title: Quality improvement in travel medicine: a programme for yellow fever vaccination centres in England, Wales and Northern Ireland.
abstract: BACKGROUND
  The National Travel Health Network and Centre (NaTHNaC), a United Kingdom public health body, is responsible for designating nearly 3500 Yellow Fever Vaccination Centres (YFVCs) in England, Wales and Northern Ireland (EWNI). In 2005, NaTHNaC established a programme of registration, training, clinical standards and audit for YFVCs following the mandate of International Health Regulations (IHR, 2005).
  
  
  METHODS
  Administration of yellow fever (YF) vaccine is complex because of the changing epidemiology of YF and the risk of rare, severe adverse events following vaccination. Additionally, there is little formal assessment of providers of travel medicine, particularly in the area of YF vaccination. In 2004, prior to introducing their programme, NaTHNaC sent a questionnaire to all YFVCs in England to assess their practice. This highlighted a need for training and institution of standards to reinforce best practice in vaccination and knowledge about YF.
  
  
  METHODS
  In 2005, NaTHNaC introduced its programme for all YFVCs. It was expected that training, adherence to standards and access to resources would lead to increased confidence and consistency of practice by YF vaccine providers.
  
  
  RESULTS
  In 2009, a questionnaire was sent to all YFVCs in EWNI to evaluate the impact of the NaTHNaC programme. Among respondents who attended NaTHNaC training 95.8% of respondents indicated that it improved their confidence about YF vaccination. Furthermore, 68.5% of centres made changes to their practice, and improved adherence to core standards was observed. NEXT STEPS AND LESSONS LEARNED: The NaTHNaC programme has led to improved standards in YFVCs and increased confidence in health professionals who administer the YF vaccine. Although this has not been tested, it is expected that this will translate to more consistent and better care for the international traveller. Elements of the NaTHNaC programme could be a model for improvement of clinical standards and for other countries as they seek to implement IHR (2005) and improve the practice of travel medicine.
authors.affiliation: University College, London, UK.
authors.forename: Nicola L
authors.initials: NL
authors.lastname: Boddington
authors.forename: Hilary
authors.initials: H
authors.lastname: Simons
authors.forename: Naomi
authors.initials: N
authors.lastname: Launders
authors.forename: David R
authors.initials: DR
authors.lastname: Hill
mesh_terms: D004356:Drug Storage; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration* / Q000592:standards; D007318:Inservice Training / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration*; D057236:Travel Medicine; D006113:United Kingdom; D022341:Yellow Fever Vaccine / Q000008:administration & dosage*
chemical_list: D022341:Yellow Fever Vaccine