AUDIT ON IMMUNISATION IN PRE-TERM BABIES Iglesias N and Persaud J, Pharmacy Department, Sandwell General Hospital SWBH NHS Trust, West Bromwich, UK
Objective: The audit aimed to investigate the proportion of pre-term babies in the neonatal unit who received their immunisation at 2, 3 and 4 months of age whilst still in-patients as recommended by the Department of Health1 .
Methods: 25 neonates between November 2008 and January 2009 were included in the audit. A data collection form was produced which included: Name, DOB, Hospital number, if immunisation was given, dates of administration and in case the immunisation was omitted the main reason for that. All the neonates that were in-patient at the time of immunisation were included in the audit with the exception of those who had infection, immunodeficiency or were on steroids at the time of immunisation.
Results: 25 babies were initially selected for the audit but only 13 met the inclusion criteria. From these 13, 5 babies received the immunisation as scheduled (plus/minus 0-5 days) the other 8 received the immunisation later, between 12-81 days. The 8 babies that received the immunisation later, 3 babies were treated with steroids in a later stage but not at the time that immunisation was due, 3 babies were suspected of NEC (necrotizing enterocolitis) and 2 babies were on CPAP (continuous positive airways pressure).
Conclusion: Only 38 % of the neonates admitted to the neonatal unit were given immunisation at the time recommended by the department of Health1. In general babies with clinical complications were not immunised until their clinical condition improved. There was a delayed immunisation of babies on CPAP until they were off the ventilator. We acknowledge that this audit only included a small number of babies for a short period of time; however, as a result of this audit the neonatal physicians in our hospital are aware of the small proportion of babies vaccinated in the correct time window. We are editing an EXCELL database to remind the doctors when immunisation is required for every patient. A re-audit will be done in the future including more babies over a longer period to investigate if these measures have been successfully implemented.
References: 1. Department of Health. Immunisation against infectious disease 2006. The Green Book. Crown 2007. Available at: www.dh.gov.uk/greenbook