Presentation on theme: "Performance Improvement Assessment of Services Provided by the Vaccine and International Travel Center Vidyulata Salunkhe MD 1, Ruth Carrico PhD RN 2,"— Presentation transcript:
Performance Improvement Assessment of Services Provided by the Vaccine and International Travel Center Vidyulata Salunkhe MD 1, Ruth Carrico PhD RN 2, Frank Groves MD 1 1 School of Public Health and Information Sciences, 2 School of Medicine, Division of Infectious Diseases, University of Louisville INTRODUCTIONRESULTS REFERENCES Travelers have contributed to the global spread of infectious diseases, including novel and emerging pathogens. To decrease the burden of travel related diseases, CDC recommends that international travelers should seek a pre-travel medical consultation at least 4–6 weeks before traveling. These services are provided by the University of Louisville’s Vaccine and International Travel Center. It provides counseling for food and water safety, recommended vaccinations and prescriptions for Travelers’ Diarrhea and Malaria prophylaxis. The aims of this performance improvement project were to: 1) Ascertain information regarding illness among patients seen in the Vaccine and International Travel Center following their international travel, 2) Identify adherence with recommendations provided to them during pre-travel counseling, 3) Elicit feedback from those patients in order to determine their satisfaction with those pre-travel services. METHODS 69 people traveled to malaria prone area and they were given counseling about mosquito prevention methods and were prescribed malaria prophylaxis medication. 62(89.8%) travelers filled their prescription before leaving for their trip and 57(82.6%) started taking their malaria prophylaxis medication before leaving for trip as recommended by the clinic. 10 travelers experienced side effects such as nausea upon taking malaria medications and 3 discontinued prophylaxis due to side effects. 3(4.34%) travelers reported that they developed malaria during or within 2 weeks after travel. 74 people travelled to diarrhea prone area and were given counseling about eating safe food and drinking safe water and were also prescribed anti bacterial medication to take in case they developed diarrhea. 64 (86.48%) travelers filled their prescription before leaving for trip. 21(28.37%) of travelers developed diarrhea while traveling to diarrhea prone area, 19 started taking medication and 18 completed the prescribed course. 4(7.7%) travelers developed diarrhea while traveling to non-diarrhea prone areas. CONCLUSIONS 1.http://www.cdc.gov/travelhttp://www.cdc.gov/travel A retrospective cohort study was done by obtaining survey responses from 126 travelers during August 2012 to June 2013. To facilitate participation, the survey was administered using three different processes including telephone, email link and paper. Data from 126 travelers were collected regarding their travel exposures and illness acquired during or within 2 weeks after returning from travel. These questions were asked to travelers who had recently used services from the Vaccine and International Travel Center for their international travel. We conclude that there is lack of adherence to counseling recommendations demonstrated by the responses indicating that not all patients fill their prescription and, even if they fill their prescription, they do not all take their medicine as prescribed. Despite pre-travel counseling, people developed travel related illness but at rate lower than that reported by CDC. Although there is a high level of satisfaction with the counseling services provided, there is room for improvement targeting interventions to improve adherence with malaria medication instructions and administration as well as activities aimed at preventing travelers’ diarrhea. Distribution of Diarrhea Cases Among Travelers Distribution of Malaria Cases Among Travelers Adherence To Malaria Prophylaxis Medication Number of travelers Got prescription for malaria prevention from clinic 69 Filled the prescription for malaria prevention before leaving for trip 62 (89.8%) Completed the course of malaria prevention medicine as prescribed 48 (69.5%) Developed malaria3(4.34%) Number of patients traveled to Malaria prone area=69 Received Malaria prophylaxis = 69 Started taking prophylaxis = 57 Developed side effects due to medication=10 Did not complete prophylaxis=1 Did not complete the prophylaxis =3 Developed Malaria =1 Did not filled the prescription= 7 Developed Malaria=1 Completed prophylaxis=7 No side effects due to medication= 47 Filled prescription= 62 Developed Malaria=1 Completed prophylaxis=46 Developed Malaria = 0 82.4% said they were very satisfied with the counseling services provided by the Vaccine and International Travel Center. Reasons given by the travelers who said they were dissatisfied or very dissatisfied were non reimbursement by insurance for service costs, expensive vaccines, and difficulty in getting an appointment. Traveled to Diarrhea prone area= 74 Received prescription for Diarrhea=74 Developed Diarrhea=1 Did not fill prescription=5 Travelled to Non Diarrhea area= 52 Developed Diarrhea=4 Do not know=5 Developed Diarrhea= 0 Total number of Travelers=126 Took prescribed medication for Diarrhea=19 Filled prescriptions=64 Completed entire course of medication=18 Developed Diarrhea=20 Total number of Travelers=96 Number of patients traveled to Non Malaria prone area= 27 Developed Malaria= 0
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