Nursing in Practice Autumn 2022 issue | Page 40

40 \| Nursing in Practice \| Autumn 2022
TEN TOP TIPS Protecting vulnerable patients this winter
GP partner and PCN clinical director Dr David Coleman offers advice on the steps nurses can take to help vulnerable patients in the community stay well this winter
With Covid-19 an ongoing concern , the current pressures on the NHS and the added stresses of a cost-of-living crisis mean this winter will present a challenge greater than most of us have encountered in our careers to date . It goes without saying that patients who are elderly , frail or have a chronic illness will be particularly vulnerable . We must also be mindful of the pressure on carers and the challenges facing young families . There is no magic bullet to improve patient care across the board but there are ways to make a positive impact . Here are ten top tips to help community nurses care for our most vulnerable patients this winter . Actively screen for mental health problems 1Screening for mental health issues at chronic disease reviews will be particularly important . Rising prices , particularly food and energy bills , mean patients are under unprecedented pressure . Financial stressors are a mental health risk factor , as is chronic disease , so in patients facing both , active screening and careful responses to mental health-related cues will be crucial . Admitting a mental health issue can be taboo for many patients , so we will need to be alert to body language and demeanour to identify patients who may need our support . Gentle , conversational questioning may reveal hidden issues . If your area offers counselling services specifically for patients with long-term conditions , make use of these . Social prescribers can also help with practical support for issues such as bills , benefits and debt management , and should be open to receiving referrals from across the primary care team . Promote the Covid-19 booster and flu vaccination campaigns 2While the national conversation has largely moved on from Covid-19 , the disease continues to take lives and create morbidity at a significant level .				Patients may grow weary of the Covid vaccine when they receive an invite for their fourth or fifth dose , but it remains important that they attend and boost their vaccine-induced immunity . This year , Australia has recorded higher case numbers at the peak of flu season than its five-year average , ¹ so we must not overlook the risk of a troublesome flu season here . Co-administration of Covid and flu vaccines can help maximise vaccine uptake ; while vaccination should not be delayed because of lack of supply of either , it makes sense to do all we can to protect patients as soon as possible and to familiarise ourselves with the updated vaccines and protocols . The JCVI statement ² and the Green Book ³ explain the eligible cohorts and available Covid vaccines ( see Box 1 for a summary ). Focus on housebound patients and the socially isolated 3The housebound are among the most vulnerable people we care for . In our practices , we are prioritising these patients for Covid and flu jabs , and tying in chronic disease reviews where possible . It is tempting to focus on efficiency , but the home setting can provide an array of sensory cues , from clutter , to trip hazards , to unopened medications . It is worth taking the time to explore these sensitively – a pile of unopened inhalers may explain those stubborn COPD symptoms ! Prioritise poorly controlled asthmatics 4My practice uses a patient ’ s birthday month to guide their chronic disease review date . This makes sense on the whole , but I like to see some flexibility for patients vulnerable to winter respiratory illnesses . A search to identify patients with a low Asthma Control Test score at their last review can work as a proxy list of those who may benefit from a further review . Text messages can be used to ask patients to complete another questionnaire prior to winter . Going through the	Dr David Coleman is a GP partner and co-clinical director at Doncaster South PCN , South Yorkshire ONLINE Scan the QR code to access the fully referenced article , or visit nursinginpractice . com / clinical	GETTY IMAGES