Application of Epidemiology – Case Study
Application of Epidemiology – Case Study
Information Summative
The statistical analysis of the Good Health Hospital’s medical records reveals the progression of Escherichia coli infection among four hospitalized patients who reported bloody diarrhea, abdominal pain, vomiting and nausea, loss of appetite, flatulence and pyrexia since last week. The summary of these cases presented below in the context of their further analysis. The findings by the CDC revealed that the E. coli manifestations emanated among the affected patients after consuming the spoiled food items attributing to meats and vegetables.
Background Information (Indicating the Requirement of Further Investigation)
Georgia Department of Public Health (GDPH) describes various nosocomial infections reported within a timeframe of 2010 – 2014 across the community environment (GDPH, 2016). These infections attribute to various acute and chronic conditions, tuberculosis invasions, Escherichia coli manifestations, hepatitis patterns and sexually transmitted conditions. Evidence-based literature indicates the Escherichia coli O121 manifestations facilitated by Shiga toxin through the contaminated flour. These manifestations affected the people of various age groups, gender and ethnicity who consumed the toxic flour in 21 states across the United States of America (CDC, 2016). Similarly, the Escherichia coli outbreak manifested from the infected sprouts predominantly resulted in the development of infection among eleven patients across the two states in the USA (CDC, 2016a). Evidence-based literature reveals that E. coli is the most common pathogen that leads to the development of food born conditions across the community environment (Torso, et al., 2015). Therefore, the cases of E. coli infection across the Good Health Hospital require further investigation in relation to exploring the preventive as well as treatment strategies for challenging the progression of this epidemic outbreak among the patient population.
Litigation Discrepancies
Significant litigation issues in relation to the E. coli outbreak across Good Health Hospital mentioned below in the context of their further analysis.
Evidence-based literature indicates the potential of E. coli transfer between the individuals in the absence of appropriate hygiene interventions (Pennington, 2014). Therefore, with the onset of E. coli outbreak in Good Health Hospital, the hygiene conventions practiced across the hospital’s wards remain questionable and require evaluation by the County Health Department.
The clinical literature also reveals the fact that food vectors are primarily responsible for E. coli transmission among the healthy individuals (Pennington, 2014). This poses serious question regarding the dietary regime followed inside the Good Health Hospital. The lack of food storage facilities might be responsible for food contamination leading to the progression of the epidemic outbreak.
The findings by (Lee, Gwack, & Youn, 2012) reveal the unidentified incubation period of E. coli pathogen. Therefore, the health care administrator at Good Health Hospital required evaluating the patients for E. coli invasion at the time of admission to the corresponding hospital-ward. Failure to do so makes the health care administrator as the subject of litigation while being responsible for facilitating the progression of the outbreak in the absence of undertaking appropriate diagnostic interventions.
The findings by CDC do not recommend the administration of antibiotics to the subjects suspected for E. coli infestation (CDC, 2014). Therefore, the initial diagnostic interventions warranted to rule out the progression of E. coli infection among the admitted patients in the context of managing their pharmacotherapy regimen for avoiding the onset of unprecedented clinical complications. However, the absence of these measures by the healthcare administrator at Good Health Hospital makes him/her as the subject of litigation.
The CDC recommends the execution of preventive measures in terms of regularly evaluating the processing and distribution of food items for surpassing the risk of food borne epidemic outbreaks (CDC, 2015). Furthermore, the screening of healthcare workers is highly warranted in the context of eliminating the transfer of infectious pathogen across the hospital environment. The healthcare administrator at Good Health Hospital bears the responsibility of evaluating these facts while administering diagnostic interventions. Resultantly, the failure in undertaking these measures warrants the execution of appropriate legal action against the healthcare administrator.
Implementation Plan
The following steps are recommended for implementing appropriate measures in reducing the risk of E. coli progression across the hospital environment:
Screening of the admitted patients for food borne infections at the time of admission in the hospital wards highly warranted by the healthcare teams to rule out the probably of infection progression across the hospital environment.
Appropriate evaluation of the clinical history of the admitted patients is necessarily warranted in the context of tracking their risk to the development of food borne infection across the community environment. The healthcare teams require giving extra attention to the elderly people, children, pregnant-women and newborns, as these individuals remain highly predisposed to the development of food borne diseases (CDC, 2016b).
The health administrator needs to facilitate the execution of food-safety measures to ascertain the development of pathogens in food items following their contamination.
The pattern of cross contamination requires cessation by healthcare teams with the implementation of hand hygiene measures for reducing the risk of bacterial transmission between the food products.
Recommendations
The recommendations in the context of the above-mentioned implementation plan documented below for their consideration by the head of the department.
The pattern of E. coli infection rationally indicates the requirement of modification in the population characteristics for reducing the scope of hospital-acquired food borne infection progression across the community environment (CDC, 2002). The effective tracking of the source of exposure and its earliest mitigation will result in the cessation of E. coli outbreak across the healthcare facilities in Georgia.
The administration of diagnostic interventions attributing to stool culture necessarily required for evaluating the cases of E. coli infection during the preliminary stage of bacterial invasion (CDC, 2002). The undertaking of standard procedures for reducing the scope of culture-contamination and data entry discrepancies will facilitate the precision in lab findings in the context of administering appropriate treatment interventions for ceasing the progression of E. coli manifestations across the target population.
