Effective general practice: audit and feedback for the primary series of immunisations

General practice immunisation audits do not always match the national rates recorded on the New Zealand (NZ) National Immunisation Register (NIR).

To complete audits at one general practice for infants requiring the primary series of immunisations (6-week, 3-month and 5-month vaccines) over a 12-month period and compare findings with the NIR audit.

A manual and electronic practice management system (PMS) audit were compared with identical NIR audit parameters for completion of the 5-month vaccination from 1 February 2011 to 1 February 2012. All three results were then combined with further sub-audits of the total practice newborn population to produce a multifaceted audit, identifying further eligible patients. The NIR database query tool was used to corroborate data on partially immunised and unimmunised patients identified.

All three initial audits produced different results for vaccinated and eligible patients: NIR 31/36; PMS audit 39/43; manual audit 41/48. The multifaceted audit identified 48 eligible infants. All 48 (100%) started their primary series-95.8% (46 of 48) fully immunised; 4.2% (2 of 48) partially immunised, missing only one injection. None were unimmunised, contrary to initial audits. Lower levels of timeliness of delivery were confirmed for this practice, with 52.1% (25 of 48) immunised on time.

Results show 9.7% higher levels of immunisation than reported by NIR statistics for this practice (95.8% vs 86.1%), above current NZ government and World Health Organization targets. The multifaceted audit produced the best estimate of eligible patients and identified deficiencies in vaccine delivery.