Healthcare Assessment | report-1

Running head: HEALTHCARE
Healthcare
Name of the Student
Name of the University
Author Note

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Abstract
The purpose of this study is to identify the fighting strategies that possess the potential to
eradicate infectious disease from the New Jersey State. In the New Jersey State, major breakouts
of infectious diseases like adenovirus outbreak and Legionnaires, have been taken place from
past decades. For this research, qualitative analysis of the collected data has been conducted.
Both primary and secondary data has been collected. effective strategies needs to be
implemented in order to eradicate infectious diseases from NJ. The government of NJ have
already implemented several steps in order to prevent further spread of infectious diseases. The
New Jersey Department of Health, mandate that every school as well as childcare service are
stipulated to immediately report regarding any kinds of physically transformable diseases which
are identified as the subject of imitate reporting to the department of health. In spite of
implementation of the mentioned technique, the occurrence of infectious disease in NJ is
increasing to a commendable amount. According to the participants, a good number of potential
measures are there that can be implemented to eradicate the issue. Establishment of strict polices
by the healthcare organizations in order ensure safe and hygienic healthcare practice within the
organization.

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Table of Contents
Problem Statement:..........................................................................................................................4
Review of the Literature:.................................................................................................................6
Types of infectious diseases........................................................................................................6
Impact of infectious diseases.......................................................................................................7
Causes behind the spread of infectious diseases..........................................................................9
Strategies to prevent the prevalence of infectious diseases.......................................................11
Methodology..................................................................................................................................13
Research philosophy and approach...........................................................................................13
Research design.........................................................................................................................14
Target population and Sampling................................................................................................14
Data collection process..............................................................................................................16
Data analysis..............................................................................................................................17
Ethical considerations................................................................................................................18
Findings.........................................................................................................................................20
Overview of content/ code.........................................................................................................20
Content analysis.........................................................................................................................23
Discussion..................................................................................................................................29
Conclusion and recommendation..................................................................................................32
Limitation......................................................................................................................................34

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Reference:......................................................................................................................................36

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Research topic: Fighting infectious diseases in New Jersey State
Problem Statement:
The term infectious disease refers to the disorders that are caused by organisms that include
bacteria, virus, parasites as well as fungi. In the New Jersey State, major breakouts of infectious
diseases like adenovirus outbreak and Legionnaires, have been taken place from past decades.
According to Soeters et al, more than 24 children had got affected and an 11th years old child had
lost his life due to an adenovirus outbreak at the New Jersey heath care facility as per the
announcement of the Department of Health of the New Jersey state (Killerby et al). The children
who were suffering from adenovirus were found to experience deterioration in their immunise
systems along with other serious medical issues along with requiring assistance in breathing and
functioning. According to Akyar et al., the chief reason behind the spread of the mentioned
infectious disease includes lack of nursing staffs a supplies that in turn is hampering the New
Jersey State’s healthcare home’s infection control as well as prevention measures. According to
the healthcare professionals of the nation, shortage of healthcare staff and supplies can be
considered as a major reason behind poor infection control practices (Nizami and Dever).
Not only adenovirus, the residents of new jersy state is found to highly vulnerable to a good
number of infectious diseases. In 2019, May another major infectious disease, Legionnaires’
disease outbreak had taken place which imposes highly adverse impact on the life of the
residents of the state. Within one month of the outbreak, more than five people had died. More
than 22 individuals, who lived in Union County or had visited the same, had been infected from
the disease (Akyar et al.). The chief reason behind rapid spread of the mentioned infectious
disease has been pointed out to be breathing in water droplets contaminated with the Legionella

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bacterium; those droplets can come from cooling towers, decorative fountains, air conditions and
plumbing systems (Soeters et al.). The government in working on preventing this contamination
of water, however, no effective strategies has been implemented till now.
It can be stated that the New Jersey State has become highly vulnerable to infectious diseases.
The fact that the government have already launched a few campaigns and program in order to
enhance the awareness of the residents as well as improve the quality of life of the same, cannot
be ignored. The Infectious and Zoonotic Disease (IZDP) Program is based in the Communicable
Disease Services (CDS) Department of Health in New Jersey. IZDP aims to improve the living
standard of all people of New Jersey by increasing and eliminating the infection that can be
transmitted. IZDP is generally responsible for Foodborne, Vectorborne, Zoonotic and Healthcare
Related Infections (Reddy et al.). IZDP personnel also work closely with our fellow members in
the Preventable Disease Vaccine Program on diseases with safe vaccines. In addition to work on
infectious and zoonotic diseases, personnel within IZDP provide state as well as local health
agencies with assistance with regulations and laws on animal control, regulation and operation of
pet facilities, dog licensing and education of Animal Control Officers (ACOs) and of animal
cruelties inspectors (ACIs). However, according to researchers, these actions, though helpful,
lacks appropriate implications and awareness (Killerby et al). More effective measures need to
be taken in order to prevent the rapidly spreading infectious diseases’ outbreak in the New Jersy
state.
It has been found that in spite of the fact that rapid and frequent spread of infectious diseases in
the nation is a dire problem, highly limited number of researches has been conducted on the
fighting strategies that has been or can be implemented by the New Jersey state healthcare
department to deal with the infectious diseases. Hence, the problem statement of this research

