Dq – response to posts Simkam 1- Epidemiology is the scientific study of the distribution and determinants (causes, risk factors) of health-related states and events in specified populations. It include pattern of diseases and frequency… it is systematic, and data-driven (Center for Disease Control and Prevention (CDC), 2012) It is a branch of study that predicts the occurrences and patterns of diseases in different groups of the population and helps in assessing the reason and factors behind the occurrence of a disease (Majumder & Jena, (2018) Epidemiologist study the cause-effect relationship between exposure and illness. They assume that Diseases do not occur at random rather from man-made causes, which are avoidable. Hence epidemiologist believe that many diseases could be prevented if the causes were known.In Epidemiology, data are collected and assessed from field investigations, surveillance systems, vital statistics, or other sources. This is called descriptive epidemiology, which answer questions related to the cause and distribution of disease, injury, or environmental hazard occurrence. The data collected is analyzed and interpreted and findings from the analysis will improve disease outbreak detection and timely intervention. (CDC, 2018) Findings from epidemiological studies provide evidence for prompt and effective public health control and prevention measures. Findings from Epidemiological studies help the Government in policy-making and resource distribution on prevention and control of disease outbreaks. It helps healthcare organizations to implement measures of prevention, intervention and control of diseases. Findings from epidemiological studies also help pharmaceutical industries to assess if their drugs are efficient enough for treatment and prevention of diseases, as to effect changes where neccessary. Example of epidemiological data and how it is used to make changes When there was an outbreak of Meningitis in a community in 2017, with some children dead and many others admitted into the state general hospital, epidemiologist from the state ministry of health were sent to the community to investigate the cause and distribution of the outbreak. The epidemiologist carried out a survey and collected demographic informations, Information on symptoms of the disease, immunization status of the children, and modalities of treatment. After the data were collected, the epidemiologists created a database with the information, data were analyzed to determine the cause and spread of the infection. Findings showed that the outbreak was as a result of poor personal and environmental hygiene, poor immunization status of the children, overcrowding, and from bad building construction without space and adequate windows for proper cross ventilation. Findings from the survey led to a massive awareness campaign using the media, religious centers, town hall meetings and healthcare providers on health educating members of the community about the importance of proper environmental and personal hygiene, adequate immunization, importance of constructing houses with adequate space and windows for cross ventilation, and preventing overcrowding. This intervention led to the prevention and reduction in the spread of the disease, thus improving and promoting the health and wellness of the community. Lilabr 2- Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems (CDC, 2012). Epidemiology is a quantitative discipline that relies on a working knowledge of probability, statistics, and sound research methods. Epidemiology is a method of causal reasoning based on developing and testing hypotheses grounded in such scientific fields as biology, behavioral sciences, physics, and ergonomics to explain health-related behaviors, states, and events. Epidemiology is not just a research activity but an integral component of public health, providing the foundation for directing practical and appropriate public health action based on this science and causal reasoning. Epidemiology is concerned with the frequency and pattern of health events in a population. Frequency refers not only to the number of health events such as the number of cases of meningitis or diabetes in a population but also to the relationship of that number to the size of the population. The resulting rate allows epidemiologists to compare disease occurrence across different populations. Pattern refers to the occurrence of health-related events by time, place, and person. Time patterns may be annual, seasonal, weekly, daily, hourly, weekday versus weekend or any other breakdown of time that may influence disease or injury occurrence. Place patterns include geographic variation, urban/rural differences, and Epidemiology is also used to search for determinants, or the causes and other factors that influence the occurrence of disease and other health-related events. Epidemiologists assume that illness does not occur randomly in a population, but happen when the right accumulation of risk factors or determinants exists in an individual. The findings provide sufficient evidence to direct prompt and effective public health control and prevention measures. Epidemiologic methods have been developed and applied to chronic diseases, injuries, birth defects, maternal-child health, occupational health, and environmental health. Epidemiologists have also started looking at behaviors related to health and well-being, such as the amount of exercise and seat belt use. With the recent explosion in molecular methods, epidemiologists can make important strides in examining genetic markers of disease risk (CDC, 2012). When a patient presents with diarrheal disease, both the epidemiologist and the medical practitioner are interested in establishing the correct diagnosis. However, while the practitioner usually focuses on treating and caring for the individual through a review of symptoms, the timeline of events leading up to the illness, and taking stool samples for a definitive diagnosis, the epidemiologist focuses on identifying the exposure or source that caused the illness