24 - Public Health Surveillance and Outbreak Investigation Flashcards
A nurse is using surveillance to collect outcome data. What information would most likely be collected?
a. ) Number of clinic services which use evidence-based protocols
b. ) Proportion of the population vaccinated against influenza
c. ) Incidence of breast cancer in the population
d. ) Probability of a bioterrorism attack occurring in the community
c.) Incidence of breast cancer in the population
Outcome data focus on change in health status; incidence rates are one example of this type of information. Process data focus on what is done, such as services provided or protocols for health care delivery. An example of process data is collection of data about the proportion of the eligible population vaccinated against influenza in any 1 year.
Which problem does a health department usually have the legal authority to investigate?
a. ) Pandemics
b. ) Unusual clusters of illness
c. ) World trends of disease
d. ) Cases of the common cold and pneumonia
b.) Unusual clusters of illness
Powers of local government include surveillance of unusual clusters of illness. A health department does not have legal authority to investigate pandemics, world trends of disease, and cases of the common cold and pneumonia.
A nurse is conducting disease surveillance. Which of the following describes the rationale for this action?
a. ) To eradicate a disease before it starts
b. ) To establish a baseline rate of disease occurrence and patterns of spread
c. ) To target populations for triage
d. ) To reduce the incidence of heart disease in a community
b.) To establish a baseline rate of disease occurrence and patterns of spread
Disease surveillance helps establish baseline rates of disease occurrence and patterns of spread to make it possible to initiate a rapid response to an outbreak. Disease surveillance is unable to eradicate a disease before it starts, to target populations for triage, or to reduce the incidence of heart disease in a community. However, disease surveillance does make it possible to initiate a rapid response to an outbreak of a disease or an event that can cause a health problem.
A college student goes to the Student Health Center with an extremely swollen neck. The advanced practice nurse determines that he has mumps. His roommate also is experiencing malaise and a sore throat. Which of the following defines these two students?
a. ) Mixed outbreak
b. ) Common source
c. ) Point source
d. ) Propagated outbreak
c.) Point source
A point source outbreak involves all persons exposed becoming ill at the same time, during one incubation period. A mixed outbreak is a common source followed by secondary exposures related to person-to-person contact. A common source outbreak refers to a group exposed to a common noxious influence such as the release of noxious gases. A propagated outbreak does not have a common source and spreads gradually from person to person over more than one incubation period.
What does each state do with the information that it receives about notifiable diseases?
a. ) Uses the information for surveillance purposes
b. ) Reports the information to the local branch of the World Health Organization (WHO)
c. ) Transmits the data electronically, weekly, to the Centers for Disease Control and Prevention (CDC)
d. ) Does nothing with the information
c.) Transmits the data electronically, weekly, to the Centers for Disease Control and Prevention (CDC)
Data is transmitted weekly to the CDC through the National Electronic Telecommunications System for Surveillance. States need to transmit the information to the CDC rather than only keeping its own records. The reports are sent to the CDC, not to the WHO.
What information is shared among agencies when they collaborate to implement a quality surveillance system?
a. ) How to use algorithms to identify which events should be investigated
b. ) Who is to blame for a disease outbreak
c. ) What shelters will be used and by whom
d. ) How political action will be necessary to ensure public health
a.) How to use algorithms to identify which events should be investigated
Collaboration promotes the development of plans and a directory of emergency responses. How to use algorithms is a key type of information that is shared. Blaming others is not part of collaboration. Determining what shelters will be used and by whom is not the priority for collaboration. How political action will be necessary to ensure public health is not a priority for collaboration.
A community coalition monitors the increasing obesity rate of children in their schools. Based on this data, they consider a variety of programming options which may possibly help decrease this trend. What was the purpose of conducting this surveillance?
a. ) Protect the children from diseases that affect obese children
b. ) Teach parents that obesity will not be tolerated in this community
c. ) Educate children on surveillance techniques
d. ) Demonstrate that new clinical and effective protocols need to be developed
d.) Demonstrate that new clinical and effective protocols need to be developed
Ongoing surveillance in a community can lead to new clinical and effective protocols to address an issue. Ongoing surveillance makes it possible to have ongoing monitoring in place to ensure that disease and event patterns improve rather than deteriorate. This surveillance cannot protect children from diseases, teach parents that obesity will not be tolerated, or educate children on surveillance techniques.