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includes identification and analysis of existing as well as potential fighting strategies that can be
implemented by the New Jersey state for reducing the impact of infectious disease. For this
research paper, primary data collection settings should include collecting information by
interviewing eminent doctors as well as personals of healthcare department of New Jersey.
Along with this secondary data by reviewing literature relevant to the study has been collected.
Key terms: infectious disease, Zoonotic Disease, healthcare, Legionnaires’, adenovirus
Infectious diseases: diseases that are caused by the microorganism like bacteria, fungi, parasites
or viruses.
Zoonotic diseases: a disease which can be transmitted from flora and fauna to individual or, more
particularly, a sickness that normally exists in animals but that posses the potential to infect
humans.
Legionnaires’: A disease that takes place due to the bacteria Legionella pneumophila found in
plumbing, shower heads and water-storage tanks.
Adenovirus: One virus group which can cause lung, stomach, intestine and eye infections.
Review of the Literature:
Types of infectious diseases
Infectious diseases include disorders that are caused by organisms like viruses, bacteria or
paucities. While some of the mentioned organisms reside in human bodies and are not harmful,
some of the microorganisms, under certain condition, possess the potential to cause diseases.
While some of the infectious diseases gets passes from one individual to other though physical

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contact, some infectious diseases gets passed by insects as well as other animals. Infectious
disease can also take place due to contaminated food items and water that are being exposed to
organisms in the environment.
According to Fonkwo, there are mainly 4 types of infectious diseases that includes viral
infection, bacterial infection, Fungal infection and Prion disease. While some infections are mild
as well as barely noticeable, others are severe as well as life threatening as well as resistance to
treatment. Morens and Anthony have pointed out that in this era of technological advancement,
despite an extraordinary advances of countermeasures, the ease of word travel as well as
enhanced global interdependence have added complexity layers that possess the potential to
affect the health as well as the economical stability of the society. HIV, severe acute respiratory
syndrome (SARS), and H1N1 influenza are some of the mention worthy examples of emerging
infectious diseases in the modern world (Lafferty et al.). Each of these diseases has resulted in
global societal as well as economic impact and is associated with unexpected illnesses and deaths
along with interference with travel, business and several normal life activities.
Impact of infectious diseases
The fact that infectious diseases can impose a highly adverse impact not only on the life of
individuals but also on the society cannot be ignored. New Jersey is suffering from a good
number of fatal infectious disease that includes Eastern Equine Encephalitis, adenovious,
Babesiosis, Borrelia Miyamotoi, Ehrlichiosis, Anaplasmosis, and Lyme Disease. A viral
respiratory illness, adenovirus outbreak has been found to kill 11 children as well as infected 23
others at a medical facility in the state. According to researchers, amongst the 18 cases of
Adinovirous 6 of them are found to be fatal. It has also been found that the Adinovirous disease
targets medically vulnerable healthcare service users who already possess minor to major

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respiratory issues befor the outbreak of the disease. The chief victims of the mentioned disease
were children as well as adolescents (Timenews). More than 11 children have lost their life due
to the mentioned disease in the state. According to researchers, considering the fact that
Adenovirus chiefly targets weakened immune system, heath care service users with preexisting
health problems along with their shared environment have facilitated the spread of adenovirus.
The affected victims have reported to be suffering from polio like illness that results in muscle
weakness, paralysis and in some fatal cases, even death.
According to Ungchusak, Kumnuan, Heymann and Pollack infectious diseases is comprised of a
tenacious as well as major public health issue across the world. The impact imposed by these
diseases is enormous. Additionally for affecting the health of people directly, infectious diseases
are also having an impact on the entire societies, economies as well as political systems. In this
era of raid development, specially sectors like heath and education have been evidenced to loss
qualified personal due to infectious diseases like Human immunideffiencicy Virus (HIV),
Tuberculosis (TB), Malaria and Acquired immune deficiency Syndrome (AIDS) the mentioned
infectious agents, along with taking a huge physical toll on humanity, are also responsible for
economic classes directly in developing counties and indirectly in developed nations. Raszek,
Guan, and Plastow have opined out that the most potential challenge associated with the
complete eradication of infectious diseases from the society is the potential of pathogens to
constantly change their genetic makeup which challenges the development of vaccines against
the infectious diseases.

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Causes behind the spread of infectious diseases
Kanamori, Weber, and Rutala have pointed out the different ways by which infectious diseases
spread. Germs carrying infectious diseases can spread through small droplets as well as tiny
aerosol particles. Other ways of spreading of germs includes contact with mucous membranes
blood as well as other body fluids. Along with the above mentioned causes, rapid climate change
is another major reason behind the spread of infectious diseases. According to Altizer, et al,
climate change has already enhanced the occurrence of diseases in some natural as well as
agricultural system. However, in several cases, the outcomes entirely depend on the form of
climate change as well as details of the host pathogen system. Climate change has already
contributed to specific extinction both directly and with the help of spreading infectious diseases.
According to Serrano-Suárez, exposure to diarrheal diseases in human has been linked with
warmer temperate as well as heavy rainfall. When it comes to cholera, another infectious disease,
contaminated water and undercooked seafood are two major reasons behind spreading this
disease.
NJ spotlight stated that one of the chief priorities of New Jersey includes preventing Asthma that
is increasing at an alarming rate due to climate change. Nearly 590,000 adults and 180,000
Children have got affected of chronic respiratory diseases due to excessive increment of
pollution on the air. Not only that, the prevalence of cholera has also got enhanced in the
mentioned state due to rapidly increasing temperature. More than 1200 residents of New Jersey
have got affected due to the climate alliance.
Jones stated that another major reason behind the spread of infectious diseases includes lack of
effective Hygiene measures as well as policies in New Jersey. As per the investigation from the
New Jersey Department of health, HealthCare service providers working at healthcare homes are

