Policy Manual sample

MDT Home Health Care Agency, Inc. 8. Refine hypotheses and carry out additional studies. Additional studies may include lab tests or environmental studies, among other methods of evaluation. 9. Implement control and prevention measures. Control and prevention methods are usually aimed toward the source of the disease, but may also include interrupting transmission or limiting exposure. 10. Communicate findings. Findings of the investigation should be communicated to local health authorities who are responsible for implementing control measures. In addition, a written report provides a legal record of the findings and contributes to public health awareness. PROCEDURES: 1. Confirm outbreak: Confirm diagnoses, Case definition, Case finding, Case interviews, Case descriptive epidemiology, Establish baseline occurrence of cases, Rule out alternative explanations (chance, bias), Generate preliminary causal hypotheses. 2. Convene an interdisciplinary team (public health nurse, medical epidemiologist (if available), collect information from local DOH reports, etc) and discuss what information needs to be collected to confirm an outbreak and to generate preliminary hypotheses. In general, we will develop a plan that addresses all these steps, even without a Guide. 3. Review known causal factors (Transmission mechanisms and dynamics). 4. Prioritize likely causes to guide control measures. 5. From the case investigation after we have confirmed an outbreak and have generated preliminary causal hypotheses. Based on our experience, we have sufficient data to implement effective control measures. 6. If the cause of the outbreak remains uncertain and/or we do not know enough to implement effective control measures, we may need to identify and prioritize causal hypotheses to implement control measures and/or to test these hypotheses and identify the most likely cause(s). 7. To save time and resources, we need a systematic and comprehensive approach: We will use the components of transmission mechanisms and dynamics to guide our review of the literature, guidelines, and experts. We aim to accomplish the following: • Prioritize likely causes to guide control measures, • Generate and prioritize testable hypotheses to conduct an analytic study if the cause remains unknown or control measures are not working. The cause investigation extends and complements the case investigation; it guides control measures and analytic studies. 8. In order to conduct a thorough investigation we will need consultation with other specialists including environmental investigators, DOH reports, laboratorians, veterinarians, law enforcement, etc. They may need to conduct their own complete investigation. There may or may not be overlap in the investigations. If there is overlap, we need to coordinate investigative activities to minimize duplication of efforts. Additionally, we need to realize that communications can be hampered by discipline-specific jargon, or terminology that has different meanings to each discipline. For example, how do the these terms' meanings differ for public health and law enforcement: • Surveillance • Evidence • Case 99999. Continue Surveillance • Detect outbreaks Home Health Agency Nursing Care & Procedures K-161