Implementation and Evaluation of Management Guidelines for Atopic Eczema for Primary Health Care Nurses: A Pilot Study

Kaarina F Meintjes

doi:10.5539/gjhs.v12n6p1

Abstract

The primary health care (PHC) management guidelines for nurses treating children with atopic eczema were developed in a baseline study. The purpose of this study was to implement and evaluate the guidelines through a pilot study in a district in Gauteng, South Africa, in order to identify challenges and to adopt or adjust the guidelines for use by primary health care nurses in South Africa. The ultimate aim is to improve the child&rsquo;s eczema and quality of life.  A process evaluation research design was followed. Data was collected through 1) in-depth interviews with PHC nurses and also with the parents of children treated by these PHC nurses, and 2) documentation using the patient files of these children.  The results showed that some aspects of the guidelines were used and seen as helpful, especially the complete emollient therapy and the evidence based health education. A simplified version of the guideline will be promoted for use by PHC nurses. The more detailed guideline could possibly be used as a basis to develop a short course on atopic eczema for PHC nurses.

Highlights

A baseline research study was done on the primary health care (PHC) management of childhood atopic eczema (AE) public health care domain in South Africa
The South African consensus document for childhood AE states that a sedative antihistamine could be used before bedtime (Manjra et al, 2005) but this was not included in the South African management guideline for childhood AE (Puterman, Lewis, Sinclair & Green, 2014)..a study on parental perception of the role of antihistamine in the management of AE in their children, found that parents valued antihistamine equal to that of topical corticosteroid (TCS) in managing their children AE (Chawla et al, 2016) and from the findings of this research is seems that PHC nurses might have the same perception, more research is needed. It became clear from the findings of this pilot study, that the primary health management guidelines for childhood AE, were only partially followed by the PHC nurses
The PHC nurses, who consented to partake in the research, found some elements of the guidelines as very helpful, especially the complete emollient therapy and evidence based health education

Summary

Introduction

A baseline research study was done on the PHC management of childhood atopic eczema (AE) public health care domain in South Africa. Based on the findings of this baseline research, primary health care (PHC) management guidelines for childhood AE were developed and validated (Meintjes, 2016) following the AGREE II Instrument (Brouwers et al, 2010). These PHC management guidelines for childhood AE (hereafter called the guidelines) have been implemented and evaluated in a pilot study in the PHC clinical setting and the findings are reported in this article

Methods

Discussion

Conclusion