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UPI/ROGER L. WOLLENBERG/NEWSCOM of individuals, families and communities in any disaster. Engaging in social advocacy and social mobilization is incumbent on all RNs, especially since the profession is held in high esteem with respect to the public trust. Levels of prevention: Primary prevention relies on epidemiological information to identify those behaviors which are protective, or will not contribute to an increase of disease, and those that are associated with an increased risk. Health promotion includes actions taken to foster a safe environment or healthful lifestyle. Specific protections include immunizations to protect against and reduce the incidence of a disease. Secondary prevention (after pathogenesis) includes screening and physical exams aimed at disease detection and early diagnosis, and interventions that provide early treatment or cure. Tertiary prevention includes limiting complications and disability, and rehabilitation/restoration to an optimum level of health, function, and well-being. Preventative Care the primary focus of preventative care nursing is to engage in health promotion and disease prevention activities for entire population groups. This means the provision of direct care through a process of assessments and evaluation of the needs of individuals in the context of their population group. The goal of preventative care is to improve the health of the community. Public health nurses, school nurses and outpatient/clinic nurses play a key role in the prevention and early detection of the spread of swine influenza, with a strong focus on mitigation or containment to avoid it reaching pandemic proportions. These RNs are the community's primary responders. RN Role in Preventative Care Case finding: surveillance, intervention and assessment of health care needs of individuals and populations. Case management: referral, follow-up, counseling and consultation. Community-focused intervention, interdisciplinary collaboraJANUARY | FEBRUARY 2010 tion, coalition building, community organization and systemfocused interventions. Making recommendations regarding closure of schools and/or public institutions and cancellation of public events to mitigate and contain any outbreak. The Public, Community and Outpatient RN Role in Preventative Care in general, only registered nurses and licensed physicians with current demonstrated and validated competency can perform assessments, prescribe/implement treatment, conduct evaluation, and determine the need for follow-up surveillance vs. "quarantine." RNs must apply the following: Secure the reporting by non-public health clinics of suspect swine flu patients to the local Public Health Department. Recognize that emergency departments play a key role in the tracking and reporting of suspected swine flu cases and must remain a key member of the state or county notification network. Ensure that RNs and MDs control their practice environment and are able to provide care in the exclusive interest of the patient, particularly in a pandemic environment. Identify individuals who have health problems that put themselves and others in the community at risk, such as those with infectious diseases like the swine flu. Collaborate with other providers of care to plan, develop, and support systems and programs in the community to prevent problems and provide access to equitable care. Assess health and health care needs of individuals. Identify nursing diagnoses, plan interventions to meet identified needs, and implement the plan effectively and equitably. Evaluate the extent to which the interventions impact the health status of individuals, families and communities. Advocate in the exclusive interest of the individual and the community. W W W. N A T I O N A L N U R S E S U N I T E D . O R G N AT I O N A L N U R S E 31