The document discusses the application of epidemiology in healthcare delivery, health surveillance, and health informatics. It defines primary, secondary, and tertiary prevention and describes activities for each level. It also discusses epidemiological surveillance, the surveillance process, health informatics definitions and objectives, and sources of health information data. The role of nurses in areas like disease prevention, control, health education, and data collection is also covered.

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

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,

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

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, 1st ed.2005,P.
555-9
 S.Soni, textbook of advanced nursing practice, jaypee
brother’s medical publishers,1st ed.P.228-6
 www.google.com