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not following sterilization procedures. Medical instruments are not being cleaned in a proper
way. This in turn exposes the health care service users to infectious diseases like Hepatitis B,
Hepatitis C and HIV that takes place through blood transmission. Lack of hand hygiene amongst
the pre hospital providers like the ambulance service providers can be also pointed out to be a
major reason behind the rapid spread of the diseases. According to a survey conducted in 2013,
multiple protocol error has been detected.
contagionlive.com stated that recent spread of the Legionnaires’ disease outbreak have taken
place due to contaminated water. Thus one of the chief reasons behind the outbreak of the
diseases includes exposure to Legionella via breathing in aerosolized water from cooling towers,
cooling misters, fountains, and plumbing systems. The bacteria can be found in water systems of
any type, but people cannot contract Legionnaires’ by drinking water. According to Serrano-
Suárez, et al., Hot water Recirculation Systems (HWRS) that are often found in hotels as well as
heath care homes are found to be one of the major sources responsible for the outbreak of the
Legionnaires’ disease. It has also been stated that the risk associated with contaminated hot water
can be prevented with the help of ensuring a better understanding of the Legionella ecology in
these systems. The first flush of the hot water tap is found to b the most susceptible source when
it comes to the Legionnaires’ infection. The chief reason behind this is the accumulation of
microorganisms, both bacteria and protozoa, at this point in the circuit where biocides, especially
temperature, are not particularly active (Lafferty et al). Fonkwo have pointed out that some other
causes associated with the sped of infectious diseases includes mass arrival of immigrants as well
as growth of urban slums that lacks basic sanitation.

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Strategies to prevent the prevalence of infectious diseases
The fact that a good number of steps have been taken from the side of government cannot be
ignored. The Department of Health of New Jersey mandates all schools and children's care
services to report all types of diseases that can be reported to the health department immediately.
The regulations include parks, facilities for young children, pre-schools, colleges and higher
education institutions.
The Local Health Department is responsible for protecting as well as promoting health as well as
in for each and every individual in New Jersey. The chief LHD offers include epidemiologists,
nurses, and registered environmental health specialists (REHS). The chief aim of the mentioned
LHDs are to protect the community against any kind of environmental hazards, spread of
diseases along with encouraging healthy behaviour. Along with this, in case of any kinds of
outbreak they can offer resources, information as well as guidance. A good number of
departments are associated with the LHDs that provides technological assistance as well as
information to the department in order to provide effective support to the healthcare service
users.
According to Warren‐Gash, Fragaszy and Hayward, effective hand hygiene possesses high
potential to reduce the transmission of infectious diseases that includes influenza as well as acute
respiratory disease. Hand hygiene within the healthcare home can be developed, maintained as
well as monitored by incorporating efficient training as well as educational campaigns. Along
with this, establishment of ongoing monitoring as well as feedback on rates of infection that
include tracking endemic along with emerging drug resist pathogen. Serrano-Suárez et al. have
stated in order to ensure effective implementation of hand hygiene, it is of paramount importance
for the management of home healthcare that a large number of hand hygiene resources, including

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patient care corridors and patient entry and exits, be made available throughout the organization.
Along with this, it is also crucial to monitor the outcome of the training session in order to
measure the efficiency of the strategy.

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Methodology
Research methodology refers to the specific procedures as well as techniques that are used for
identifying, selecting, processing as well as analysing information about specific topic. This
section has been designed for allowing the readers for critically evaluating the overall validity as
well as reliability of the study. In the following section, the method that has been used for
collecting the data for the research issue and analysing the same has been identified.
Research philosophy and approach
A research philosophy can be defined as the believe of the researchers about the way in which
data about a specific research issue should be gathered, analysed as well as used. For this
research, the positivism research philosophy has been used. According to the mentioned research
philosophy, the reality is stable and can be observed as well as described from an objective view
point that is without interfering the phenomenon that has been studied (Kumar). The positivism
research philosophy only adheres to the view that only knowledge that is factual and has been
gained with the help of observation along with measurement is trustworthy. Considering the fact
that the research topic is to explore effective fighting strategies that has been and can be
implemented by the state of New Jersey in order to reduce as well as eliminate infectious
diseases, interview has been conducted for collecting the data. Hence for this research,
positivism philosophy has been used.
When it comes to research approach, the research approach that has been followed by the
mentioned researcher is inductive. Inductive approach, also called inductive reasoning, initiates
with the observations as well as theories are proposed towards the ending of the research
process as a result of observations. Inductive research includes the search for partners from

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observation as well as the development of theories (Mackey). No theories as well as hypothesis
are applied in a inductive study while initiating a research and the researchers is free to alter the
direction for the study. Considering the fact that the mentioned research issue is based on
identification and analysis, no hypothesis has been developed. Hence as a research approach,
inductive research approach has been selected.
Research design
The term research design can be defined as the overall strategy that has been selected for
integrating the different component of a specific study in a logical as well as coherent way and
thus ensure that the research problem has been adequately addressed (Bresler). For this research,
exploratory research design has been selected. As the name implies, exploratory research intends
to explore the research questions instead of offering a final as well as conclusive solution to the
existing issue. Therefore it can be said that this type of research is usually conducted for studying
a problem which has not been defined in a clear manner till now (Flick). Considering the fact
that the chief aim of this research is to analyse the strategies available for the state of New Jersey
to fight infectious diseases, the exploratory research design has been selected for this research.
Target population and Sampling
The target population of a research can be defined as the population whom the researcher wants
too study. a sample can be defined as a individual or a group of individual who have taken part in
the research. For this research, the target population has been segregated into two parts (Ledford
and Gast). One of the parts includes the population for whom the research has been conducted.
Considering the fact that the research issue includes effective fighting strategies for eliminating
infectious diseases from which he residents of the states are getting affected, the research has
been conducted for the residents of New Jersey (Fletcher). The second target population of this

