DNP-825 Topic 2 DQ 1

DNP-825 Topic 2 DQ 1

How could you better implement descriptive epidemiological methods in your current or future practice? Provide an example of an instance when you might use descriptive epidemiology to improve care. Explain. Support your response with relevant literature.

REPLY TO DISCUSSION

Nov 4, 2022, 5:54 PM

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Upon review of this discussion / topic, what was one important take away for you?

Nov 5, 2022, 10:17 PM

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My take from this week discussion and the our topic is the mutual beneficial relationship between the fields of epidemiology and implementation science and show how together these fields can ultimately affect population health. The IRBs is quality improvement work which makes my other point of view in the rigorous QI is a form of translational research as it takes evidence-based practices proven through health services research or clinical trials and tries to implement them to improve outcomes. Epidemiology is critical to identifying patterns of disease distribution which can pinpoint public health problems, as well as understanding and measuring associated causes of and potential solutions or interventions with which to address those problems.

These findings can lead to actionable information that may inform policy and practice decisions. However, effective interventions are only as useful as they are adopted, implemented, and sustained in practice. Implementation science is critical to identifying strategies that can drive adoption, implementation, and sustainability, ultimately leading to sustained practice change. In this way, the two fields contribute in parallel to improving population health. But these fields also can contribute to and collaborate with one another to the same end.

Epidemiology can inform or drive implementation science by supplying evidence on causes of disease and effective interventions as well as informing study methods, measurement, and designs. Implementation science can enhance epidemiology by informing the research questions epidemiologists seek to answer as well as the measures and methods we use. Together we can have a greater impact on improving population health.

Reference

Curley, A. L. (2020). Epidemiological Methods And. In A. L. Curley, Population BasedNursing: Concepts and competencies for advance practice (pp. 53-86). New York: Springer Publishing Company, LLC.

Phillips, M. S., Abdelghany, O., Johnston, S., Rarus, R., Austin-Szwak, J., & Kirkwood, C. (2017). Navigating the Institutional Review Board (IRB) Process for Pharmacy-Related Research. Hospital pharmacy, 52(2), 105–116. https://doi.org/10.1310/hpj5202-105

Nov 6, 2022, 4:41 PM

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Thank you for your response and insight, Lydia.

Nov 7, 2022, 8:04 PM

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checking back in on this.

Nov 8, 2022, 1:55 PM

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One important takeaway from this week’s discussion is how descriptive epidemiology can be applied to nursing practice. Descriptive epidemiology allows clinicians to organize and analyze data on health and disease in order to understand the variations in how disease varies amongst people based on person, place, or time (Marra et al., 2020). In nursing practice nurses can identify people or populations that are deemed high risk for developing a disease. Nurses can then implement preventative strategies for specific patient populations. Furthermore, nurses would play a role in monitoring progress of diseases and tracking outcomes to see if interventions were effective. If interventions were effective, nurses can spread those best practices across various healthcare organizations.

Reference

Marra, A. R., Algwizani, A., Alzunitan, M., Brennan, T. M., & Edmond, M. B. (2020). Descriptive epidemiology of safety events at an academic medical center. International Journal of Environmental Research and Public Health, 17(1), 353. https://doi.org/10.3390/ijerph17010353

Nov 3, 2022, 11:30 AM

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Welcome to Week 2

Greetings Class!

Welcome to Week 2! This week we will focus on:

Topic 2: Descriptive Epidemiology and Public Health Nursing

Objectives:

1. Explain how descriptive epidemiology supports nursing practice.
2. Evaluate epidemiological study designs for nursing practice.
3. Identify the Institutional Review Board (IRB) process at a specific clinical site.

In addition to the two discussion board forums, you will have the opportunity to increase familiarity with the IRB process with the “Clinical Site QI-IRB report assignment.

• Requires Lopeswrite
• Assessment Description

This purpose of this assignment is to increase familiarity with the IRB submission process.

In this assignment, you will create a mock GCU Quality Improvement (QI) IRB submission. You will be required to submit your actual DPI-Committee-Approved DPI Project Proposal to iRIS in the DNP-960 course, and so to prepare, you will begin reviewing the submission process and all requisite IRB documents in this assignment. However, you will not be submitting an IRB proposal for your DPI Project at this point in time. This assignment is a practice opportunity to ensure you are aware of the QI-IRB submission process at your clinical/practicum site and that you are familiar with the types of documents required.

General Requirements:

Use the following information to assist you in executing the correct procedures for timely, successful completion of the assignment:

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. 

