Epidemiology Paper
Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

Choose one communicable disease from the options below.

Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
Influenza
Epidemiology Paper Requirements

Address the following:

Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
Describe the social determinants of health and explain how those factors contribute to the development of this disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

AttachmentsNRS-427VN-RS2-CommunicableDiseaseChain.doc
RUBRIC

Attempt Start Date: 15-Apr-2019 at 12:00:00 AM

Due Date: 21-Apr-2019 at 11:59:59 PM

Maximum Points: 150.0

Epidemiology Paper – Rubric
No of Criteria: 11 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory0.00 %Less than Satisfactory75.00 %Satisfactory83.00 %Good94.00 %Excellent100.00 %Content80.0 Comprehensive Description of a Communicable Disease and the Demographic of Interest10.0Demographic of interest and clinical description are omitted or presented with many inaccuracies.Limited and/or vague summary of demographic of interest and communicable disease is provided. Overview does not offer a clear representation of information necessary for epidemiological study.Overview of the demographic of interest and clinical description of the communicable disease is presented with some inaccuracies of the clinical descriptors.Clinical description of the communicable disease and demographic of interest is provided. Summary is brief but accurate.Overview describing the demographic of interest and clinical description of the communicable disease is presented with a thorough, accurate, and clear overview of all of the clinical descriptors.Determinants of Health and Explanation of How Determinants Contribute to Disease Development10.0Description of the determinants of health and their role in disease development is omitted or presented with many inaccuracies.Paper partially describes the determinants of health in relation to disease development.Paper identifies the determinants of health in relation to the communicable disease selected but does not include an explanation of their role in the development of disease. Paper describes each determinant of health with a comprehensive discussion of their contribution to disease development and progression.Paper comprehensively discusses the determinants of health in relation to the communicable disease, explains their contribution to disease development, and provides evidence to support main points.Epidemiologic Triangle (Host Factors, Agent Factors, and Environmental Factors)20.0Description of the epidemiologic triangle is omitted or presented with many inaccuraciesThe communicable disease is described with some inaccuracies within the epidemiologic triangle. A visual description of the factors and interaction is not present.The communicable disease is described accurately and clearly within the context of the epidemiologic triangle. The communicable disease is described accurately within the context of the epidemiologic triangle. A brief description of factors and interaction is presented.The communicable disease is described thoroughly, accurately, and clearly within an epidemiological triangle. A visual description of the triangle and how the components of the model interact is included. Role of the Community Health Nurse and Importance of Demographic Data20.0Discussion of the role of the community health nurse is omitted or unclear. An explanation of why demographic data are necessary to community health is omitted or unclear.Discussion of the role of the community health nurse is vague, with no integration of case finding, reporting, data collecting, data analysis, or follow-up skills. An incomplete explanation of why demographic data are necessary to community health is provided.Discussion of the role of the community health nurses is limited, with a brief overview of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is summarized.Discussion of the role of community health nurse is clear, with a comprehensive description of skills associated with community assessment and planning. An explanation of why demographic data are necessary to community health is presented.Discussion of the role of the community health nurse is clear, comprehensive, and inclusive of the community nurse’s responsibilities to primary, secondary, and tertiary prevention through tasks such as case finding, reporting, data collection and analysis, and follow-up. A clear explanation of the importance of demographic data to community health is presented.National Agency or Organization That Works to Addresses Communicable Disease10.0Agency and description of contribution are omitted. An agency or organization is identified, but discussion is vague or inaccurate in relation to the communicable disease chosen.An agency or organization is identified, but discussion regarding efforts to address communicable disease is lacking.An agency or organization is identified, but discussion regarding efforts to address communicable disease is brief.An agency or organization is identified. A clear and accurate description of efforts to address communicable disease is offered. Global Implication10.0Global implication of the disease is omitted or unclear.A discussion of the global implication of the disease is vague, with no integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is not provided.A discussion of the global implication of the disease is limited, with some integration of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.A discussion of the global implication of the disease is clear, with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.A discussion of the global implication of the disease is clear, comprehensive, and inclusive with a comprehensive description of how this is addressed in other countries or cultures and if the disease is endemic to a particular area. An example is provided.Organization and Effectiveness 15.0 Thesis Development and Purpose5.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed and/or vague, purpose is not clear. Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive, contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction5.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice, sentence structure, and or word choice are present.Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.Format 5.0 Paper Format 2.0Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken, lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used. There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)3.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage 100