especially the water source for the community, age and gender of those affected, the primary water source of the population, similar foods eaten at the same restaurant, the number of other persons who may have been similarly exposed, the sanitary habits of each individual affected and their families, the potential for further spread in the community; and interventions to prevent additional cases or recurrences. For example, members of a community present to the ER with abdominal cramping, diarrhea, vomiting, and weight loss. The symptoms are all of the same nature for populations receiving their water from a good system. The epidemiologist will test the well water as well as the water that feeds the well upstream and the water downstream of the well. The well water is determined contaminated from run-off upstream from the well. Further study reveals poor sanitary habits of the community due to no toilet facilities so the population of the community uses the bathroom wherever. Members of the population do not realize they are contaminating their water source upstream from the well. Education regarding these habits as well as establishing bathrooms in this community is paramount to the wellness of the community. Fnushe 3- Epidemiology is the study of health-related states or events, including disease. Epidemiology is used to control diseases and other health problems and provides a comprehensive understanding of the magnitude, causes, and consequences Epidemiologic investigations include observation or surveillance and descriptive or experimental studies to examine the distribution of the health determinants. Epidemiology is considered a methodology for studying health conditions and developing the body of knowledge of the health condition (Helbig & Ambrose,2018) As epidemiology is one of the essential disciplines of public health, that has a crucial role in describing health status, identifying risk factors, and analyzing relationships between health and different hazardous agents (Gulis &Fujino, 2015). Epidemiology measures the relationships between hosts and agents in certain environments, also analyses the health status of the population living in that environment. However, to improve the health status of the population, the knowledge produced by epidemiology needs to be used and translated into interventions. There are different types of interventions that work with hosts and improve their immune system, increase their knowledge, and motivate behavioral change to make the hosts more resistant to agents. Public health can also influence the presence and distribution of agents, this is often done via traditional hygiene measures, such as provision of safe drinking water, clean air, and good waste management, but also via anti-smoking regulations, diet advice, and physical activity guidelines( Gulis & Fujino, 2015). Epidemiologists collect and assess data from field investigations, surveillance systems, vital statistics, or other sources. This task, called descriptive epidemiology, answers the questions about disease, injury, or environmental hazard occurrence. An example is an epidemiologic investigation done during an outbreak of pneumonia in a military camp in 2009 (Dawood, Ambrose, Russell et al., 2011). Epidemiologists collected data on symptoms, past medical history, laboratory testing, exam findings, and recent treatments that trainees and training staff had received. Epidemiologists surveyed all trainees and training staff of the camp. Data were collected regarding demographic information, information on symptoms of illness, health care use, influenza vaccination status, and treatment with antibiotics during the investigation period. The data were analyzed to determine trainee and training staff characteristics thought to be associated with the infection. The epidemiologists used what they learned to prevent future outbreaks from occurring. They were able to stop the outbreak after trainees and training staff received vaccinations and antibiotics, and after hand hygiene and cough, etiquette was strengthened. The information gained from this investigation will improve outbreak detection and timely response at military training installations, and new vaccines may provide opportunities to reduce pneumonia among military trainees in the future (Dawood, Ambrose, Russell et al., 2011) Deerob 4- Epidemiology is the study of the origin and causes of diseases in a community. It is the scientific method of investigation problem-solving used by disease detectives— epidemiologists, laboratory scientists, statisticians, physicians, and other health care providers, and public health professionals—to get to the root of health problems and outbreaks in a community (CDC, n.d.). Accessible epidemiological data are of great value for emergency preparedness and response, understanding disease progression through a population, and building statistical and mechanistic disease models that enable forecasting. Epidemiological data have a variety of uses. From a public health perspective, they can be used to gain an understanding of population-level disease progression. This understanding can, in turn, be used to aid in decision-making and allocation of resources. Recent outbreaks like Ebola and Zika have demonstrated the value of accessible epidemiological data for emergency preparedness and the need for better data sharing. These data may influence vaccine distribution, and hospitals can anticipate surge capacity during an outbreak, allowing them to obtain extra temporary help if necessary. From a modeler's perspective, high-quality reference data (also commonly referred to as ground truth data) are needed to enable prediction and forecasting. These data can be used to parameterize compartmental models as well as stochastic agent-based models. They can also be used to train and validate machine learning and statistical models (Fairchild, 2018). An example of epidemiological data collection In February 2009, when two fatal cases of meningitis occurred at Fort Leonard Wood, MO, an Army training center, it was time for disease