Establishing an opportunistic catch up immunisation service for children attending an acute trust in London

Gandhi, Mihir; McKenna, Stacey; Geraets, A; Bhatt, Rohit; Greenberg, Meidad; Bartley, Angela; Rodger, Alan

doi:10.1136/adc.2010.198515

Cited by 3 publications

(5 citation statements)

References 3 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Potential barriers identified by the paediatric team correlate with the finding of other researchers (Conway, 1999;Walton et al, 2007;Gilbert and Wrigley, 2009) and are largely unfounded. Studies spanning back to the early 1990s have demonstrated that accessing central databases is straightforward, very few children have absolute contraindications to immunisation, and large numbers are amenable to immunisation before discharge (Riley et al, 1991;Bell et al, 1997;Conway, 1999;Henderson et al, 2004;Gandhi et al, 2011). Appointing a dedicated immunisation coordinator sidesteps many of these issues and led to an 83% pre-discharge immunisation rate in one centre (Shingler et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Accurate immunisation documentation is the foundation of any opportunistic immunisation service (Crawford and Buttery, 2008;Shingler et al, 2012) and five UK studies from large urban centres have piloted schemes to improve identification of under-immunised paediatric patients and facilitate catch-up immunisation (McKinlay and Rankin, 1991;Riley et al, 1991;Conway, 1999;Walton et al, 2007;Gandhi et al, 2011). These studies reported under-immunisation status in 13-40% of inpatients, with 3-75% of parents agreeing to catch-up immunisation prior to discharge.…”

Section: Introductionmentioning

confidence: 99%

“…Decades of domestic and international recommendations from bodies such as the World Health Organization (2013; Hutchins et al, 1993), the National Institute of Health and Care Excellence (NICE) (2009), the Health Protection Agency (2012,2013), Public Health England (2014) and the UK Department of Health (2003Health ( , 2004Health ( , 2006 have all advocated the provision of opportunistic immunisations in every clinical setting. A growing body of evidence demonstrates that tertiary paediatric units can play a useful role in identifying under-immunised children and facilitating catch-up immunisations (Ferson, 1990;Bell et al, 1997;Conway, 1999;Walton et al, 2007;Ressler et al, 2008;Blair, 2010;Gandhi et al, 2011;Shingler et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vaccine-preventable disease susceptibility in a British paediatric assessment unit

Allen

Vickerstaff

Collinson

2014

Journal of Infection Prevention

View full text Add to dashboard Cite

Aims: To evaluate practice within a paediatric secondary-care centre before and after introduction of simple interventions to improve identification of under-immunised children and facilitate catch-up immunisations. Methods: The population-based child health database was used to check immunisation status for two cohorts of 200 consecutive admissions before and after routine printing of immunisation histories from the database and raising staff awareness. Vaccine-preventable disease (VPD) susceptibility burdens were calculated for each child. Case notes were assessed for accuracy and documentation of ward-based interventions. Results: Fourteen per cent of all children were under-immunised on admission and 27% of these were more than five years behind schedule. Under-immunised children’s VPD susceptibility burdens ranged from 0–40,858 days and in 59% exceeded 1,000 days. Over one month the paediatric admission unit saw children with a combined VPD susceptibility burden of 1,323 child-years. Positive identification of under-immunised children increased by 40% (95% confidence interval: 12–62, p=0.002) following the introduction of routine database printouts. Conclusion: Children presenting to British secondary care units have large VPD susceptibility burdens. Positive identification of under-immunised children substantially improved after the introduction of routine database printouts, but catch-up immunisation rates did not increase.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vaccine-preventable disease susceptibility in a British paediatric assessment unit

Allen

Vickerstaff

Collinson

2014

Journal of Infection Prevention

View full text Add to dashboard Cite

show abstract

“…Up to 40% of patients presenting to urban centres lack one or more immunisations [1][2][3][4][5] and I was concerned that we may be missing patients who were vulnerable to vaccine-preventable diseases.…”

Section: Recent Outbreaks Of Vaccine-preventable Diseases In England Andmentioning

confidence: 99%

“…[1,4] In every country a proportion of parents may decline immunisation for their children, however, studies consistently demonstrate the existence of a cohort of children who are amenable to immunisation when offered in the clinical setting, but for one reason or another do not actively seek immunisation and are not identified by routine immunisation history-taking. [1][2][3][4][5]9] The use of regional Child Health Information Systems (CHISs) which hold individual immunisation records has been advocated as a means of improving the quality of immunisation histories for decades. [1,5] Several studies in urban paediatric centres have successfully used CHIS-based systems to improve identification of under-immunised patients, [1, 3,-4] however there is no published evidence from more rural areas with higher rates of cover.…”

Section: Introductionmentioning

confidence: 99%

Using routinely collected data to improve immunisation histories

Allen

2013

BMJ Qual Improv Report

View full text Add to dashboard Cite

Immunisation is one of the most effective health interventions in existence yet outbreaks of vaccine-preventable diseases continue to occur in developed countries. High rates of cover are needed to provide adequate herd immunity and there is evidence that a significant proportion of paediatric inpatients are not up to date even in areas with high levels of community cover. A proportion of these children will have parents who consciously declined immunisation, however the remaining children represent a vulnerable cohort whose under-immunisation is not routinely identified.Two-hundred consecutive admissions to rural paediatric assessment unit had their routinely documented vaccination histories checked against their records on the regional Child Health Information System (CHIS). 30 children (15%) were not up to date on the CHIS, yet routine clerking only identified 5 of these children (17%). After introduction of a simple system whereby ward clerks and doctors were taught how to access and print full immunisation histories from the CHIS, a further 200 consecutive admissions were audited. A similar number were not up to date (29/200) but the proportion of children with missing immunisations correctly identified in the clerking documentation increased to 52% (15 children). This is a 35% improvement (95% CI; 12–58%).Access to routinely collected data can significantly improve identification of under-immunised children and contribute towards higher levels of individual and herd-immunity.

show abstract

Immunisation

Bedford¹

2023

The Great Ormond Street Hospital Manual of Children and Young People's Nursing Practices

View full text Add to dashboard Cite

Establishing an opportunistic catch up immunisation service for children attending an acute trust in London

Cited by 3 publications

References 3 publications

Vaccine-preventable disease susceptibility in a British paediatric assessment unit

Vaccine-preventable disease susceptibility in a British paediatric assessment unit

Using routinely collected data to improve immunisation histories

Immunisation

Contact Info

Product

Resources

About