Shared Learning: Children and Family

Projects that have focused on educating children and their families to tackle antimicrobial resistance


 Royal Wolverhampton NHS Trust (Winner – Antibiotic Guardian Awards 2017)


Name: Riva Eardley


Provide a brief overview of your project: In the autumn of 2016, the Royal Wolverhampton NHS Trust teamed up with Public Health professionals from the City of Wolverhampton Council and Wolverhampton CCG to raise awareness of antibiotics resistance in Wolverhampton. One aspect of the programme focussed on improving awareness of and education about antibiotics resistance amongst children and young people, in line with the expected theme for the PHE campaign in November. Primary schools were offered the opportunity for key stage 2 primary school pupils to receive a special presentation from their designated school nurse. The presentation was developed by a microbiologist working at New Cross Hospital in collaboration with public health colleagues.


The session focused on four major themes:

  • What antibiotic resistant bacteria is and why it is an important public health issue
    • The differences between bacteria and viruses and why antibiotics do not work on viruses
    • The importance of taking antibiotics as directed by doctors and nurses
    • The importance of hand washing for the prevention of infection

Following the session, all pupils were invited to enter a city-wide poster competition. The five posters judged to be the best were reproduced and enlarged and displayed at various locations around New Cross Hospital and the local children’s centre for a six week period. At the same time, the organisers arranged for a large display of the winning posters to be placed outside the learning room at Wolverhampton Art Gallery. At a special launch day of the poster campaign, the winning children, their parents and teachers as well as guests from the Trust and Council were invited to view the poster display and celebrate their achievement. The children were congratulated by the Director of Public Health, the local Councillor for Public Health and the Lead Infection Prevention Nurse who were delighted to see the children passing on messages about hand hygiene, the difference between bacterial and viral infections and the importance of taking antibiotics correctly. The location of the Art Gallery display was ideally placed so that individuals from schools and other educational establishments using the learning room would have to pass it to get to the learning centre. The initiative was celebrated in a press release, highlighted on social media and shared by the Lead Pharmacist at PHE.


List any supporting partners or organisations worked with:

  • The Royal Wolverhampton NHS Trust
    • The City of Wolverhampton Council
    • Wolverhampton City CCG
    • Wolverhampton Art Gallery
    • Local Primary Schools


How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category? Antibiotic stewardship was successfully highlighted to all school nurses in the training they received to be able to deliver the workshops in primary schools. It was highlighted to all teachers and pupils during the workshops. The quality of posters received was a testament to the fact that children had taken on board messages and translated them in to posters. This project operated on the assumption that educating young people about the importance of hand hygiene and appropriate use of antibiotics would contribute to achieving aims of the local antibiotic stewardship group around decreasing the spread of infections and reducing patient demand for antibiotics for simple self-limiting illnesses. The intention was to target children with an interactive educational campaign that would, as a by-product, raise awareness amongst parents and teachers.
At every stage of the project children, parents and teachers were directed to the Antibiotic Guardian website. For example information about the project was placed in the local newsletter for teachers along with links on how to become an antibiotic guardian and raise awareness using E-bug. The children’s homework sheets also contained information about becoming an antibiotic guardian. Local publicity of the project raised awareness of stewardship and particularly the role of health educators in raising awareness amongst children and young people. The addition of the poster competition element meant that children enthusiastically reproduced the key messages in a creative way. At the launch event the children went on to discuss what they had learnt and how they would help to spread awareness to others. The children that participated in the competition were invited to apply for their Junior Antibiotic Guardian Badges.


