all teachers had received a flyer with specific information about Shigella, its care, and its prevention.
She observed that bathrooms had filled soap dispensers, that friendly signs reminding students to wash hands were posted near sinks, and that students were given the opportunity to wash hands before lunch and snacks. The public health department likewise continued surveillance activities after encouraging physicians to collect and submit stool culture specimens for suspected cases and to report cases to the health department. Rates of diarrhea declined rapidly in the week after the school outbreak. The infection did not spread to other schools or community groups. This outcome can be attributed to successful epidemic management, yet surveillance remains critical if the public’s health is to be protected.
Levels of Prevention
Primary
- Teach students and staff about hand washing and hygienic practices.
- Maintain a system that promotes safe food-handling practices.
- Exclude those with symptoms from school or food handling.
Secondary
- Collect stool culture specimens from all symptomatic individuals.
- Treat those with advanced diarrhea symptoms with antibiotics.
- Exclude those with positive culture results from food handling, and exclude those with symptoms from school.
- Advise families and individuals in the care of those with diarrhea.
Tertiary
- Treat and counsel those determined to be carriers of Shigella.
Information on Shigella infections is available at https://www.cdc.gov/shigella/index.html
Number Exposed by Meal and Food Item (N = 143) EXPOSURE VARIABLE (FOOD EATEN) Number Who Ate Number Who did not Eat ODDS RATIO∗ ILL (A) NOT ILL (B) ILL (C) NOT ILL (D) Ate on Monday 47 60 18 18 0.78 Ate on Tuesday: 63 57 3 20 7.37 Fajitas 57 52 8 26 4.56 Salad 44 21 24 54 4.7 Salsa 26 29 40 48 1.07 Tortillas 48 53 16 26 1.47 Beans 29 32 34 48 1.28 Milk 53 56 11 23 1.98 Ate on Wednesday 21 64 43 15 0.11
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
CLICK ON THE LINK HERE: https://www.perfectacademic.com/orders/ordernow
Also, you can place the order at www.collegepaper.us/orders/ordernow / www.phdwriters.us/orders/ordernow
Do You Have Any Other Essay/Assignment/Class Project/Homework Related to this? Click Here Now [CLICK ME]and Have It Done by Our PhD Qualified Writers!!