Rheumatic Fever Prevention in the Eastern Bay of Plenty Sandra Ball
Rheumatic Fever Prevention in the Eastern Bay of Plenty Sandra Ball
Rheumatic Fever Prevention in the Eastern Bay of Plenty Sandra Ball
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<strong>Rheumatic</strong> <strong>Fever</strong> <strong>Prevention</strong> <strong>in</strong> <strong>the</strong><br />
<strong>Eastern</strong> <strong>Bay</strong> <strong>of</strong> <strong>Plenty</strong> <strong>Sandra</strong> <strong>Ball</strong>
<strong>Eastern</strong> <strong>Bay</strong> <strong>of</strong> <strong>Plenty</strong> Programmes;<br />
Opotiki, Kawerau, Murupara and<br />
<strong>the</strong> Tuhoe rohe
<strong>in</strong>crease school and community knowledge RF / “sore<br />
throats matter”<br />
provide school based <strong>in</strong>tervention <strong>in</strong>clud<strong>in</strong>g sore throat<br />
swabb<strong>in</strong>g (T/S) twice per week<br />
liaise with whanau GP to supply antibiotic free <strong>of</strong> charge<br />
whanau support (removal <strong>of</strong> barriers)<br />
support best practice, Heart Foundation/ 2012 Primary<br />
Care handbook supplied to GP practices<br />
report<strong>in</strong>g for quality and evaluation<br />
Core service specs
OPOTIKI<br />
RFCHW<br />
Nita Walker and<br />
Miriam Steadman<br />
ten schools;<br />
Kura Kaupapa o<br />
Torere<br />
Omarumutu<br />
Waioeka<br />
Ashbrook<br />
St Josephs<br />
Opotiki Primary<br />
Woodlands<br />
Opotiki college<br />
Waiotahi<br />
Kutarere<br />
Whakatohea Iwi and Social Health Services,(WISH)1650<br />
children commenced Term 3 2009 (Pilot), BOPDHB (125/100<br />
000 , 5-15 yrs )
KAWERAU<br />
RFCHW<br />
Liisa Wana and<br />
Melissa Bennett<br />
seven schools;<br />
Te Mahoe<br />
Te Teko<br />
Kawerau College<br />
Putauaki<br />
Intermediate<br />
Te Whata tau o<br />
Putauaki<br />
South School<br />
<strong>Eastern</strong> <strong>Bay</strong> Primary Health Alliance,(EBPHA) 1403 students,<br />
term 4 2010, BOPDHB (88/100 000 5-15 yrs )
MURUPARA<br />
RFCHW<br />
Moana Hall<br />
Marie Merriman<br />
three schools;<br />
Murupara primary<br />
Rangitahi college<br />
Te Kura kaupapa;<br />
Motuhake o Tawhiuau<br />
Te Ika Whenua Hauora (TIWH), 542 children, commenced<br />
term 1 2011, BOPDHB (258/100 000 5-15 yrs )
TUHOE ROHE<br />
RFCHW<br />
Pia Harawira<br />
Mah<strong>in</strong>a Harawira<br />
T<strong>in</strong>a ‘Sunsh<strong>in</strong>e’ Biddle<br />
six schools;<br />
Matahi Valley school<br />
Waimana<br />
Taneatua<br />
Ruatoki<br />
Tawera<br />
Waiohou<br />
Te Kaokao O Takapau Health and Disability service (TKK) 515<br />
children commenced 2012 term 1, MOH contract
RN Cl<strong>in</strong>ical Lead<br />
CL role<br />
Set up:<br />
•tra<strong>in</strong><strong>in</strong>g staff,<br />
•establish<strong>in</strong>g relationships/ education for<br />
stakeholders e.g. GP practices , Pathlab,<br />
pharmacies, schools ...<br />
Quality advocacy:<br />
• education staff/ allied health pr<strong>of</strong>essionals<br />
• management education<br />
•report<strong>in</strong>g/evaluation per service specs<br />
• quality manual(South Auckland Wiri school<br />
project )<br />
•promote peer relationships<br />
(support/challenge/co-ord<strong>in</strong>ate)<br />
•RF steer<strong>in</strong>g group member<br />
•Go between for organisations <strong>in</strong>volved<br />
•Community experience/passion for<br />
prevention
community leadership<br />
local whanau on brochures<br />
removal <strong>of</strong> barriers e.g.<br />
communication/cost/transport/cultural (kanohi te kanohi)<br />
health literacy ‘Sore Throats Matter’,<br />
families are engaged with GP practices<br />
<strong>in</strong>ter-provider skill shar<strong>in</strong>g<br />
consistency<br />
role model programme<br />
Why <strong>the</strong> programmes are<br />
succeed<strong>in</strong>g:
meet each school term<br />
provide feedback<br />
problem solve<br />
health promotion cohesion<br />
resource shar<strong>in</strong>g<br />
pr<strong>of</strong>essional development<br />
consistency/competition<br />
sector support<br />
RF Sector 2011 term1
The RF sector
Pr<strong>of</strong>essional Development; Cardiac<br />