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research includes the population from which the samples have been collected. Individuals who
possess adequate knowledge about the current impact of the diseases, the reason behind the same
as well as effective strategies that can be implemented for fighting the infectious diseases has
been targeted. The target population includes physicians, government officials of the healthcare
department of New Jersey as well as environmental biologists.
When it comes to sampling, for this research, non-probability sampling has been used. The term
non probability sampling can be defined as the sampling technique where the participants are
gathered following a process which does not provide all the individuals in the population equal
chances of getting selected (Quinlan). Considering the fact that for this research, individuals who
possess enough knowledge about the infectious disease as well as strategies to deal with the
same is required, professionals like physicians, health department officials as well as
environmental biologists are selected for sampling for this research convenience sampling has
been performed. Convenient sampling refers to a non probability sampling which includes the
sample being drawn from that part of the population which is close to the hand. 3 samples that
includes, I pathologist, 1 environmental biologist and 1 government official who works in the
Health care department of New Jersey has been selected for conducting in depth interview. The
chief reason behind selecting the environmental biologist as an interviewee was to gain in-depth
knowledge of the reasons behind the occurrence of the diseases and how the diseases can be
prevented. A pathologist has been interviewed in order to gain in-depth knowledge about the
current impact of infectious diseases on New Jersey as well as strategies to prevent the same.
Finally, an eminent government official of the health department of NJ has been interviewed in
order to understand the strategy that has been already implemented as well as the strategies that
needs to be implemented.

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Data collection process
Research data collection can be defined as the procedure of collecting, measuring as well as
analysing accurate insights in order to research with the help of using standard validated
techniques (Taylor and Bogdan). For this research, we have conducted both primary as well as
secondary data collection procedure. The term primary data collection can be defined as the data
collected by the researchers from first hand sources that include methods like surveys, interviews
as well as experiments. It is collected with the research in mind, from primary sources. For this
research, unstructured interview has been conducted in order to collect primary data. This
process of collecting primary data has been selected keeping in mind the requirement of the
problem statement. It is unlikely to conduct survey or any other primary data collection process
for gathering data about the strategies that can be implemented for fighting infectious diseases
(Mihas). This is because, publics lacks the knowledge that needs to answered for this research
paper. however, this can be done by conducting interview with eminent people who possess the
require knowledge. This is why, for collecting primary data, interview has been conducted.
Along with primary data, secondary data collection procedure has also been conducted for this
study. The term secondary data collection refers to the data that is collected by the researchers
from the studies or report conducted for other purpose but are relent to the current research topic.
Some of the major sources of secondary data collection includes newspapers, diaries, interviews,
transcripts, etc. Secondary data can be both qualitative and quantitative. While qualitative
secondary data includes research papers, academic articles, newspapers and others, quantitative
research papers includes financial statements and statistics. Common sources of
existing secondary data include data collected by government public services departments,
libraries, internet searches and censuses, such as the United States Census. For this research,

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qualitative secondary research has been collected. 5 academic articles that are relevant to the
research topic has been selected for reviewing. Along with this data obtained from news articles
has also been collected in order to gain knowledge about the impact of the infectious diseases on
the residents of the state (Harding). It has been found that while a good number of researchers
have conducted researchers on the type of infectious disease and how they possess the potential
to affecting individual, highly limited number of researchers has been conducted on impact of
infectious diseases on the residents of New Jersey and the specific strategies that can be
implemented to deal with the same.
Data analysis
Data analysis can be defined as the process of applying systematically logical as well as
statistical techniques for describing as well as illustrating, condensing as well as evaluating data.
A large number of analytical procedures allow inductive interferences from data to be extracted
and the signal to be separated from the noise in data. There are two types of data analysis method
that can be pursued by the researchers (Quinlan). These procedure include qualitative data
analysis method as well as quantitative data analysis method. When it comes to qualitative data
analysis method, it includes content analysis, narrative analysis, Discourse analysis and
Grounded theory. Content analysis is considered to be the most common method for analysing
qualitative data. It is used for analysing documented information in the form of texts, media as
well as physical items. Whether a researcher should use this method or not depends on the
research questions (Mihas). Content analysis is usually used for analysing responses from the
interviews. When it comes to narrative analysis, it includes method that is used for analysing
content from various sources like interviews of respondents, observations from the fields or

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surveys. It focuses on using the stories and experiences shared by people to answer the research
questions.
The third and fourth type of quantitative analysis includes discourse analysis as well as grounded
theory. In comparison to narrative analysis, speech processing is used to evaluate experiences
with individuals. It focuses, however, on examining the social context in which interaction is
conducted between the scientist and the respondent. It does this by studying a number of similar
cases and using these data to gather causal explanations in various settings. Researchers possess
the potential to alter the explanations as well as create new ones as they conduct study more
cases until they arrive at an explanation that fits all cases.
For this research, content analysis method has been used for data analysis of this research.
Analysis of the interview has been conducted. Thematic map and coding has been performed for
analysing the data provided by the interviews. Coding of the information has been conducted.
The code has been then mapped for obtaining the data.
Ethical considerations
One of the most important research components can be described as ethical considerations. The
ethical consideration holds the validity, reliability and the authenticity of the research. The
following ten elements are the most important ethical concepts in the doctoral theses:
1. Research participants should not be subjected to harm in any ways whatsoever.
2. Full consent should be obtained from the participants prior to the study.
3. Respect for the dignity of research participants should be prioritized.

