Week 3: Epidemiology, the Basis for Public Health
The study of epidemiology includes the examination of infectious disease, mental health and health-related events such as accidents or violence, and occupational and environmental exposure and their effects, as well as the examination of positive health states (Stanhope & Lancaster, 2016). Additionally, the study of epidemiology includes research into the morbidity and mortality of chronic illnesses that are found in the United States and across the globe. Infectious diseases like polio, TB, measles, and malaria have been almost eliminated in the United States; however, these diseases continue in other parts of the world for a variety of reasons. Highly contagious infectious diseases can and do lead to death despite the fact that many are preventable. The United States has used childhood vaccinations to prevent and eradicate illnesses such as smallpox and polio. In order to reduce the incidence of malaria in the United States, DDT—a known carcinogen in humans that is also toxic to birds—and other pesticides were used in the past and have since been replaced with nontoxic insecticides and larvicides to reduce the numbers of mosquitoes.
Unfortunately, developing countries often do not have the resources to engage in the same sorts of prevention programs and may have to resort to unsafe or toxic means to control vectors. They may not have the financial resources or health care personnel available to engage in mass vaccination campaigns. In addition, countries that experience frequent wars, acts of terrorism, and political instability face additional challenges to the provision of health care to their populations, especially when faced with an outbreak of an infectious disease.
This week, you will focus on the epidemiology of infectious and communicable disease and how nursing practices change in response to threats and outbreaks.
Learning Objectives
Students will:
• Analyze public health settings in relation to prevention of disease transmission
• Analyze public health nurse’s role in outbreak investigations
• Apply the epidemiological triangle for an infectious or communicable disease outbreak
• Analyze leadership roles of nurses in bringing an outbreak under control
• Evaluate nursing strategies for health promotion in mitigating outbreaks
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Learning Resources
Required Readings
Holtz, C. (2017). Global health care: Issues and policies (3rd ed.). Burlington, MA: Jones & Bartlett.
• Chapter 9, “Infectious Diseases from a Global Perspective” (pp. 229-254)
• Chapter 13, “Global Perspectives on Violence, Injury, and Occupational Health” (pp. 347-378)
• Chapter 7, “Global Perspectives on Mental Health” (pp. 173-196)

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.
• Chapter 13, “Infectious Disease Prevention and Control” (pp. 286–318)

Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.
• Chapter 12, “Epidemiology” (pp. 256–285)

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.
• Chapter 24, “Public Health Surveillance and Outbreak Investigation” (pp. 529–544)

Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

HealthyPeople.gov. (2016). Global health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/global-health

Required Media
Laureate Education, Inc. (Producer). (2016). The role of the nurse in public and global health with Dr. Letitia Robinson. Baltimore, MD: Author.

Note: The approximate length of this media piece is 7 minutes.

Accessible player

TED. (2014). What makes us get sick? Look upstream. Retrieved from https://www.ted.com/talks/rishi_manchanda_what_makes_us_get_sick_look_upstream

Note: The approximate length of this media piece is 18 minutes.

Dr. Rishi Manchanda suggests physicians and health care workers look upstream to discover the root causes of why patients are sick.

Writing Resources and Program Success Tools

Document: AWE Checklist (4000) (Word document)

This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.

Walden University. (n.d.). Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved May 20, 2016, from http://academicguides.waldenu.edu/ld.php?content_id=7980455