detectives to get to work. The investigation would identify the cause Epidemiologists determined that the two fatal cases of meningitis were the only meningitis cases identified during the investigation period, and 72 cases of pneumonia were identified among all the trainees. They were able to rule out the following risk factors as not being associated with getting sick: taking antibiotics, living in a bay (more than four trainees per room), smoking, having one or more illness symptoms, and living on a particular floor of the barracks. of the outbreak and lead to interventions to prevent further cases of the disease. Epidemiologists collected data on symptoms, past medical history, laboratory testing, exam findings, and recent treatments that trainees and training staff had received. They reviewed medical records from the training camp and civilian hospitals, including a list of trainees who were too ill to participate in routine training and medical charts of patients with pneumonia in the troop companies. Epidemiologists determined that the two fatal cases of meningitis were the only meningitis cases identified during the investigation period, and 72 cases of pneumonia were identified among all the trainees. They were able to rule out the following risk factors as not being associated with getting sick: taking antibiotics, living in a bay (more than four trainees per room), smoking, having one or more illness symptoms, and living on a particular floor of the barracks (CDC, n.d.). Sim kam II 5.2 - As the use of computer and technology in hospitals, clinics, and private practice expands, healthcare Information Technology (IT) nurse information technology is being used in countless ways to improve healthcare delivery, patient safety, and the relationship between patients and healthcare providers. The patient-generated health data are created, recorded to help address health concerns. The most notable use of IT is inpatient records and data management. The health electronics records gather all patient data and can be easily accessed. The data includes health history, treatment history, biometric data, symptoms, and lifestyle choices. In the current practice, healthcare professionals can track patients' records securely and easily, appending pharmacy records, test results, X-rays, and even vital signs to a virtual chart that is easier to read and share, and this can also be compared to other databases. The use of MyChart portals enables patients to check up on the latest test results and enables them to participate in decision making regarding the care. The use of electronic prescribing allows the doctor to communicate directly with the pharmacy and this saves on time when patients are going to pick up their medications. With the use of nursing informatics, more data is generated in regard to clinical care. Through the information obtained on patient care, analysis can be done that focuses on improving patient care. With the use of IT, nurses can spend less time on charting and focus more on saving patients' lives. The use of IT enables early detection of medical errors. The information and data collected can be used to provide patients with consistent care. This incorporates several doctors, nurses, and other medical professionals that ensure all areas of a patient's health are addressed. The data enables the improvement of patient care within a health care facility and this can be obtained from the satisfaction surveys and complaints. On the other, the data generated can be used for research purposes that in turn improves/ promotes quality patient care. The incorporation of various stakeholders in the patient care can promote sharing of ideas from various institutions and a solution to a patient's health problem obtained. Lilabr 6.2 Reporting patient safety events is a useful approach for improving patient safety. The mechanism was then extended to healthcare systems with additional features such as anonymous reporting, meaningful feedback, ease of reporting. Through collecting adverse events and near misses in healthcare, the reporting systems enable safety specialists to analyze events, identify underlying factors, and generate actionable knowledge to mitigate risks. Since the emergence of electronic patient safety reporting (e-reporting) systems, the collection, and analysis of events tend to become a more efficient manner than traditional paper-based systems. However, the promising benefits of such systems in healthcare are yet to be fully seen. Currently, low-quality reports have been found as a roadblock hampering the data utility for quality improvement and patient safety research. It is reported that a large amount of inaccurate and incomplete information, such as inconsistent records and misclassifications, is typically contained in the systems. As the world responds to the coronavirus disease 2019 (COVID-19) outbreak, telehealth has become a critical resource. With e-visits and video visits, organizations across the Epic community are freeing up health system capacity to respond to COVID-19 cases and slowing the spread of infection by giving patients the option to stay home rather than visit the clinic. Several Epic community members across the United States and in outbreak epicenters are using telehealth to address COVID-19. Video visits help clinicians triage patients remotely, which helps reduce lines at the clinic while encouraging patients to stay at home when possible. At our hospital patients see a reminder that video visits are available when they visit MyChart’s home page. Our institution also updated the appointment reminders to let patients know when to stay home instead of coming into the clinic and to provide hygiene instructions for in-person visits. Patients can speak with a nurse or self-evaluate symptoms from home. This is both convenient for patients and the best practice for containing COVID-19 because patients can avoid contacting others who might be infected if they are well and avoid spreading the infection if they’re ill.
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