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4. Any type of communication in relation to the research should be done with honesty and
transparency
5. The protection of the privacy of research participants has to be ensured.
6. Adequate level of confidentiality of the research data should be ensured.
7. Affiliations in any forms, sources of funding, as well as any possible conflicts of interests
have to be declared.
8. Any deception or exaggeration about the aims and objectives of the research must be
avoided (Harding).
9. Any type of misleading information, as well as representation of primary data findings in
a biased way must be avoided.
For this research, no animal has been harmed. Research participants were free to leave the
research whenever they wanted to. Not only this, no participants were pressurized during the
research procedure.

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Findings
Overview of content/ code
Parent code Code
process of reducing infectious diseases incorporating campaign for awareness
current strategies implemented Title 6A, Chapter 16‐2 and N.J.A.C.10:122
regulation
current strategies implemented mandate reporting communicable disease
effectiveness of the stratagies implemnt strict polices
environmental factors responsible for
infectious diseases
introduction of new agent in host population
environmental factors responsible for
infectious diseases
results from establishment in host population
environmental factors responsible for
infectious diseases
caused by pathogen already present in the
environment
process of reducing infectious diseases goverment reguation for vacciation and
contraceptives
fighting infectious disease in NJ techniques that needed to be implemented
fighting infectious disease in NJ effectiveness of the stratagies

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fighting infectious disease in NJ environmental factors responsible for
infectious diseases
fighting infectious disease in NJ process of reducing infectious diseases
fighting infectious disease in NJ types of infectious disease
fighting infectious disease in NJ the chief reasons behind spreading of the
disease
fighting infectious disease in NJ current strategies implemented
techniques that needed to be implemented establishmwnt of strict polices in hospitals
the chief reasons behind spreading of the
disease
Lack health practice knowledge
techniques that needed to be implemented effective healthcare training and education
programs
current strategies implemented medical waste disposal, hand hygiene, sharp
disposal
current strategies implemented medical campaigns
fighting infectious disease in NJ
the chief reasons behind spreading of the
disease
inefficient health practices
the chief reasons behind spreading of the lack of awaress

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disease
techniques that needed to be implemented practicing safer sex
types of infectious disease Legionaires, Hepatises B, Hepatitis C, HIV,
Lyme diseases
types of infectious disease bite of infected ticks
types of infectious disease through water droplets
effectiveness of the stratagies current policies are satisfectory
techniques that needed to be implemented online and offline campign
techniques that needed to be implemented disinfecting hot zones in residence
Content Map

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Content analysis
Document
name
Code Segment
environmenta
l biologists
\environmental factors responsible
for infectious diseases\
introduction of new agent in host
population
The first process includes introduction of
the agent in the new host population that is
where the pathogen originated in the
environment, possibly in another species or
a a variant if an existing human infection.

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environmenta
l biologists
\environmental factors
responsible for infectious diseases\
results from establishment in host
population
infection also results from establishment as
well as further dissemination within the
new host population
environmenta
l biologists
\environmental factors
responsible for infectious diseases\
caused by pathogen already
present in the environment
Majority off the emerging infections
appears to be caused by the pathogens that
are already present in the environment or
are brought out of obscurity or has been
provided with selective advantage by the
changing condition and provided with
opportunity to infect new host population.
environmenal
biologists
\process of reducing infectious
diseases\goverment reguation for
vacciation and contraceptives
As per my opinion, the government should
implement effective regulation that will
enhance the potential of the health care
organization by improving access to
vaccinations and contraceptives, and by
facilitating screening, counselling and
education of those at risk of infection.
environmenal
biologists
\process of reducing infectious
diseases\incorporating campaign
for awareness
Along with this, incorporating campaigns
to enhance the awareness about
immunization will also be beneficial to a

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great extent.
government
official
\current strategies implemented\
Title 6A, Chapter 16‐2 and
N.J.A.C.10:122 regulation
One of the chief policies that has been
established by the government includes
New Jersey Administrative Code, Title 6A,
Chapter 16‐2 and N.J.A.C.10:122 that
mandate each school childcare centre hall
should report any kinds of communicable
disease on an emergency basis whether
confirmed or presumed.
government
official
\current strategies implemented\
mandate reporting communicable
disease
One of the chief policies that has been
established by the government includes
New Jersey Administrative Code, Title 6A,
Chapter 16‐2 and N.J.A.C.10:122 that
mandate each school childcare centre hall
should report any kinds of communicable
disease on an emergency basis whether
confirmed or presumed.
government
official
\effectiveness of the strategies\
implemnt strict polices
Along with this, healthcare organizations
has been instructed to implement strict
polices so that spread of infectious diseases
due to unhygienic and usage healthcare

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practice can be prevented.
government
official
\effectiveness of the stratagies\
current policies are satisfectory
Well, as per my opinion, the policies
already implemented by the government
are satisfactory and are beneficial when it
comes to preventing infectious diseases.
government
official
\techniques that needed to be
implemented\ online and offline
camping
More awareness campaigns , both online
and online needs to be incorporated in
order to enhance basic knowledge an skill
like disinfecting hot zones in the residence,
practicing safer sex as well as ensuring
efficient food preparation to avoids
infectious diseases by the residents.
government
official
\techniques that needed to be
implemented\disinfecting hot
zones in residence
More awareness campaigns , both online
and online needs to be incorporated in
order to enhance basic knowledge an skill
like disinfecting hot zones in the residence,
practicing safer sex as well as ensuring
efficient food preparation to avoid
infectious diseases by the residents.
government
official
\techniques that needed to be
implemented\practicing safer sex
More awareness campaigns , both online
and online needs to be incorporated in
order to enhance basic knowledge an skill