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Discussion: Preventing Disease in Communities: The Role of Public Health, the Silent Sentinel
Our “world” starts with our own community, county, and state, then moves out in concentric rings from that point to include our country and eventually the world. Disease is transmitted from person to person through direct contact, or from a source such as a vector or contaminated water through a variety of means, such as flood waters or even terrorist actions. Individuals with limited or no knowledge of safe sex methods may have unprotected sexual relations and knowingly or unknowingly transmit disease to their partners, then to their partners’ partners, and on and on. Often it is the role of the public health nurse to investigate a disease outbreak, contain it, and then educate others so that the same situation doesn’t happen again.
In this Discussion, you will visit a site and interview people who work there about risks for disease transmission, then report on your findings.
To prepare, select which site you will visit from the following options:
• High school nurse’s office
• Water treatment plant
• Public health department
• Pediatrician’s office
Create a brief description of your setting, providing some context; for example, how many patients are seen, size or capacity of the facility as applicable, and/or the location of the office or organization.
Take pictures of the building and surrounding area/neighborhood to provide context. You do not have to include the interior/s of the building/s or people/clients who may be there.
Then, during your site visit, pose the questions listed in the following chart:
High school nurse • What is the school’s policy on giving students advice about birth control?
• How often do you get requests for information about birth control or how to protect oneself from an STD?
• How do you track vaccination compliance, and what happens to students who fall out of compliance?
Local water treatment plant • Where does your community’s water come from?
• Where is it stored?
• How often is it tested for purity?
• What safeguards are in place to prevent tampering with the water supply?
Local public health department • Does this department have an STD clinic?
• In addition to testing, does the department offer treatment of one party or both parties?
• What is the most frequently diagnosed STD?
A pediatrician’s office • What is your policy on accepting patients who refuse vaccinations?
• What are the most common reasons parents decline vaccinations for their children in this particular office?
• What is the policy at this office for giving antibiotics to treat viral syndromes?
Now, look at the site you visited through the eyes of the public health nurse (PHN). Imagine you are the PHN and have been asked to investigate an outbreak at this facility.
• What questions would you ask?
• What suggestions could you make to avoid a disease outbreak at the facility?
• What would your role as a change agent be for any deficiencies you find in your on-site inspection?
By Day 3
Post your brief description and pictures of the site you visited. Share the answers you were given to the questions you posed. Then, respond to the above prompts through the eyes of a PHN asked to investigate an outbreak at this facility.
Support your response with references from the professional nursing literature.
Note Initial Post: A 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).
By Day 7
Read two or more of your colleagues’ postings from the Discussion question (support with evidence if indicated).
Respond to at least two colleagues. Your responses should be substantial and should contribute to the discussion.
Post a Discussion entry on 3 different days of the week.
Submission and Grading Information
Grading Criteria

To access your rubric:
Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 7

To participate in this Discussion:
Week 3 Discussion

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Assignment: Epidemiology in Public and Global Health
Note: You were introduced to this Assignment in Week 2 and will submit your work this week.
By Day 7 of Week 3
Submit a 3- to 4-page paper that includes the following:
• A summary of the article, including the title and author
o Identify the title of the article with in-text citation and corresponding reference in reference list
• The relationship among causal agents, susceptible persons, and environmental factors (epidemiological triangle)
• The role of the nurse in addressing the outbreak
• Possible health promotion/health protection strategies that could have been implemented by nurses to mitigate the outbreak
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
• Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.
• Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:
Week 3 Assignment rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:
Submit your Week 3 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 3

To submit your Assignment:
Week 3 Assignment

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Week in Review
This week, you provided a summary of your article summarizing the relationship of the epidemiological triangle and the role nurses play in addressing and mitigating outbreaks. In addition, you tried your hand at being a PHN via your site visit and interviews with those who work in high risk areas and reported on those findings.
Next week, you will transition into emergencies and natural disasters. Be prepared to ‘take a walk’ into potential health threats in your neighborhood in order to develop strategies to help protect susceptible populations and the public at large.

