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September 2018

RCN to launch ‘Best Practice’ guideline for childhood immunisations



The RCN’s General Practice Nurse Forum has produced new ‘Best Practice’ guidelines for the management of childhood immunisation clinics, due to be launched next month.

GPN Forum chair Marie Therese Massey writes: Immunisation programmes in the UK are one of the most successful public health strategies that are delivered by General Practice Nurses. The current UK childhood immunisation programme has increasingly become more complex over the past decade. Children are now scheduled to receive between 18 and 20 immunisations before their 18th birthday.

While there is a wealth of resources and guidelines to support the safe delivery and administration of vaccinations, to date there is no specific guidance that addresses the safe setting up and running of clinics in general practice, where the majority of immunisations are administered.

Evidence from the National Patient Safety Agency has shown that immunisation-related errors form the largest part of Serious Adverse Events in general practice. After surveying our Forum members, we found a lack of consistency in the way immunisation clinics are operated nationally with some GPNs allocated as little as 10 minutes to administer immunisations in a challenging environment.

One GPN commented: ‘Ten minute appointments are ridiculous – we need double appointments for sure.’

Another said: ‘I have 16 years’ experience but I think it is unsafe to prepare, give, talk and administer four vaccines in 15 minutes.’

Immunisation errors can be influenced in a number of ways. Some of the most common include insufficient appointment time allocated for vaccinations, leading to difficulties in gathering all the information required. This is particularly relevant when the records of child are not up to date, inaccurate, unclear, or unavailable, or when dealing with groups who have limited language skills. The other main factor is confusion between siblings: this, as well as coping with having the whole family present during appointments, can result in the wrong child being vaccinated. Just to add to the mix we have to contend with vaccines with similar sounding names and packaging all adding to the stress of the consultation.

Since starting the GPN Forum Facebook page, questions around the safe administration on ‘imms and vaccs’ has been a common theme, demonstrating the need for easily accessible and concise information being readily to hand for GPNs. The Forum recognised a gap in the current guidelines and we hope we have provided a useful and clear resource to support our members in this carrying out this vital public health service.

This resource, which will be in the form of a pocket guide and downloadable poster, aims to provide a practical checklist to support the General Practice Nurse in setting up and managing safe and effective childhood vaccine and immunisation clinics in their Practice. The poster will be available from October at https://www.rcn.org.uk/get-involved/forums/general-practice-nursing-forum, and from RCN Publications https://www.rcn.org.uk/professional-development/publications