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like disinfecting hot zones in the residence,
practicing safer sex as well as ensuring
efficient food preparation to avod
infectious diseases by the residents.
pathologist \types of infectious disease\
Legionnaires, Hepatises B,
Hepatitis C, HIV, Lyme diseases
Well, as per my opinion, the most
prevalent type of infectious disease that are
most common in new jersey includes
communicable diseases like Legionaires,
Hepatises B, Hepatitis C, HIV, Lyme
diseases and others.
pathologist \types of infectious disease\bite of
infected ticks
For instance, when it comes to Lyme
diseases, it chiefly spread to individuals
due to the bite of infected ticks.
pathologist \types of infectious disease\
through water droplets
Now if you think about Legionnaires
disease, it can be considered as an water
borne disease. It spread through water
droplets.
pathologist \the chief reasons behind
spreading of the disease\inefficient
health practices
Inefficient healthcare practices along with
lack of awareness about proper handling
and disposition of surgical instruments, as
per my opinion is one of primary reasons

28HEALTHCARE
behind the spread of the diseases.
pathologist \the chief reasons behind
spreading of the disease\lack of
awareness
Inefficient healthcare practices along with
lack of awareness about proper handling
and disposition of surgical instruments, as
per my opinion is one of primary reasons
behind the spread of the diseases.
pathologist \the chief reasons behind
spreading of the disease\Lack
health practice knowledge
I, in my professional life have experienced
lack of basic knowledge about how to use
and dispose a needle after using the same
in a good number of nurses. This lack of
efficient hygiene practice can be blamed
for the spread of the infectious diseases in
NJ.
pathologist \current strategies implemented\
medical waste disposal, hand
hygiene, sharp disposal
For instance, periodic monitoring of the
healthcare practices like appropriate
medical waste disposal, hand hygiene,
sharp disposal as well as heath care
practice awareness is being performed.
pathologist \current strategies implemented\
medical campaigns
Along with this, campaigns are also held
by NGOs in order to enhance the
awareness of the healthcare professionals
about the impact of healthcare practice on

29HEALTHCARE
reduction of infectious diseases. However,
I believe that, these steps alone are not
enough.
pathologist \techniques that needed to be
implemented\ establishment of
strict polices in hospitals
The very first step that needs to be taken
includes establishment of strict polices by
the healthcare organizations in order
ensure safe and hygienic healthcare
practice within the organization.
pathologist \techniques that needed to be
implemented\effective healthcare
training and education programs
Along with this, incorporating effective
training as well as education programs by
the nurses are also required in order to
enhance their knowledge, awareness as
well as skills to ensure effective hand
hygiene and other healthcare practices that
possess the potential to prevent such
diseases.
Discussion
From the data gather from both the primary and secondary data collection, it has been found that
different factors are responsible for the prevalence of infectious diseases in New Jersey.
Amongst them, lack of effective, hygienic and safe healthcare practices has been pointed out to
be one of the chief reasons. According to researchers, majority of the germs that causes major

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infections in healthcare gets spread by hands. Thus hand hygiene can be considered to be an
effective way of preventing infections (Togias et al.). In USA, in spite of the significance of the
issue and developed of a good number guide lines, hand hygiene compliance range amongst the
healthcare service providers is merely 38.70 percent (Uyeki et al.). The chief reasons behind lack
of hand hygiene includes lack of healthcare personnel, low ratio of nurses to patients, lack of
time, negligence, lack of medical staff, weak nursing relationship with patients, time constraints,
inability to provide washing facilities, crowded hospital, shortcomings in management systems,
poor understanding and knowledge of the risk of infection and its impacts, low level of self-
efficacy, cultural barriers, personal beliefs, etc. The fact that nurse are the chief healthcare
providers who interacts directly with the health of service provider possess special roles in this
serious issues, cannot be avoided (Nelson et al.). In a good number of developed countries,
infection control nurses are recruited specially in order to provide care to patient suffering from
infectious diseases. Infectious control nurses are the health care service users who specialize in
preventing as well as treating infectious agents that includes virus, bacteria, parasites as well as
fungus (Oster et al.). They possess the understanding of normal anatomy, epidemiology,
physiology along with keen assessment and monitoring skills as well as vas knowledge about
infectious disease processes infection prevention techniques (Ly et al.).
As per the data provided by the World Health Organization, approximately 1.2 billion
individuals lack access to enhanced water supply sources (Hills). On the other hand 2.4 billion
individuals lack access to appropriate sanitation factors. More than 2 million deaths takes place
due to diarrhoeal diseases, most of them are children less than 5 years of age (Kugeler et al.).
Other factor that is contributing to the enhancement of infectious diseases in the mentioned
environment includes rapid climate change, lack of awareness amongst the residents of the

