Applications of Epidemiology A Case Study

HSA535 – Managerial Epidemiology

Professor Donna Levesque

This paper provides a review of the Good Health Hospital records regarding an overwhelming outbreak of E. coli in Ward 10 which is located on the second floor. In an effort to get a clear understanding of the situation, the hospital contacted the CDC to receive more information, conduct a study and communicate the results of their findings.

E. coli contamination has spread over all the hospitals in the Tampa Bay area, according to the investigation report, from the consumption of food that was spoiled. It has been recommended that further investigations be conducted in an effort to discover the source of the disease, along with replacing the vending services with a new one. Chief Administrator Joe Wellborn requested this investigation after a litigation issue with a patient to determine that this patient already had symptoms of E. coli prior to the outbreak.

Keywords: E. coli, nosocomial infections

Epidemiology describes, quantifies, postulates causal mechanisms for diseases in populations, and develops methods for the controls of diseases. Good Health Hospital is in need of Epidemiology’s discipline since they have become overwhelmed with an E. coli outbreak located in Ward 10 on their 2nd floor. E. coli is a bacterium commonly found in the intestines of humans and other animals, where it usually causes no harm according to There are several stains of this disease, some of which causes food poisoning in the elderly and young children. There are six people that has contracted nosocomial infection of E. coli at the Good Health Hospital. The social science researcher’s role is to investigate the various causes and patterns of E. coli and its effect on patients. Understanding litigation issues which are questioning the hospital’s safety precautions and procedures surrounding the spread of this disease from patient to patient is extremely important to the social science researcher. Good Health has no desire to encounter a negligence claim. Contacting the DOH and CDC to obtain their data regarding nosocomial disease allows the researcher the opportunity to gain valuable information related to the various ways to stop the spread.

This paper will analyze Good Health Hospital’s records, list the most recent nosocomial infections which occurred in the last year, classify the various parameters in the gathering of data into the information, establish six or more questions for the health care administrators, identify a targeted audience at Good Health Hospital, design a plan to be implemented based on the hypothetical meeting with the hospital health care administrator, recommend five or more steps taken in the implementation plan to the department head, and utilize these approved recommendations to design a safety protocol that should be visible in public areas of the hospital.

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.

Nosocomial infections are those infections that are acquired in hospitals and/or other healthcare facilities. In order to be classified as nosocomial infections a patient would have to be admitted for a reason that is not related to the infection. The researchers identified the trigger of the E. coli outbreak was the spoiled cafeteria food. There were six known outbreaks of E. coli.

Good Health Hospital currently dealing with four cases of nosocomial outbreak of E. coli on Ward 10 located on the second floor. These four cases were identified and have been linked to the cafeteria’s spoiled food and there are two more cases pending. Post meeting with the chief administrator, Joe Wellborn, one of the patients may possibly have shown signs and symptoms prior to admission. The parameters of discussion are below:

Propose at least six (6) questions for the health care administrator at Good Health Hospital, regarding potential litigation issues with infections from the nosocomial disease. Rationalize, in your report, the logic behind your six (6) questions.

  • Person: 4 identified cases.
    • 1. Male, age 23
    • 2. Female, age 21
    • 3. Male, age 15
    • 4. Female, age 42
  • Place: Good Health Hospital, Ward 10, second floor
    • Good Health Hospital Cafeteria
    • Other Hospitals in the Tampa Bay area
  • Time: Within the past week

As the health care administrator at Good Health Hospital, the obligation is to prevent litigations involving patients. However, there must be a plan in place if litigation issues arise. In an effort to prepare for the litigation process, several questions are prepared:

What is the primary goal of nosocomial infection control at Good Health Hospital?

How will the hospital implement a plan to achieve the goal and avoid legal actions against the organization for nosocomial diseases?

What protocols must be available to assist in the management of patients with suspected or confirmed viral infections?

What policies would Good Health hospital create and distribute to all staff members to implement?

Who is held liable for the negligence?

How does Good Health hospital plan to prevent the organization from lawsuit cases with infections from associated with inpatient visits?

Nosocomial infections are typically viewed as unavoidable risks of hospitalization. However, where this risk is materialized, the infections were typically benign and treatable (Kleinpell). Legal claims were not often pursued even when the consequences of nosocomial infections were severe because of the perception that infections acquired at hospitals were a common risk which most often materialized without negligence. Even when lawsuits are filed, typically they are focused on the treatment of the infection rather than how and why the infection was acquired (Kleinpell). Healthcare providers and facilities have a legal duty to care for their patients. Patients that can prove they suffered harm as a result of a healthcare provider’s incompetency to meet an appropriate standard of care can bring a claim of negligence against the provider as well as the healthcare facility.

