Today we're going to talk
about the levels of prevention.
As a reminder, public health nurses protect
and maintain the health of the public
through health promotion
and disease prevention.
Now there are three main
levels of disease prevention-
As you can see,
a lot goes into each level of prevention.
When developing plans for each level,
we first consider the target population.
So whose health are
we aiming to improve?
Then the objective.
What's our goal of
we consider the strategy.
What are we going to
do to impact health?
So let's take a look at
each level in detail.
Primary prevention is aimed
at individuals or groups
who are at risk for an illness
but do not yet have an illness.
The goal here is to prevent the
transmission or the onset of disease.
And we can do this through a
variety of different strategies.
Here are some strategies that
public health nurses can use
to prevent the transmission or the onset
of disease for those who are at risk.
Administration of vaccines help to decrease
the risk of vaccine preventable diseases.
Education can also be
used as a strategy here
to make communities aware of the risks of
a specific disease and ways to prevent it.
Use of personal protective
equipment or PPE is one way
that nurses help prevent transmission
of disease in a clinical setting.
Working into control or eliminate
vectors in the environment
could also be done as a
means of primary prevention.
So let's use the example of
measles in school-aged children
to apply all levels
Starting here first
with primary prevention.
Here we have three healthy children
who are at risk of contracting measles,
but do not yet have the disease.
In primary prevention, our goal is to
stop them from contracting the measles.
For school-aged children,
one of the most effective primary
prevention strategies against the measles
is receiving the measles, mumps,
and rubella or MMR vaccine.
A public health nurse might engage in
direct care and administer the vaccine,
or maybe even work behind the scenes to
collaborate with community organizations
to run a large scale vaccine
clinic in response to an outbreak.
Both are examples of
is aimed at individuals
or groups who have a
disease or an illness,
but they're very early in the disease
process and most likely asymptomatic.
Our goal here is to prevent
or inhibit the disease
in instances where
it's already occurred.
There are several strategies
that public health nurses
can use to inhibit disease
once it's already occurred.
The first step
here is screening,
screening to determine
if the disease is present
in individuals who
This allows the public health nurse to
do case finding an early intervention
to decrease the impact and
the spread of the disease.
Early intervention should
be disease specific.
And education is also important
in secondary prevention.
Once an individual or a group has been
diagnosed with an illness or a disease,
education is necessary to inform those
who are impacted about the disease,
about screening techniques,
about ways to inhibit its progress,
and most importantly,
ways to decrease the spread.
So back to our example of our children,
our school-aged children with the measles.
So for our children here,
early diagnosis and treatment
is the key to inhibiting
the spread of measles.
This might entail
seeking care for a child
who's been in contact
with an infected friend,
and is just starting to show some of
those very early signs of disease.
By seeking early care,
it's possible to screen,
diagnose and provide early intervention
And most importantly,
here we can provide education
to ensure that the
disease is not spread.
Moving on finally to
Tertiary prevention is aimed at individuals
or groups who have established disease
and are showing signs and
symptoms of that disease.
Our goal here is to prevent morbidity and
mortality related to the disease process.
Again, we have a variety of strategies
that public health nurses can use.
Oftentimes, this requires treatment
of disease specific symptoms.
Treatments could be pharmacological
Tertiary prevention also requires
that complications of the disease
are managed if they arise.
And once again, we see the need for
education in tertiary prevention.
Education at this level may be focused
on different treatment options,
or informing patients and families when
they should seek more advanced care.
Okay, and now here we have
our school-aged children again
who now all have the measles.
There are several strategies that we
can employ within tertiary prevention.
We can educate them
and their families
about over-the-counter medications
that can be taken to ease the symptoms,
we can encourage rest,
we can encourage fluids.
But it's also important to remember
that as public health nurses,
our client, our unit of care
is the school community.
So within tertiary prevention, in order
to decrease morbidity and mortality
for the entire school community,
we may provide some education,
education to parents, to faculty,
to teachers, to administrators,
to teach them about
the signs of symptoms,
and most importantly,
prevention of the measles.
So here, we have all three levels
back together in one place,
what I want you to remember is
that the level of prevention
is determined by the
and your intervention objective,
not necessarily the strategy that you use,
because as you can
see on this table,
education as a strategy
spans all three levels.
think outside of this box,
and really focus on the target population,
and the objective of the
intervention in order to determine
what level of prevention
you're working at.
Now, primary, secondary,
and tertiary prevention
are the three levels that
we hear about the most.
there are two other levels.
And these two book and the
three that we just talked about.
They are primordial prevention,
and quaternary prevention.
So let's take a look
at each of these.
With primordial prevention,
the target population
is the entire population
that may be at risk for
an adverse health outcome.
The objective here is to
address the social conditions
that promote the
onset of disease.
Strategies in this level
or to prevent disease
by addressing those
underlying social conditions
that put entire populations at risk
for disease in the first place.
An example is the implementation
of policies that prevent
or discourage negative health behaviors,
such as increasing taxes on cigarettes,
or putting in sidewalks or bike
lanes to encourage physical activity
and decrease the risk of disease
for the entire population.
Now, all the way on the other side,
we have quaternary prevention.
The target at this level
is those who have illness
and are already
The goal here is to protect
individuals or populations
from medical interventions that are
likely to cause more harm than good.
Strategies here can include educating
patients or healthcare providers
on how to make sure that unnecessary
treatments are not encouraged.
This could also include treatment
for the effects of interventions
that have already caused
more harm than good.
So now, if we go back
to our measles example,
here are strategies that
fit into these levels.
At the level of
one strategy would be to advocate for
strong state level immunization policies
that require all eligible children to
have the MMR vaccine before school entry.
On the opposite end of
one strategy would be to
make sure that children
who are already
diagnosed with measles
and are receiving treatment are
only receiving evidence based care,
no unnecessary care that
could do more harm than good.
Now, if you're planning
to go into acute care,
you might be wondering
why this is important.
As nurses no matter where
we work or our specialty,
we have a shared goal of
keeping our patients healthy,
or preventing disease
before it even begins.
By understanding the
levels of prevention,
you'll be more prepared to collaborate
with your patients and communities
to move them towards wellness.