Reportable Illness Protocol

Which of the following best describes a disease that should be reported to the local or regional public health department?  

A. Diseases where public health intervention is needed to help prevent spread to the region or community.  

B. Diseases with significant rates of mortality and morbidity.  

C. Diseases that are most often noted among individuals with significant immunocompromise. 

D. Diseases where intervention in early life helps lead to improved health in adulthood.  

---

YouTube: https://www.youtube.com/watch?v=oBvF5QT9RQE&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=120

Visit fhea.com to learn more!

Transcript

Voiceover: Welcome to NP certification Q&A presented by Fitzgerald Health Education Associates. This podcast is for NP students studying to pass their NP certification exam. Getting to the correct test answers means breaking down the exam questions themselves. Leading NP expert Doctor Margaret Fitzgerald shares her knowledge and experience to help you dissect the anatomy of a test question, so you can better understand how to arrive at the correct test answer. 

So, if you're ready, let's jump right in. 

Margaret Fitzgerald: Which of the following best describes a disease that should be reported to the local or regional public health department?  

A: Diseases where public health intervention is needed to help prevent spread to the region or community.  

B: Diseases with significant rates of mortality and morbidity.  

C: Diseases that are more often noted among individuals with significant immunocompromise. 

D: Diseases where intervention in early life helps lead to improved health and adulthood. 

The correct answer is A: Diseases where public health intervention is needed to help prevent spread to the region or community. Where should you start with a question like this? First, determine what kind of a question it is. This is a question that could fall under either assessment or, as well, professional issues. And it's a kind of a question that could be fair game regardless of what exam you are taking. 

I also clarify this as a question that I call a hit the panic button question. What do I mean by that? The panic button question is what I refer to as a question that a person encounters while taking the boards and will say to themselves, oh, we didn't do a public health module specifically in our program. 

I don't know anything about public health. Where should I even start? In reality, you've actually had a good deal of public health education in your program. And I dare say, if you dig back into the memory bank a fair amount in your undergraduate nursing program as well. This is the type of question that if you simply approach it by using your common sense and your nursing knowledge, you're going to be able to figure out the answer. 

First, as we do with all of these podcasts. Let's take a look at some background information. What is public health? And according to the Kaiser Family Foundation, public health can be broadly defined as the science and art of preventing disease, prolonging life and promoting health. And it also further defined as what we do together as a society to ensure the conditions are in place where everyone can be healthy. 

The overarching focus of a public health system is to help with disease prevention, health promotion, and to close gaps in health disparities. The reach of public health can be local, regional, statewide or national, depending on the governmental organization involved. Examples of essential public health services, including investigating in-depth diagnosing and addressing health problems that affect the population in their catchment area. 

Providing ongoing advisories on new health challenges such as uncommon or emerging infectious diseases and ensuring adequate and equitable distribution of health care resources, often comes under the public health umbrella. Just remember, what are we talking about? Health and public. Those two words together, they really help define what we're talking about. However, a question like this can really throw you on boards where you might say, hey, just give me another high blood pressure question, give me another diabetes question, give me another term question. 

I'll be ready. I'll be ready. But I'm not ready for this question. And what I ask you to do when you encounter a question like this on boards is take a deep breath. Look at the question. Use your critical thinking skills. Break it down as you would any other question. Then choose the best response. With that in mind, let's take another look at the question. 

And by the way, I've had people tell me, well, I got a question on two reportable diseases on boards. And the person would say back to me, so do I need to memorize? It's measles, it's tuberculosis. It's this, it's that no no no no no no. That would be an example of look-up information on the boards of what is considered to be a reportable disease. 

But on the other hand, this is more a conceptual question, if you will. So back to the question which of the following best describes a disease that should be reported to local or regional public health department? A: Diseases where public health intervention is needed to help prevent spread to the region or community. As I mentioned before, this is of course the best answer. 

But why is it? Please note some key words. One is mentioned specifically in public health interventions. Okay. The other word key word is spread. While not saying this specifically, it implies this is some kind of infectious disease, likely with significant mortality more morbidity. It could include well-established diseases like syphilis and tuberculosis and occur also include select vaccine preventable diseases with significant risk for mortality and morbidity like measles, i.e. using the measles example. 

Most communities right now are not having a measles outbreak. Some are most are not. But if you had measles in your community, there would be public health measures like offering immunization clinics advised on what measles looks like, etc., where public health interventions would be really helpful for minimizing the spread of a highly infectious disease like measles throughout the community. 

The fact that this is the best answer might become a little bit clearer when I go over the other options. Truth be told, you might get down to the end of this question and go, yeah, I was just the least horrible answer. I'm overstating things, but I will be clearer when we go over the other ones here. The diseases with significant mortality and morbidity. 

All right, one more time. Think this through. This would mean that if we're looking at major causes of mortality and morbidity in our overall population, it would mean that we would be reporting many malignancies virtually all cardiovascular and cerebrovascular disease to public health because they ranked among the top causes of death and top causes of morbidity in our population. 

And given that cardiovascular disease, cerebrovascular disease and cancers rate as those just top causes of death in the overall population, it's a little bit impractical. Plus, the fact that one person has heart disease does not mean another person is going to, if you will, catch it from another person. Same thing with the vast majority of malignancies. So, if you think that one through you'll go, yeah, we're not going to report the 98-year-old who just passed from a stroke, or that the 98-year-old has cerebrovascular or cardiovascular disease. 

It's impractical and it would not contribute to public health. C: Diseases that are most often noted among individuals with significant immunocompromise. Again, think this one through it would mean that anyone on an enemy module, or anyone on any kind of immunosuppressant therapy, and then people with immunosuppression from other etiologies where they develop a disease that's particularly severe in the presence of immunocompromised, that would need to be reported to public health. 

What is public health going to do with that information? And if you get to a point where you say, oh, I've reported to public health, but then public health would not have a specific action that they could do to help out this person or help out the community. Then you've got your answer. It's not a good choice. It would be hard to delineate what public health would do under these circumstances. 

It's not a good answer. And then diseases where intervention in early life leads to improved health in adulthood. Well, there are screening programs looking for kids who might have more challenges at the achievement of benchmark developmental milestones. Generally, these programs are handled more by the local or regional school system, not so much by the public health department.  

Key takeaway: when you encounter a question on the NP boards that you didn't anticipate such as this, take a deep breath. Break it down. Use your common sense and remember that you are a well-educated person who can use your critical thinking skills to dig through a test item like this and come up with the best answer. 

Voiceover: Thank you for listening to NP certification Q&A presented by Fitzgerald Health Education Associates. Please rate, review, and subscribe to this podcast, and for more NP resources, visit fhea.com.