Procedures:

Use the following information to ensure successful completion of the assignment:

1. Work with your preceptor/mentor at your clinical/practicum site to understand the DPI Project approval process for IRB and quality improvement projects. This includes timelines, committees involved (IRB, Nursing Research, Quality Improvement), and the authorizing signatures required. Ensure you address timeframes and submission documents required in addition to the approval process for a quality improvement DPI Project to be conducted at your clinical/practicum site.
2. Review the resources within the IRB Documents folder, located in the DC Network. Navigate to the IRB Documents folder by selecting DNP Community, DNP Program Documents, DNP-960, and then the IRB Documents folder.
3. Read the “IRB Documents Checklist for DNP Learners,” located in the DNP-960 folder.
4. Review the IRB Submission Training Videos for iRIS.
5. With your instructor, determine which documents you will need to submit for your IRB application based on the “IRB Documents Checklist for DNP Learners,” located in the DNP-960 folder.
6. Use the following document templates as needed: informed consent, site authorization letter, recruitment script, confidentiality statement, conflict of interest form, and HIPAA authorization form, located in the DNP-960 Folder/IRB Documents folder.

Directions for Submission:

Construct a 250-500-word Clinical/Practicum Site QI-IRB Report that outlines the steps in the DPI Project approval process for IRB and quality improvement projects at your clinical site.

Upload the following to the assignment dropbox: Your completed DNP-10 Strategic Points document (including all updated required revisions from your DNP-815A course), sample site authorization letter, (identifying the authorizing official), DNP Committee Approval Form, QI Determination Form, and any other IRB documents that pertain to your DPI Project.

Learners will submit this assignment using the assignment dropbox in the digital classroom. In addition, learners must upload this deliverable to the Learner Dissertation Page (LDP) in the DNP PI Workspace for later use.

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Epidemiology is an indispensable tool for characterizing occurrences of infectious disease in communities, medical institutions, or regions and determining the relationship in humans on exposure-disease, acquisition modes, and spread that are significant for control, treatment, and prevention (Mayhall, 2012). Healthcare personnel and clinicians use epidemiologic methods to identify risk factors for the investigation of outbreaks, outcome measurements of infectious diseases, and disease surveillance. Infection control interventions and practices were studied and implemented to understand and control infectious disease epidemics. Epidemiology programs in healthcare organizations were the earliest projects to use scientific methods and statistics to analyze infectious data and utilize these results to improve the quality of care and patient outcomes (Mayhall, 2012). 

Infectious diseases continue to be one of the leading causes of mortality and morbidity worldwide. Compared to noncommunicable diseases, infectious pathogens can evolve and spread rapidly which can lead to the emergence of novel human pathogens and antibiotic resistance organisms (Tang et al., 2017). In a healthcare setting, the components of the agent, host, and environment triad connect in multiple ways to produce healthcare-associated infections. Genomic epidemiology has played a larger role in understanding healthcare settings outbreaks such as healthcare-associated infections (HAIs). Higher-level decisions and policies of infection control interventions at a patient level may benefit from additional knowledge of genomic analyses, and the use of genomic tools for infection control and prevention will see more successful interventions for outbreaks, ultimately may contribute to the reduction of HAIs (Tang et al., 2017).

References

Mayhall, G. (2012). Hospital epidemiology and infection control. Lippincott Williams & Wilkins.

Hospital Epidemiology and Infection Control – Google Books

Tang, P., Croxen, M.A., Hasan, M.R., Hsiao, W.L. & Hoang, L.M. (2017). Infection control in the new age of genomic epidemiology. American Journal of Infection Control, 45 (2), 170- 179.

https://doi.org/10.1016/j.ajic.2016.05.015

Nov 8, 2022, 12:24 PM

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Nov 5, 2022, 6:55 PM

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Epidemiology is a crucial aspect to our every day practice, especially in the public health setting. It is defined as the method to find causes of health outcomes in a population (What Is Epidemiology?, 2016).  Descriptive epidemiology is a specific and important aspect of this method. This aspect of epidemiology covers time, place, and person (Descriptive Epidemiology, 2012). Looking at these 3 areas can be advantageous for a number of reasons. These advantages include gaining familiarity with the data, learning the extent of the health problem being investigated, creating a detailed description, and the quick identification of areas or groups that have high rates of disease (Descriptive Epidemiology, 2012).  This makes descriptive epidemiology a powerful tool with a wide range of possible uses.

I am currently the nurse manager of two units specializing in neuro within a large urban hospital. When stroke patients are discharged home, a follow-up phone call is placed to them shortly after discharge. This call is meant to ensure that everything is going well for the patients in the post discharge period, and to avoid re-admissions. Descriptive epidemiology could go a long way toward helping refine the questions being asked. We could help tailor the questions to certain demographics of patients, depending on certain characteristics. This type of use could be a real game-changer for these patients and their families.

Descriptive epidemiology. (2012, May 18). Centers for Disease Control and Prevention. Retrieved November 5, 2022, from https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section6.html#:~:text=Descriptive%20epidemiology%20covers%20time%2C%20place,very%20familiar%20with%20the%20data.

