immunisation providers via a telephone advice line. NSWISS is staffed by a ... two years, NSWISS has built its profile w
NSW IMMUNISATION SPECIALIST SERVICE
BIENNIAL REPORT 2015–16 AND 2016–17
CONTENTS 2
OVERVIEW Key highlights Staff
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PERFORMANCE REPORT Drop-in immunisation clinic Specialist Immunisation Clinic Telephone advice line Vaccination for special risk groups Promotional activities
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EDUCATION Education at The Children’s Hospital at Westmead External education
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NETWORKS Adverse Events Following Immunisation Clinical Assessment Network NSW Public Health Immunisation Network The Paediatric Active Enhanced Disease Surveillance
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RESEARCH Safety surveillance – AusVaxSafety Research projects Publications Research students
ALL CHILDREN SHOULD BE GIVEN EVERY OPPORTUNITY TO BE APPROPRIATELY VACCINATED WHILE ATTENDING THE CHILDREN'S HOSPITAL AT WESTMEAD SO THEY ARE PROTECTED AGAINST VACCINE-PREVENTABLE DISEASES.
NSW IMMUNISATION SPECIALIST SERVICE BIENNIAL REPORT 2015–16 AND 2016–17
1. OVERVIEW In September 2015, the NSW Immunisation Specialist Service (NSWISS) was established in partnership with the NSW Ministry of Health (who provided the core funding), the National Centre for Immunisation Research and Surveillance (NCIRS) and the Sydney Children’s Hospitals Network (SCHN). We are located at The Children’s Hospital at Westmead (CHW). The aim of NSWISS is to provide better access to vaccination and to improve immunisation coverage for children with chronic medical conditions, their siblings and parents. These children are most ‘at risk’ from vaccine-preventable diseases and most likely to experience severe disease. In some cases, they require additional vaccines, so it is essential that they are vaccinated on time. In the past, children attending the Hospital could only receive vaccines if these were recommended and prescribed by their treating clinician. This dedicated immunisation service increases the opportunities children and their families are able to receive vaccinations when visiting the hospital. The service also provides a Specialist Immunisation Clinic to review and manage patients who have had an adverse event following immunisation, and give advice to families who have concerns regarding vaccine safety. Families who are outside of the Sydney metropolitan area are offered consultations via a telehealth service. NSWISS also provides clinical advice and support to immunisation providers via a telephone advice line. NSWISS is staffed by a highly experienced cohesive medical and nursing team. The team includes dedicated specialist nurse immunisers, clinical nurse consultants and paediatric medical staff who provide a range of immunisation services, consultation and education.
The four core activities of NSWISS are: • A drop-in opportunistic immunisation clinic • A Specialist Immunisation Clinic • A specialist immunisation telehealth service • A telephone advice line (1800 NSWISS) In addition to these core activities, NSWISS also participates in educational activities both within CHW and externally to update nurses and healthcare providers on recent important changes in the immunisation schedule. NSWISS links clinical service to research activities, is an active contributor to Australia’s active vaccine safety surveillance system (AusVaxSafety), and leads a number of research studies including a national multicentre trial to understand the causes, genetics and outcomes of rare neurological adverse events following immunisation. This service report highlights the activities and achievements of NSWISS since its inception to date: September 2015 to June 2017. In its first two years, NSWISS has built its profile within CHW and with other healthcare providers in NSW and has established good relationships with patients, clinicians and families who attend the Hospital. This has created a strong base for ongoing success and improvements in immunisation coverage, as well provision of highquality technical and clinical support to immunisation providers in NSW.
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Key highlights • The drop-in opportunistic immunisation service has vaccinated over 2000 adults and children since its establishment. • Over 1000 influenza vaccines were administered in 2017, nearly double the number of the previous year. • Over 300 children were seen through the Specialist Immunisation Clinic, including 24 telehealth consultations for rural patients unable to attend in person. • The NSWISS telephone advice line takes an average of 115 calls per month from immunisation providers and the general public.
Staff Medical • Nicholas Wood (Medical head) • Kristine Macartney • Lucy Deng Nursing • Karen Orr, Clinical Nurse Consultant (Clinic manager) • Deidre Brogan, Clinical Nurse Specialist • Rosemary Joyce, Registered Nurse • Lois Leacey, Registered Nurse • Melanie Coorey, Registered Nurse • Kathryn Meredith, Registered Nurse • Gemma Saravanos, Registered Nurse
• A service for needle-phobic and ‘hard-to-vaccinate’ children within CHW has been established.
Administration
• Vaccines administered are now electronically captured in the Hospital’s electronic medical record system.
Past staff members
• Over 200 children who received vaccines participated in AusVaxSafety, Australia’s smartphone-based active safety surveillance system.
• Jody Stephenson, Clinical Nurse Consultant
• Tiffany Cooper
• Ben Smith • Jeannette Comeau • Kath Canning, Clinical Nurse Consultant Medical and nursing staff appointments are fractional. Positions are funded by NSW Ministry of Health and in kind from NCIRS.
Some of the NSWISS team – Back (from left to right): Tiffany Cooper, Rosemary Joyce, Lois Leacey, Deidre Brogan, Kathryn Meredith, Lucy Deng. Front: Nicholas Wood, Melanie Coorey, Gemma Saravanos.
NSW IMMUNISATION SPECIALIST SERVICE BIENNIAL REPORT 2015–16 AND 2016–17
2. PERFORMANCE REPORT Drop-in immunisation clinic The drop-in immunisation clinic opened at The Children’s Hospital at Westmead (CHW) on 1 September 2015. It is prominently located near the patient cafeteria area and operates from 8:30am to 3:30pm Monday to Friday. Clinic hours are extended during influenza vaccination periods to increase accessibility for families. The drop-in immunisation clinic is staffed by registered nurses who specialise in immunisation, under the supervision of the immunisation clinical nurse consultant and in consultation with a specialist paediatrician. Opportunistic immunisation and advice are offered to all outpatients and visitors of the Hospital. The service provides free vaccination for vaccines under the National Immunisation Program, as well as other non-funded vaccines that are available for purchase.
THE NUMBER OF CHILDREN AND FAMILIES USING THE SERVICE HAS ALMOST DOUBLED OVER THE PAST TWO FINANCIAL YEARS Overall drop-in numbers The drop-in immunisation clinic has seen the number of children and families using the service almost double over the past two financial years. In 2016/2017, there were a total of 1317 outpatient encounters compared to 782 in the previous financial year.
Graph 1: Total number of drop-in immunisation clinic encounters by financial year 1400 1200 1000 800 600 400 200 0
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2016/17
Influenza vaccination From April every year, the seasonal influenza vaccine is offered to patients for free in the immunisation clinic. Parents are also able to get their influenza vaccine at the same time (at a small cost if they are not eligible for free vaccination through the National Immunisation Program). Over the past two years, we have seen a steady increase in the number of both children and adults vaccinated for influenza in the clinic. During April to June 2017, 703 children and 455 adults were vaccinated for influenza, compared to 454 children and 342 adults in the whole of 2016.
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703 CHILDREN AND 455 ADULTS WERE VACCINATED FOR INFLUENZA IN THE CLINIC IN 2017 Graph 2: Total number of influenza vaccinations in drop-in clinic by year, for adults and children
Graph 4: Total number of influenza vaccinations in drop-in clinic by year and age group
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