Immunization practices in physicians' offices on the avalon peninsula of Newfoundland

O'Keefe, Catherine (2000) Immunization practices in physicians' offices on the avalon peninsula of Newfoundland. Masters thesis, Memorial University of Newfoundland.

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Abstract

The immunization needs in Newfoundland and Labrador are currently met through a mixed delivery system. Immunization is performed through the Regional Health and Community Services offices, approximately 60% and private practice physicians, approximately 40%. This study assessed immunization practices in private physicians' offices with a focus on storage, handling and documentation compared with National Advisory Committee on Immunization (NACI) Guidelines. One of the key aspects of storage and handling is the maintenance of the cold chain. The cold chain is the process of maintaining vaccine at the optimum temperature from the time it is manufactured until it is administered. Since the inception of the cold chain concept, methods to assess and promote proper vaccine storage and handling have been developed. -- This study has a quasi-experimental, pre and post intervention design. The study group consisted of solo and group private practice physicians who provide childhood immunizations in urban and rural practices on the Avalon Peninsula in the Province of Newfoundland and Labrador. Starting in March 1998, the researcher contacted 37 offices representing 89 physicians to participate in the study. -- The study consisted of an office visit during which information was collected concerning the practice for handling vaccine. This information was collected through a questionnaire, observation of the storage area and documentation of the refrigerator temperature. The intervention included the provision and discussion of National and Provincial guidelines for storage and handling of vaccine. A second visit six to eight months later assessed change in practice post intervention. -- Of the 37 available offices, 27 (73%) participated in the study representing 89 physicians; all offices visited met at least 18 of the 24 guidelines. Vaccine was stored in the body of a refrigerator in 95% of the participating offices, 37% of the offices had a thermometer in the refrigerator, and less than 20% used thermal transport bags. Documenting the refrigerator temperature on a regular basis was only done in one office. Post intervention visits indicated little change In practice. This study has collected baseline data about physicians' practices and has given some data as to what is effective in encouraging physicians to maintain the cold chain.

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