Which is a feature of public health surveillance?
a. ) Sharing of the results with others
b. ) Defining public health policy
c. ) Evaluating interventions
d. ) Planning national programs
a.) Sharing of the results with others
One of the features of public health surveillance is sharing of the results with others. Defining public health policy, evaluating interventions, and planning national programs are all purposes of surveillance, not features.
The SARS (severe acute respiratory syndrome) outbreak was an epidemic that spread over several countries. Which of the following terms describes what happened?
a. ) Hyperendemic
b. ) Pandemic
c. ) Mixed outbreak
d. ) Holoendemic
b.) Pandemic
A pandemic refers to the epidemic spread of the problem over several countries or continents. If a problem is considered hyperendemic, there is a persistently (usually) high number of cases. A mixed outbreak is a common source followed by secondary exposures related to person-to-person contact. Holoendemic implies a highly prevalent problem found in a population commonly acquired early in life.
A person has returned from overseas and it is determined that he has Q fever. Which of the following must occur?
a. ) This is not a disease that is on the notifiable list; nothing need be reported.
b. ) The case must be reported to the state and local health departments.
c. ) The patient must be isolated immediately.
d. ) The patient will probably die, so it is not reportable.
b.) The case must be reported to the state and local health departments.
Q fever is on the notifiable list and must be reported to the state and local health departments. Thus, it needs to be reported, but does not imply immediate isolation or probable death.
A staff nurse has demonstrated the ability to be competent as a participant in surveillance and investigation activities. Which of the following skills would you expect that nurse to possess? (Select all that apply.)
a. ) The ability to identify appropriate data sources
b. ) The ability to communicate effectively using written reports
c. ) The ability to collaborate with community agencies
d. ) The ability to create a budget
e. ) The ability to interpret laboratory findings
a.) The ability to identify appropriate data sources
b.) The ability to communicate effectively using written reports
c.) The ability to collaborate with community agencies
d.) The ability to create a budget
The staff nurse must have analytic assessment skills, communication skills, and community dimensions of practice to be a participant in surveillance and investigation. The ability to interpret laboratory findings is not a core competency.
A large amount of data related to hypertension rates is collected in a community. The data is analyzed. Which of the following describes the next step in the surveillance process?
a. ) Collecting data from multiple valid sources
b. ) Evaluating the impact on the surveillance system
c. ) Interpreting the data and disseminating it to decision makers
d. ) Asking political officials to finance a hypertension clinic
c.) Interpreting the data and disseminating it to decision makers
After data is collected and analyzed, the findings must be disseminated. Collection of data is the step described in this scenario and the question asks what must be done next. Evaluating the impact on the surveillance system occurs after dissemination. Dissemination may occur to a broader audience than only political officials.
A nurse is collecting morbidity data. Which of the following would be the source that the nurse would use?
a. ) Vital statistics reports
b. ) Birth records
c. ) Death certificates
d. ) Specialized disease registries
d.) Specialized disease registries
There are many sources of morbidity data (rate of disease incidence), including specialized disease registries. Vital statistics reports, birth records, and death certificates are part of mortality data.
What was the purpose of the CDC creating the first list of standard case definitions for notifiable diseases?
a. ) Some diseases were underreported and others were overreported.
b. ) There was no central office to collect data.
c. ) Some people refused to notify officials when diseases were seen.
d. ) No one knew where to report the information that was collected.
a.) Some diseases were underreported and others were overreported.
The initial work was done by the CDC because diseases were overreported or underreported. Before this time, state and local health departments used many different criteria for identifying cases of reportable diseases. There was a central office to collect the data and providers knew that this information needed to be reported, but what was being reported by departments was different.
A nurse is investigating a potential bioterrorism attack. Which of the following evidence would a nurse find if a bioterrorism attack occurred?
a. ) A large number of cases of influenza
b. ) A case of cholera in a local politician following a trip to India
c. ) Dengue fever in a group of students who just returned from a mission trip
d. ) An unusual illness in a population
d.) An unusual illness in a population
Unusual illness in a population should trigger an investigation that may signal a covert bioterrorism attack. Cases of influenza, cholera, and dengue fever in a group would not be considered unexpected illnesses.
