Primary prevention takes place when people are focused on preventing the occurrence of disease (Demarco & Harkness, 2016). Having genetic testing at birth can be an excellent way to support health promotion at a primary level. If genetic testing is done and a person is found to have results showing they are a high risk for skin cancer, they can start then with the prevention process. This would include the use of sunscreen, reduced sun exposure and avoiding sunburns. Education would be the main prevention method to use with primary prevention.
Community nurses can do a thorough assessment of the community and families and offer informative gatherings on different disease processes and make them aware of the resources that are available to them. MacPhail et al. (2018) showed that providing funds to women for managing their healthcare through social grants was an effective way to reduce or prevent infections. Perhaps this could be a method to use for health promotion for genetic testing.
Once a person has a disease process, a person should be proactive in preventing exacerbations. In the example of skin cancer, once a person has a form of skin cancer, it is essential to seek medical care as soon as a lesion is suspicious. One way to continue to maintain skin health is regular yearly skin screenings to monitor for additional lesions. With the shortage in healthcare professionals and the demand for more providers with the passing of the ACA the question arises of quality.
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The Healthcare Effectiveness Data Information Set (HEDIS) focus’ primarily on the quality of secondary prevention. One of the quality measures on the HEDIS is screenings for multiple disease processes. Health plans have to be compliant with these measures in order to receive accreditation. In Virginia, all but 2 of the plans reported by the National Committee of Quality Assurance (2019) achieved accreditation status. One negative reported by DeMarco and Harkness (2016) is that many screening tests may not offer the sensitivity and the specificity to offer valid results. Nurses in communities that are performing these screens need to be aware and educate the public before the screening. Knowledge of screenings could hopefully ease someone emotionally if the results are not concrete.
As skin cancer turns into a life-threatening disease process, many options for treatments are available. Palliative radiation to the area can be done along with palliative chemotherapy. Adequate pain management with end-stage cancer can foster a better quality of life. Pain management is a major topic of concern these days with the opioid crisis. One method of tertiary prevention is chiropractic care. Eklund et al. (2018) provides evidence that chiropractic care is an effective method for treating pain. This is an excellent solution to consider instead of narcotics.
The opioid crisis has affected hospice patients as well. GolAiA, Dobrila-Dintinjana, GolAiA, PavloviA and GoviA-GolAiA (2018) reported that 46 percent of hospice patients’ pain was underestimated. This is a crisis for patients who have reached the end of their journey. The benefit to tertiary prevention for hospice patients is when they reach the level of being hospice appropriate, that most companies provide, charitable admissions. Hospice care for someone that has insurance coverage can get all their medications and medical equipment free of charge.
