Adverse events following immunization: evaluating an enhanced nursing role for PHNs

Maintaining confidence in vaccine safety is critical to successful public health immunization programs. Surveillance and assessment of adverse events following immunization (AEFIs) are important for maintaining vaccine safety. The authors describe the evaluation of an initiative at Fraser Health Authority designed to enhance the role of a communicable disease nurse coordinator (CDNC) in assessing AEFI reports, in collaboration with a designated medical health officer (MHO) as required, and providing recommendations to clients and immunization providers. Previously, only MHOs performed this role. This evaluation project demonstrates this initiative's feasibility and provides a roadmap for health authorities interested in pursuing a similar model. MHOs, public health nurses and public health management expressed satisfaction with the process and the quality of the CDNC's recommendations. There was no statistically significant difference in median turnaround time for AEFI reporting date and date of recommendation, indicating this work is completed in as timely a manner by the CDNC as by the MHO. This role provides opportunity for professional growth, facilitates nursing practice to full scope, enables acquisition of specialized knowledge and provides a platform to share nursing expertise at a provincial level.