Pre‐ and post‐intervention study examining immunisation rates, documentation, catch‐up delivery and the impact of a dedicated immunisation service at a tertiary paediatric hospital

Author(s):  
Adrian J Tarca ◽  
Gloria TY Lau ◽  
Filomena Mascaro ◽  
Patricia Clifford ◽  
Anita J Campbell ◽  
...  
2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Armiento ◽  
M Hoq ◽  
E Kua ◽  
N Crawford ◽  
K Perrett ◽  
...  

Abstract Introduction 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia nationally in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch up vaccination. We also explored the association between policy motivation, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. Referrals to the Specialist Immunisation Clinic (SIC) were also reviewed. Methods Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led SIC. Vaccine-uptake was measured using the Australian Immunisation Register at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, policy motivation and VH was explored by logistic regression. Results Of 607 children included, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) of parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Fewer children were fully immunised at 7 months if their parents were VH (difference 18%; OR 0.24, CI 0.1-0.54,p<0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). Conclusions The 'No Jab' policies motivated attendance to a tertiary immunisation service but children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised post attendance, compared to baseline. These data will be used to inform a comprehensive evaluation of the impact of the policies, particularly the educational impact from loss of early childhood education.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027945
Author(s):  
Celina Lichtl ◽  
Kayvan Bozorgmehr

ObjectiveMeasuring the effect of introducing a walk-in clinic on ambulatory care sensitive (ACS) hospitalisations among asylum seekers in a large state reception- and registration centre.Design and settingPre–post intervention study using anonymous account data from a university hospital functioning as referral facility for a state reception- and registration centre in the third largest German federal state.ParticipantsWe included all asylum seekers residing in the reception centre and admitted to the referral hospital between 2015 to 2017.InterventionsEstablishment of an interdisciplinary walk-in clinic in the reception centre (02/2016).Main outcome measuresInternational lists for ACS conditions for both adults and children were adapted and used to calculate the prevalence of ACS conditions among the population (primary outcome measure). The impact of the intervention on the outcome was analysed using a segmented Poisson regression to calculate incidence-rate ratios with respective 95% CIs, adjusted for age, sex and admission.ResultsThe prevalence of ACS hospitalisations changed over time, as did the effect of age, sex and quarter of admission. Introducing the walk-in clinic reduced the prevalence of ACS hospitalisations among asylum seekers compared with the period before establishment of the clinic (incidence-rate ratios (IRR)=0.80 (0.65 to 1.00), p=0.054), but the effect was attenuated after adjustment for time trends. The average difference in prevalence of ACS hospitalisations compared with the period before establishment of the clinic, corrected for pre-existing time trends, age and sex of asylum seekers was IRR=1.03 ((0.69 to 1.55), p=0.876).ConclusionsA walk-in clinic in reception centres may be effective to reduce ACS hospitalisations, but our study could not prove evidence for a measurable effect after full adjustment for time trends. Further research, ideally with parallel control groups, is required to establish evidence for the effectiveness of walk-in clinics in reception centres on reducing ACS hospitalisations.


1997 ◽  
Vol 27 (4) ◽  
pp. 199-202 ◽  
Author(s):  
Mubina Agboatwalla ◽  
Dure Samin Akram

A prospective community-based intervention study was conducted in a slum area of Karachi, Pakistan, with the objective of evaluating the impact of health education on the knowledge of mothers. One hundred and fifty households were studied in the intervention and the same in the non-intervention group. The post intervention knowledge scores of the mothers showed a significant difference of P < 0.05. Nearly 50.7% mothers in the intervention group knew of at least four diseases against which vaccination is given as compared to the non-intervention group ( P < 0.05). Similarly, mothers in the intervention group were more aware about the advantages of breast feeding, signs of dehydration, measures for prevention of measles and tuberculosis as compared to the non-intervention group ( P < 0.05). Finally, a comparison was made between the pre- and post-intervention scores between the two groups. The score in the non-intervention group changed from 11.5 to 16.1 ( P > 0.05) as compared to the intervention group in which it changed from 10.2 to 32.2 ( P < 0.05).


Author(s):  
Ameen M. Almohammadi ◽  
Huda M. Al-Dhahri ◽  
Shroug H. Al-Harbi

Aims: There are series of medical errors that can be prevented by taking precautions.             Therefore, the study evaluates the impact of the electronic prescribing system on prescription errors. Study Design:  A pre-post study design was conducted. Place and Duration of Study: The study was conducted at outpatient pharmacy services of a teaching hospital in Jeddah city. Methodology: Prescriptions were evaluated for the presence of the essential prescription elements such as patient information, drug name, dose, frequency, strength, and other prescription completeness parameters. Results: In the pre-intervention study, 1182 handwritten prescriptions were evaluated, and 6627 errors were detected from these prescriptions. The length of the pre-and post-intervention period was two weeks each. The most prevalent prescribing errors were that of medications written without defined dosage forms were recorded 1653 (55.90%) time followed by prescriptions written by trade names 1493 (22.5%), without route of administration 1266 (19.1%), and without specified duration 1009 (15.2%). However, 1512 prescriptions were evaluated in the post-intervention study, among which 339 errors were detected. The errors included prescriptions written without diagnosis (5.09%), or without doctor’s name or stamp (1.52%), written by trade names (4.49%), without defined dosage forms (4.29%), and without specified duration (2.84%). Conclusion: The study concluded that E-prescribing eliminated prescription errors that resulted from handwritten prescriptions.


PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0223122 ◽  
Author(s):  
Alexia Verroken ◽  
Noémie Despas ◽  
Hector Rodriguez-Villalobos ◽  
Pierre-François Laterre

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e033612 ◽  
Author(s):  
Anna Machowska ◽  
Babu Lal Bamboria ◽  
Courtney Bercan ◽  
Megha Sharma

IntroductionPeople living with HIV and AIDS (PLWHA) experience stigma and discrimination throughout their life. The consequences of stigma and discrimination are severe when enacted by healthcare providers (HCPs), and result in a delay in or poor adherence to treatment. Studies have demonstrated the presence of stigmatising behaviours among HCPs, yet only a few have presented the impact of interventions on the knowledge and attitude of practising (clinicians and nurses) and future (students) HCPs.ObjectivesTo evaluate knowledge, attitudes and infection risk perceptions related to HIV/AIDS among practising and future HCPs in central India. In addition, the impact of the ‘HIV-related stigma-reduction workshop’ using a pre-intervention and post-intervention study design was evaluated.Settings and participantsThe study was conducted in 2016 at two tertiary-care hospitals and three healthcare colleges in central India. Overall, 650 HCPs (75 clinicians and 211 nurses) and students (205 medical, 123 nursing and 36 Diploma in Medical and Laboratory Technology (DMLT)) voluntarily participated in the study.InterventionThe educational intervention comprised of training in epidemiology, the transmission and treatment of the HIV infection, the rights of PLWHA, the duties of HCPs and the use of standard precautions.ResultsAt pre-intervention, DMLT students had the lowest and clinicians the highest knowledge scores (24% and 45%, respectively). The stigmatised attitude was reflected in all groups, the lowest among clinicians (21%) and the highest among DMLT students (34%). Improvement in the post-intervention knowledge scores was the highest in medical students (36%) and the lowest among clinicians (16%). The participants’ attitudes improved between 3% and 17% across all groups.ConclusionsSignificant post-intervention improvements were seen in both knowledge and attitudes in all groups. Students had a higher tendency to improve than HCPs. Further long-term studies are needed to evaluate the sustainability of the improvements in knowledge and attitudes of the participants.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S351-S351
Author(s):  
Mikaela Brown ◽  
Joy Uzoma ◽  
Ryan P VanSice ◽  
Kelly M Conn ◽  
Allison Ramsey ◽  
...  

Abstract Background Despite the negative implications associated with a penicillin (PCN) allergy label, less than 0.1% of ~25 million subjects with PCN allergy undergo a PCN skin testing (PST). There is a lack of data assessing patient knowledge and attitude about PCN allergy and PST. The purpose of this study was to evaluate the impact of an educational brochure on knowledge and perception of PST in adult inpatients with a PCN allergy label. Methods This was a pre-post intervention study conducted at a 528-bed community teaching hospital between June 2016 and March 2019. An electronic medical record was used to identify adult inpatients with an active PCN allergy. Participants completed a pre-brochure survey to assess demographic characteristics and baseline knowledge of PCN allergy and PST. Individuals then read an educational brochure, returned it to study personnel and were provided a post-brochure survey to complete. The primary and secondary outcomes of knowledge and perception were measured based on the level of agreement with statements about PCN allergies and PST using a 5-point Likert scale. McNemar’s test was used to compare responses for those who agreed vs. did not agree to knowledge statements. Results Among 125 patients approached, 101 completed the survey (80.8%). Patients were predominantly female (66.3%), >65 years of age (42.6%), Caucasian (78.2%) and completed high school or beyond (81.2%). The minority of patients (40.6%) previously heard about PST while 25.7% agreed they had previous discussions about PST with a healthcare provider. Only 24.8% agreed that people can outgrow a PCN allergy at baseline; however, after reading the brochure, this percent tripled (77.2%) (P < 0.01). Among 56 participants who disagreed that PST would be helpful for them at baseline, 30 subsequently agreed with this statement on the post-brochure survey (P < 0.001). Post-brochure, 86.1% indicated they felt better informed about PST. Despite this, 34.7% indicated they would be scared to use PCN again if future PST results were negative. Conclusion An educational brochure improved general knowledge of PCN allergy and PST, including subject report of feeling more informed. Although the brochure successfully educated patients, gaps remain regarding how individuals will personally apply this new information. Disclosures All authors: No reported disclosures.


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