What is epidemiology? (2016, June 17). Centers for Disease Control and Prevention. Retrieved November

Nov 6, 2022, 1:23 AM

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Thanks, Jonathan for your post on Descriptive epidemiology. You mentioned asking questions in Descriptive epidemiology about the patient discharge follow-up approach. Questioning is a major component of descriptive epidemiology. As part of the data collection answer to the disease, the condition describes the nature of the health problem. It goes further in questioning finding the rate the disease has spread, when it started, the area, and the population affected (Centers for Disease Control and Prevention [CDC] 2018). Questioning is vital in achieving the purposes of descriptive epidemiology. From the data obtained through questioning in Descriptive epidemiology interpretations that guide toward prevention, control and management are hypothesized.

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Descriptive epidemiology aims to describe the distributions of diseases and determinants (Neta et al., 2018).   According to Naito (2014), it provides a way of organizing and analyzing these data to describe the variations in disease frequency among populations by geographical areas and over time (i.e., person, place, and time). Descriptive epidemiology can thus generate hypotheses of etiologic research. “Person” refers to socio-demographic characteristics of cases and includes variables such as age, ethnicity, sex/gender, occupation, and socioeconomic status. “Place” refers to spatial relationships that are important in describing the occurrence of illnesses and may include variables that describe clustering, rural-urban status, city, province/territory, or country. “Time” refers to examining when and over what period the illnesses occur and may describe a point source epidemic, secular trends, or temporal clustering. Descriptive epidemiology forms one of the main parts of an epidemiology summary.  Neta et al. (2018) listed goals of descriptive epidemiology in enteric outbreak investigations are to assess trends in health and disease: illnesses are monitored to identify emerging problems (e.g., potential outbreaks). Comparisons can be made among population groups (e.g., different age groups or sexes), geographic areas, and periods as well as identifying problems and generate hypotheses (e.g., if illnesses occur in a specific demographic or geographic location, this could suggest initial ideas for the source of an outbreak).

Studies show that demographic information is always relevant, e.g., age, sex, and address, because they are often the characteristics most strongly related to exposure and disease risk.   I can implement better implement descriptive epidemiological methods in my future practice by looking for shared links in disease outbreaks, such as in the Covid-19 epidemic, where the rule of thumb was to do “hypothesis-generating interviews” to know about other personal characteristics, such as travel, occupation, leisure activities, medication use, tobacco, and drugs. The goal was to find out what the victims had in common. Where did they do their grocery shopping? What restaurants had they gone to in the past month or so? Had they traveled? Had they been exposed to other people who had been ill?  When investigating the source of an infectious disease outbreak, Investigators record the date of onset of disease for each of the victims and then plot the beginning of new cases over time to create what is referred to as an epidemic curve (Neta et al., 2018).

Naito M. (2014). Utilization and application of public health data in descriptive epidemiology. Journal of Epidemiology, 24(6), 435–436. https://doi.org/10.2188/jea.je20140182

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Thank you for your post. I like the way you tie descriptive epidemiology in with the pandemic. Obviously, the pandemic is still a major concern for public health, and this could be a useful tool in the fight against it. Descriptive epidemiology is an aspect of epidemiology that covers time, place, and person (Descriptive Epidemiology, 2012). Looking at these 3 areas can be advantageous for a number of reasons. These advantages include gaining familiarity with the data, learning the extent of the health problem being investigated, creating a detailed description, and the quick identification of areas or groups that have high rates of disease (Descriptive Epidemiology, 2012). The information gained from this could be valuable in the realm of COID-19.

Descriptive epidemiology. (2012, May 18). Centers for Disease Control and Prevention. Retrieved

Nov 9, 2022, 6:58 PM

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Thank you for your response to my post-Jonathan. When researching this topic and reflecting on how my organization focused on the Covid pandemic, it was a clear example of descriptive epidemiology.

Nov 7, 2022, 10:04 AM

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As you mention COVID 19 and epidemiology it brings another important topic to this dialogue. We often focus on the spread of infections within humans, but studies demonstrate there is a need for a focus on coinfections and wildlife. This will help us better understand the biological process the transmission of the infections that are occurring. Hoarau et al. (2020) makes an important point they describe that coinfection reflects the simultaneous presence of multiple infections but also involves the interactions between the community and the infection agents.  It is evident that coinfections to have effects on the fitness, and the infectious epidemiology (Hoarau et al., 2020). The study of infectious disease associated with wild host are needed int order to improve the knowledge of mechanisms involve in the epidemiology of infectious disease (Hoarau et al., 2020). Researchers understand that this can be a challenging task but with the use of current theoretical and experimental tools it can be made possible (Hoarau et al., 2020).

