Community and Public Health Nursing
Prevention framework
Primary prevention acts before disease occurs (immunisation, seat belts, water fluoridation, health education). Secondary prevention is early detection in asymptomatic people (mammography, cervical screening, blood pressure checks, tuberculin testing). Tertiary prevention limits disability and promotes rehabilitation (cardiac rehabilitation, support groups, prosthetics). Most community items hinge on this classification.
Epidemiology
Incidence is new cases over a period; prevalence is all existing cases at a point in time. Attack rate describes an outbreak. Herd immunity protects those who cannot be vaccinated when coverage is high. Know the reporting chain: specified communicable diseases and outbreaks are reported to the local public health authority, which investigates, performs contact tracing, and issues guidance.
Practice settings
Public health nurses assess aggregates, not only individuals. They identify vulnerable groups (people who are homeless, older adults, uninsured or migrant populations), plan culturally congruent interventions, and coordinate partners. Home visit safety: plan visits in daylight, know the route, carry a phone, sit nearest the exit, and never enter a home where you feel unsafe.
Disaster triage
START assigns colour by respirations, perfusion, and mental status: green for walking wounded (delayed), yellow delayed, red immediate, black deceased or expectant. During the response phase, do not spend scarce resources on black tags.
Worked rule
Ask whether the disease has occurred yet: before = primary, early detection = secondary, after = tertiary. A diabetes screening fair is secondary; a diabetic foot-care class is tertiary.