physiology
• 50 participants<br />
welcomed<br />
• National RF leaders<br />
presented...<br />
• Provided RFCHW with an<br />
<strong>in</strong>sight that <strong>the</strong>y are part<br />
<strong>of</strong> a national RF<br />
prevention framework.<br />
• Show cased <strong>Eastern</strong> <strong>Bay</strong><br />
<strong>of</strong> <strong>Plenty</strong><br />
• Motivation for quality<br />
2012 29 th March RF hui
Support<strong>in</strong>g GPs/PN ... Pr<strong>of</strong>essor Lennon<br />
lure; d<strong>in</strong>ner meet<strong>in</strong>gs 2009 , 2012<br />
peers; MC Dr Jo Scott-Jones chair rural<br />
GP network, Pr<strong>of</strong>essor Lennon, Dr<br />
Malcolm, TTO Dr Jim Miller, Russell<br />
Ingram -Seal<br />
best practice advocacy ,HF,2012<br />
Primary care handbook ; once daily<br />
Amoxicill<strong>in</strong> (drug <strong>of</strong> first choice to<br />
treat GAS) ...<br />
steer<strong>in</strong>g group update<br />
change <strong>in</strong> swab tak<strong>in</strong>g behaviour<br />
provision <strong>of</strong> resources /research articles<br />
RF CME
fund<strong>in</strong>g f<strong>in</strong>e tun<strong>in</strong>g<br />
scope <strong>of</strong> practice/qualifications/tra<strong>in</strong><strong>in</strong>g<br />
GP prescrib<strong>in</strong>g<br />
consistency / keep<strong>in</strong>g momentum<br />
GAS pharyngitis <strong>in</strong>cidence<br />
CL support<br />
resources<br />
report<strong>in</strong>g<br />
normalis<strong>in</strong>g whanau seek<strong>in</strong>g HP GP/PN support for sore<br />
throats...<br />
challenges
Iwi advocacy for local community<br />
Health Promotion; ideas/activities/resources<br />
Whanau health literacy ;“sore throats matter”,<br />
enroll<strong>in</strong>g whanau with GPs<br />
Daily Amoxicill<strong>in</strong><br />
Heart Foundation resources<br />
RF Sector<br />
RF Hui ‘how we fit <strong>in</strong>to <strong>the</strong> national picture’<br />
Operations Manual/ quality measures<br />
Contracts, 2012-13/long term commitment<br />
Media activity<br />
DHB support<br />
Successes
four programmes underway with 4160 pupils <strong>in</strong> 26 low decile schools 1-3<br />
(74% <strong>of</strong> students <strong>in</strong> low decile schools EBOP)<br />
community health literacy “sore throats matter”/RF<br />
swab numbers, exponential <strong>in</strong>crease community sourced swabs, from<br />
programmes and practices<br />
swab results (four areas) , positivity <strong>of</strong> GAS results from swabs taken 12%<br />
average school terms 1and 2 2012<br />
swabs taken total term 2 2012 3483 (four areas) (12%=418 GAS tve )<br />
RF <strong>in</strong>cidence decl<strong>in</strong>e<br />
GP/PN ; May June 2012 audit daily Amoxicill<strong>in</strong>, 10 days abs , Heart Foundation<br />
algorithm 99% scripts= best practice<br />
evaluation
Quality primary prevention programmes ongo<strong>in</strong>g...<br />
Pr<strong>of</strong>essional and programme development<br />
(Sk<strong>in</strong> <strong>in</strong>fections/hous<strong>in</strong>g /whanau ora)...RN tra<strong>in</strong><strong>in</strong>g<br />
National RFCHW tra<strong>in</strong><strong>in</strong>g package<br />
Support <strong>the</strong> BOP RF register<br />
BOPDHB Bicillen adm<strong>in</strong> policy<br />
Health Pr<strong>of</strong>essional student knowledge<br />
Health literacy/action.... all stakeholders best practice; “Sore throats<br />
matter”<br />
Normalise behaviour <strong>of</strong> seek<strong>in</strong>g nurse/ doctor check <strong>of</strong> sore throats<br />
and first consideration to be strep throat/ RF prevention<br />
The future
Tutohia and whanau
Acknowledgements<br />
Dr John Malcolm<br />
L<strong>in</strong>dsay Lowe<br />
Russell Ingram-Seale<br />
Te A Hou PHO<br />
The RFCHW teams<br />
EBPHA , WISH, TIWH,TKK<br />
Dr Jo Scott-Jones<br />
Helen Herbert<br />
Pr<strong>of</strong> Diana Lennon<br />
Lizzie Farrell<br />
Kura/whanau that ‘we’ work<br />
with<br />
RF children/whanau<br />
Tutohia Huriwaka -Biddle<br />
Toi Te Ora Public Health<br />
BOP/Lakes MOHs<br />
Bel<strong>in</strong>da Lor<strong>in</strong>g
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