HEALTH PROTECTION IS EVERYONE’S BUSINESS Erin Dean reports on a week of action aimed at raising the profile of crucial public health work The UK has one of the highest rates of tuberculosis in western Europe. The bacterial infection thrives on the fringes of society, preying on those who are homeless, misuse drugs or alcohol or live in poor housing. One approach to tackling the spread of tuberculosis (TB) is the Find and Treat service in London. Staff working from a van with digital mobile radiography equipment, can provide on-the-spot diagnosis.

Above: nurses, regardless of their role, should be alert to health protection opportunities

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Alistair Story, clinical lead and manager for Find and Treat at the University College London Hospitals NHS Foundation Trust, says his team goes to hard-to-reach populations who are most likely to have undiagnosed TB. ‘There is no other service like this,’ Mr Story says. ‘We are working with a population most people would cross the street to avoid.’ Despite the relatively high rates of TB in many UK cities, nurses

may not think of it when they see a patient who has had a cough for more than three weeks, which is one of the symptoms. Mr Story says: ‘It is a public health responsibility of all front line staff that they should know the symptoms of TB and are aware of what to do if they suspect a patient has TB. But there is a low awareness of the disease.’ Raising the profile of this potentially deadly infection is one of the aims of a week publicising the health protection aspects of public health and the contribution of nursing and midwifery to this area. The Health Protection Week of Action, beginning on February


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Sphere of influence

PHE deputy director of nursing Joanne Bosanquet says it is an opportunity to show all nurses that they have a role in public health. ‘My passion is to demystify and widen the understanding of public health so that every nurse and midwife at any stage of their career understands it and will do something with it, however small. ‘My vision is that all nurses will have some appreciation of their sphere of influence at an individual level, community level and up to population or strategic level.’ Through activities during the week, including blogs from national leaders, online chats with expert nurses, social media updates and a series of top tips for staff, the Department of Health and PHE hope to increase awareness of key public health issues among nursing staff. There will also be career profiles of public health nurses, to boost awareness of the work they do and help nurses see how public health is intertwined with their own job. There will be a focus on the UK five-year antimicrobial resistance strategy, published by the government last September. This aims to tackle the rapid spread of bacteria resistant to antibiotics. ‘Antimicrobial resistance is not going to go away. It is a huge issue and everyone has to take ownership of it,’ says Ms Bosanquet. Paul Weaving, consultant nurse in infection prevention and control at North Middlesex University Hospital NHS Trust in London, explains the focus



has shifted from infection control to infection prevention. North Middlesex University Hospital has, like most trusts, strict policies on antibiotics, and uses narrow spectrum versions where possible to minimise the chance of resistance. Patients are screened and, if necessary, treated for MRSA and isolated in a single room, reducing the chances of them becoming ill and exposing other patients. ‘Our infection prevention and control team has a strong presence,’ Mr Weaving says. ‘But while we are here to encourage, advise and educate, infection prevention is everyone’s business. It has got to be the people who are looking after the patients who implement infection prevention in everything they do.’ He points out that action does get results, as the drive against MRSA shows: ‘Many trusts have

A week of action, starting on February 24,   will highlight the health protection aspects of public health and nurses’ contribution to them.   A series of events and activities, run by Public Health England, will encourage all nurses to consider what they can do in three areas – antibiotic resistance, immunisation, and TB. Author Erin Dean is a freelance journalist


24, is one of three ‘awareness weeks’ taking place this year and organised by Public Health England (PHE). The other two will focus on health improvement, and public health advice. Three areas will be highlighted during health protection week: antibiotic resistance, immunisation and TB.

FOCUS ON IMMUNISATION Immunisation is one of three main focuses for the Health Protection Week of Action. Vanessa Baugh, nurse consultant for North East and North Central London Health Protection Unit, says nurses should use opportunities to promote immunisation. ‘While we have seen a considerable reduction in many vaccine-preventable diseases, clusters and outbreaks of infection such as measles are reported to Public Health England each year. ‘We need to step up efforts to prevent these cases by improving coverage of immunisations in our patient groups. As nurses, we need to be able to signpost families towards information resources and other health professionals who can help.’ She adds that nurses should ensure they have had their jabs. ‘We need to be up to date with recommended immunisations to protect ourselves, our patients and families. We act as role models in this way.’

not had an MRSA bloodstream infection for more than a year.’ Between 2007/08 and 2012/13, the number of MRSA bacteremia reports from hospitals dropped from more than 4,450 to just over 920, according to PHE figures. However the increasing difficulty of treating infections means that more progress has to be made. Antimicrobial resistance is also an issue in the spread of TB, which is increasingly hard to treat with available medication. Persuading patients who have disordered lives to complete their course is difficult. For those with a strain of TB resistant to many of the available antibiotics, treatment can take up to two years. Just over a third of all the TB cases identified by the Find and Treat team have forms that are resistant to medication. Mr Story says. ‘It is a public health issue and the onus and responsibility to support people to take treatment rests on the health service. Healthcare staff need to get TB back into their consciousness. If they are not thinking about TB they are not going to spot it’ NS See page 71

Join the Twitter chat Get involved in Health Protection Week of Action by taking part in the #wenurses Twitter chat with senior public health nurses on Tuesday February 25 at 8pm @wenurses @MrsBosanquet @VivJBennett And follow the week’s activities on Viv Bennett’s blog at vivbennett.dh.gov.uk february 19 :: vol 28 no 25 :: 2014  25 

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Health protection is everyone's business.

A week of action, starting on February 24, will highligh the health protection aspects of public health and nurses' contribution to them. A series of ...
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