NURS FPX 6020 Assessment 1 Risk Assessment

 Student Name

Capella University

NURS-FPX6020 A1

Professor

Submission Date

Risk Assessment

The environmental effects from Hurricane Harvey have resulted in several new environmental conditions that have markedly increased the level of risk for infection control throughout an entire area, including the West & South of the U.S. and the Houston metropolitan region. The flooding caused the introduction of pathogenic bacteria into the homes in residential neighbourhoods by the floodwater, and extensive destruction of buildings due to the floodwaters resulted in favourable conditions that promoted the growth and reproduction of both bacteria and mould. The data on ED visits revealed that ED visits to locations affected by the flood damage were significantly higher in comparison to ED visits to non-flooded locations, such as insect bites, acute respiratory illnesses, and pregnancy complications, as well as gastrointestinal tract illnesses (Ramesh et al., 2021). Since there are many overlapping environmental threats, which were caused by the impact of Hurricane Harvey, an integrated, evidence-based approach will be required to assess and create priorities in infection-related health threats within the affected regions.

Application of Decision-Making Approach

The southeast United States was impacted heavily by Hurricane recovery efforts in Western North Carolina at the end of September 2024. Flooding disastrously affected communities across the region, and the infrastructure of western North Carolina was in shambles. Most of these communities also lost all their power, were unable to have clean water to drink and bathe, could not access hospitals, and were unable to access different kinds of goods and services. Moreover, the sewage and other dangerous substances found in the floodwaters affecting these communities also gave them an even higher chance of becoming infected with contagious diseases, since those who already had an underlying medical condition, had a weakened immune system, and had open wounds at the time of this flood event (PBS News, 2024). This alone provides enough information to enable public health officials to gauge how much of a risk there could have been during long-term recovery efforts from any potential infectious diseases to these specific populations as related to Hurricane recovery efforts. 

Affected Populations and Infection Risks

The mountain ranges that have encircled the city of Asheville have resulted in higher susceptibility to extended isolation of the seniors, families living in remote locations, and those who need frequent medication. People displaced by the floodwater were at a greater risk of being exposed to waterborne bacteria caused by floodwater, mucor due to exposure to water-damaged wood, and exposure to vector-borne illness. After landfall of Helene in Florida, there were at least 38 Vibrio vulnificus infections documented in the state (ABC News, 2024). The exposure groups mentioned above imply that each of the groups at risk must have targeted infection prevention measures.

Decision-Making Process: The Haddon Matrix

By applying the Haddon Matrix Assessment, the Public Health personnel will be able to look at Host, Agent, and Environment factors at different times of the Pre-Event, Event, and Post-Event. The application of the Haddon Matrix is not comparable to other broad Risk-Based prioritisation assessment methods since the Haddon Matrix not only classifies but also prioritizes in time bound, the interventions made in sequence, and also considers the Biological and environmental factors where the risk is located (Khan et al., 2022). Contaminated water as a Vector for Infection is the main focus for reducing the effect of post-event infection; the Haddon Matrix will then assist in prioritising clean drinking water availability, educational opportunities such as how to care for a wound, and the organisation and distribution of medical supplies to at-risk populations.

Demographic and Environmental Risk Factors

The effect of Hurricane Helene differed across the different demographics since they experienced varying rates of potential healthcare risks caused by Hurricane Helene based on their respective exposure levels to the environment and the nature of their respective exposures. To illustrate, older adults who are single and reside in remote mountainous locations have several layers of potential danger because of their inability to move, because chronic illnesses are present, and because they cannot access medications (Chow et al. 2020). Older adults who reported having flooded their homes were much more likely to have been hospitalized compared to those who were under thirty-five years of age and were much more likely to report difficulty with concentration (Ramesh et al. 2021). These major disparities in these varying demographics contribute towards the existence of various interventions based on the nature of the population and the amount of exposure that the population underwent. 