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nation and contaminated water. one of the chief reasons behind the outbreak of the diseases
includes exposure to Legionella via breathing in aerosolized water from cooling towers, cooling
misters, fountains, and plumbing systems. According to Serrano-Suárez, et al., Hot water
Recirculation Systems (HWRS) that are often found in hotels as well as heath care homes are
found to be one of the major sources responsible for the outbreak of the Legionnaires’ disease. It
has also been stated that the risk associated with contaminated hot water can be prevented with
the help of ensuring a better understanding of the Legionella ecology in these systems.
From the analysis, it has been found that the government has already taken some crucial steps to
deal with the mentioned crisis. One of the chief policies that has been established by the
government includes New Jersey Administrative Code, Title 6A, Chapter 16‐2 and
N.J.A.C.10:122 that mandate each school childcare centre hall should report any kinds of
communicable disease on an emergency basis whether confirmed or presumed (Nicolle et al.).
These regulations relate to child care centres, preschoolers, youth camps, schools as well a
intuitions of higher education. Along with this, healthcare organizations has been instructed to
implement strict polices so that spread of infectious diseases due to unhygienic and usage
healthcare practice can be prevented.
However, more effective and active polices needs to be implemented. Some major strategies that
possess the potential to reduce the prevalence of infectious diseases includes implementing
effective regulation that will enhance the potential of the health care organization by improving
access to vaccinations and contraceptives (Dellit et al.). More awareness campaigns, both online
and online needs to be incorporated in order to enhance basic knowledge and skill like
disinfecting hot zones in the residence, practicing safer sex as well as ensuring efficient food
preparation to avoid infectious diseases by the residents.

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Conclusion and recommendation
From the above discussion, it can be concluded that effective strategies needs to be implemented
in order to eradicate infectious diseases from NJ (Walsh et al.). Infectious diseases, resulting for
different factors are found to be prevalent in the mentioned state. Major breakouts of infectious
diseases like adenovirus outbreak and Legionnaires, have been taken place from past decades.
considering the fact that Adenovirus chiefly targets weakened immune system, heath care service
users with preexisting health problems along with their shared environment have facilitated the
spread of adenovirus. Other infectious diseases that are most common in new jersey includes
communicable diseases like Legionaires, Hepatises B, Hepatitis C, HIV, Lyme diseases and
others. , when it comes to Lyme diseases, it chiefly spread to individuals due to the bite of
infected ticks. NJ spotlight stated that one of the chief priorities of New Jersey includes
preventing Asthma that is increasing at an alarming rate due to climate change. Nearly 590,000
adults and 180,000 Children have got affected of chronic respiratory diseases due to excessive
increment of pollution on the air (Pappas et al.). Another major reason behind the spread of
infectious diseases includes lack of effective Hygiene measures as well as policies in New
Jersey. Lack of hand hygiene amongst the pre hospital providers like the ambulance service
providers can be also pointed out to be a major reason behind the rapid spread of the diseases.
The government of NJ have already implemented several steps in order to prevent further spread
of infectious diseases. The New Jersey Department of Health, mandate that every school as well
as childcare service are stipulated to immediately report any kinds of communicable diseases
which are identified as reportable pursuant to the department of health. Along with this a good
number of healthcare homes has been approached in order to implement strict healthcare
policies. it is highly crucial for the management of the healthcare home to ensure that a good

33HEALTHCARE
number of hand hygiene resources needs to be make accessible throughout the organization,
including patient care corridors and at the entrance and exit of patient rooms.
In spite of implementation of the mentioned technique, the occurrence of infectious disease in NJ
is increasing to a commendable amount. According to the participants, a good number of
potential measures are there that can be implemented to eradicate the issue. Establishment of
strict polices by the healthcare organizations in order ensure safe and hygienic healthcare
practice within the organization. Implementing strict policies will ensure enhanced urge to
follow healthcare practices which in turn will result in decrement in pathogen exposure, Hospital
Acquired infection (HAI), limited pathogen transfer and eventual reduction in infectious
diseases. Along with this, online and offline campaigns in order to enhance the awareness of the
public can also be implemented (Walsh et al.). The government should also work on improving
access to vaccinations and contraceptives, and by facilitating screening, counselling and
education of those at risk of infection.
In the following paragraph, effective recommendations that can be implemented by the
government of NJ in order to eradicate healthcare issues have been discussed.
1. The first step that needs to be taken by the government of NJ is to invest more on
healthcare organizations by offering resources that can help them to provide efficient
training as well as education about hand hygiene and other health care practices (Dellit et
al.). Obtaining financial resources from the government will not only make it easier for
healthcare homes to organize training and workshops for nurses but will also encourage
the same to maintain the implemented strategies.

34HEALTHCARE
2. The second step that needs to be incorporated include implementation of effective
policies in healthcare homes as well as educational institution along with conducting
regular monitoring measures of the implemented policies. Providing training and
educational workshop alone will not be able to ensure that nurses are developing a well
as maintaining hand hygiene. In order to ensure the same, management of healthcare
home needs to implement strict policies and regulation, violation of which will result in
severe penalty or legal action (Serrano-Suárez, et al.). Along with this, regular monitoring
of the efficiency of the implemented process also needs to be checked.
3. Along with enhancing the awareness as well as skills of the healthcare professionals,
awareness of public of NJ also needs to be enhanced. For this, the first step that needs to
be taken includes organization of both online as well as offline campaign. Offline
campaigns on various factors that are responsible for increment of infectious diseases in
New Jersey and household as well as regular habits that needs to implement will be
discussed. For offline promotions, healthcare homes can post informative videos or
information on popular social media sites that are accessible to a huge number od people
in a limited amount of time (Serrano-Suárez, et al.). The government should implement
effective regulation that will enhance the potential of the health care organization by
improving access to vaccinations and contraceptives, and by facilitating screening,
counselling and education of those at risk of infection.
Limitation
One of the major limitation of this paper includes lack of information about the perspective of
common people on how to reduce the impact of infectious diseases on NJ. The chief reason

35HEALTHCARE
behind this includes lack of time and financial constraints. Considering the fact that highly
limited number of researches has been conducted on the mentioned topic, another major
limitation of this paper includes usage of limited number of academic journals and articles for
gathering secondary data for the research. Apart from this no major limitation of this research
has been evidenced.

