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Ash's Certification Study > Epi, Surveillance, and Outbreaks > Flashcards

Epi, Surveillance, and Outbreaks Flashcards

1
Q

study of the frequency, distribution, cause, and control of disease in populations- forms the basis of all health-related studies. Provides the background for interventions to reduce transmission of infecting organisms, reduce the number of healthcare ass infections, and protect hc providers from infection

A

epidemiology

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2
Q

Main components of epi definition

A

frequency
distribution
cause
control

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3
Q

Ds of epi

A

Distribution
Determinants
Deterrents

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4
Q

How we describe determinants

A

Person
Place
Time

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5
Q

epi triangle

A

Host
Agent
Env

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6
Q

As one variable changes, there is a concomitant or resultant change in the quantity or quality of another variable

A

Association

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7
Q

3 types of associations

A
  • artifactual (spurious)
  • Indirect or noncausal
  • causal
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8
Q

This type of association may be caused by errors in study design or analysis, bias, errors in analysis, or failure to control for confounding variables

A

Artificial or spurious association

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9
Q

this type of association may be caused by mixing of effects between the exposure, disease, and confounding variable that may be associated with the exposure and independently affect the outcome of interest

A

Indirect or noncausal

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10
Q

This type of association occurs when evidence indicates that one factor is clearly shown to increase the probability of the occurrence of a disease

A

Causal

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11
Q

The stronger the relation between a risk factor and the effect, the less likely it is that the relation is due to a third or extraneous factor

A

Strength of assocition

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12
Q

Multiple studies in a range of settings report similar results

A

Consistency

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13
Q

Ideally, the effect has only one cause

A

Specificity

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14
Q

the purported cause should be present before the effect occurs

A

temporality

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15
Q

A dose-response relation between the risk factor and the effect

A

Biological gradient

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16
Q

there should be a rational the theoretical basis explaining how or why the risk factor led to the effect

A

Biological plausabiity

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17
Q

The association should not conflict with known facts

A

Coherence

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18
Q

Is there any supportive research based on experiment; if preventative action is taken, does the effect dissipate?

A

Experimental evidence

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19
Q

A previously accepted phenomenon in one area can be applied to another

A

Analogy

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20
Q
  1. strength of association
  2. consistency
  3. specificity
  4. temporality
  5. biological gradient
  6. biological plausibility
  7. coherence
  8. experimental evidence
  9. analogy
A

Bradford Hill’s Criteria for Causation

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21
Q

Level of prevention with the goal to complete prevention of diseases before any manifestation of that disease occurs

A

Primary

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22
Q

Early dx and treatment and preventing further deterioration by intervention as early in the disease course as possible

A

secondary

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23
Q

Reducing complications

A

Tertiary

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24
Q

Examples secondary prevention

A

Screening
skin testing for TB
Mammograms

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25
Q

Examples Primary prevention

A

Wellness programs
Immunizations
Folic Acid
Exercise
Seat Belts

26
Q

Examples of tertiary prevention

A

Rehab
Organ transplantation

27
Q

the number of existent cases of a given disease at a given time

A

prevalence

28
Q

An excess over the expected incidence of disease within a given geographical area during a specified time period

A

Epidemic

29
Q

An epidemic spread over a wide geographical area, across countries or continents

A

Pandemic

30
Q

The usual incidence of a given disease within a geographical area during a specified time period

A

Endemic

31
Q

Is a sudden increase in occurrences of a disease in a particular time and place

A

Outbreak

32
Q

The number of new cases of a given disease in a given time periods

A

incidence

33
Q

The probability or likelihood of an event occurring

A

RIsk

34
Q

A place in which an infectious agent can survive but may or may not multiple

A

Reservoir

35
Q

A characteristic, behavior, or experience that increases the probability of developing a negative health status

A

Risk factor

36
Q

An inanimate object on which organisms may exist for some period of time

A

Fomite

37
Q

The resistance of a group to invasion and to spread of an infectious gent, based on the immunity of a high proportion of individual members of the group

A

herd immunity

38
Q

Infection that is not present at the time of admission to the hospital, but are temporally associated with the admission to or a procedure performed in a healthcare faciity

A

Healthcare associated infection

39
Q

Infection present on admission with no association to a recent hospitalization

A

Community acquired infection

40
Q

Reasons for OBs (often multifactorial)

A
  • lapses in IP
  • Colonization or infection for HCP
  • Defects or contamination of product or device
41
Q

When should outbreaks in healthcare be suspected?

A

HAIs or adverse events occur above the baseline rate or when an unusual microbe or adverse event is recognized

42
Q

Can 1 case of an unusual disease be an outbreak?

A

Yes

43
Q

Outbreak investigation: confirm

A

confirm presence of an outbreak

44
Q

Outbreak investigation: alert

A

alert key partners about the investigation

45
Q

Outbreak investigation: research

A

Perform a literature review

46
Q

Outbreak investigation: define

A

Establish a preliminary case definition

47
Q

Outbreak investigation: finding cases

A

Develop methodology for finding cases

48
Q

Outbreak investigation: line list

A

Prep line list and epi curve

49
Q

Outbreak investigation: observation

A

observe and review potentially implicated patient care activities

50
Q

Outbreak investigation: sampling

A

consider whether env sampling should be performed

51
Q

Outbreak investigation: control

A

implement control measures

52
Q

Follow up investigation components

A
  • refine the case def
  • continue case finding and surveillance
  • review regulatory control measures
  • consider whether an analytic study should be performed
53
Q

Organism response tier:
- contains resistance mechanisms novel to the U.S.
- Pan-resistant
- needs more extensive evaluation to better define risk for transmission

A

Tier 1

54
Q

Example of Tier 1

A

Pan-R OXA-23 Acinetobacter baumanni

55
Q

Organism response tier:
- primarily found if hc settings but not believe to be found regularly in the region
- information is available about how transmission occurs and groups primarily at risk

A

Tier 2

56
Q

Examples of Tier 2

A

-Cabapenem resistant enterobacteriaceae with novel mechanisms
- VIM producing Pseudomonas aeruginosa
- NDM-producing CRE
- OXA-48 type producing CRE

57
Q

Organism response tier:
- already established in U.S. and have been identified in the region before
- not endemic
- info is available about transmission

A

Tier 3

58
Q

Example of tier 3

A

-carbapenem-resistant Enterobacteriaceae producing Klebsiella pneumoniae carbapenemase in regions where organism more commonly identified

59
Q
A
60
Q

What shows facilities with need for improvement?

A

TAP- targeted assessment prevention

61
Q

What is CAD?

A

Cumulative attributable dif
(# of infections to prevent to meet goals)

62
Q

Elements of a successful surveillance program : methods

A

Select methodology

Ash's Certification Study (22 decks)

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