Respond on two different days who selected at least one different factor than you, in one or more of the following ways:Offer alternative diagnoses and prescription of treatment options for urinary tract infections.Share an insight from having read your colleague’s posting, synthesizing the information to provide new perspectives

Main Post

Urinary tract infections (UTI) are one of the most common infections in the world, and advanced practitioners must be able to diagnose and treat the varying types of UTIs. Understanding the location of the UTI, upper or lower, the pathophysiology, and specific signs and symptoms are crucial for treatment. An advanced practitioner must also be aware of the roles that gender and age play in the development of a UTI. UTIs are common in the outpatient setting but can also happen in the hospital and can also be caused by a Foley catheter, which is considered a hospital-acquired event that the hospital will not receive reimbursement.

Pathophysiology of Lower Urinary Tract Infection

A lower urinary tract infection involves the path of least resistance or the most opportunistic point of entry for an organism, usually bacterial and involves the urethra and the bladder. An infection in the urethra or bladder (cystitis) are considered a lower urinary tract infection. The microbial spectrum of UTIs consists mainly of Escherichia coli, with occasional other species of Enterobacteriaceae such as Proteus mirabilis and Klebsiella pneumoniae and other bacteria such as Staphylococcus saprophyticus (Yamamichi, Shigemura, Kitagawa, and Fujisawa, 2018).

Pathophysiology of Upper Urinary Tract Infection

The upper urinary tract consists of the kidneys and ureters. Infection in the upper urinary tract generally affects the kidneys (pyelonephritis), which can cause fever, chills, nausea, vomiting, and other severe symptoms. It can be caused by an infection that has made its way up the urinary tract and can become a complicated infection from an obstruction, such as benign prostatic hypertrophy, and calculi.

Similarities and Differences

Although the location of the infection is different many of the signs and symptoms can present the same; fever, dysuria, frequency, or urgency may be present in both. Many lower tract UTIs may be asymptomatic, and in upper tract UTIs, the symptoms may be more severe, including nausea and vomiting, flank pain, or costovertebral angle tenderness. Finding the underlying cause and treatment is the same; antibiotics for bacterial infections and analgesics for pain control. Intravenous antibiotics are preferred for upper tract UTIs in an attempt to preserve organ damage, but mat be converted to oral after initial treatment.

Gender and Age as Factors

While common in both males and females, females are more prone to community-acquired UTIs than men, basically because of anatomical differences. Lema (2015) acknowledges that the close proximity of the vagina and urethral meatus to the anal opening, the shorter length of the female urethra, and the opportunity for trauma during intercourse allows for the opportunity for a UTI to be acquired. Although this happens across the lifespan of a woman, the peak times are from mid-teens to the early forties or the sexually active years. Young children, especially females, are a high-risk group due to not being able to clean themselves properly after using the bathroom or poor technique. Older patients are also high risk; men with prostate issues cannot empty their bladder are also at risk.

Diagnosis and Treatment

Diagnosis of a lower tract UTI can be done with the assessment of signs and symptoms and urine culture, midstream is preferred. Research by Lee (2018) acknowledges that patients with non-febrile uncomplicated UTIs, active pain control and minimal use of antibiotics should be prioritized, including uncomplicated cystitis. Pain in acute cystitis is a natural consequence of the inflammatory response, and pain-mediated urinary frequency or urgency is the chief complaint of patients. Painkillers, including nonsteroidal anti-inflammatory drugs (NSAIDs), are a good choice for managing symptoms while reducing the usage of antibiotics. Urinalysis and urine culture confirms the diagnosis of acute pyelonephritis and according to the Infectious Diseases Society of America (2019) a urine culture showing at least 10,000 colony-forming units (CFU) per mm3 and symptoms compatible with the diagnosis. Symptoms management and oral antibiotic therapy are needed, and in severe cases, hospitalization with intravenous antibiotic therapy may be required.

