Pre‐ and post‐intervention study examining immunisation rates, documentation, catch‐up delivery and the impact of a dedicated immunisation service at a tertiary paediatric hospital

Abstract

Aim To explore immunisation rates and catch‐up delivery to children admitted to hospital before and after an immunisation service was commenced. Methods This pre‐ and post‐intervention study examined 300 admissions prior to (cohort 1) and 300 following (cohort 2) the introduction of an immunisation service. Immunisation rates, documentation, catch‐up delivery and accuracy of the Australian Immunisation Register (AIR) were examined. Results On admission, 75% (cohort 1) and 89% (cohort 2) were up‐to‐date with immunisations. Immunisation history was documented in the medical record in 78% and requirement for catch‐up documented in 10%. AIR was incorrect in one‐third of cases. By 3 months following discharge, 28% (cohort 1) and 64% (cohort 2) of patients were immunised. Conclusions Children admitted to hospital have lower immunisation rates than the national average. Documentation was poor, opportunities for catch‐up were missed and AIR is error‐prone. Catch‐up rates increased following the introduction of an immunisation service.

Interventions delivered in secondary or tertiary medical care settings to improve routine vaccination uptake in children and young people: a scoping review

“…Includes older children (up to 15–21 years old depending on study)26 27 30 34 35 38 43 45–49 51–53 55 57 58 61–63…”

“…Several studies had assessed baseline vaccination coverage to determine the pool of eligible patients 23–46. For all due/overdue vaccinations, baseline coverage ranged from 44%24 40 to 89%,35 with little difference by setting and lower coverage in older studies. For influenza, baseline coverage was lower, ranging from 25%47 to 50.5% 31…”

“…Two UK studies had combined checking handheld documentation with telephoning the local health authority to check registry data 23 25. Several Australian studies had used the Australian Immunisation Register, a national register that records all vaccines administered and which staff can access remotely 28 32 33 35 41. A New Zealand study had used a similar approach 42…”

Examining prescribing, timeliness and data recording of immunisations onto a national electronic immunisation register for inpatients at a tertiary paediatric hospital

“…A lower proportion of inpatients were up to date with routine immunisations (83%), compared with the overall state immunisation rate of more than 91%. 4 Reasons for this are likely multifactorial 5 and education around false contraindications to vaccination, as well as promoting timeliness with immunisations, could assist. The value of hospital-based pharmacists was demonstrated, with correction of two prescription drug errors.…”

“…2 With almost one out of every two children administrated a vaccine as an inpatient not recorded onto the electronic registry, further targeted education strategies are required, and a dedicated immunisation service can assist. 5 Easily accessible prescribing information for vaccines in immunisation resources could also support prescribers. 4…”