Cite 3 examples within the project which highlight promotion of the protection of antibiotics?:


  1. In the Autumn term of the 2016/17academic year, key stage 2 primary school children in Wolverhampton were taught about- the need to reduce inappropriate antimicrobial demand
    – the importance of washing and drying hands to prevent infections and stop them from spreading, including when and how hands should be washed.This preceded the publication of NICE guidance on Antimicrobial stewardship (NG663) in January 2017. The talk was developed and delivered in a way to help children understand the importance of protecting antibiotics; a message they can take forward throughout their lives. The posters received indicate that children understand that antibiotics are a finite resource for treating bacterial infections and should not be used for viruses. They also understood that hand washing was the most effective way to prevent the spread of infections and avoid getting ill in the first place. Moreover on attending presentation assemblies, it was clear that children had listened and remembered the key messages when questioned.2. Children were encouraged to share their learning with parents and given the opportunity to design a poster at home. The idea was to encourage families to discuss the issue and the poster was a vehicle for doing so. Children were given a hand out to take home that reinforced their learning and directed them to the Antibiotic Guardian website. The five winners were presented with prizes during assemblies which were attended by their school nurse and representatives from the Trust and City Council. During these assemblies, most of which were also attended by groups of parents, the main messages of the campaign were again reinforced.3. The five winning posters were reproduced for display in numerous locations throughout the city. Posters designed by children have attracted a lot of attention in previous campaigns (e.g. road safety) and it was believed that this would help promote the protection of antibiotics in a more effective way than a traditional poster. At the poster launch event members of the public stopped to view the display and ask questions. There was also a press release which was highlighted on the trust website and social media sites:


Key outcomes of project?:

  • Approximately 700 children (and their teachers) received a presentation on antibiotics from their school nurse and now have greater awareness of the issue.
    • Five poster designs that were used for a poster campaign around the city including the local hospital, children’s centre and art gallery.
    • Highlighted on social media.
    • People came together across different organisations (hospital, schools, primary care and local community) to ensure the project was delivered.
    • Funding was identified to print more posters to be displayed in other key locations including GP surgeries, libraries, all schools, leisure centres, children’s centres and community pharmacies.


How is the project to be developed in the future?: The project group are currently considering options for future delivery and have secured a presentation slot on the city’s head teachers meeting in July. At this meeting the intention is to discuss different options for future delivery including offering training for teachers to deliver E-Bug and support from school nurses for more sessions. The winning posters will continue to be used as part of the AMR Stewardship programme in Wolverhampton and will be deployed to other key locations as mentioned under key outcomes.


West Lancashire Scouts (Highly commended – Antibiotic Guardian Awards 2017)

 Name: Shelagh Snape  nominating Steve Morton and Clare Williams

Provide a brief overview of your project? Max 400 words: I am nominating Steve Morton, Clare Williams and West Lancashire Scouts for the Children and Family Antibiotic Guardian Award. Steve works for PHE as a Health and Wellbeing Manager in NW PHE Centre and is also County Commissioner in the West Lancashire Scouts (WLS) organisation. Clare Williams is a Leader Training Manager WLS and also a Nurse Manager for Occupational Health at University Hospitals of Morecambe Bay NHS Foundation Trust.
As part of EAAD and WAAW in November 2016 Steve agreed to approach WLS Management Team with a proposal to undertake activities for Scouts to become Antibiotic Guardians (this work fits soundly within the Scout Community Impact element of their training framework). He has spearheaded this project within WLS, securing funding to provide badges and handwashing training kits for groups to complete the activities to achieve their badges. Groups are able to download the activity packs from the WLS Website, linked from their twitter and Facebook accounts, where they are also required to upload and share their successes. The activity packs are linked to the e-Bug web pages for KS1&2 – Beavers and Cubs, and KS3&4 for Scouts and Explorers. Young People are encouraged to showcase their work on the site to gain a digital badge.
Training in the use of the handwashing kits and activities is being organised for WLS Leaders. Lancashire County Council’s Infection Prevention and Control Nurses from the Patient Safety and Quality Improvement team will provide a ‘Train the Trainer’ session for WLS Leaders to roll out to others in the organisation. Clinical and pharmacy professionals working within WLS are available to the groups for further advice.
‘Call to action: Complete the badge and choose one simple pledge about how you’ll make better use of antibiotics and help save these vital medicines from becoming obsolete. Young people and adults alike are encouraged to make a promise and become antibiotic guardians. More information on Antibiotic Guardians can be found at
This provides an excellent opportunity where members of the county can have a major impact on global health by acting locally as part of our Community Impact agenda, it is what we do! It is what we have always done, look after others!’ (WLS Antibiotic Guardian Scheme).

