Health promotion is the science and skill of facilitating individuals changes in their lifestyle toward a state of ideal health (Edelman, 2014 p. 11). Nurses promote health by advocating for patients in the hospital setting and community. Nurse support positive health practices and the hope is that these activities will become part of a normal occurrence. In this paper there is an examination of nursing roles and responsibilities and implementation methods that nurses use to recognize and extinguish crisis or potential crisis situations. In reviewing three journal articles about health promotion, it was determined that each dealt with health promotion on various levels of preventions. In this analysis we will review each health promotion prevention level mentioned and how they are classified. Purpose and Nursing Roles and Responsibilities
Health promotion and disease prevention coexist with the nursing practice. We act as consultants, educators, and we enhance the effectiveness of an experience of health care services. Nurse’s attempt to lead the patient to positive health outcomes while adhering to the concept of increased knowledge and awareness of their illness, quality of life by understanding limitations and the nurse follows evidence based practices. In the mental health environment we are cognitive of behaviors and crisis in the milieu. In the community we can help support awareness. One article examined indicated that approximately 10-20% of the younger population 0-25 have mental health problems. Typically 50% of mental illnesses are revealed before the age of 14 and 75% by the age of 24. Mental disorders account for high burdens of disease in the younger age range. It is led by anxiety and mood disorders. In this age bracket it is the responsibility of the school nurse and counselors to recognize those at risk individual and use early interventions to prevent hospitalization and promote health and healing (Catina et al., 2011). When implementing health promotion competencies multidisciplinary knowledge includes alertness, ability to implement, and consciousness of the economic and cultural issues people face. Primary Prevention
In the primary prevention health promotion occurrence a nurse would use skilled competency including collaboration, communication, assessment, and be an advocate for the patients. Primary Prevention focuses on both the patient and the environment. It assists individuals to expand coping mechanisms enabling them to cope effectively with stress and it aims at reducing destructive entities in the environment. Primary prevention is focused on the pursuing of segments of the population at risk and then providing informative programs (Townsend, 2011 p. 710-11). For example teens are offered sex education, nutrition education, information about suicide prevention, eating disorders, and programs like DARE to prevent drugs and alcohol use. Secondary Prevention
Secondary Prevention is clearly indicated once the individual have illness and it involve controlling symptoms or shorting course of the illness. The core concepts of secondary prevention are interventions intended to minimize initial symptoms of mental health illnesses or other medical health issues. It is targeted toward reducing the duration and frequency of the illness. It accomplishes this by early recognition of the problem and prompts initiation of effective treatments. Nursing in secondary prevention focuses on recognition of symptoms and looks into getting treatment. This could involve having group therapy after an initial alcohol or substance abuse problem. Support groups include alcoholics anonymous. Depending on the severity determines how aggressive the treatment should be. Maybe someone is hospitalized and agree to outpatient therapy before discharge to help them cope with their disorder. The idea is we want to prevent a long term problem. One journals article revealed that with the shrinking numbers of graduate programs preparing traditional child/adolescent (C/A) clinical nurse specialist (CNS) and the additions of only 20 newly certified C/A Psychiatric mental health (PMH) CNS’s per year means that children could be slipping from the secondary prevention level into the tertiary prevention levels (Delaney, 2011). Tertiary Prevention
Tertiary Prevention the complications of a disease and it involves prompting maximum functioning. Basically, we are trying to keep them out of the hospital setting. We try to keep them out of the hospital and control the symptoms and we want to help them maintain their maximum mental health possible. They will have exacerbation that may depend on what stressors are going on in their life. Stress is usually a trigger for worsening of mental health symptoms. So there are lots of crisis that could trigger mental health or inappropriate coping. Services are meant to reduce lingering defects that are related to severe and persistent mental illness. So we are trying to promote rehabilitation that is directed toward achievement of each individual’s maximum level of functioning. This for example may involve ongoing home health nursing checks to confirm the patient diagnosed schizophrenia is taking medications. In reviewing the final journal from child and adolescent psychiatric nursing it discussed a tertiary prevention model. It reviewed the downward trend of restraints and seclusion in children Psychiatric facilities.
The article looked specific guidelines to reduce restraints and seclusions using six core strategies presented by the National Association of State Mental Health Program Directors (NASMHPD) (Waqar Azeem et al., 2011). Primarily nurses and doctors were analyzed tertiary prevention level patients and the hope was to reduce restraints and seclusions by having adequate staffing training and monitoring. In closing health promotion is viewed from the primary, secondary, and tertiary prevention levels. Nurses’ roles and responsibilities are to safe guard patients by educating the patient and guiding the patient towards better health outcomes. In doing so the nurse must intervene and implement intervention that aid in the recovery of the patient. In doing so the nurse should be an advocate for the patient and review their resources to resiliency to adjust to the health situation.
Catina, L.S., Hetrick, S.E., Newman, L. K., & Purcell, R. (2011, October). Prevention and early intervention for mental health problems in 0-25 year olds. Advances in Mental Health 10 (1) p. 6-19. Delaney, K. (2011). Building a child mental health workforce: What vision are we working toward?. Journal of Child and Adolescent Psychiatric Nursing 24, 1-2.
Edelman, C., Kudzma, & C., Mandle, C., (2014). Health promotion throughout the life span, 8th edition. Mosby. VitalBook file. Townsend, M. (2011). Essentials of psychiatric mental health nursing concepts of care in evidence based practice. F.A. Davis Company. Page 710-11. Waqar Azeem, M., Aujla, A., Rammerth, M., Binsfeld, G., & Jones, R., (2011). Effectiveness of six core strategies based on trauma informed care in reducing seclusions and restraints at a child and adolescent psychiatric hospital. Journal of Child and Adolescent Psychiatric Nursing 24, 11-15.