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