Evidence-Based Practice for Nurses

1. Detect a possible outbreak.


2. Find cases in an outbreak.


3. Generate hypotheses through interviews.


4. Test hypotheses through analytic studies and laboratory testing.


5. Solve point of contamination and original source of outbreak vehicle.


6. Control outbreak through recalls, facility improvements, and industry collaboration.


7. Decide an outbreak is over.
   Modified from Centers for Disease Control and Prevention. (2004, November 17). Steps in an
   Outbreak Investigation. Available at https://www.cdc.gov/foodsafety/outbreaks/investigating
   -outbreaks/investigations/index.html

BOX 8-1 Steps of an Outbreak Investigation

indirect mechanisms. Direct transmission occurs from

person to person; indirect transmission occurs through

vehicles (e.g., water, food), vectors (e.g., mosquitoes), and

airborne mechanisms (e.g., droplet, dust).

The purpose of an outbreak investigation is to stop

the transmission of disease from the environment to

the host, the host to the agent, or the agent to the environment. For example,

the cycle of transmission of disease from the environment to the host can be

stopped through hand washing, water chlorination, and food safety. The cycle

of transmission of disease from the host to the agent can be broken with im-

munizations, isolation, and treatment. Finally, the cycle of transmission from

agent to the environment can be stopped with insect and vector controls. In an

outbreak investigation, nurses can follow steps to prevent further transmission

of disease (see Box 8-1).

FYI

Epidemiologists view disease through the

lens of the epidemiologic triangle: The host

is the human, the agent is the organism, and

the environment is the world in which we live.

When you watch the news, what kinds of outbreaks are reported? Are any of these concerns for col-

lege students? Have you encountered patients diagnosed with a disease associated with an outbreak?

CRITICAL THINKING EXERCISE 8-1

1. All of the following are components of the epidemiologic triangle except:
   a. agent
   b. environment
   c. host
   d. population

TEST YOUR KNOWLEDGE 8-2

How did you do? 1. d

196 CHAPTER 8 Epidemiologic Designs: Using Data to Understand Populations