Conclusion

As future practitioners, understanding the pathophysiologies of an upper tract UTI and a lower tract UTI is paramount to obtaining a diagnosis. Untreated and under treated UTIs can lead to life-threatening complications. Management of the signs and symptoms is important, but the treatment of the underlying cause can stop a lower tract UTI from spreading into the upper urinary tract. Age and gender play significant roles in UTIs, women of childbearing years, and older men who have trouble emptying their bladder are at high risk. Assessment and quality interviews can assist the practitioner in prevention through education.

References

Acute pyelonephritis. (2019). Retrieved July 18, 2019, from https://www.idsociety.org/clinical-practice/patient-care/patient-care/

Lee, S. (2018). Recent advances in managing lower urinary tract infections. F1000Research, 7, 1964. https://doi-org.ezp.waldenulibrary.org/10.12688/f1000research.16245.1

Lema, V. M. (2015). Urinary Tract Infection In Young Healthy Women Following Heterosexual Anal Intercourse: Case Reports. African Journal Of Reproductive Health, 19(2), 134–139. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=mnh&AN=26506666&site=eds-live&scope=site

Yamamichi, F., Shigemura, K., Kitagawa, K., & Fujisawa, M. (2018). Comparison between non-septic and septic cases in stone-related obstructive acute pyelonephritis and risk factors for septic shock: A multi-center retrospective study. Journal Of Infection And Chemotherapy: Official Journal Of The Japan Society Of Chemotherapy, 24(11), 902–906. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jiac.2018.08.002

This is a CLC assignment.

As a group, observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.

Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of 500-750-words in which you do the following:

1. Identify, prioritize, and describe at least four problems.
2. Provide substantiating evidence (assessment data) for each problem identified.
3. Identify and describe at least four medical and/or nursing interventions.
4. Discuss your rationale for the interventions identified.

Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Scripted Dialogue Portion

Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.

Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:

Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”

APA format is not required for this part of the assignment, but solid academic writing is expected.

Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”

Entire Assignment

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite.

Respond to your colleagues post by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

at least 2 references in each peer responses! 

Much like in the nursing process, the step of evaluation is very important in implementing any change. Deciding how the policy will be evaluated should be done as the policy is being created (Laureate education). The Institute of Medicine wants nurses to be at the forefront of healthcare change. This also contributes to the fourth aim of the quadruple aim which is to fight healthcare worker fatigue (Milstead & Short, 2019). When nurses have a say in the changes, they will be more likely to help implement them.

Nursing input was asked for in evaluating the Affordable Care Act (ACA) (Milstead & Short, 2019). They were, “urged to engage in the evaluation process, advocate for cost transparency, campaign for patient education regarding enrollment in subsidized health insurance plans, and assist with the dissemination of accurate evaluation results” (Milstead & Short, 2019, pp. 121). With nurses being at the forefront of healthcare and the largest group of healthcare workers, their input is critical in evaluating how a new policy is working and they are also able to identify problems.

Nursing professional organizations, such as the American Nurses Association (ANA) and the American Association of Nurse Practitioners (AANP), among many others, were asked to provide formative data to lawmakers while the ACA was being evaluated (Milstead & Short, 2019). In addition to assisting with data collection, they were also asked to help disseminate evaluation data among peers, stakeholders, and patients (Milstead & Short, 2019). By being highly involved in a nursing organization, a nurse can have an excellent opportunity to review policies.

There are some challenges that exist in evaluating health policies. One factor is public opinion (Milstead & Short, 2019). This played a huge role in reviewing the ACA. Members of the public were constantly being manipulated by the press to think it was either bad or good and their opinions affected congress members’ decisions since they rely on votes to stay in office. A policy that might be overall beneficial to the public, could die by public opinion. To combat that, nurses need to make sure that they advocate for policies they believe in. This could make a difference since they are a trusted profession.

Another challenge is the rapid pace of policy changes (Milstead & Short, 2019). Some policies take time to truly see the effect they will have, but constituents and stakeholders want results overnight. This challenge might be met by establishing evaluation criteria from the start and asserting that time will be needed to fully know the impact.

Laureate Education (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.