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A Guide to Clinical and Preventive Services


Preventive health care is a burning aspect to be discussed in modern American society. According to the Centers for Disease Control and Prevention (2017), only half of the recommended rate of Americans chooses preventive services due to removed cost-sharing, co-payments, and co-insurance. In this paper, the peculiarities of cervical cancer screening and falls in older adults screening will be discussed through the prism of the population at risk, assessment tools, screening tests, time, and interventions.

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Cervical Cancer Screening

The necessity to improve women’s health in the United States cannot be ignored anymore. Cervical cancer is a disease that begins in the cervix and then extends to the vagina and uterus. Although it is a preventable type of cancer, approximately 13,000 women are diagnosed with it annually (National Cervical Cancer Coalition, n.d.). Its main cause is the presence of human papillomavirus (HPV) infection. Other supporting factors include a compromised immune system and exposure to diethylstilbestrol (Agency for Healthcare Research and Quality, 2014). Screening for cervical cancers depends on the age of women. Women younger than age 21, older than age 65, and those with the removed cervix do not need to take regular tests because they can bring some harm to health instead of expected benefits. Screen with cytology (Pap smear) is recommended for women between 21 and 65 years every three years (Agency for Healthcare Research and Quality, 2014). In addition, cytology combined with HPV testing should be chosen by women aged between 30 and 65 years.

To develop appropriate interventions, patients should meet the criteria for testing, and clinicians must check timing, test intervals, and follow-up care. Any health profession includes the necessity to provide patient-centered care and employ evidence-based practice (Stevens, 2013). In this case, screening tests introduce the step to prevent the development of cervical cancer in women by identifying precancerous lesions and applying necessary interventions. Ablative and excisional therapies like cryotherapy (freezing), laser ablation, and conization are recommended for serious cases when lesions are large (Agency for Healthcare Research and Quality, 2014). Surgery or chemotherapy is appropriate for the cases when cervical cancer is detected at an early stage.

Being one of the leading causes of death among women in the United States, it is important for the population to predict cervical cancer and treat it at an early stage. Poor medical insurance coverage, no time to visit hospitals, and ignorance of symptoms are the main reasons why women are not able to prevent this disease. No screening may result in poor child health, mental problems, and the development of new health problems. Therefore, advanced clinical practitioners have to pay their attention to this type of cancer.

Falls in Older Adults Screening

Nowadays, falls in older adults is a serious threat to the health of the US population that reduces their abilities to move and stay independent. According to Bergen, Stevens, and Burns (2016), 2.8 million older adults (aged ≥ 65 years) address emergency departments because of fall-related injuries, and about 27,000 die because of fall outcomes. In many cases, people do not find it necessary to report on their falls, so this condition remains untreated for some period of time, putting both adult men and women under threat. Risk assessment for screening includes the analysis of a history of falls and mobility problems (Agency for Healthcare Research and Quality, 2014). This practice includes asking patients questions about falls during the last year and checking their walking abilities. In addition, advanced clinical practitioners recommend taking the timed Get-Up-and-Go test when several simple actions contribute to assessing patient’s mobility. Time of screening depends on patients, their level of communication and understanding of the requirements, and the abilities to complete tasks.

To predict falls in older adults, simple interventions can be applied in healthcare practice. For example, physical therapy with certain exercises and tasks are offered. Vitamin D supplementation every 12 months is another step to protect older adult health and avoid serious complications after falls (Agency for Healthcare Research and Quality, 2014). Finally, the evaluation of risk factors, communication with families, and the recognition of patient values cannot be ignored. Unintentional injuries because of falls challenge the quality of life in older adults, making them dependent on other people and circumstances. To prevent injuries, reduce the number of traumas, and avoid deaths, fall screening and prevention have to be promoted among the US population. This type of screening is one of the most important tasks in advanced clinical practice because not many adults are ready to talk about their health problems and neglect the possibility to prevent fall-related outcomes.


Nursing and healthcare fields undergo considerable changes regularly. It is crucial for advanced clinical practitioners to study recent improvements and preventive strategies to contribute to public health and avoid serious complications. Cervical cancer is a leading cause of death among women, and falls in older adults influence the quality of life. Both conditions are preventable and require screening as a free service for patients at risk.

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Agency for Healthcare Research and Quality. (2014). A guide to clinical preventive services. 

Bergen, G., Stevens, M. R., & Burns, E. R. (2016). Falls and fall injuries among adults aged ≥ 65 years – United States, 2014. Morbidity and Mortality Weekly Report, 65(37), 993-998.

Centers for Disease Control and Prevention. (2017). Preventive health care. Web.

National Cervical Cancer Coalition. (n.d.). Cervical cancer overview. 

Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2). Web.

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