Nurses make a difference in immunisation service delivery

Abstract

Objective: The study aimed to determine nurse characteristics associated with childhood immunisation coverage and timeliness in the New Zealand primary care setting. Design: In 2005‑2006 a survey of randomly selected practices and health providers was conducted, with multiple regression analysis to establish significant determinants of coverage and timeliness. The multivariate analysis adjusted for social deprivation, region, practice governance and the age of the children registered at each enrolled practice. Setting: The study was conducted in family practices in two regions in New Zealand, where approximately 66% of the national population reside. Subjects: One hundred and fifteen practice nurses employed in the primary care setting. Main Outcome Measures: Nurse characteristics, knowledge and attitudes associated with immunisation. Results: Immunisations were delivered by 95% of practice nurses. Factors associated with higher practice immunisation coverage and less delay were a lower ratio of nurses to children ‑ in the practice (1:1 to 1:74 (85)1:75 to 1:1290 (30) coverage P=0.04, timeliness P=0.03), nurse comfort with their own immunisation knowledge (Yes (105), No (4) coverage P<0.001, timeliness P=0.01) and their perception of parental apathy (Yes (56) No (53) coverage P=0.01, timeliness P=0.02), or fear (Yes (66) No (43) coverage P=0.01), as a barrier to immunisation. Conclusion: Higher coverage and more timely immunisation delivery is achieved at practices where the nurse to child ratio is lower, where nurses are confident in their immunisation knowledge and are perceptive of parental attitudes which can be barriers to immunisation.