Inpatients are subjected to infections related to their hospital care. According to Kleinpell, approximately 1 in 25 inpatients are infected at any given time. These infections cost the healthcare system in the US billions of dollars yearly. They also lead to a loss of tens of thousands of lives. Other nosocomial infections are identified as Urinary Tract Infection (UTI), Gastrointestinal Infections (GI), Pneumonia, Eye, Cardiovascular System Infection (CVS), Surgical Site Infection (SSI), Blood Stream Infection (BSI), and Skin and Soft Tissue (SST).

Controlling infectious diseases happens to be one of the most familiar applications of epidemiology at work in the medical community. Friis, R.H., & Sellers, T. (2014) Infections acquired by hospitals, also known as nosocomial infections, are increasing in the U.S., therefore it is extremely important for healthcare providers to provide their patients with the highest level of care and professional skills necessary to maintain the health of the patient. states, “A nosocomial, or hospital-acquired, infection is exactly what it sounds like – an infection that happens as a result of treatment in a hospital but is secondary to a patient’s original admitting diagnosis.

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 targeted audience with Good Health Hospital are healthcare providers, administration, administrative staff, food service workers, stakeholders, risk management, human resources and all hospital employees (Reybrouck, 2000). Healthcare providers and facility administrators have the unique opportunity to decrease the potential of hospital-acquired infections. Healthcare facilities must utilize the skills and knowledge of nursing practice, facilitate patient recovery while minimizing complications related to infections. Poor hand washing hygiene is responsible for a large number of infections transmitted in hospitals. Surveys have proven that improvement in compliance with hand washing decreases nosocomial infections (Reybrouck, 2000). Making sure that hand washing stations are accessible and the use of alcohol gels improves the level of compliance. Alcohol gels dries rapidly and is a bactericidal and fungicidal. Protective garments are also necessary for healthcare providers exposed to body fluids such as sweat, oropharyngeal fluids, blood and/or urine. Gloves and aprons must be work when handling body fluids.

Using invasive procedures increases the risk of nosocomial infections. Accessing the vein, the risk can be decreased by the use of specific sites such as subclavian vein rather than internal jugular or femoral veins.

In the Good Health Hospital there were strong concerns regarding the target subjects and what needs to be done to reduce the amount of infections. Healthcare facilities face vulnerability because agents performing certain services are not taking the necessary precautions. Healthcare workers, dieticians, environmental service specialists, administration, and maintenance workers help keep the facility operating successfully. Each occupation operates various systems at the facility during various times and usually have the opportunity to expose themselves as well as patients to multiple infectious diseases if they are following protocol.

Healthcare workers are exposed to infectious disease which creates a hostile and difficult environment for workers and patients. Therefore, healthcare administrators must implement a strategic plan to assist in combating the transferring of infection. Good Health Hospital’s plan demonstrates their desire to solve the nosocomial disease outbreak by identifying the source of the problem and making changes. The following are four steps that will be useful in the final implementation plan.

The four steps relative to the implementation plan:

    • Create, document, and implement the right material to identify and fight the disease.
    • Locate the cause and risk factor that affect the target subjects of the disease.
    • Control the target areas by strategies, preventions and research.
    • Establish better communications between government health agencies and local health departments.
    • Introduce protocols that will reach all national and international centers regarding major outbreaks or biochemical threat is detected.

Suggest at least five (5) recommendations to your department head based on the steps taken in the implementation plan. Provide rationale for your suggestions.

  • Explain the purpose of implementing this plan.
  • Collect data needed to support the plan.
  • Identify target.
  • Adhere to the protocol recommended.

In an effort to better serve the department, protecting the staff and the facility several recommendations must be made. The required recommendations are as follows:

These are the recommendations that will guarantee the hospital’s protection from the spread of infectious diseases. It will protect the hospital and patients that are relying on have an incident free hospital stay.

  • Examine and update the protocols and guidelines for the safety of the facility.
  • Review and approve documentation necessary in carrying out the plan.
  • Introduce the disease prevention policy to staff.
  • Provide precise and consistent communication between healthcare workers regarding sanitation.
  • Train and retrain all staff regarding infectious control and disease prevention.

Using these approved recommendations, design a safety protocol itinerary that must be placed in public access areas of the hospital.

The approved recommendations require a safety protocol itinerary. Therefore, all public access areas of the hospital will include: