Nurse-led eczema project a winner for GPs too

19 November 2020

This article was originally published by Health Quality and Safety Commission New Zealand and has been edited and added to with permission. 

West Hamilton’s South City Health practice nurse Melissa Castillo’s fourth child developed severe facial eczema at five months, which resulted in her being admitted to hospital to have intravenous antibiotics.

Melissa wanted a better way to manage her baby daughter’s eczema so created a clinic that is delivering great results for the practice’s under five-year-olds suffering from the painful skin condition – and their families. West Hamilton’s South City Health. 

"I’m a nurse, but I’m also a mum and I knew if I was finding it difficult to manage my daughter’s eczema, others must be too. We knew our patients were being seen by a GP and medication was being prescribed, but the parents would sometimes be back within a week with no improvement in the child’s eczema."

Mrs Castillo says language barriers, different carers, and a fear of using steroid cream all contributed to the problem.

The report written of the study is also being used for South City Health’s Continuous Quality Improvement (CQI) initiative in their Cornerstone accreditation. Accreditation in the CQI module recognises practice teams as leaders in quality improvement and rewards them for their equity initiative efforts.

Dr Kate Sinclair is a GP at the clinic and found it invaluable to be able to send families with young eczema patients to see the eczema nurse straight after her consultation. 

“The nurse is able to spend more time connecting with the whānau and understanding their unique circumstances. She also helps support the parents with empathy and understanding because they often have a very fractious child, which can be stressful.

“Have the nurse clinic was so helpful for reinforcing the messages I had already given my patients about their condition and helping them to understand how to use their creams most effectively and the reasons for using the creams. With this additional support patients have been much better about adhering to their therapy and very quickly we have seen the benefits from this intervention on reducing morbidity,” says Kate.

“I would highly recommend that GP practices consider training a nurse who may have a particular interest in this condition and then look at setting up something similar in their own practices.

“One downside is that there is no allocated funding for this at the present time and we have not wanted to charge our patients for this additional service. It may be that if more nurse-led clinics of this nature are set up around the country, providing good evidence for reduced hospital admissions and visits to outpatient clinics and GP visits, then funding options may become more easily accessible,” says Dr Sinclair. 

Read the original story that details the study.