List any supporting partners or organisations worked with: Steve and Clare have worked with key local organisations to seek support for this work. This includes PHE, Lancashire County Council, e-Bug and Antibiotic Guardian.

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category? Max 400 words: The project went live on the WLS Twitter and Facebook pages on 23/02/2017. The Twitter page has had 2065 views in the first 3 weeks and 50 badge information sheets/resource links downloaded, 4 junior e-Bug packs and 2 senior e-Bug packs have also been downloaded with others having been downloaded direct from the e-Bug site. Although it is early days since the project became live, Steve reports a high level of interest including from other scouting regions within the UK, as far afield as Sussex, Bristol and Aberdeen. The project is being tweeted by WLS to all its 2776 followers, and shared with over 20,000 on Facebook, which include many other similar organisations.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics? Max 400 words: 1. Scouts are asked to complete one of several suggested activities e.g. Learn about different bugs from the e-Bug Pack
2. In order for the scouts to earn their badge they are required to showcase their knowledge of Antibiotics and Antibiotic Resistance and upload the evidence to the WLS Facebook page or site entitled ‘I am a junior Antibiotic Guardian’ e.g. poster, presentation or video.
3. Scouts are also asked to make one of the following promises or pledges:
A. I will sing the ABC song when washing my hands with soap and water. Washing hands properly (at least 30 seconds), especially before eating, is the single best way to prevent the spread of bad germs and keep you and your family healthy
B. If I am prescribed antibiotics, I will ensure they are taken exactly as prescribed and never share them with others
C. I will wash my hands with soap and water after touching or handling my pets
D. I will tell my parents/carers and teachers about Antibiotic Guardian and ask them to choose a promise too

Key outcomes of project?: Potential uptake of the Antibiotic Guardian Scheme by 13,600 WLS members including 3,500 adult volunteers = increased Antibiotic Guardians in Lancashire.
Increased Antibiotic/Antibiotic Resistance awareness among scouts, young people, adults and their families.

How is the project to be developed in the future?: • Project will continue to be available with resources to future Scout co-hort.
• Potential roll out to other Scouting areas in the UK. Other Scout counties in the North West of England have expressed an interest in rolling out the scheme with a total membership of over 55,000
• Potential for other similar organisations to adopt and adapt project in their organisations.


NHS Leeds North Clinical Commissioning Group

Provide a brief overview of your project? Max 400 words: To raise awareness of AMR in children and young people.

The Leeds CCGs partnered up with Space2, who are a vibrant arts and community charity, who working in some of the most disadvantaged areas of Leeds. They use various art forms to work with young people to help them make important changes around their health.

The aim of the project was to work with children and young people to develop their own media format to promote and raise awareness of how antimicrobials are used for that specific target audience.

We worked with a school that is in one of the most deprived areas of Leeds and also in an area where GP practices are amongst the highest prescribers of antibiotic.
In previous years we have targeted the adult population but felt that it was important to engage with the younger population, to improve education around antibiotic use from an early age.

The project involved:-

• Focus group sessions to understand young people’s view on antibiotics, and ideas of what sort of film /animation would work targeting years 7, 8, and 9.
• Workshops with school to come up with the story idea working with musicians and film makers.
• Creation of an animation and resources that can be used across the city.

A copy of the short video and flyer are sent in a separate email.

Once the video was produced a special assembly was arranged where members of the Leeds antimicrobial group were invited to attend and the video was shown to the rest of the school.

List any supporting partners or organisations worked with: Space2
David Young Academy, Seacroft.
Musician Boff Whalley of Chumbawamba
Film maker Jelena Zindovic

How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category? Max 400 words: This project resulted in a produced a short video that has been produced by the students for the students and this has been shown to the school which has over 1000 pupils. The video gives as advice that antibiotics are not for coughs and colds and gives advice about what to do, in an easy and fun format with a catchy tune.

