1. Educational Module to Improve Vaccine Storage and Handling in Private Practices Gillian Milne 1, Heather Martin 1, Jo Ann Nelson 1, Julie Boom M.D. 1,2 1 Texas Children’s Hospital 2 Baylor College of Medicine Houston, Texas

2. Background Immunization Project has developed Immunization Action Plan (IAP) Clinic assessment and feedback Standardized education Automated reminder system Development of registry

3. Background Texas Children’s Hospital Integrated Delivery System (TCHIDS) 43 private provider offices 3 health centers 110+ physicians

4. Background IAP Education Focus Educational module for nursing personnel Implementation of standardized materials Storage and handling of vaccines

5. Objective To evaluate the effectiveness of an educational module focusing on improvement of vaccine storage and handling

6. Methods Develop assessment tool (checklist) Project personnel TCH pharmacy Houston Department of Health and Human Services Vaccines for Children Program

7. Storage and Handling Checklist

8. Methods Baseline practice evaluation –43 pediatrician’s offices, 3 health centers Introduction of educational materials –Video: Ice, Champagne and Roses –Storage and handling guidelines Re-evaluation –Thirteen months after introduction of educational materials

9. Results Baseline 21/46  80% Range 50 - 89% Mean 79% Post implementation 36/44  80% Range 71 - 100% Mean 89% (p<0.01)

10. Results Most Improved Areas Personnel knowledge of power outage emergency plan (p<0.01) Correct warning signs on storage units (p<0.01) Temperature log maintenance (p<0.01) Correct temperature range maintenance (p<0.013)

11. Results Areas Needing Improvement Items other than vaccines in units Vaccines out of original containers Open tuberculin test kits not dated No evidence of stock rotation

12. Follow-up Activities to Acknowledge Participants Announcement in monthly newsletter –Practices scoring 100% –Top 3 most improved practices Certificates and cookies for most improved practices

13. Future Plans Reassess practices annually Update guidelines as necessary Serve as resource for all practices Train Health Plan personnel on storage and handling evaluations

14. Conclusions Vaccine storage and handling can be significantly improved through simple interventions In an integrated health care delivery system, such as TCHIDS, it is relatively easy to implement standardized education