INFLUENZA VACCINE DELIVERY - at Karori Medical Centre Robyn Taylor RN MPHC Nurse Manager - Immunisation Advisory Centre

INFLUENZA VACCINE
    DELIVERY
 at Karori Medical Centre

      Robyn Taylor RN MPHC
          Nurse Manager
       Karori Medical Centre

Staff at KMC:

• 14 General Practitioners
• 8 Practice Nurses
• 12 Administration Staff
• 1 Health Care Assistant

CHAMPION in the practice …
              One of the most
                important
          ingredients for success

    • Ensure ready to go at beginning of the season

    • Ensure all the GPs (and nurses) have had training on
      how to give the flu vaccines

    • Ensure all the GPs know how to record the flu
      vaccine into the immunisation screen so goes to NIR

• Personal mission to ensure as many of our eligible
       population are vaccinated as possible

     • Carries out regular audits / follow-ups to get people in

• Has the confidence to …
     • Approach GPs / Admin / Nurses who are regularly
       missing patients or are making mistakes

• Needs to be approachable

Lead in ….

• Receive the flu kit

• Pre-order the vaccines

• Nurses meet specifically to discuss the logistics of
  how best to deliver the vaccines … how to
  improve on last year

       particularly important this year with
        Zostavax coming in on 1st April 2018

Make patients aware the flu vaccines are available

   • Once flu vaccines arrive …

   • Initial contact is via patient portal

   • Wait on ‘word of mouth’ for a couple of weeks

   • Identify eligible population (including pregnant
     women) who haven’t had the vaccine via the DrInfo
     Audit tool

   • Text / telephone / send letters to unvaccinated
     patients - this is an ongoing task

•   All clinicians recommend the influenza vaccine to
    patients

•   All staff are offered a free influenza vaccine at KMC

•   Opportunistic vaccination is a main focus

•   Use Medtech Appointment Scanner every morning to identify
    eligible patients – ‘FLU’ note put on appointment template

TEAM APPROACH …

Receptionists:
• Ask every patient presenting to reception
  65 years or over if they would like a flu
  vaccine before seeing the doctor or nurse

• Place on the nurse appointment template.
  Every attempt is made for the nurse to give vaccine
  before seeing the doctor to reduce waiting time for the
  patient

• Once season in full swing, reception use Dashboard to
  identify those who have not yet had the vaccine

Nurses:

• Ask every patient if they want a flu vaccine –
  eligible or not, including children

• Always recommend the flu vaccine

• Check the Dashboard for unvaccinated
  patients who are seeing the nurse

DOCTORS …

 • Encourage patients to have vaccine

 • Doctors are gently encouraged to …           the vaccine

 • There is reluctance to give to children –
   understandable due to different doses etc.

Logistics …

 • Ensure there is enough room in the vaccine
   fridges to appropriately store the vaccines

 • Are consent forms ready / pamphlets
   available?

 • Verbal consent is documented from our enrolled
   patients 16 years and older

 • Written consent is obtained from parents/guardians
   for those under 15 years, and casual patients

• Open clinics every week day

• Booked appointments in the nurse evening
  and Saturday clinics

• Visit two rest-homes and a residential facility for
  disabled people. Vaccinate residents and staff

• Visit people in their own home who find it
  difficult to come into KMC

• Offer workplace flu vaccines to organisations in
  Karori … New World, Countdown, Zealandia,
  local school staff

• All new staff at KMC are trained on how to give
  and record influenza vaccines on the NIR.

• Refresher offered to those who may have forgotten
  from last year … (or at least I check if they know)

• All clinicians are given a laminated copy of:

   o the eligible medical conditions for patients …
     particularly for those ‘other’ criteria that are not
     as well known

   o the strains for the current season

   o the age range for the different vaccines

Plastered everywhere …

• Many places around KMC

• Library noticeboard

• Mall noticeboard

• Advertising in the local newspaper

On the back of every clinical door …

Questions