TOPIC:APPLICATION OF EPIDEMIOLOGY IN HEALTH CARE DELIVERY, HEALTH SURVELLIANCE AND HEALTH INFORMATICS

imp for msc nursing first year students

1. WELCOME

2. COLLEGE OF NURSING WANLESS HOSPITAL-MIRAJ SUBJECT: ADVANCED NURSING PRACTICE TOPIC:APPLICATION OF EPIDEMIOLOGY IN HEALTH CARE DELIVERY, HEALTH SURVELLIANCE AND HEALTH INFORMATICS PRESENTED BY : MR.TUSHAR KEDAR MSc (N)

3. APPLICATION OF EPIDEMIOLOGY IN HEALTH CARE DELIVERY, HEALTH SURVELLIANCE AND HEALTH INFORMATICS Introduction: The ultimate goals of health care services are to promote and protect health, to alleviate and minimize suffering and disabilities and regain health so as to lead socially useful and economically productive life.

4. There are three major level of prevention Primary prevention Secondary prevention Tertiary prevention

5. PRIMARY PREVENTION: “primary prevention can be defined as “action taken prior to the onset of disease, which removes the possibility that disease will ever occur ”. The specific intervention are : Health promotion Specific protection

6. HEALTH PROMOTION Improve the environment and favor healthy living. The health promotion activities are summarized below : health education good standard of nutrition adjusted to developmental stage of life attention to personality development provision of adequate housing and recreation and agreeable working conditions

7. CONT… marriage and sex education genetic screening periodic selective examination

8. SPECIFIC PREVENTION protection individual against specific agents e.g. immunization against poliomyelitis, or pasteurization of milk or chlorination of water. The activities of specific protection will include : Use of specific immunization, e.g. vaccination. Attention to personal hygiene for self-care. Use of environmental sanitation, e.g. chlorination of well. Protection from accident, e.g. wearing helmets.

9. Use of specific nutrients. Protection from carcinogens. Avoidance of allergens. Protection against occupational hazards

10. SECONDARY PREVENTION: “Secondary prevention focuses on the individuals who are experiencing health problems or illnesses and who are at risk for developing complication.” The objective of secondary preventive measures are : Early diagnosis and treatment Disability limitation :

11. Early diagnosis and treatment: Case finding measures: individuals and mass. Screening surveys. Selective examination Cure and prevention of communicable diseases and complication

12. Disability limitation : Adequate treatment to arrest disease process and prevent complications. Provision of facilities to limit disability and prevent death.  

13. TERTIARY PREVENTION Tertiary prevention occurs when a defect or disability is permanent. Here the activities of restoration and rehabilitation will include : provision of hospital and community facilities Selective placement. Work therapy and hospital

14. Implication of epidemiology in community health nursing Essential to nursing practice. Epidemiology methods used in the study of disease causation and the body of knowledge arises Epidemiology is a tool in conducting the investigation to evaluate and explain phenomena As tools for assessing community needs and evaluating the impact of community health programmes

15. CONT.... Epidemiological knowledge provides a framework for planning and evaluating community intervention programmes for assessing individual and family health needs and for planning nursing interventions.  

16. HEALTH SURVEILLEANCE : Introduction The surveillance means supervision or close watch especially on suspected person. It involves identification of missed and suspected cases and contacts, their conformation by source of infection and channel of transmission .

17. The epidemiological surveillance can be done at the following levels INDIVIDUAL / FAMILY SURVEILLANCE It includes surveillance of an infected person in a family as long as the individual is the source of infection to other e.g. typhoid case carriers.

18. Cont… COMMUNITY / LOCAL POPULATION SURVEILLANCE It include surveillance of the whole community for early detection and prevention and control of disease e.g. malaria. NATIONAL SURVEILLANCE It include surveillance at the national level e.g. surveillance of small pox after its eradication.

19. INTERNATIONAL SURVEILLANCE: It include surveillance of some of the diseases which are listed by WHO e.g. malaria, influenza, filaria and polio etc. and are to be reported to WHO which then provides information to the countries in the world to take timely actions.  

20. SURVEILLANCE PROCESS : Surveillance is the systematic process . The main steps involved are: Collection of relevant information about the disease Effectiveness of surveillance system depends upon identification of cases, collection of relevant information about disease, their recording and reporting. It may be easier to find some diseases and may be difficult to identify some other. because of this difficulty no single method can be adopted for surveillance of all diseases

21. THE VARIOUS METHODS OF SURVEILLANCE ARE AS UNDER: Routine reporting of cases and death recorded : To maintain record reported in their outpatient departments and clinics. i.e. address ,diagnosis date of onset and remark The practice of recording of cases under the routine reporting system is called as passive surveillance

22. CONT… ACTIVE SURVEILLANCE: The type of cases who have not been recorded under the routine system It is done by health workers and community people e.g. surveillance of malaria or tuberculosis cases. EPIDEMIOLOGICAL INVESTIGATIONS: when there is sudden outbreak of any disease and when a communicable disease which has never occurred now.

23. SENTINEL CENTERS Sentinel centers are those hospital, health centers, laboratories etc. which are identified for collecting information for selected diseases. The information is collected complied and forwarded to higher action and for making future plans and policies.