Physicians associated with the hospital must undertake the responsibility of reporting the pattern of the onset of infection among the admitted patients. Physicians should also report the inconsistencies in laboratory findings for surpassing the scope of their erroneous interpretation by the healthcare professionals.
The physicians should refrain themselves from conventional diagnostic interventions and follow the evidence-based procedures for tracking the risk of development of food-borne infections among the target population.
The statistical analysis of epidemic outbreaks in the context of "person", "time" and "space" necessarily required for retrieving conclusions in the context of devising strategies to mitigate the manifestations of E. coli infection among patients across the community environment (CDC, 2002).
The certified nutritionists and healthcare teams must undertake the monthly evaluation of food processing techniques across hospital kitchen for tracking the pattern of contamination that might prove to be the source of nosocomial infection leading to the onset of an epidemic outbreak.
The monitoring of the treatment regimen of patients affected with E. coli manifestations highly warranted in the context of modifying therapeutic approaches in accordance with the clinical symptoms and corresponding outcomes.
The healthcare teams must evaluate the quality of life and immune system of the patients requiring admission in the hospital ward in the context of identifying their predisposition towards the development of bacterial infection during the course of clinical intervention.
The healthcare teams need appropriate education and training in relation to the evaluation and management of the hydration level of the patients affected with the patterns of E. coli manifestations during the course of treatment intervention. The administration of IV protocol and electrolyte replacement therapy highly warranted for maintaining the metabolism of the affected individuals across the clinical setting.
The weekly evaluation and reporting of the patterns of bloody stools and abdominal cramps of the affected patients required by the healthcare teams in effectively differentiating their gastrointestinal symptoms in the context of diagnosing the pattern of E. coli infestation.
The regular evaluation and health screening of the members of hospital’s kitchen warranted in evaluating the pattern of E. coli invasion and the affected individuals must be immediately quarantined to reduce any probability of bacterial invasion to the healthy individuals as well as the corresponding food items.
Legal action requires execution against the healthcare teams who refrain themselves from administering the appropriate screening interventions for the admitted patients in the context of diagnosing the pattern of E. coli manifestations across the hospital environment.
Safety Protocol Itinerary
The safety itinerary subjected to public display includes the following evidence-based attributes:
Patients who travel abroad and require admission in the hospital-ward need to undertake screening interventions in the context of eliminating the probability of infection transfer across the hospital environment.
Patients must report their hypersensitivity to the food items (if any) to the healthcare administrator in the context of reducing the scope of onset of food borne diseases following the non-recommended dietary intervention.
The patients must immediately report the patterns of abdominal pain or bloody stools to the healthcare administrator to rule out the pattern of food borne diseases during the course of treatment intervention across the hospital ward.
The healthcare teams as well as the treated patients must rigorously follow the hand hygiene measures for challenging the scope of bacterial transmission across the hospital environment.
Patients require exercising appropriate cleansing measures while defecating, and lack of hygiene across the public toilets requires immediate reporting to the healthcare teams.
The healthcare teams should regularly monitor the purity level of drinking water across the hospital premises and any irregularity in the process of evaluation must be strictly dealt with, in accordance with the statutes of administrative conventions.
Patients must consciously maintain their hydration levels during the course of medical interventions and drink appropriate quantity of water in accordance with the recommendation by the healthcare teams.
The patients as well as healthcare workers require practicing individual hygiene measures and the kitchen staff should effectively sanitize the food items and utensils while utilizing recommended procedures for reducing the scope of progression of nosocomial infection.
References
CDC. (2002, 04 2002). A Multistate Outbreak of E. coli O157:H7 Infection. Georgia: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Retrieved from https://www.cdc.gov/epicasestudies/downloads/ecolii.pdf
CDC. (2014, 12 1). CDC - E.Coli. Retrieved from http://www.cdc.gov/ecoli/clinicians.html
CDC. (2015, 03 24). CDC - Preventing Future Outbreaks. Retrieved from http://www.cdc.gov/foodsafety/outbreaks/prevention-education/future.html
CDC. (2016, 06 1). CDC - Escherichia coli. Retrieved from http://www.cdc.gov/ecoli/2016/o121-06-16/index.html
CDC. (2016a, 03 25). CDC - Escherichia coli. Retrieved from http://www.cdc.gov/ecoli/2016/o157-02-16/index.html
CDC. (2016b, 05 05). CDC - Shiga Toxin-Producing E. coli & Food Safety. Retrieved from http://www.cdc.gov/features/ecoliinfection/
GDPH. (2016). DPH - Georgia. Retrieved from https://dph.georgia.gov/epidemiology
Lee, D. W., Gwack, J., & Youn, S.-K. (2012). Enteropathogenic Escherichia coli Outbreak and its Incubation Period: Is it Short or Long? Osong Public Health and Research Perspectives, 43-47. doi:10.1016/j.phrp.2012.01.007
Pennington, T. H. (2014). E. coli O157 outbreaks in the United Kingdom: past, present, and future. Infection and Drug Resistance, 211-222. doi:10.2147/IDR.S49081
Torso, L. M., Voorhees, R. E., Forest, S. A., Gordon, A. Z., Silvestri, S. A., Kissler, B., . . . Harrison, L. H. (2015). Escherichia coli O157:H7 Outbreak Associated with Restaurant Beef Grinding. Journal of Food Protection, 78(7), 1272-1279. doi:10.4315/0362-028X.JFP-14-545
