Root cause analysis underscores the importance of understanding, addressing, and communicating cold chain equipment failures to improve equipment performance

Lennon, Pat; Atuhaire, Brian; Yavari, Shahrzad; Sampath, Vidya; Mvundura, Mercy; Ramanathan, Nithya; Robertson, Joanie

doi:10.1016/j.vaccine.2016.09.068

Cited by 28 publications

(27 citation statements)

References 11 publications

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“…The monitoring of immunobiological conservation is part of ensuring the maintenance of the immunogenic power of these inputs, conferred by the producing laboratory, and must be ensured by means of appropriate structure and procedures, in order to ensure effective results in the practice of immunization (13,14,24).…”

Section: Discussionmentioning

confidence: 99%

“…A study conducted in Zaragoza (Spain) identified that an electrical power system would prevent economic loss for the NIP resulting from the interruption in the cold chain by cutting off the electrical power (8). Besides, the absence of an alternative energy supply source has been associated with exposure of immunobiologicals to temperatures outside the limits (4,24). Therefore, a no-break or a generator is required to compensate the shortcomings of the electrical network (9).…”

Section: Discussionmentioning

confidence: 99%

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Validity of an instrument to evaluate the immunobiological cold chain

Oliveira

Ferreira

et al. 2020

Av. enferm.

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Objective: To develop and to test the validity of content and layout of a multidimensional tool to evaluate maintenance of the cold chain for immunobiological conservation.Method: A methodological study carried out in three steps: integrative review; development of theoretical and logical model for the development of the tool; implementation of the Delphi Technique to test the validity of content and layout. The Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated considering appropriate those values greater than or equal to 75% and 0.4, respectively.Results: The instrument consisted of 7 questions about structure and 20 about process, subdivided into three components: Transportation/Reception (n=3); Storage/Handling (n=13); Supervision/Permanent education (n=4). The CVI value was 87.4%, with values equal to 85.7% and 89% in the structure and process dimensions, respectively. The process components obtained CVI values equal to 88.9, 88.9 and 89.2%, respectively. The CVR was 0.8, with values equal to 0.7 and 0.8 in the structure and process dimensions. As for the layout validation, the questionnaire was considered intelligible.Conclusion: The study provides an instrument with validity of content and layout for health professionals in charge of the supervision of activities of immunobiological conservation, ensuring the maintenance of the immunogenic quality of the products offered to the population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Validity of an instrument to evaluate the immunobiological cold chain

Oliveira

Ferreira

et al. 2020

Av. enferm.

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“…National immunization staff and procurement officers may consider the value of cold chain equipment that is designed to avoid freezing and to operate successfully in areas without reliable access to electricity [20] (Franzel et al). Program managers may find it surprising to know that their investigations of equipment failures can yield valuable and actionable information for technicians, procurement officers, equipment manufacturers, and international partners [22].…”

Section: Logistics Datamentioning

confidence: 99%

Immunization supply chains: Why they matter and how they are changing

Rao

Schreiber

Lee

2017

Vaccine

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“…10,19,20 These findings highlight the need to develop local infrastructures to coordinate resources and ensure accountability. 17,18 Finally, key factors in the effective use of RTMDs include training staff members on device maintenance and data interpretation and developing standard procedures for responding to alarms. Without the underpinning of appropriately trained and resourced cold-chain staff members, RTMD use alone will not be sufficient to ensure that vaccines are stored under the correct conditions to preserve potency.…”

Section: Lessons Learned and Recommendationsmentioning

confidence: 99%

“…10,19,20 These findings highlight the need to develop local infrastructures to coordinate resources and ensure accountability. 17,18…”

Section: Lessons Learned and Recommendationsmentioning

confidence: 99%

Demonstration of the Use of Remote Temperature Monitoring Devices in Vaccine Refrigerators in Haiti

Cavallaro

François²,

Jacques³

et al. 2017

Public Health Rep

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After the 2010 earthquake, Haiti committed to introducing 4 new antigens into its routine immunization schedule, which required improving its cold chain (ie, temperature-controlled supply chain) and increasing vaccine storage capacity by installing new refrigerators. We tested the feasibility of using remote temperature monitoring devices (RTMDs) in Haiti in a sample of vaccine refrigerators fueled by solar panels, propane gas, or electricity. We analyzed data from 16 RTMDs monitoring 24 refrigerators in 15 sites from March through August 2014. Although 5 of the 16 RTMDs exhibited intermittent data gaps, we identified typical temperature patterns consistent with refrigerator door opening and closing, propane depletion, thermostat insufficiency, and overstocking. Actual start-up, annual maintenance, and annual electricity costs for using RTMDs were $686, $179, and $9 per refrigerator, respectively. In Haiti, RTMD use was feasible. RTMDs could be prioritized for use with existing refrigerators with high volumes of vaccines and new refrigerators to certify their functionality before use. Vaccine vial monitors could provide additional useful information about cumulative heat exposure and possible vaccine denaturation.

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Root cause analysis underscores the importance of understanding, addressing, and communicating cold chain equipment failures to improve equipment performance

Abstract: HighlightsEighty-six refrigerators were evaluated for non-performance in Mozambique and Uganda.Communicating equipment failures resulted in actions that addressed failures.Systematic monitoring, failure analysis, and reporting strengthen the cold chain.

Cited by 28 publications

References 11 publications

Validity of an instrument to evaluate the immunobiological cold chain

Validity of an instrument to evaluate the immunobiological cold chain

Immunization supply chains: Why they matter and how they are changing

Demonstration of the Use of Remote Temperature Monitoring Devices in Vaccine Refrigerators in Haiti

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