142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Role of Public Health Nursing in the Norovirus Outbreak Prevention Project

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Veronica Caballero, R.N., B.S.N., P.H.N , Los Angeles County Department of Public Health, Monrovia, CA
Evelyn Ocampo, R.N., B.S.N., P.H. N. , Los Angeles County Department of Public Health, Pomona, CA
Evelyn Gonzalez, R.N., B.S.N., P.H.N. , Los Angeles County Department of Public Health, Pomona, CA
Rachel Civen, M.D., M.P.H. , Los Angeles County Acute Communicable Disease Control Program, Los Angeles, CA
Background/Issue:Each year skilled nursing facilities (SNFs) within Los Angeles County (LAC) are the most frequently reported sites for Gastroenteritis (GE) outbreaks (OBs). In 2011, 34 GE OBs affecting 543 patients and 144 SNF staff reported; 26 Norovirus (NV) was laboratory confirmed. Spring 2012, a Norovirus Outbreak Prevention (NOP) Workgroup convened in response to the sustained number of annual NV OBs in SNFs.

Public Health Nurses (PHNs) utilized a NV toolkit presentation prior to start of NV season. The goal was to decrease the number and size of NV OBs, while empowering SNF administration to effectively manage and teach NV prevention.

Description: 77 licensed SNFs were identified. PHNs contacted 77 facilities to schedule NV trainings. 155 SNF administrative staff attended two training sessions. 74% of SNFs received PHN presentations and toolkit training material was posted on the LAC DPH website.                                                                         

Lessons learned:On-site presentations by PHNs to line staff fostered improved communication between SNF and PHNs. The toolkit became the primary resource for PHNs and SNFs during OB episodes. Disciplines collaborated with SNFs, relationships were enhanced and viewed proactively.


SNFs became empowered during management and reporting of OBs.  Autonomy and increased reporting time resulted in decreased ill staff & residents.

PHN role facilitated shorter case management and surveillance time thus promoting health and well-being in SNFs.

Learning Areas:

Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related education
Public health or related nursing

Learning Objectives:
Describe and demonstrate the Norovirus Outbreak Prevention Toolkit as seen on Los Angeles County Department of Public Health website List two advantages of implementing Norovirus Outbreak Prevention Toolkit in outbreak management

Keyword(s): Self-sufficiency and Empowerment, Health Promotion and Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Los Angeles County (LAC) Public Health Nurse for 10 years and consistently case manage the highest number of gastrointestinal outbreaks in skilled nursing facilites for Service Planning Area 3. I cover 26 census tracts within the LAC geographic region. I work collaboratively with LAC Acute Communicable Disease Control. In 2013, I received the award for "Outstanding Oral Presentation". I have presented this project to the LAC Public Health Commissioners in September 2013.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.