Cite 3 examples within the project which highlight promotion of the protection of antibiotics? Max 400 words: • The focus groups to talk about the children’s views and thoughts were around antibiotics
• The production of the video
• The showing of the video at the school.

Key outcomes of project?: The production of the video which is aimed at children and pitches the messages for that specific audience.

How is the project to be developed in the future?: The intention is for this video to be shared with schools across Leeds, shown in GP practices as part of the Life Channel and also to be shared as a resource with other areas.
Also use this format to deliver other messages around antibiotics such as resistance, hand washing etc.



Newent Community School and Sixth Form

Name: Di Harrill

Provide a brief overview of your project? Newent Community School worked with E Bug and the Forest of Dean District council to run a peer education programme. The five workshops – Microbe Mania – Sneeze Machine – How clean in your Kitchen – Anti-biotic Awareness and hand Washing were demonstrated to all the year 8 students. The workshops were practical and fun. 20 year 8 students were selected to be peer educators.
These students were each given a T shirt and then had the opportunity to practice their workshop with the support from E Bug and environmental health team.
Second day- year 8 Peer educators taught the year 7’s, they moved around each workshop learning about all the different elements. After the year 7 sessions, the year 8 peer educators did the workshops with the local primary school.  This is the fourth year we have run this 2 day event.


List any supporting partners or organisations worked with: E Bug
Forrest of Dean District council – environmental health team
Newent Students also helped to trial the new E Bug website and evaluate it


How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category?: Several hundred students have now gone through this E Bug peer education programme. The workshops are interactive and fun, and the peer educators do an amazing job of passing on the information to the students. Students are encouraged to share the information with their families.
The messages are reinforced when primary school students attend Newent, they can be peer educators.
The local paper had an article and there are photographs of the event in our school prospectus and on our website.
The message is further followed up in PSHE and science.


Cite 3 examples within the project which highlight promotion of the protection of antibiotics?: Microbe Mania – this workshop was very practical, the students talked about the different types and looked at images of them. They also talked about how they can be treated and transmitted. Students then made a microbe out of modelling clay and took it home in a petri dish
Understanding Antibiotics – this involved the use of balloons – again a practical demonstration that help the students understand the difference s between bacteria and a virus. The visual nature of the demonstrated helped them to retain the knowledge. They also learnt about antibiotics – why we shouldn’t over use them, and why if we prescribed them we should make sure we take the full dose.
Hand Washing – this again was a visual and practical activity – which showed them under ultraviolet light – the importance of thorough hand washing and the use of soap to kill bacteria. They also learnt about when it is important to wash your hands.


Key outcomes of project?: Several hundred students have learnt, in a visual, practical fun way many of the issues around antibiotics and health. The peer educators also had the added impact of practicing presentations skills – speaking to an audience – things that helped them to develop confidence. We also found that the students appeared to be more attentive when being taught by a peer.
What and why illnesses become resistant to antibiotics.
They learnt about thorough hand washing – catching a sneeze – and food hygiene.


How is the project to be developed in the future?: This project has now been run for four years. It is a two day event – which has a big impact on the whole school. The main hall is left set up for students to walk around and read the large poster.
It also means that students get the opportunity to revisit the learning points – year 5, 6, 7 and 8.



NHS Greater Glasgow and Clyde

Name: Kate Stock


Provide a brief overview of your project? Our project was focused on European Antibiotic Awareness day 2016, with the aim of promoting infection control and antibiotic awareness with children and their family members. We had a brightly coloured ‘pop up’ stall in the atrium of the Royal Hospital for Children in Glasgow and this featured a variety of promotional material and information on how to become an antibiotic guardian.

Our main focus was on the children themselves and we consulted with a primary school teacher on how best to create a display that was both inviting for children and interactive, to create learning through fun. We also accessed e-bug junior to help us design our activities.