References: 

Hoarau, A. O. G., Mavingui, P., & Lebarbenchon, C. (2020). Coinfections in wildlife: Focus on a neglected aspect of infectious disease epidemiology. PLoS Pathogens, 16(9), 1–5. https://doi.org/10.1371/journal.ppat.1008790

Nov 9, 2022, 6:54 PM

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Thank you for your response to my post. You brought forth an essential aspect of coinfections. Noting the need for a wildlife coinfection focus, I looked at infections in animals and was very surprised by the plethora of infections spread by animals. Over 60% of western families are estimated to own a pet, with most of these households keeping a dog (Gnat, S. et al., 2021).  According to Gnat S. et al. (2021), dogs are a significant reservoir for zoonotic infections.  Zoonoses are diseases that implicate humans and animals and can be transmitted by domestic pets or wildlife animals.  Dogs transmit several viral and bacterial diseases to humans.  Zoonotic diseases can be transferred to humans by infected saliva, aerosols, contaminated urine or feces, and direct contact with a dog.   Viral infections such as rabies and norovirus and bacterial infections including Pasteurella, Salmonella, Brucella, Yersinia enterocolitica, Campylobacter, Capnocytophaga, Bordetella bronchiseptica, Coxiella burnetii, Leptospira, Staphylococcus intermedius and Methicillin resistance staphylococcus aureus are the most common viral and bacterial zoonotic infections transmitted to humans by dogs.  Thus, dog owners should be informed about zoonotic diseases and their ways of transmission to reduce these infections in the human population (Shapiro D. S., 2017).  Research shows that most viral and bacterial infections are transmitted from dogs to humans by a dog bite; however, other diseases caused by protozoa have fecal-oral transmission. Thus, food hygiene, such as washing vegetables well and cooking meat adequately, should be carefully done to eliminate the rate of zoonotic infections.

Gnat, S., Łagowski, D., Nowakiewicz, A., & Dyląg, M. (2021). A global view on fungal infections in humans and animals: opportunistic infections and microsporidiosis. Journal of Applied Microbiology, 131(5), 2095-2113.

Shapiro D. S. (2017). Infections Acquired from Animals Other Than Pets. Infectious Diseases, 663–669.e2. https://doi.org/10.1016/B978-0-7020-6285-8.00074-5

Nov 5, 2022, 1:30 PM

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Descriptive Epidemiology and public health intertwine entities associated with increasing the population’s well-being (Boston University School of Public Health, n.d.). Through their efforts, they monitor the health and use the information to formulate possible solutions (Boston University School of Public Health, n.d.). Descriptive epidemiology for the health educator and school nurse may take on several roles. However, I will apply this policy to teenage suicide prevention. Suicide is the second leading cause of death in the adolescent population’ patients ending their lives via suicide have often been in a state of altered mental health with inadequate resources (Pelkonen & Marttunen, 2003). Descriptive epidemiology identifies that the stigma associated with mental health decreases the likelihood of patients receiving treatment(Pelkonen & Marttunen, 2003). In addition, we understand, and review data trends using descriptive epidemiological methods and apply proven intervention methods for addressing the issues; hence, the combination of altered mental health and poor decisions would require analyzing trends that increase these statistics(Pelkonen & Marttunen, 2003). Epidemiological descriptions note that early recognition by primary care physicians assists with decreasing adolescent suicide. Research findings support the need for effective interventions citing “family adversity, social alienation, and precipitating problems also contribute to the risk of suicide (Pelkonen & Marttunen, 2003).”

Using this information, I am working to organize a teen-led program called SCREAM. SCREAM is an acronym, meaning students create resources, education, and mental health awareness. Students are working to develop an app for reporting students at risk or allowing students experiencing depression etc., an outlet for getting help. Students will post resources such as drug and alcohol abuse, depression help, coming out assistance for the LGBTQ community, and the voice for the bullied. Again, the use of descriptive epidemiology may assist as the intervention includes peer-led interventions, the hypothesis being that peers may relate better and come up with solutions or resource possibilities that I, as an older adult, may not have considered.

In this case the application of descriptive analysis includes the person (teenagers) place (high school or college setting) time (current and future trends) this information will then be applied to interventions that address the issue using persons (fellow teenagers) places (access to mental health resources at school or referrals to non judgmental places) time (immediate access to interventions via social media or technology.

Boston University School of Public Health. (n.d.). Descriptive epidemiology. https://sphweb.bumc.bu.edu/otlt/MPH-Modules/EP/EP713_DescriptiveEpi/EP713_DescriptiveEpi_print.html#:~:text=Specific%20tasks%20of%20descriptive%20epidemiology%20are,public%20health%20priorities%20for%20a%20population.&text=Specific%20tasks%20of%20descriptive,priorities%20for%20a%20population.&text=of%20descriptive%20epidemiology%20are,public%20health%20priorities%20for

Pelkonen, & Marttunen. (2003). Child and adolescent suicide: epidemiology, risk factors, and approaches to prevention. PubMed.