Section I Communicable Disease Nursing

COMMUNICABLE DISEASE NURSING

Communicable disease by definition is an illness due to a specific infectious agent or its toxic products. These agents are then transmitted to a susceptible host either directly or indirectly causing illness. The effects of communicable diseases are still a major problem in much of the world today. Communicable diseases increasingly threaten public health and contribute significantly to the escalating costs of health care. As society, technology and the environment change, some pathogens evolve or spread, while others come under control or seemingly disappear. Well documented emerging infectious diseases in the U.S. include a wide variety of parasitic, bacterial, and viral diseases. These diseases drain populations and cause reductions in the abilities of people to work and learn. The ability to identify and control communicable diseases is vital and entails a two-fold problem: protecting the health of the individual patient and protecting the community from exposure to the disease. A. Community Nursing Responsibilities 1. Utilize the epidemiologic triad model (agent, host & environment) to assist in the understanding of the diseases and developing nursing interventions. 2. Conduct surveillance activities for communicable diseases and facilitate the process of reporting disease cases to the appropriate health authorities. 3. Have knowledge of the distribution and determinants of infectious disease. 4. Develop capacity to assess the community by the utilization of epidemiologic information to derive a community diagnosis and assess community needs. 5. Identify characteristics of the population who are considered at-risk and identify primary, secondary and tertiary prevention strategies that can be implemented. 6. Conduct epidemiological investigations in coordination with the Rapid Response Teams and/or Infectious Disease Epidemiology Section as necessary. 7. Utilize the principles of epidemiology as a basis for nursing assessment, planning, intervention and evaluation and in the delivery of appropriate health services. 8. Evaluate the interaction of the disease, population-at-risk and medical practice dynamics and use epidemiologic principles for clinical decision making. 9. Provide health education to the community and at-risk population regarding disease prevention and transmission; implement public health intervention and control measures. 10. Serve as a communicable disease consultant to other health care providers and institutions.

NOTE: The Public Health Nurse works jointly with other health professionals (private physicians, infection control practitioners, State Health Officer/Medical Director, sanitarians, regional epidemiologists and Regional Rapid Response Team Coordinator) in epidemiological investigations.

B. Patient Care Responsibilities: 1. Assure appropriate infection control procedures; not all patients need total isolation. (Refer to Control of Communicable Diseases, American Public Health Association). 2. Teach good personal hygiene according to disease specific recommendations, such as frequent handwashing, covering nose and mouth with disposable tissues, etc., to attendant(s) and patient(s) 3. Instruct appropriate persons on good sanitation measures. 4. Assess/assure appropriate quality of patient care & follow-up. 5. Teach the family to care for the patient and to carry out isolation techniques and medical instructions. 6. Interpret communicable disease regulations to families, school authorities and others. 7. Secure laboratory specimens when indicated - urine, feces, blood, and other. 8. Review and assist in instituting preventive measures relative to group outbreaks, e.g., schools, day care centers. 9. Encourage and provide immunization/prophylaxis and other preventive measures as indicated. 10. Follow-up as needed to ascertain patients health status/outcome and track for secondary case development related to the index case patient.

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