K. Thattakkat, S. Jayakumar and N. Sharief
Seeks to assess whether referrals for immunisation as day cases are appropriate and to identify any adverse events following hospital‐based immunisation.
Abstract
Purpose
Seeks to assess whether referrals for immunisation as day cases are appropriate and to identify any adverse events following hospital‐based immunisation.
Design/methodology/approach
Computerised consent forms and the ward registers were used to generate a list of children immunised in the day case ward of Basildon University Hospital between 1 January 2003 and 31 December 2003.
Findings
There were 57 referrals for immunisation under medical supervision in the day case ward during the 12‐month period. General practitioners referred 30 cases (53 per cent) followed by eight (14 per cent) referrals each from the Immunisation Coordinator Clinic and health visitors. The commonest reason for referral was previous reaction to vaccine (21 cases, 37 per cent), followed by history of egg allergy (11 cases, 23 per cent). The types of vaccines that were most frequently administered were the MMR first dose (18 cases, 32 per cent) and the second dose of DPT/OPV/HIB/Men C (13 cases, 23 per cent).
Practical implications
A total of 24 (42 per cent) of the referrals were judged to be inappropriate as per the UK Department of Health's guidelines. No adverse events were noticed during hospital‐based immunisation. Definite guidelines exist in the UK for immunisation. However, a large proportion of children who deserved immunisation in the community were referred to the hospital day case unit.
Originality/value
This paper identifies the inappropriateness of hospital‐based immunisation and emphasises the need to create increased awareness regarding the true contraindications to immunisation among healthcare professionals by further education and training. Further, it is expected to stimulate many paediatric departments to look at their own practice and find ways to improve service efficiency and effective use of resources.
Details
Keywords
K. Thattakkat, R. Garr and A. El‐Badri
The paper's purpose is to document a clinical study of children with Henoch‐Schonlein Purpura that facilitated decision‐making with regard to investigations, follow up and timely…
Abstract
Purpose
The paper's purpose is to document a clinical study of children with Henoch‐Schonlein Purpura that facilitated decision‐making with regard to investigations, follow up and timely referral to a nephrologist.
Design/methodology/approach
A retrospective analysis of clinical records of 33 children diagnosed with Henoch‐Schonlein purpura who attended the Whiston Hospital Paediatric unit over a 60‐month period between January 2001 and December 2005 was performed.
Findings
In the study 53 per cent (n 17) of the patients were boys. The commonest age group affected was between five to ten years (n 17), with mean age of 7.2 years (range 1 to 17 years). Of the cases , 71 per cent (n 22) presented between July and December. Four patients (13 per cent) had haematuria on dipstick examination at presentation. Eight patients (25 per cent) had neither blood pressure measurement on admission nor a documented plan for urine dipstick or blood pressure measurement on discharge. Daily urine dipstick was performed in 47 per cent (n 15) patients with one patient having checks twice a week. Information to parents was not documented in 72 per cent (n 23) of case notes.
Practical implications
The need to provide better parental education and support in the form of an information leaflet was identified.
Originality/value
This study highlights the importance of follow up of children with HSP with emphasis on regular urine dipstick examination and measurement of blood pressure even if they remain asymptomatic to ensure that they do not develop long‐term renal impairment.