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Delivery of the HINI Vaccination Programme within the Southern Health and Social Care Trust
A reflection
Glynis Henry
Assistant Director of Nursing for workforce Development and Training
Glynis Henry
Assistant Director of Nursing for workforce Development and Training
ContentsContents
Context Background Working structure and arrangements Activity Learning through reflection
ContextContext Late April 2009 – WHO announced emergence of
a novel influenza virus From a health and social care system perspective
spring 2009 was characterised by planning to prepare for a potential pandemic influenza
11th June 2009 the World Health Organisation had announced a move to pandemic alert 6, the intensity of preparedness planning intensified.
Vaccination development was underway
Pandemic Influenza (H1N1) Vaccination Programme Pandemic Influenza (H1N1) Vaccination Programme
1st July 2009 HSS (MD) 28/2009:Vaccine availability, timeframe, licensing, number of doses, storage and presentation, initial priority groups, resources, training, information materials and data collection
14th August 2009 HSS (MD)37/2009Increased clarity re supply, prioritisation and that the seasonal influenza programme would continue as normal
Pandemic Influenza (H1N1) Vaccination ProgrammePandemic Influenza (H1N1) Vaccination Programme 6th October HSS (MD) 44/2009
Covered specific issues including vaccines, supply, distribution, storage, priority groups, Trust arrangements, primary care arrangements, university health service, monitoring uptake and information.
15th October HSS (MD) 47/2009Provision of final details of the programme and Launch date for programme
Pandemic Influenza (H1N1) Vaccination ProgrammePandemic Influenza (H1N1) Vaccination Programme
Further updates followed including HSS (MD)49/2009, HSS (MD)58/2009 24th November which announced phase two of the programme, through to end of the financial year and beyond, HSS (MD) 9/2010.
Structure and arrangementsStructure and arrangements Regional Pandemic Vaccination work-stream
Comprising a number of stakeholders including for example, PHA, BSO, HSCB, DHSSPS HSC Trusts and universities and was multidisciplinary in make up.Met frequently and communication was via a range of modes.
SHSCT pandemic vaccination work-streamIncluded PHA, HSCB and Trust staff. Multidisciplinary initially with a relatively small membership which expanded as information about the programme increased. Meetings scheduled to follow regional meetings.
SHSCT pandemic vaccination work-streamSHSCT pandemic vaccination work-stream
Purpose: Prepare plan to deliver pandemic vaccination programme and deliver that plan
Plan included a number of elements:
Model, supplies of vaccine(s), workforce, training, information and communication, system for data collection, monitoring and reporting
Programme streamsProgramme streams
All pregnant women Those within clinical risk groups 6 months - 65
years Household contacts of immunocompromised
individuals People aged 65 and over in the current seasonal
flu vaccine clinical at risk groups Frontline health and social care workers (extended
to all)
Pandemic Influenza (H1N1) Vaccination ProgrammePandemic Influenza (H1N1) Vaccination Programme
Special schools Inpatients within clinical risk groups with hospital
stay of more than 7 days Egg and constituent allergy vaccination clinic Domiciliary/housebound community (supporting
primary care) Children 6 months – 5 years
The Trust had to ensure arrangements were in place for it deliver vaccination to all these streams
ActivityActivity H1N1 Swine Flu vaccination programme activity: Number of staff vaccinated 3895 (as at 1st January 2010) Number of pregnant women vaccinated 2358 (as at week ending 16th April 2010) Egg and constituent allergy vaccinations 116 dose 1 and 102 dose 2 (as at week ending 16th April 2010) Total number of ‘at risk inpatients’ vaccinated 209 (as at 31st March 2010) Number of Children >6 months and < 5years vaccinated 2669 (week end 12th March 2010)
ActivityActivityPandemic (Swine) Flu Vaccination Programme in Special Schools
23rd October 2009 - SHSCT
SPECIAL SCHOOL No. Eligible No. Immunised Dose 1
No. requiring 2 doses
No. Immunised Dose 2
Lisanally
99
76
20
16
Sperrin View
84
64
30
25
Donard
55
43
24
15
Ceara
95
71
19
14
Rathore
113
94
55
38
Total
446
348
148
108
Activity Activity Patients vaccinated in domiciliary setting Dec 2009/ Jan 2010 Total no. patient vaccinated
Total no. of no access visits
Number of vaccines declined
Number of vaccines deferred
1493 44 141 106 H1N1 flu vaccinations – Nursing home numbers Newry & Mourne 270 Armagh 148 Portadown 64 Dungannon 38 Banbridge 170 Lurgan 164 Total 854
The reflective cycle (Gibbs 1988)
Gibbs reflective cycleGibbs reflective cycle
Description: what happenedFluid dynamic situation
Feeling: what we were thinking and feelingDynamic, changing, trying to keep pace, communication
Evaluation: what was good and badGood-Regional and local groups, team work, support, commitment of staff, training, responsiveness of all involved, expertise of colleagues. Regional group approach to learning the lessons Challenge- Trying to keep everyone informed in a fluid situation
Gibbs reflective cycleGibbs reflective cycleAnalysis: What sense we could make of it
Recognise need to strike the right balance between regional direction and local delivery model. The approach based on prioritisation worked well. Sound decision making at critical points. Support the creative thinking of staff.
Conclusion: what else could we have done
Encouraged more engagement with areas where public health is not as embedded. Continued focus through the ongoing programme
Action plan: If it arose again what would we doFeel better prepared in light of the experience We think the focus on priority groups encouraged uptake and lessened the impact of surge on the acute hospital system
ConclusionConclusion
Don’t judge each day by the harvest you reap, but by the seeds you plant.
(Robert L Stevenson)
A final word:
Thank you, colleagues from Regional Agencies and Education Providers who supported us.
Thanks to the Trust’s Vaccination Group, the vaccinators and to all those staff and managers who contributed and supported this work.
Thank you all for listening.
Glynis Henry