NUR344: Action Plan for Rheumatic Heart Disease in Australia

This document presents an action plan focused on addressing Rheumatic Heart Disease (RHD) within the Indigenous population of Australia. It highlights the disproportionate impact of RHD on this group and proposes strategies for community health nursing intervention. The plan emphasizes early diagnosis of Group A streptococcal infections, adherence to Benzylpenicillin treatment, and culturally competent care. It also includes lifestyle modifications related to cooking fuel and ventilation, and hygiene interventions. The evaluation of the strategies involves assessing environmental modifications, access to primary treatment, and adherence to medication. The author stresses the need for improved healthcare delivery to address the high prevalence of RHD within this community. The action plan also addresses the promotion of health and independence through education and community involvement. The plan includes references to relevant research and data sources.

Running head: ACTION PLAN 1
Action Plan
Student’s Name
Institutional Affiliation

ACTION PLAN 2
Action Plan
Selection of topic
The topic selected for this discussion is Rheumatic Heart Disease among the Indigenous
population in Australia.
Action plan
Community Health Nursing Action Plan
Target group The indigenous population in Australia
Health challenge Rheumatic Heart Disease
Promotion of health Early diagnosis of group A streptococcal infections
among children
Treatment of pharyngitis
Early diagnosis of Rheumatic Fever
Adherence to Benzylpenicillin treatment
Promotion of
independence
Education on the causes and sequelae of the
disease
Lifestyle modification on sources of cooking fuel
and ventilation in the house
Hygiene intervention to prevent the spread of
pharyngitis
Evaluation of strategies Assess the environmental modifications at the
household

ACTION PLAN 3
Assess access to primary treatment
Assess adherence to Benzylpenicillin treatment in
those with Acute Rheumatic Fever
Original Discussion Post
Rheumatic Heart Disease is an autoimmune illness characterized by valvular dysfunction
as a result of a primary streptococcal infection (Gray et al., 2017). Despite the indigenous
population accounting for only 3 % of the national population, they experience a
disproportionate affliction to the disease. In 2017 among those living with RHD in Australia,
87% were from the indigenous population (AIHW, 2019).
Evidence-based strategies at the primordial level such as minimizing crowding in the
household show a reduction in the incidence of the disease. Additionally, maternal education on
the disease was associated with a lower incidence of RHD in a study (Coffey, Ralph & Krause,
2017). In effecting secondary prevention, I would ensure that those diagnosed with Acute
Rheumatic Fever receive and adhere to Benzylpenicillin treatment (Zeitz et al., 2019). According
to AIHWA, secondary prevention is a cost-effective strategy at both the community and clinical
levels.
Culturally incompetent care due to the language barrier was among one of the factors
highlighted in poor health promotion of RHD among the indigenous population in a study
(Belton et al., 2018). To provide culturally congruent care I would ensure the patient is a part of
the health-seeking strategy. I would ensure that a community worker from the indigenous
population is present to allow for the translation of important information. Additionally, through

ACTION PLAN 4
a known community representative I would educate the community on the importance of altering
some cultural norms such as fuel source and living quarters to prevent disease.
In the evaluation of this action plan, I will assess the lifestyle risks, adherence to
treatment and health-seeking behavior before implementing the strategies and after then compare
the two. The key amenable areas would be what cooking fuel source they adopted, any new
ventilation in the house and follow up on medication for those with Acute Rheumatic Fever. The
tools I would use for this is an observational checklist and key informant interviews.
I would like to highlight once again that 3% of the population is burdened with 87% of
disease. How did we as healthcare providers allow it to get to that? And are there any other
measures we can use to remedy the situation?

ACTION PLAN 5
References
Australian Institute of Health and Welfare. (2019). Acute rheumatic fever and rheumatic heart
disease in Australia. Retrieved from https://www.aihw.gov.au/reports/indigenous-
australians/acute-rheumatic-fever-rheumatic-heart-disease
Coffey, P. M., Ralph, A. P., & Krause, V. L. (2018). The role of social determinants of health in
the risk and prevention of group A streptococcal infection, acute rheumatic fever and
rheumatic heart disease: a systematic review. PLoS neglected tropical diseases, 12(6),
e0006577, https://doi.org/10.1371/journal.pntd.0006577
Zeitz, C., Henthorn, R., Roper, S., Gell, K., Cottrell, J., Welke, S., & Ivanhoe, T. (2019).
Partnering to Improve Management of Rheumatic Heart Disease. Heart, Lung and
Circulation, 28, S56. https://doi.org/10.1016/j.hlc.2019.05.144
Belton, S., Kruske, S., Jackson Pulver, L., Sherwood, J., Tune, K., Carapetis, J., Vaughan, G.,
Peek, M., McLintock, C. and Sullivan, E( 2018). Rheumatic heart disease in pregnancy:
How can health services adapt to the needs of Indigenous women? A qualitative
study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58(4),
pp.425-431 https://doi.org/10.1111/ajo.12744
Gray, L.A., D’Antoine, H.A., Tong, S.Y., McKinnon, M., Bessarab, D., Brown, N., Reményi, B.,
Steer, A., Syn, G., Blackwell, J.M. and Inouye, M( 2017). Genome-wide analysis of
genetic risk factors for rheumatic heart disease in Aboriginal Australians provides
support for pathogenic molecular mimicry. The Journal of infectious diseases, 216(11),
pp.1460-1470. https://doi.org/10.1093/infdis/jix497

ACTION PLAN 6