As EAAD was at the start of the winter season we decided to teach children about the importance of infection control with coughs and sneezes. We created our own ‘snot gun’ which the children could spray against an easel to demonstrate how far harmful microbes travel, we told them that other people can breathe in these microbes causing them to get ill, so it is important that they should cover their mouths. We also had a hand washing glow box so we could ask them to wash their hands after ‘sneezing’ to see if they had washed all of the germs away and we were then able to teach them how to wash their hands properly and explain the importance of good hand hygiene. Parents and carers were also encouraged to use the hand washing glow box. To emphasise hand hygiene we had a set of huge hulk hands holding a cuddly e.coli, the children were able to try these on and see that ‘dirty hands carry bugs’. Whilst the children were undertaking the activities, we were also able to engage with their parents to enforce the message that antibiotics do not work against viruses and the importance of prudent use of antibiotics.
Both children and parents were encouraged to become antibiotic guardians and signposted to the e-bug website to try other fun activities. Young children were given the EAAD colouring picture and pencils to take away and we gave older children and adults antibiotic guardian leaflets and promotional pens with which to complete them.


Please list any supporting partners or organisations worked with: Greater Glasgow and Clyde Infection Control Team
Greater Glasgow and Clyde Hand Hygiene Co-ordinator
Scottish Antimicrobial Prescribing Group Public Partners
Greater Glasgow and Clyde Infectious Disease and Microbiology Teams


How has your project demonstrated success in highlighting antibiotic stewardship within your chosen category? Specific outcomes from EAAD promotion were not measured, however the main focus from the day was to raise awareness of antimicrobial stewardship within families as the children we are treating now are the ones that will face the adverse outcomes of antibiotic resistance as adults. As the stand was in the main atrium of the children’s hospital it also attracted attention from hospital staff, which we were able to use to raise the profile of the Antimicrobial Management Team.

Following this, we were able to establish invaluable links with clinicians and engage with them further to develop strategies to improve antibiotic prescribing and management of patients with infections. In particular:
– An invitation to present to a non-medical prescriber study day about antimicrobial   stewardship.
– Engagement with Emergency Department staff to look at front line empiric prescribing.
– Establishing a carbapenem drug use evaluation project in paediatric intensive care.
– Interest for further EAAD activities within the childrens hospital.

Together with positive feedback from parents, children and healthcare staff on the day, this achieved our objective for the day with respect to promoting antimicrobial stewardship and encouraging infection control. It far surpassed our expectations with regard to clinician engagement and the further work that has ensued. All of this can only have a positive impact on safeguarding antibiotics for the future of our children.


Cite 3 examples within the project which highlight promotion of the protection of antibiotics?

1) Encouragement to sign up to become an antibiotic guardian
2) Use of ‘Guide to treat your infection’ endorsed Public Health England, NHS Scotland and other bodies. Advising patients/parents that common ailments are self limiting and when they should consult their GP.
3) Teaching children (and parents!) the importance that good hand hygiene prevents the spread of infection. Good infection control measures reduce antibiotic use.


Key outcomes of project?: Our main desired outcome was to engage families and teach the importance of infection control through fun and spread the word regarding antibiotic resistance.
Other key outcomes were that created invaluable links with other members of the healthcare team and highlighted the importance of antimicrobial stewardship being the responsibility of everyone. We raised the profile of the local AMT, even in simple terms of being able to put names to faces and establish friendly links for people to ask questions. Development of further improvement projects as a result of our EAAD promotion which embeds antimicrobial stewardship into local and national practice.


How is the project to be developed in the future?: We hope to expand on our success, by running further promotional days within the children’s hospital with different fun and interactive activities with the desired aim of recruiting more antibiotic guardians. We have also reported back our success to the Association of Scottish Antimicrobial Pharmacists and have put forward an agenda to educate other children and families within other health boards. Our ultimate goal would be to engage with local councils to see if we could incorporate the importance of antimicrobial stewardship into schools