Summary
The Vital 5 initiative offered by Guys and St Thomas' NHS Foundation Trust was devised by Kings Health Partners. It advocates for people to make improvements in/to five factors that have a major impact on health, at an individual and population level. The factors are: blood pressure, obesity, mental health, smoking status, and alcohol intake. Vital 5 was implemented using a ‘Making every contact count’ (MECC) approach at a Dermatology Day Centre treating dermatological conditions. Patients attending the centre require topical application, bandaging and/or patient education. MECC seeks to change behaviour utilising day-to-day interactions.
Method
Records were examined for existing evidence of Vital 5 data, to ensure that they were not being recorded already in an ad hoc manner. A total of 30 patients referred to the centre were reviewed. Overall numbers with recorded data were low, with 0 patients having anxiety and depression scores recorded, three having alcohol and smoking status recorded, nine having BMI noted, and 11 having their blood pressure recorded. A total of 10 patients also completed a verbal questionnaire and scored over 8/10 for the importance of being asked about Vital 5 and the helpfulness of having a booklet containing their Vital 5. A pilot study of 10 patients was then performed. A patient passport was produced with signposting information. Vital 5 measurements and method of recording were confirmed. Training for the team was organised.
Results
Vital 5 measurements were initially recorded on 10 patients. The results strongly indicated a need to implement the project fully on the unit. The results showed that eight of the 10 patients approached wanted health promotion measures. Five patients had a BMI of 26 or above, while two were referred on to an Improving Access to Psychological Therapies (IAPTs) programme with depression and anxiety. One patient requested smoking cessation support. One patient was on blood pressure medication. The two who did not require intervention were also supported, as one requested advice regarding support for relationship issues and the other had overdue blood tests requested by her GP. Since Vital 5 has been further embedded, patients with suicidal ideation and issues relating to bereavements that occurred during the COVID-19 pandemic have been helped. Now members of the team feel that they are caring for their patients holistically.
Sustainability and Spread
Efforts to embed the project on the unit are ongoing, with all new starters being trained appropriately. There are weekly meetings with the MECC team and the MECC practitioners visit the unit periodically to work with the team and discuss any issues that have arisen. A poster board is being set up in the waiting room for patients, which will rotate information on each of the Vital 5 measures monthly. A poster and presentation were made on the implementation of Vital 5 at the British Dermatological Nursing Group conference in September 2021. An article has also been accepted for Dermatological Nursing. Internally, a presentation was made at the Dermatological Nursing Grand Round. A further aim is to present a poster within the trust at Nurses’ Day.
