High rate of inappropriate referrals to specialised day case unit for immunisation

Abstract

PurposeSeeks to assess whether referrals for immunisation as day cases are appropriate and to identify any adverse events following hospital‐based immunisation.Design/methodology/approachComputerised 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.FindingsThere 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 implicationsA 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/valueThis 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.