Preventing skin cancer among a farming population: implementing evidence-based interventions.

Agricultural workers are at risk for developing skin cancer due to exposures to ultraviolet radiation. Occupational health nurses implemented a skin cancer screening during an agricultural trade show to facilitate primary and secondary prevention of skin cancer through risk assessment, visual skin examination, counseling, and education. The purpose of this article is to present an evidence-based practice model that describes the demographics of a skin cancer screening population, self-reported risk factors, the occurrence of presumptive diagnoses, and compliance with health-related recommendations. Eighty-eight individuals were screened. Thirty-nine (44%) of all screened participants were referred for further evaluation. Of the 39 referrals, 16 (41%) were recommended for biopsy. One month after the screening, 21 (54%) of the participants had completed or arranged follow-up. Status of the identified lesion was also explored. General comments yielded statements that demonstrated appreciation for the screening, teaching, reminders, and encouragement.

Health surveillance for rural volunteer firefighters and emergency medical services personnel.

The purpose of this study was to assess the effectiveness of coronary heart disease risk screening as a primary prevention tool. Screening included a lipid screening and American College of Cardiology Framingham cardiac risk profile for volunteers 45 years and older desiring A (interior) or B (exterior) classifications. Health surveillance records from 1998 to 2003 were reviewed for all firefighters and emergency medical services personnel in a rural New York county. Of the 1,458 volunteers evaluated, 1,166 were men and 292 were women. Three hundred fifteen individuals were screened for coronary heart disease risk; 52 had scores indicative of substantially increased risk. Subsequently, a health care provider or cardiologist saw 39 of these individuals, 26 (67%) of whom received pharmacologic, surgical, or other health care intervention. Coronary heart disease risk screening is an effective intervention in this population, and provides volunteers and their primary care providers with added motivation to actively reduce the risk of coronary heart disease via early intervention.

An occupational health nursing education program. Relevance to nurses in nonoccupational practice settings.

A collaborative effort between community health faculty in an upper division nursing program and nurses from a nearby agricultural health and research center resulted in an educational program focused on occupational health and safety issues in the agricultural industry. The 3 hour class was presented each semester between 1997 and 1999 to RN students enrolled in a community health organization class. In addition to information about the health and safety hazards in agriculture, the nursing students learned about the center's research projects and clinical services available to the farming community. A follow up survey was mailed to the nursing students to evaluate the effectiveness and relevance of the occupational health program by identifying the proportion of the nurses' caseloads spent on occupational health problems, and whether the information and materials presented in the class were relevant to practice. Results showed that even though the surveyed nurses were employed in nonoccupational practice settings, nearly everyone rated the occupational health information as useful. Findings also revealed that although nurses in nonoccupational practice can spend nearly a quarter of their time caring for clients with work related health problems, they may lack adequate educational preparation to do so.