This interactive simulation will provide you with valuable principles to use as an advanced practice nurse in your community. 

This interactive simulation will provide you with valuable principles to use as an advanced practice nurse in your community.

We hope you will learn information that you can apply in your organizations, transforming them into proactive facilities ready for any healthcare challenge in the future.

This web-based activity is designed to enhance your knowledge regarding public health outbreaks.

This activity will improve your ability to investigate collect and analyze epidemiological information and construct a plan to enhance safety for the community.

Crab Apple valley is a city in the four corners area of the Western US., and is known for its independence and self-reliance. The Population of 125.000 is divided into Rural, suburban, and urban sections. The Rural area is comprised of farmers who grow apples and crab apples. The suburban area comprises local businesses, private houses, and townhomes with one Urgent care and several clinics, and a private medical office. The Urban section has apartment buildings, several large department stores, supermarkets, industry, and a community hospital that serves the residents. Manny symptoms, a 40-year-old farmer, just purchased a 100-acre apple orchard and farmhouse in the rural section of town. As he was more closely inspecting the property, he noticed many dirt mounds between the rows of trees. In the evening he discovered many tiny, red itchy bites on his ankles. He completed the inspection and returned to the farmhouse to manage the itching. Initially, he wiped them down with alcohol, then considering they might be chiggers rather than fleas, he took a bath in very hot water. No chiggers appeared.

“chiggers are bugs so small you need a magnifying glass to spot them. They aren’t dangerous, but their bite can leave you with an urge to scratch.  Their favorite spots are moist, grassy areas like fields forests, and lawns. Chigger bites often show up in clusters around the waist or lower legs. Your skin may also turn red or have a hives-like rash. Chiggers don’t spread diseases. But too much scratching could cause more skin irritation or infection. If you think you’ve been around chiggers, take a bath or shower and scrub your skin with soap and water. Using hot water, wash your clothes and any blankets or towels that touched the ground. Then treat your bites with an OTC anti-itch cream.”

Despite experiencing mild flu-like symptoms with a temperature of 100f on July 30th, he visited several farmer’s markets in the suburban area and three local markets in the city to investigate potential sales opportunities for his produce. There are approximately 120 Vendors and attendees at the farmer’s markets and another 80 among the three local markets. The following day he noticed discomfort in his groin, which spreads rapidly to other lymph node locations.  Several hours later, he began to experience breathing difficulty and a developing productive cough. Growing a bit more concerned about his symptoms, he called the neighbor who sold him the farm to ask for the name of the local medical provider. He decided to wait until the next day to ensure the symptoms persisted and avoid an unnecessary trip. Later that day, the neighbor called to ask how he was feeling. The farmer did not answer the phone.. The neighbor called again but assumed the farmer must have been asleep as he did not answer. The following morning the concerned neighbor knocked on the farmer’s door and peeked in the window when there was no response.. He observed the farmer lying motionless on the floor. He entered through the unlocked door and called Emergency Medical Service(EMS). EMS began resuscitation efforts and transported Manny to the local Emergency Room. All efforts were unsuccessful despite the 20-minute code. Seventy-three(73) of the local farmers market attendee and city produce purchasers had also presented to the Emergency Department with flu-like symptoms. Sixty-two ( 62)  required additional testing. All were very disturbed to hear that Manny was brought into the hospital in critical condition and did not survive. The next morning the EMS workers presented to the ED with reported flu-like symptoms, Lymph node tenderness, and cough. Give of those hospital employees in attendance during Manny’s code also reported experiencing the same symptoms(MD, RN. Respiratory therapist, X-ray tech, lab tech). By the end of the week, thirty-one(31) of the four hundred and eighty(480) employees manifested symptoms. The hospital had to take the next steps, but what were they? Furthermore, what was causing this illness?

Ten-step approach to outbreak investigation. Identify surveillance team-> establish the existence of outbreak->Verify Diagnosis -> Construct Case definition-> find cases->Conduct research study->Evaluate hypothesis -> Implement Control Measures-> Communicate Finding-> maintain Surveillance.

Hypothesis

Independent Variable: Individuals attending the farmer’s market

Dependent Variable: plague

Measurable: Cumulative incidence

Tested: elevated serum antibody titer (s) to Yersinia pestis fraction1 (F1) antigen

Predict Outcome: individuals exposed will contract the disease

State Theory: in clear, concise, and easy-to-understand language

Remember to reflect on your learning experience by responding to these three questions: A what do you know now that you did not know before?

B how would you envision your role as an outbreak team member if given the opportunity?

C in what way (s) can you apply these concepts to your current clinical practice?

Please provide constructive feedback on the outbreak scenario to help us generate continuous quality improvement.

Cumulative incidence is calculated as the number of new events or cases of a disease divided by the total number of individuals in the population at risk for a specific time interval. Researchers can use cumulative incidence to predict the risk of a disease or event over short or long periods.

***Individuals who have person-to-person contact with the plague at the farmer’s Market will contract the disease****

Total number of new cases/ population at risk per 100,000 or 1,000

Residential area by Zipcode calculates the cumulative incidence for the individual zip codes and the total population of Crab apple valley and includes the information in your presentation. Enter the cumulative incidence value for each zip code and totals.