Lesley Nish talks accident prevention

 “Accident prevention is a clear public health issue. Epidemiology identifies the origins and characteristics where focus on prevention is required.
 
Accident prevention areas typically include road traffic and vehicular, pedestrian injury, falls, burns and scalds, poisoning and drowning. Accidents or unintentional injuries can occur in various locations, for example on the roads and in public areas, in homes and in workplaces. Public Health has an important role in identifying areas which require focus, in reducing health inequalities, and identifying new and emerging issues.
 
It’s widely accepted that Public Health policy in the form of laws, regulations and guidelines can have a profound impact on health and wellbeing. This is also well recognised in the field of injury prevention and is frequently described as the E’s of injury prevention. In Public Health we use the E’s of injury prevention including – Environment, Engineering, Enforcement, Education, Empowerment and Equity -- as the main approaches for prevention activity and to apply an evidence based approach. To optimise success, coordinated, multifaceted approaches should be used.
 
Public Health also promotes alignment of prevention with strategy and policy. For example GIRFEC and in particular the wellbeing assessment (SHANARRI) provides clear routes for safety and for prevention of injury in children.
 
In NHS Greater Glasgow and Clyde (NHSGGC) a strategic partnership approach - driven by Health Improvement, Public Health, RoSPA, The Royal Hospital for Children and a range of partners - has facilitated a number of issues to be tackled and campaigns implemented and evaluated.The partnership reviews data and evidence to develop prevention activity.

For example, when the issue of children ingesting liquid laundry pods or caps was identified, a workshop was facilitated to develop the Not for Play project, which provided a cupboard catch (engineering and environmental changes) as part of a brief intervention (education and empowerment) with parents/ carers (equity) as part of GIRFEC from around 6 months of age. This project also played an important role in influencing revision of European standards (engineering and enforcement) and a resulting change in the packaging for liquid laundry pods/ caps. Not for Play has been continuously monitored and evaluated and a cost benefit analysis completed.
 
RoSPA resources and campaigns proved helpful in highlighting issues to parents in NHSGGC.
We use a range of their resources, e.g. the height chart, which is available for all staff working with children and families, including health visitors and nursing staff, and teams who use this as part of a discussion about safety with families. And we’ve been very fortunate to work closely with RoSPA Scotland on a number of programmes including:

• Straight off, Straight away – a hair straightener burn prevention programme
• Not For Play, as described above was highly commended by the BMJ
• The development of an aide memoire for teams which highlights common injuries at relevant ages and how families can prevent them
• STOP a first aid for burns and scalds programme.

It’s important that public health professionals support accident prevention interventions in order to prevent injury, reduce health inequalities and admission to hospitals. Public Health also has an important role to play in contributing to the evidence base and in facilitating the partnership approaches to prevention.
 
Prevention can and should be part of everyone’s business, and it is important to recognise that not everyone will have Public Health in their title, e.g. a third sector or voluntary organisation who works closely with families and children have a key role to play in the same way that a nurse or support worker can.
 
Every patient and family contact is a health improving opportunity, and as such we should use opportunities to prevent injuries and accidents. NHSGGC facilitates a patient centred approach and means that staff working with families can discuss prevention at the stages relevant to infants, children and their families.”
 
Lesley Nish, Health Improvement Lead, Public Health, NHS Greater Glasgow & Clyde
 

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