To go to the next week:
Week 4

Rubric Detail

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Name: NURS_4115_Week_3_Discussion_Rubric

• Grid View
• List View
Excellent Proficient Basic Needs Improvement
Required Content
Created a brief description of the setting, providing some context, e.g. how many patients are seen, size or capacity of the facility as applicable, and/or the location of the office or organization with picture(s) of the building/facility. 18 (24%) – 20 (26.67%)
Initial post contains well developed and insightful analysis and brings new insight into the discussion. 16 (21.33%) – 17 (22.67%)
Initial post contains reasonable analysis that is focused and brings insight into the discussion. 14 (18.67%) – 15 (20%)
Initial post contains minimal analysis that is somewhat focused and brings limited insight into the discussion. 0 (0%) – 13 (17.33%)
Initial post lacks analysis and/or is not focused and brings little or no insight into the discussion.
Required Content
Developed a selected list of possible questions asked to determine any deficiencies to avoid a disease outbreak at the facility. 14 (18.67%) – 15 (20%)
Initial post contains well developed and insightful analysis and brings new insight into the discussion. 12 (16%) – 13 (17.33%)
Initial post contains reasonable analysis that is focused and brings insight into the discussion. 11 (14.67%) – 11 (14.67%)
Initial post contains minimal analysis that is somewhat focused and brings limited insight into the discussion. 0 (0%) – 10 (13.33%)
Initial post lacks analysis and/or is not focused and brings little or no insight into the discussion.
Required Content
Determined what changes could be made to reverse any deficiencies that were noticed during the visit. If no changes should be made, described the best practices the facility is using. 14 (18.67%) – 15 (20%)
Initial post contains well developed and insightful analysis and brings new insight into the discussion. 12 (16%) – 13 (17.33%)
Initial post contains reasonable analysis that is focused and brings insight into the discussion. 11 (14.67%) – 11 (14.67%)
Initial post contains minimal analysis that is somewhat focused and brings limited insight into the discussion. 0 (0%) – 10 (13.33%)
Initial post lacks analysis and/or is not focused and brings little or no insight into the discussion.
Response Posts
“Entered the discussion thread on 3 separate days. Wrote at least two posts to two separate peers. Responses are appropriate to the topic, substantive, and promoted discussion by one or more of the following: • contributing insight to move the discussion forward. • offering substantial and/or different points of view and asks questions to add to discussion • including extra references or websites for peers to consider • relating discussion to different areas of practice and applying concepts to practice **Additional points may be deducted for late posting per the University late policy.” 14 (18.67%) – 15 (20%)
Response posts add substantial ideas and perspectives that invite further analysis and discussion. Participated 3 or more days in the classroom and responded to more than 2 classmates. 12 (16%) – 13 (17.33%)
Response posts are proficient and provide adequate analysis and discussion. Participated 3 days in the classroom and responds to at least two classmates. 11 (14.67%) – 11 (14.67%)
Response posts are limited and provide minimal analysis and discussion. Participated less than 3 days in the classroom and/or responds to less than two classmates. 0 (0%) – 10 (13.33%)
Response posts are inadequate and provide no analysis of discussion and/ or there is no participation in the classroom.
Writing and Format
Uses evidence to support a claim and give credit to the source. Uses course learning resources and seeks additional scholarly resources to support ideas. Displays sentence, paragraph, and essay skills. Writes in a scholarly, well-organized manner using own words by synthesizing evidence/resources. Paraphrases to avoid plagiarism of the source. APA: No more than one short, unique quote with correct APA format. Appropriate use and format of in-text citations and reference list. 9 (12%) – 10 (13.33%)
Writer demonstrates excellence in all sentence and paragraph level skills within discussion board posts to meet the 4000 Level Academic Writing Expectations. 8 (10.67%) – 8 (10.67%)
Writer demonstrates proficiency of most sentence and paragraph level skills within discussion board posts to meet the 4000 Level Academic Writing Expectations with only one format or writing issue needing to be addressed. 7 (9.33%) – 7 (9.33%)
Writer demonstrates minimal skill in meeting sentence level and/or paragraph level skills within discussion board posts to meet the 4000 Level Academic Writing Expectations with less than or equal to three format or writing issues needing to be addressed. 0 (0%) – 6 (8%)
Writer demonstrates inadequate skill in meeting the sentence and/or paragraph level skills to meet the 4000 Level Academic Writing Expectations with four or more format or writing issues needing to be addressed.
Total Points: 75
Name: NURS_4115_Week_3_Discussion_Rubric