[Show abstract][Hide abstract] ABSTRACT: The National Travel Health Network and Centre (NaTHNaC) introduced a program of registration, training, standards, and audit for yellow fever vaccination centers (YFVCs) in England, Wales, and Northern Ireland (EWNI) in 2005. Prior to rolling out the program, NaTHNaC surveyed YFVCs in England.
To reassess the practice of YFVCs in 2009, 4 years after the institution of the NaTHNaC program, to identify areas for ongoing support, and to assess the impact of the program.
In 2009, all YFVCs in EWNI were asked to complete a questionnaire on type of practice, administration of travel vaccines, staff training, vaccine storage and patient record keeping, use of travel health information, evaluation of NaTHNaC yellow fever (YF) training, and resource and training needs. Data were analyzed using Microsoft Excel® and STATA 9®.
The questionnaire was completed by 1,438 YFVCs (41.5% of 3,465 YFVCs). Most YFVCs were based in General Practice (87.4%). In nearly all YFVCs (97.0%), nurses advised travelers and administered YF vaccine. An annual median of 50 doses of YF vaccine was given by each YFVC. A total of 96.7% of nurses had received training in travel medicine, often through study days run by vaccine manufacturers. The internet was frequently used for information during travel consultations (84.8%) and NaTHNaC's on-line and telephone advice resources were highly rated. Following YF training, 95.8% of attendees expressed improved confidence regarding YF vaccination issues. There was excellent adherence to vaccination standards: ≥ 94% correctly stored vaccines, recorded refrigerator temperatures, and maintained YF vaccination records.
In the 4 years since institution of the NaTHNaC program for YFVCs, there has been improved adherence to basic standards of immunization practice and increased confidence of health professionals in YF vaccination. The NaTHNaC program could be a model for other national public health bodies, as they establish a program for YF centers.
Journal of Travel Medicine 03/2012; 19(2):84-91. DOI:10.1111/j.1708-8305.2011.00587.x · 1.58 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The National Travel Health Network and Centre (NaTHNaC), a United Kingdom public health body, is responsible for designating nearly 3500 Yellow Fever Vaccination Centres (YFVCs) in England, Wales and Northern Ireland (EWNI). In 2005, NaTHNaC established a programme of registration, training, clinical standards and audit for YFVCs following the mandate of International Health Regulations (IHR, 2005).
Administration of yellow fever (YF) vaccine is complex because of the changing epidemiology of YF and the risk of rare, severe adverse events following vaccination. Additionally, there is little formal assessment of providers of travel medicine, particularly in the area of YF vaccination. In 2004, prior to introducing their programme, NaTHNaC sent a questionnaire to all YFVCs in England to assess their practice. This highlighted a need for training and institution of standards to reinforce best practice in vaccination and knowledge about YF.
In 2005, NaTHNaC introduced its programme for all YFVCs. It was expected that training, adherence to standards and access to resources would lead to increased confidence and consistency of practice by YF vaccine providers.
In 2009, a questionnaire was sent to all YFVCs in EWNI to evaluate the impact of the NaTHNaC programme. Among respondents who attended NaTHNaC training 95.8% of respondents indicated that it improved their confidence about YF vaccination. Furthermore, 68.5% of centres made changes to their practice, and improved adherence to core standards was observed. NEXT STEPS AND LESSONS LEARNED: The NaTHNaC programme has led to improved standards in YFVCs and increased confidence in health professionals who administer the YF vaccine. Although this has not been tested, it is expected that this will translate to more consistent and better care for the international traveller. Elements of the NaTHNaC programme could be a model for improvement of clinical standards and for other countries as they seek to implement IHR (2005) and improve the practice of travel medicine.