36HEALTHCARE
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Appendix
Interview conducted with a Pathologist
1. What type of infectious disease are found to be affecting the residents of New Jersey
and how?
Well, as per my opinion, the most prevalent type of infectious disease that are most common in
new jersey includes communicable diseases like Legionaires, Hepatises B, Hepatitis C, HIV,
Lyme diseases and others. different factors are responsible for the spread of the diseases. We
cannot blame one. For instance, when it comes to Lyme diseases, it chiefly spread to individuals
due to the bite of infected ticks. Several species of ticks are found in New Jersey. Along with
being an unwelcome parasite on the residents of the state, pets as well as wildlife, ticks can also
transmit certain diseases such as Lyme Disease and Rocky Mountain Spotted Fever.
Now if you think about Legionnaires disease, it can be considered as an water borne disease. It
spread through water droplets. Bacteria when contaminate vapour or mists our affects people
from sources like whirlpool spas or while drinking or bathing.
2. Why do you think are the chief reasons behind spreading of the disease?
Inefficient healthcare practices along with lack of awareness about proper handling and
disposition of surgical instruments, as per my opinion is one of primary reasons behind the
spread of the diseases. I, in my professional life have experienced lack of basic knowledge about
how to use and dispose a needle after using the same in a good number of nurses. This lack of
efficient hygiene practice can be blamed for the spread of the infectious diseases in NJ.
3. What are the current strategies implemented in order to deal with the diseases?

42HEALTHCARE
Well, one must admit that the government is taking several steps to address this issue. For
instance, periodic monitoring of the healthcare practices like appropriate medical waste disposal,
hand hygiene, sharp disposal as well as heath care practice awareness is being performed. Along
with this, campaigns are also held by NGOs in order to enhance the awareness of the healthcare
professionals about the impact of healthcare practice on reduction of infectious diseases.
However, I believe that, these steps alone are not enough.
4. What, according to you, are some of the techniques that needed to be implemented for
fighting infectious diseases in NJ?
The very first step that needs to be taken includes establishment of strict polices by the
healthcare organizations in order ensure safe and hygienic healthcare practice within the
organization. Implementing strict policies will ensure enhanced urge to follow healthcare
practices which in turn will result in decrement in pathogen exposure, Hospital Acquired
infection (HAI), limited pathogen transfer and eventual reduction in infectious diseases. Along
with this, incorporating effective training as well as education programs by the nurses are also
required in order to enhance their knowledge, awareness as well as skills to ensure effective hand
hygiene and other healthcare practices that possess the potential to prevent such diseases.
Interview conducted with an environmental biologist
1. What are the environmental factors that are responsible for development of
infectious diseases?
Well, the emergence of infectious disease can be viewed operationally as a two step process. The
first process includes introduction of the agent in the new host population that is where the
pathogen originated in the environment, possibly in another species or a a variant if an existing

43HEALTHCARE
human infection. Secondly, infection also results from establishment as well as further
dissemination within the new host population. Factors that promote one or both of these steps
will, therefore, tend to precipitate disease emergence. Majority off the emerging infections
appears to be caused by the pathogens that are already present in the environment or are brought
out of obscurity or has been provided with selective advantage by the changing condition and
provided with opportunity to infect new host population.
2. How can we reduce the impact of infectious diseases on New Jersey State?
The prevalence of infectious disease in New jersey is indeed alarming. As per my opinion, the
government should implement effective regulation that will enhance the potential of the health
care organization by improving access to vaccinations and contraceptives, and by facilitating
screening, counselling and education of those at risk of infection. Along with this, incorporating
campaigns to enhance the awareness about immunization will also be beneficial to a great extent.
Interview conducted with a government official
1. What are the current strategies that have been implemented by the government to
deal with the increasing spread of infectious diseases?
One of the chief policies that has been established by the government includes New Jersey
Administrative Code, Title 6A, Chapter 16‐2 and N.J.A.C.10:122 that mandate each school
childcare centre hall should report any kinds of communicable disease on an emergency basis
whether confirmed or presumed. These regulations relate to child care centres, preschoolers,
youth camps, schools as well a intuitions of higher education.

44HEALTHCARE
Along with this, healthcare organizations has been instructed to implement strict polices so that
spread of infectious diseases due to unhygienic and usage healthcare practice can be prevented.
2. Do you think the strategies that have been implemented are sufficient to deal with
the current condition of infectious diseases?
Well, as per my opinion, the policies already implemented by the government are satisfactory
and are beneficial when it comes to preventing infectious diseases. However, more strategies and
strict monitoring of the implemented strategies are needed in order to ensure gradual eradication
of infectious diseases from NJ.
3. What new strategies needs to be implement by the government in order to eradicate
the impact of infectious disease from New Jersey?
I have noticed, lack of effective awareness campaigns for public, immunization practices as well
as enhancement in investment costs to prevent infectious diseases are three chief loopholes that
needs to be addressed. More awareness campaigns , both online and online needs to be
incorporated in order to enhance basic knowledge an skill like disinfecting hot zones in the
residence, practicing safer sex as well as ensuring efficient food preparation to avod infectious
diseases by the residents.