This case study provides you with an opportunity to immerse yourself in the role of a Community Health Nurse and examine primary, secondary, or tertiary prevention strategies related to two population health problems. As you work through the case, reflect on what you have learned from this course about community health nursing and apply it to this scenario.
Your role: You continue to work as a community health nurse in your local health department. At a department meeting several months ago, new epidemiological data was presented that showed a disturbing increase in alcohol abuse rates. A community wide coalition was convened to assess these problems and you volunteered to be a member of this task force. The task force has met several times and analyzed assessment data and is beginning to consider intervention options.
Task force members:
• Christina is a social worker with the health department.
• Tracey is a case worker from Child Protection Services.
• Paul is a pastor at a local church.
• Susan is the school nurse with the elementary and middle schools.
• Eric is the director of a local emergency department.
Your charge:
Visit The Community Guide website (https://www.thecommunityguide.org/) to explore interventions related to excess alcohol consumption. https://www.thecommunityguide.org/alcohol/index.html
Choose one evidence-based intervention (one that is recommended) and present this intervention to the task force.
• Summarize this intervention and the Community Health Nurse’s role in implementing this strategy.
• Describe whether it (evidence-based intervention) is considered a primary, secondary, or tertiary prevention strategy and include your rationale (see Nies & McEwen, 2015, Chapter 1, p. 7 for a review of levels of prevention).
Nies & McEwen, 2015, CHAPTER 1 PAGE 7 EXCERPT BELOW:
Leavell and Clark (1958) identified three levels of prevention commonly described in nursing practice: primary prevention, secondary prevention, and tertiary prevention.
Primary prevention relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. Primary prevention consists of two elements: general health promotion and specific protection. Health promotion efforts enhance resiliency and protective factors and target essentially well populations. Examples include promotion of good nutrition, provision of adequate shelter, and encouraging regular exercise. Specific protection efforts reduce or eliminate risk factors and include such measures as immunization and water purification (Keller et al, 2004a, McEwen and Pullis, 2009).
Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis. Secondary prevention is implemented after a problem has begun but before signs and symptoms appear and targets those populations that have risk factors (Keller et al, 2004a).
Mammography, blood pressure screening, scoliosis screening, and Papanicolaou smears are examples of secondary prevention.
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