Teaching clinical preventive services to community health nursing students through health screening of vulnerable populations

Clinical preventive services have been prominent in the national healthcare debate since the regulations of the Affordable Health Care Reform Act include recommendations of the U.S. Taskforce on Clinical Preventive Services. The revision of recommendations regarding mammograms and PSA testing has brought public attention to the Taskforce. It is important that nurses understand the epidemiologic and clinical basis for such recommendations. Clinical preventive services provide a rich opportunity to teach basic public health principles to nursing students. Senior nursing students, led by their clinical instructor, have volunteered to participate in a project to provide health screening in two district populations in San Francisco and Oakland. Services are provided to at-risk young adults participating in a transformative ‘tattoo removal clinic,' and seniors living in low-income housing. The difference serves well to illustrate how clinical preventive services are provided across life stages. The students have become skilled in providing immunizations, hearing and vision testing for the seniors, blood glucose and cholesterol level testing, blood pressure measurement, weight assessment, and have improved their interviewing skills. They learn how to interpret results, make appropriate recommendations, and referral when needed. In didactic portions of training they do literature reviews to find the latest reliable guidelines for diabetes, cardiovascular disease, immunizations, and other preventive conditions, and learn how to calculate sensitivity, specificity, and positive predictive values. We recommend that clinical faculty provide students with training and opportunities for practice while providing services to at-risk populations that are likely to have reduced access to clinical preventive services.