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Select an actual outbreak that has occurred in the community and the patients ar

ID: 129011 • Letter: S

Question

Select an actual outbreak that has occurred in the community and the patients are arriving in the hospital setting. As the hospital’s infection prevention and control nurse you will need to find an infection prevention plan and describe the following components. (Ebola)

Introduction to scenario, and background

The affected population

The data available and verification of outbreak existence

The goals of the city or state

The initial plan

Events selected for monitoring

Surveillance criteria and case definition

The time period for data collection

The process for collecting data

Calculation of rates and analysis of data

Evaluation of the plan.

Explanation / Answer

Introduction: Ebola doesn’t stay at the initial place of infection; it migrates to nearby lymph nodes and then travels to the liver, spleen, and adrenal gland. Liver cells die off and clotting factors that help clot your blood so you don’t bleed out, become abnormal. This can cause prolonged or excess bleeding. Ebola can also result in Adrenocortical death which causes low blood pressure and makes it hard to make steroids. The Ebola virus also initiates a release of cytokines that are associated with inflammation which can cause impairment of clotting and result in multi-organ failure.

Caring for patients with EVD presents unique management issues and requires input from multiple individuals and services within the healthcare system.

One element of this specialized care that deserves significant attention is the role of infection prevention and control.

There are many facets of infection prevention involved in the care of patients with EVD, including the use of an appropriate facility, delivery of medical care in personal protective equipment, safe transport, laboratory processing of specimens, waste management, and provisions for care outside of the biocontainment facility. All of these infection control issues should be thoroughly evaluated and approached in a multidisciplinary manner in order to safely provide care for patients with EVD.

Key Infection Control Precautions Recommended for Preventing Ebola Transmission:

Patient Placement

Personal Protective Equipment (PPE)

Patient Care Equipment:

Aerosol Generating Procedures (AGPs)

Hand hygiene

Safe Injection practices

Environmental infection control

Monitoring and Management of Potentially Exposed Personnel

Data Management:

There were two types of data management system used to provide timely situation reports and describe the trends of key epidemiological indicators – The Epi Info Viral Hemorrhagic Fever line list database and a Microsoft Excel-based line list database.

Ebola virus disease data collection, collation, and analysis are critical components of the surveillance and epidemiological investigation pillar of the EVD prevention and control strategy; it is, therefore, important to ensure that it is effectively managed.

Monitoring and interpreting the severity of the outbreak must take into account those potential factors, and it requires combination of well-coordinated and consolidated multiple data sources including observed number of cases and deaths in the VHF (Viral Hemorrhagic Fever) database, the number of daily call alerts on the deaths, the number of reported laboratory swab positive results, active case search (field investigation), and review of existing district situation reports.

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