A school based nurse-led clinic in Auckland
Mana Health Clinic is a nurse-led clinic based at a primary school in a low socio-economic area of Auckland. The clinic also caters for two intermediate schools and a second primary school in the vicinity. Mana Health Clinic is staffed by one public health nurse, with the support of on-call health professionals. The nurse runs two clinics per day - before and after school hours – and is open 20 hours a week on a drop in basis. Outside of these hours the nurse may visit clients at home or take scheduled appointments. The nurse offers health promotion, health education, assessment, referral and treatment of minor illness and injury.
While the focus is on 5-13 year old children who attend the schools, the nurse sees families, school staff and community members. Adults make up a large proportion of attendees. The most frequent users of the clinic are Pacific. The most common conditions the nurse sees are skin and ear conditions and asthma or respiratory problems. The nurse has initiated health education at an individual, family and community level in response to the large numbers of children presenting with skin conditions and asthma. Jill Clendon, Lecturer at the School of Health Sciences, Massey University Auckland, led a two year study to measure outcomes at the clinic. Both qualitative and quantitative data were gathered, based on conditions seen, age and ethnicity of users, types of services provided and impact on hospital usage.
Since the inception of the clinic, the study found a significant decrease in the number of children from the area visiting general paediatrics at Starship Children’s Hospital. Visits to Starship for illnesses associated with lower socio-economic status - like skin conditions and asthma - are common. Visits to the Ear Nose and Throat department at Starship also declined.
Prior to setting up the clinic, the community identified a lack of easily available health information. The majority of adults attending the clinic receive some form of health advice, and outcomes would suggest that the clinic is addressing this need (Clendon 2004). The study concluded that nurse-led clinics are effective for school-aged children and their families. “Where the nurse has been able to identify particularly high numbers of people presenting with certain conditions and has taken steps to address these utilising a comprehensive approach, the results are clear: health outcomes for children are improved.” (Clendon 2004). Further reading:
Clendon, J. and Krothe, J. 2004. The nurse-managed clinic: An evaluative study. Nursing Praxis in New Zealand, 20(2):15-23.
Reference:
Clendon, J. 2004. Demonstrating outcomes in a nurse-led clinic: How primary health care nurses make a difference to children and their families. Contemporary Nurse,18:164-176.
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