REDUCING MISSED OPPORTUNITIES FOR ELDERLY VACCINATION: AUTHORISED VACCINATORS FOR AGED RESIDENTIAL CARE (ARC) Louise Lewis Immunisation Facilitator

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1 REDUCING MISSED OPPORTUNITIES FOR ELDERLY VACCINATION: AUTHORISED VACCINATORS FOR AGED RESIDENTIAL CARE (ARC) Louise Lewis Immunisation Facilitator

2 Authorised Vaccinators for Aged Residential Care While frailty and cognitive decline abound within nursing homes, progressive organisations practice an enabling model of care focusing on whole person wellness Source: A/Prof Christopher Poulos (Hammond Care)

3 Authorised Vaccinators for Aged Residential Care Maintaining function is a key ingredient to enablement, quality of life and the prevention of the deleterious effects of immobility and inactivity Source: A/Prof Christopher Poulos (Hammond Care)

4 When it comes to maintaining function, its all about functional reserve Source: A/Prof Christopher Poulos (Hammond Care)

5 The impact of vaccine preventable illness on nursing home residents Source: A/Prof Christopher Poulos (Hammond Care)

6 Rationale Studies indicate that a workplace influenza vaccination programme not only reduces illness, absenteeism, diminished employee performance, but also most importantly protects vulnerable patients who are being cared for Ref: NZMJ Vol. 120 The Health and Safety Employment Act and the influenza vaccination of healthcare workers Can workplace vaccination rates in Aged Residential Care (ARC) be improved by introducing Authorised Vaccinators? Can this model be readily extended to provide a comprehensive vaccination service for consumers of ARC?

7 Authorised Vaccinators for Aged Residential Care Assessment; Planning & Education: Inception Infection Prevention and Control Team Expression of Interest and Guest Speaker Nov 2014 The Trail Blazers Facilitation of Registrations IMAC Flexi-Tutorial Nov 2014:CCDHB, HVDHB & ARC

8 Authorised Vaccinators for Aged Residential Care Assessment; Planning & Education: Clinical Assessment process and documentation Emergency Equipment and CPR Re-certification Local Immunisation Programme (LIP) Cold Chain and Cold Chain Accreditation Ongoing clinical coaching and mentoring Member of Health of Older People Forum

9 Authorised Vaccinators for Aged Residential Care Implementation: Clinical Assessment: Clinical Trials Unit Immunisation Champions Influenza 2015 Vaccination Launch Consent Forms; 2015 Flu Resource Pack Modus Operandi Cold Chain Management; Cold Chain Accreditation training

10 2015 CCDHB Immunisation Champions

11 Coverage Rates 2015: ARC Facility A Total Vaccinated Coverage 2015 Coverage 2014 Change Staff % - - Residents % - - No data available from

12 Coverage Rates 2015: ARC Facility B Total Vaccinated Coverage 2015 Coverage 2014 Change Staff % 35% +10% Residents % - - Staff Total In House Own GP Refused HCA RN Ancillary 5-4 Other Total

13 Coverage Rates 2015: ARC Facility C+D Total Vaccinated Coverage 2015 Coverage 2014 Change Staff % 47% +20% Residents % - - Staff Total In House Own GP Refused HCA RN Ancillary Other Total

14 Barriers and Successes Barriers: Misinformation and personal beliefs Negative reaction towards previous vaccinations Rostering of vaccinators on the same shift Concern about vaccination during pregnancy Scared of the needle Not enough vaccines available

15 Barriers and Successes Successes: Larger staff uptake due to RN vaccinator on site Very skilled vaccinator and great documentation Providing options (on site, own GP, pharmacy)

16 Authorised Vaccinators for Aged Residential Care Evaluation: Reporting - ARC Nurse Managers; Infection Prevention and Control Nurse group Influenza communications to ARC Proposed quarterly catch-up after IPCN meeting Include in feedback survey September 2015

17 Authorised Vaccinators for Aged Residential Care Phase 1 (Year 1) Objectives ARC nurses to operate as Authorised Vaccinators administering Influenza (and preferably Boostrix) vaccinations to staff ARC nurses to be able to vaccinate residents against Influenza alongside the GP

18 Authorised Vaccinators for Aged Residential Care Phase 2 (Year 2): Objectives ARC nurses to operate as a fully-fledged comprehensive vaccination service for the benefit of both staff and residents To be able to accurately identify residents who need additional vaccination for Pneumococcal Disease and Shingles Phasing in of pharmaceutical fridges and attaining CCA (2016) More ARC facilities to come on-board and support staff to train as vaccinators

19 How good is good enough? Good enough is taking every opportunity to help people maximise their quality of life throughout the life course, including at older age and in residential care Source: A/Prof Christopher Poulos (Hammond Care) This includes protecting our older population through vaccination

20 Acknowledgements The ARC Nurses who have volunteered to take on this additional responsibility and their managers who have supported them The IPCN Team at CCDHB - both for inviting me to speak at the IPCN/ARC Group Meeting in Nov 2014 and for their support Trish Wells Morris - Facilitator for Nov 2014 IMAC Flexi-Tutorial Helen Hartley Former colleague; co-assessor at the Clinical Trials Unit and co-presenter at the Influenza 2015 launch Vicky Noble Director of Nursing for Primary Care and Integrated Care Andrea McCance Director of Nursing and Midwifery Associate Professor Christopher Poulos (Hammond Care) Source material for some slides, and for inspiring me to do more in this field

21 THANK YOU FOR YOUR ATTENTION! QUESTIONS?

22 How good is good enough?