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Michelle Falconer

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About Michelle Falconer

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    Runcorn, Cheshire
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  1. This project was completed during August 2008 so there have been organisational changes but I hope you don't mind me sharing, I feel it offers a little insight into how alternative venues for childhood vaccination can be used. For this project, we conducted a pilot immunisation session at a local shopping centre. This venue was selected due to its central location, easy access using public transport and close proximity to the surgery where patients being invited to the immunisation session were registered. The session ran from 9am – 6pm with PCT immunisers and nursery nurses working three hour slots. The immunisation co-ordinator was present throughout the day and a children’s entertainer attended for part of the day. In total, 286 children were invited to the session and 67 attended (24%). 5 children who had not been invited were brought in to the session and immunised as required (Pre school booster or MMR only) on a drop in basis. Children requiring further vaccines to bring them up to date with the current schedule were referred back to their Health Visitor / GP. 68% of children attended the session between the hours of 11am and 4pm and 139 vaccines were administered, of these, 70 were MMR, 58 were pre-school boosters and 11 were pre-school boosters with Hib booster. The total cost for this session was approximately £650. (Immunisers were working within their contracted hours). Although this event was not formally evaluated from a parents perspective, comments from parents attending the pilot session were positive. Children who did not attend for this appointment receive further appointments to attend their GP for outstanding vaccines Following this, a further four sessions were delivered, 2 sessions in the same shopping centre, and two sessions in community clinic buildings. Risk assessments were completed following discussion with the Ambulance Service and Infection Control, vaccine storage and supply issues were addressed, a staffing rota was developed and equipment requested as necessary (e.g. chairs, desks and children’s toys etc) The team for each session consisted of 4 immunisers per 3 hour slot; 2 nursery nurses; Clerical support; the PCT Immunisation Trainer; the PCT Immunisation co-ordinator and a Children’s entertainer To promote the pre-school childhood immunisation programme, postcards with a reminder about ensuring pre-school vaccines were up to date were developed and distributed locally, methods of distribution included the local shop selling school uniforms adding a card to carrier bags when items of school uniform were purchased, local hairdressers displaying cards in waiting areas and the local Library inserting a postcard in all children’s books borrowed. The postcards were also displayed at customer services desks in the shopping centre. Messages used on the card were taken from Department of Health immunisation publications to ensure consistency of information for parents. Parents were invited to attend the appointment by Child Health Computer Services and were allocated to a 1 hour time band during which they could attend. On arrival at the venue, parents were asked for their invite letter and personal child health record (red book). The clerical officer would mark them as attended on the clinic list and the parent was then given a ticket with a number on to ensure children were seen in the order they arrived in. The child’s personal child health record (Red book) and appointment letter were given to the immunisation trainer / immunisation co-ordinator to ensure their correct immunisation history was recorded. The vaccine controller allocated vaccines to immunisers to ensure strict control of storage conditions and stock. Children were immunised following normal consent and pre-vaccination procedures A children’s entertainer was present at all the sessions and children were able to participate in various activities such as Plate spinning and balloon modelling. Approximately 300 children were invited to each of the four sessions (total 1,025) and a total of 398 attended (approx 100 per session), this represented a 39% attendance rate. Children attending were registered with 12 different GP practices in the PCT which demonstrated that parents are willing to travel to alternative venues if they are accessible and convenient. The majority of parents brought their children between 11am – 3pm and a total of 728 vaccines were administered: 339 MMR; 255 Pre-school boosters; 53 Hib/MenC and 81 PCV (Prevenar). There were no adverse events during the sessions. One child felt faint following vaccination and recovered following a biscuit and orange juice. Parents views were very positive: "Really good idea, I am up here anyway doing the shopping so only needed to drop in" "They know there is something wrong when you take them to the Doctors" "Less stressful" "More convenient" "More child friendly" "Excellent way of doing it" Overall Outcome for five immunisation sessions 465 children were brought up to date with their immunisations 867 vaccines were administered: (409 MMR, 324 PSB, 53 Hib/MenC, 81 PCV)