1. What are the three levels of clinical prevention and what are their main goals? Provide an example of an

intervention for each level.

- The three levels of clinical prevention are primary, secondary and tertiary. The main goal of primary

prevention is to prevent disease or injury from occurring in the first place. An example of a primary

prevention intervention is immunization. The main goal of secondary prevention is to detect and treat

disease or injury early, before it causes significant harm or complications. An example of a secondary

prevention intervention is screening for breast cancer. The main goal of tertiary prevention is to reduce the

impact and consequences of disease or injury, and to prevent further deterioration or complications. An

example of a tertiary prevention intervention is rehabilitation after a stroke.

2. What are the five A's of evidence-based practice in clinical prevention and health promotion? Explain

what each A stands for and how it can be applied in nursing practice.

- The five A's of evidence-based practice in clinical prevention and health promotion are: Ask, Acquire,

Appraise, Apply and Audit. Ask means to formulate a clear and focused question based on the patient's

needs, preferences and situation. Acquire means to search for the best available evidence from reliable and

relevant sources. Appraise means to critically evaluate the quality, validity and applicability of the evidence.

Apply means to integrate the evidence with clinical expertise, patient values and context. Audit means to

monitor and evaluate the outcomes and effectiveness of the intervention.

3. What are some of the barriers and facilitators to implementing clinical prevention and health promotion

interventions in nursing practice? Give at least two examples of each and suggest possible strategies to

overcome or enhance them.

- Some of the barriers to implementing clinical prevention and health promotion interventions in nursing

practice are: lack of time, resources, knowledge, skills, motivation, support, incentives or feedback;

competing priorities or demands; resistance or reluctance from patients, colleagues or managers; ethical,

legal or cultural issues; organizational or system constraints; conflicting or inconsistent evidence or

guidelines. Some possible strategies to overcome these barriers are: prioritizing prevention and health

promotion activities; allocating sufficient time, resources, training, supervision, recognition or rewards;

engaging patients, colleagues or managers in shared decision making; addressing ethical, legal or cultural

issues with respect and sensitivity; seeking or providing feedback; adapting or tailoring interventions to the

specific context; updating or reviewing evidence or guidelines regularly.

- Some of the facilitators to implementing clinical prevention and health promotion interventions in nursing

practice are: availability, accessibility, quality, relevance or applicability of evidence or guidelines; clear,

consistent, concise or actionable recommendations; strong, positive, supportive or collaborative

relationships with patients, colleagues or managers; shared vision, values, goals or expectations; motivation,

interest, enthusiasm or confidence; incentives, rewards, recognition or feedback; ethical, legal or cultural

alignment; organizational or system support, leadership or culture; innovation, creativity or flexibility. Some

possible strategies to enhance these facilitators are: seeking, using or disseminating evidence or guidelines;

following or developing recommendations; building, maintaining or improving relationships with patients,

colleagues or managers; communicating

or negotiating vision, values, goals or expectations; fostering or expressing motivation,

interest, enthusiasm or confidence; providing or receiving incentives,

rewards,

recognition