1 of 7

Slide Notes

Centers for Disease Control and Prevention. (2012). Tuberculosis: Basic TB Facts. Retrieved from http://www.cdc.gov/tb/topic/basics/default.htm

Centers for Disease Control and Prevention. (2012). Tuberculosis: Basic TB Facts, Signs and Symptoms. Retrieved from http://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm

Centers for Disease Control and Prevention. (2014). Tuberculosis: Testing and Diagnosis. Retrieved from http://www.cdc.gov/tb/topic/testing/default.htm
DownloadGo Live

Case Study: Outbreak from Africa

Published on Feb 07, 2016

No Description

View Outline

MORE DECKS TO EXPLORE

PRESENTATION OUTLINE

1.

Case Study: Outbreak from Africa

  • Three Labor and Delivery Registered Nurses (RN) return from a medical missions trip in Katima Mulilo, Namibia.
  • During their stay, they volunteered in the located hospital working in the labor and delivery unit.
  • Due to the increased population of tuberculosis cases in the area, the hospital they volunteered at had a tuberculosis clinic.
  • After returning to Arizona, the RNs return back to work on their hospital unit.
  • About three weeks after their return, one of the RN’s develops a chest cough, weakness, fatigue, and loss of appetite. After attempting to come into work with what she believes is a cold, she leaves work early as the severity of her fatigue and cough increases (Centers for Disease Control and Prevention [CDC], 2012).
  • Later in the week, the RN begins to cough up a small amount of blood tinged sputum blood (CDC, 2012).
  • The RN goes to her primary care physician’s office and receives a tuberculin skin test. After returning later to get get the test read, the results are positive. The RN then receives a chest x-ray which further show the RN has active tuberculosis (CDC, 2014).
  • The RN had likely been exposed to tuberculosis at some point on her Medical Missions Trip. After not being tested for tuberculosis after returning to work in the United States, the RN had likely exposed multiple people, including mothers, fathers, family members, newborn babies and fellow co workers in the hospital to the tuberculosis virus (CDC, 2012).
Centers for Disease Control and Prevention. (2012). Tuberculosis: Basic TB Facts. Retrieved from http://www.cdc.gov/tb/topic/basics/default.htm

Centers for Disease Control and Prevention. (2012). Tuberculosis: Basic TB Facts, Signs and Symptoms. Retrieved from http://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm

Centers for Disease Control and Prevention. (2014). Tuberculosis: Testing and Diagnosis. Retrieved from http://www.cdc.gov/tb/topic/testing/default.htm
Photo by orkomedix
2.

Reporting: Local and State

  • In Arizona, Tuberculosis active disease, is considered a reportable communicable disease (Arizona Department of Health Services [ADHS], n.d).
  • Case Study: The RN’s primary care physician is required, by law, to submit a report to the Pima County Health Department, “within one working day after a case or suspect case is diagnosed, treated, or detected” (ADHS, n.d).
  • The report is submitted to the Pima County Health Department, which is then submitted to the Arizona Department of Health (ADHS, n.d)
Arizona Department of Health Services. (ADHS). (n.d.). Epidemiology & Disease Control: Communicable Disease Reporting – Healthcare Providers. Retrieved from http://www.azdhs.gov/preparedness/epidemiology-disease-control/index.php#re...
Photo by cobalt123
3.

Reporting: United States and Global

  • The Center for Disease Control and Prevention (CDC) considers Tuberculosis a Nationally Notifiable Condition/Disease (National Notifiable Disease Surveillance System [NNDSS], 2015).
  • It is voluntary for states to notify to the CDC of a Nationally Notifiable Condition (NNDSS, 2015).
  • Case Study: Due to the RN traveling abroad recently, the Arizona Department of Health Services chooses to notify the National Notifiable Disease Surveillance System (NNDSS) within the CDC.
  • This will allow the NNDSS to monitor and track disease trends associated with Tuberculosis (NNDSS, 2015).
  • The CDC reports the case of active Tuberculosis to the International Health Regulations (IHR), part of the World Health Organization (WHO), due to the face the RNs flew on multiple airplanes and went to numerous airports, both nationally and internationally, exposing numerous people from different countries and continents (World Health Organization [WHO], 2016).
National Notifiable Diseases Surveillance System. (NNDSS). (2014). 2016 Nationally Notifiable Conditions. Retrieved from http://wwwn.cdc.gov/nndss/conditions/notifiable/2016/

National Notifiable Diseases Surveillance System. (NNDSS). (2014). Data Collecting and Reporting. Retrieved from http://wwwn.cdc.gov/nndss/data-collection.html

World Health Organization. (WHO). (2016). About IHR. Retrieved from http://www.who.int/ihr/about/en/.
Photo by shaire productions
4.

Challenges with Public Health Reporting

  • Due to the Tenth Amendment of the United States Constitution, public health infrastructures are left to the power of the state government (Staes, Wilson, & Lenert, 2014).
  • This creates dichotomies of the functionality and activity of public health lying in the local government authority, but the implementation and planning in the hands of the states and federal government (Staes, Wilson, & Lenert, 2014).
  • This competing infrastructure lead to difficulties with computing information, data ownership, standardization, not sharing data/information, and system development between local governments (Staes, Wilson, & Lenert, 2014).
  • The challenge of privacy over public interest, whether health information should be shared across communities or stay a private matter (Whetton, 2013).
Staes, C., Wilson, M., & Lenert, L. (2014). Public Health Informatics. Chapter 11. In R. Nelson and N. Staggers (Eds.) Health Informatics: An Interprofessional approach. 1st Ed.). St. Louis, MO: Elsevier

Whetton, S. (2013). Using personal health information: Do we manage conflicting interests? Health Informatics: Digital Health Service Delivery – The Future is Now. IOS Press. pages 135-141
Photo by Yang and Yun's Album
5.

Strategies for Improvement

  • Creating a data exchange system, were as opposed to the current mandate of information to be reported there will be an exchange of reported data in order for it to be republished for population health issues (Staes, Wilson, & Lenert, 2014). The public health department will receive data, and then in exchange use it publish and inform the population of current health issues (Staes, Wilson, & Lenert, 2014).
  • Implementing systems that instead have clear boundaries on what can or cannot happen in the realm of population health, as opposed to laws that dictate what one can and cannot do (Whetton, 2013).
  • Implementing reusable data design software, in which there is data standards for how information is stored and exchanged (Reeder, Hills, Demiris, Revere, & Pina, 2011).
Reeder, B., Hills, R. A., Demiris, G., Revere, D., & Pina, J. (2011). Reusable design: A proposed approach to public health informatics system design. BMC Public Health, 11, 116-2458-11-116.

Staes, C., Wilson, M., & Lenert, L. (2014). Public Health Informatics. Chapter 11. In R. Nelson and N. Staggers (Eds.) Health Informatics: An Interprofessional approach. 1st Ed.). St. Louis, MO: Elsevier
Whetton, S. (2013). Using personal health information: Do we manage conflicting interests? Health Informatics: Digital Health Service Delivery – The Future is Now. IOS Press. pages 135-141
Photo by NCDOTcommunications
6.

References

7.

References

Tracey Stevenson

Haiku Deck Pro User