Does every heart matter? Developing a CVD service at a high-security prison

Abstract

Working as a nurse in a high-security prison for men is challenging. It requires the health practitioner to think ‘outside the box’ on how to deliver models of care, within the constraints of a secure environment. Such a challenge presented itself when providing cardiovascular disease (CVD) services at a prison. The use of ambulatory blood pressure monitoring (to help identify and monitor patients with newly diagnosed hypertension) was not approved by the prison, because of security considerations. Therefore, a new way of working was needed to deliver the service, in line with National Institute for Health and Care Excellence (NICE) recommendations. This article discusses three areas of service development that were implemented within a high security prison; these are hypertension management, cardiac rehabilitation and implementation of NHS Health Checks. Because of the challenging and restrictive environment, the development of these services has been recognised both locally and nationally, obtaining awards and being presented at conferences.