24. SPECIAL SAMPLE SURVEY : There are different sample of survey but the survey by cluster sampling technique is recommended by the WHO. The target population , the sample size vary from disease to disease e.g. the target population for poliomyelitis is 5-9 years for diarrhea 0-4 years ,

25. CONT…. REPORTING OF DATA AND PROVIDING FEEDBACK: once the data is analyzed a report is to be prepared in the format prescribed by the authority The report is sent regularly for each reporting period. The report should be complete If there is nil information , it should be reported.

26. If some information is missed or received late, it should be included in the next reporting period feedback should be given to all the members of health team as to how the data are used which are collected by them and reported through regular meetings and when desired by anyone.

27. Introduction: Health information system is an integral part of the national health system

28. Definition: “ A mechanism for the collection ,processing analysis and transmission of information required for organizing and operating health service and also for research and training.”

29. OBJECTIVES To provide reliable , up to date , adequate , timely and reasonably complete information To share technical and scientific information To provide periodic intervals the data that will show the general performance of the health services.

30. Requirements to be satisfied by health information system: The system should be population based The system should avoid the unnecessary data The system should be problem oriented. Express information briefly and imaginatively (e.g. tables, charts, percentage) The system should make provision for feedback of data

31. COMPONENTS OF SYSTEM : Demography and vital events Environmental health statistics Health status ;mortality ; morbidity ; disability and quality ,of life Health resources ;facilities Utilization and non-utilization of health services ;attendance ,admission waiting list.

32. USES OF HEALTH INFORMATION To measure the health status of people For local national and international comparison of health status For assessing the attitude and degree of satisfaction of beneficiaries with the health system. For research into particular problems of health and disease

33. Sources of health informatics: CENSUS: . at regular intervals usually of 10 years. A census is process of collecting ,compiling and publishing demographic ,economic and social data The first regular census in India was taken in 1881 The supreme officer who directs ,guides and operates the census

34. REGISTARION OF VITAL EVENTS: Registration of vital events i.e. live births, deaths, fetal deaths, marriages ,divorces, adoptions, legal limitations, recognitions, annulments and legal separations. The time event for registering the event of birth is 14 days and that for deaths is 7 days.

35. SAMPLE REGISTRATION SYSTEM : SRS was initiated in mid-1960’s to provide reliable estimates of births and death rates at the national and state level. It is a Independence survey every 6 months by an investigator supervisor. This system is more reliable for information on birth and death rate , age specific fertility and mortality and mortality rates, infant and adult mortality etc.

36. NOTIFICATION OF DISEASES: Focus on prevention and control of the disease. Notification is also a valuable source of morbidity data It covers only a small part of the total sickness in the community

37. HOSPITAL RECORDS: hospital data constitute a basic primary source of information about diseases prevalent in the community. They provide information on only those patients who seek medical care.

38. DISEASE REGISTERS Morbidity registers exist only for certain diseases such as stroke, myocardial infarction, cancer blindness, and congenital defects. The useful information can be obtained provide useful data on morbidity

39. RECORD LINKAGE the process of bringing together records relating to one individual the record originating in different times or places. The events commonly recorded are birth , marriage death , hospital admission It has been applied only on a limited scale e.g. measurement of morbidity, chronic disease epidemiology

40. EPIDEMIOLOGICAL SURVEILLANCE set up to report on the occurrence of new cases and on efforts to control the diseases. E.g. immunization is performed. considerable morbidity and mortality data for specific disease.

41. OTHER HEALTH SERVICE RECORDS These are hospital OPD, PHC and sub center, MCH centers; school health records diabetics and hypertensive clinics etc. For E.g. records in MCH centers provide information about birth weight, height, immunization disease specific mortality and morbidity.

42. ENVIRONMENTAL HEALTH DATA provide data on various aspect of air water and noise pollution; harmful food additives; industrial toxicants etc. It is helpful identification and quantification of a factors causative of diseases.

43. ROLE OF NURSE: The prevention and control of diseases at various levels. The nurse participates in prevention and control of communicable diseases . The nurse provide health education Investigates regarding frequency and distribution and possible determinants and analyzes the information collected. provides ongoing in-service training .

44. Cont. The nurse conducts studies to determine risk factor leading to infections. She participate in data collection , data analysis ,planning, implementation and evaluation. She also participates in national programs  

45. CONCLUSION: Epidemiology is very important to study in order to find out the disease causation in our country in an earlier stage and to find proper solution for it. Epidemiology can be well utilized by the health care professionals to protect and saves the life of people in our country.

46. SUMMERY: Today we discussed regarding the levels of prevention , Epidemiological surveillance level, surveillance process , health informatics definition, objective, requirements to be satisfied by health informatics system ,uses and sources of health informatics system. I hope u understood my presentation and use this knowledge in clinical settings.  

47. BIBLOGRAPHY: Basher SP, SY. khan, a concise textbook of advanced nursing practice, Emmess medical publishers, S. kamalam , essentials in community health nursing practice, jaypee brothers publication, 1 st ed.2005,P. 555-9 S.Soni , textbook of advanced nursing practice, jaypee brother’s medical publishers,1 st ed.P.228-6 www.google.com