Opportunistic immunisation of paediatric inpatients at Rotorua Hospital: audit and discussion
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Published on: July 31, 2021
Rowena Gilbert1, Katharine Wrigley
1Paediatrics, Lakes DHB, Rotorua, New Zealand.
Insights
Hospital audits revealed poor opportunistic immunisation practices for young children. Most inpatient records lacked vaccination status, and few under-immunised children received timely catch-up immunisations, indicating a need for system improvements.
Area of Science:
- Pediatric Health
- Public Health
- Immunisation Practices
Background:
- Opportunistic immunisation offers a chance to update vaccinations in children who present for other healthcare needs.
- Current practices in New Zealand hospitals regarding opportunistic immunisation require evaluation to identify areas for enhancement.
Purpose of the Study:
- To audit the current state of opportunistic immunisation within a New Zealand hospital setting.
- To identify deficiencies in documentation and follow-up for under-immunised children.
- To propose evidence-based recommendations for improving immunisation uptake.
Main Methods:
- A retrospective audit of inpatient notes for 369 children aged 3-23 months over a 6-month period.
- Data collection focused on immunisation status, documentation accuracy, and interventions for under-immunised patients.
- Recommendations were developed through literature review and consultation with local clinicians.
Main Results:
- Immunisation status was documented for 84% of patients, but only 60% were up-to-date.
- Official immunisation records were seldom available during admission.
- Follow-up action was not recorded for 79% of under-immunised children, with only 4% receiving catch-up immunisations.
Conclusions:
- Existing opportunistic immunisation protocols in the audited hospital are suboptimal.
- Implementing routine systems for obtaining immunisation records is crucial.
- Visual reminder systems and enhanced staff training are recommended to improve immunisation rates.
Aim:
To audit current practice around opportunistic immunisation in a New Zealand hospital and make recommendations for improvement.
Methods:
We reviewed inpatient notes for 369 patients aged 3-23 months admitted over a 6-month period in 2007. Data was obtained regarding children's immunisation status, documentation of this and action taken in response to the under-immunised child. Literature review and discussion with local clinicians were used to identify recommendations for future practice.
Results:
84% of patients had their immunisation status documented on admission; only 60% of these were up-to-date with immunisations. Official immunisation records were rarely available. In 79% of patients who were behind with immunisation, no follow-up action was recorded, and only 4% of under-immunised children received catch-up immunisation on the unit.
Conclusions:
Current practice around opportunistic immunisation is poor. A number of measures could be expected to improve this; these include establishing routine systems for obtaining immunisation records, a visual reminder system for immunisation and training more staff in immunisation.
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