Childhood Atopic Eczema Case Study

This assignment will focus on the project management of a childhood atopic eczema session within a

parenting group, implemented by Health Visitors. By adopting a systematic approach, ensuring

effective practice change, and that the development is a continuous process. Focusing on the nature

of the facilitation and the theoretical underpinnings needed to enable the change to occur, for this

purpose a management of change model will be used. Time management and a resources plan will

be included and used as a tool to evaluate practice and critically discuss how we can better manage

childhood eczema in the community. Application of leadership skills and conflict management will be

analysed and will include a discussion on
best practice and the use of evaluation and reflection.

Issues related to the quality of care and how leadership can maintain or improve it, an understanding

of the process of change and leadership styles. To conclude, a summary of the learning process and

recommendations for future practice will be discussed.
Skin diseases affect between one–third and one–quarter of the population at any one time. 60000 referrals to secondary care in 2012, with atopic eczema being the most common inflammatory skin disease of childhood (Nice, 2012). Atopic eczema is an inflammatory skin condition characterised by intense itching (Charman, 2001). When eczema is active the skin becomes itchy and inflamed and vesticles develop. The condition presents primarily in infancy and childhood, with the peak age of onset before three months. Williams and Wuthrich (2000) cited in Hoare et al,( 2000) suggest that around 80% of cases commence before the age of five years. However research suggests that around 75% of children have grown out of the condition by their teens (McHenry et al, 2005). Public health nurses are therefore are in a prime position to strengthen the commissioning for early intervention and screening, enabling detection, health promotion and prevention. Leading and delivering the core fundamentals of the Healthy Child Programme using a family-centred approach is essential but also to go beyond the minimum core and instigate parenting support into
one programme. This is clarified by the government’s Acheson Report and its findings on parenting and the contribution of good health, improving the quality of care as highlighted in the Nursing and
Midwifery Council (NMC) Standards of proficiency for specialist community public health nurses,
2004. As a core part of our service, we are charged with identifying risks to health and are ideally placed to identify need within a community, respond appropriately and using professional judgement to empower families to make informed decisions and choices.

Current research indicates that the prevalence of atopic eczema has been rising over the last thirty years and that the burden of dermatological problems in the community is substantial (Russell-Jones,
2006). Also the evidence does suggest that the reason for the rise seems uncertain and as health professionals we must continue to pursue a clearer understanding of the links between the disease itself and behaviour, lifestyle, home and external environmental factors ( McNally et al, 2008).

Schofield et al, 2009 highlights this with increasing demand for dermatology care in the United
Kingdom continuing to escalate whilst hospital and community resources are decreasing. This is also emphasised in two UK studies. Emerson et al, 2001 and Herd et al, 2006 both attempted to calculate the cost of burden of atopic eczema in children both to the health service and the families of children with the condition.