Uncertainties and Bias

The probability of getting infected based on the risk of the infection to populations and /or demographic groups that were affected by Hurricane Helene has many grey areas. For example, individuals who are displaced and/or in a high-stress situation may have a difficult time recalling what they have been exposed to; therefore, self-reported exposure data may have recall bias. The CDC has documented a good example of such situation in a survey of the immunosuppressed survivors in Houston, Texas where such survivors reported that only a small percentage of them had used recommended respirators to clean up after the floods and it would therefore suggest that there could have been inconsistency between how the respondents reported on their protective behaviours and the data on their behaviours would therefore have been inaccurately captured (Tada et al., 2023). To come up with more precise and specific estimates of risk that are demographically based, future research needs to deal with these problems in the future to come up with more accurate estimates.  

Combination of Epidemiological and System-Level Data

In line with aggregate surveillance data gathered after Hurricane Helene, the patterns of infectious diseases were evident in the southeastern states affected. Measuring bacterial prevalence through local health departments gives information on the possible future health outcomes of populations who were exposed to flooding. To be more precise, the Florida Department of Health has published thirty-eight cases of Vibrio vulnificus identified, which led to seventy-six cases in Florida so far (ABC News, 2024). It will enable prioritization of the risks of infection in the state that need to be addressed by state agencies on the basis of this system-level data.

Relevance of Data

Local and regional surveillance data usage played a significant role in legitimizing areas of interest in the risk of infectious diseases that needed priority consideration. Without hospital or laboratory pooled data, public health would not be capable of determining the prevalence of a disease in a population that is distributed across a vast geographic area. Ramesh et al. (2021) found that patients who resided in a census tract with flooding used emergency department services more often than patients who resided in a census tract without flooding, both regarding intestinal infectious disease and acute respiratory infection. Such an approach is data-driven, which enables allocation of resources to reflect disease burdens within a community as opposed to the underlying assumptions of areas of disease burden.

Need for Communication

Effective communication of risk will be achieved through developing various forms of communication based on various literacy levels, languages, and access to information of different types of residents. The isolation of the mountain locations in Western NC is especially disadvantageous because of the difficult terrain of their mountainous residences, where the storm had a serious drainage effect on infrastructure involved in transportation, not to mention the limited connectivity of communication systems. In Asheville, NC, the largest healthcare distribution center in this area, in the aftermath of the storm, over 400 roads were inactive (Honey, 2024). The ultimate struggle over these challenges is key to providing vulnerable populations with timely instructions on how to avoid being infected with diseases. 

Examples

Communication plays an important role in assisting individuals to make sound decisions on the way to save themselves from a disease when trying to salvage the effects of a disaster incident. This population of older adults and those who have chronic illnesses would benefit greatly because they would be able to be provided with direct guidance on water safety and how to take care of their wounds (Toda et al., 2023). As an example, specialists have expressed that coordinated efforts with local pharmacists to refill prescriptions in the wake of a disaster are one of the most significant elements to effectively deal with chronic illnesses in the aftermath of the catastrophe (Virginia Tech News, 2024). Such focused communication will reduce the number of individuals who, though preventable, end up having complications caused by the storm, hence aid in the recovery of the whole community.

Conclusion

Hurricane Helene has made quite clear the cumulative effect of natural disasters on infection control; not only are people affected by a hurricane (Hurricane Helene in this case) some of the most vulnerable populations, but a clear example of the effect of widespread environmental disasters (like hurricanes). By applying both epidemiological epidemiology and Haddon’s Matrix, we are able to systematically examine the needs of stricken communities following an environmental disaster to ascertain what their healthcare requirements entail, how to prioritize these needs, and what efforts are already being undertaken to address those healthcare needs based on their demographic characteristics and the relevant constraints of information access and dissemination capabilities. The community task forces can evolve new plans towards enhancing their resiliency to infection control challenges during times of a disaster in several ways.