title: Evaluation of travel medicine practice by yellow fever vaccination centers in England, Wales, and Northern Ireland.
abstract: BACKGROUND
  The National Travel Health Network and Centre (NaTHNaC) introduced a program of registration, training, standards, and audit for yellow fever vaccination centers (YFVCs) in England, Wales, and Northern Ireland (EWNI) in 2005. Prior to rolling out the program, NaTHNaC surveyed YFVCs in England.
  
  
  OBJECTIVE
  To reassess the practice of YFVCs in 2009, 4 years after the institution of the NaTHNaC program, to identify areas for ongoing support, and to assess the impact of the program.
  
  
  METHODS
  In 2009, all YFVCs in EWNI were asked to complete a questionnaire on type of practice, administration of travel vaccines, staff training, vaccine storage and patient record keeping, use of travel health information, evaluation of NaTHNaC yellow fever (YF) training, and resource and training needs. Data were analyzed using Microsoft Excel® and STATA 9®.
  
  
  RESULTS
  The questionnaire was completed by 1,438 YFVCs (41.5% of 3,465 YFVCs). Most YFVCs were based in General Practice (87.4%). In nearly all YFVCs (97.0%), nurses advised travelers and administered YF vaccine. An annual median of 50 doses of YF vaccine was given by each YFVC. A total of 96.7% of nurses had received training in travel medicine, often through study days run by vaccine manufacturers. The internet was frequently used for information during travel consultations (84.8%) and NaTHNaC's on-line and telephone advice resources were highly rated. Following YF training, 95.8% of attendees expressed improved confidence regarding YF vaccination issues. There was excellent adherence to vaccination standards: ≥ 94% correctly stored vaccines, recorded refrigerator temperatures, and maintained YF vaccination records.
  
  
  CONCLUSIONS
  In the 4 years since institution of the NaTHNaC program for YFVCs, there has been improved adherence to basic standards of immunization practice and increased confidence of health professionals in YF vaccination. The NaTHNaC program could be a model for other national public health bodies, as they establish a program for YF centers.
authors.affiliation: National Travel Health Network and Centre, University College London Hospitals NHS Foundation Trust, London, England.
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: Mary
authors.initials: M
authors.lastname: Gawthrop
authors.forename: Alexandra
authors.initials: A
authors.lastname: Stillwell
authors.forename: Claire
authors.initials: C
authors.lastname: Wong
authors.forename: John
authors.initials: J
authors.lastname: Mathewson
authors.forename: David R
authors.initials: DR
authors.lastname: Hill
mesh_terms: D004356:Drug Storage / Q000592:standards; D004493:Education; D004650:Employee Performance Appraisal / Q000706:statistics & numerical data; D004739:England; D019983:Guideline Adherence; D055991:Health Records, Personal; D006801:Humans; D017146:Models, Organizational; D020380:Needs Assessment; D010818:Practice Patterns, Physicians' / Q000458:organization & administration / Q000592:standards; D015397:Program Evaluation; D015980:Public Health Practice / Q000592:standards*; D013192:Staff Development / Q000592:standards / Q000706:statistics & numerical data; D014195:Travel; D057236:Travel Medicine / Q000379:methods / Q000706:statistics & numerical data; D014611:Vaccination / Q000379:methods / Q000592:standards; D015004:Yellow Fever / Q000517:prevention & control*; D022341:Yellow Fever Vaccine / Q000592:standards / Q000627:therapeutic use
chemical_list: D022341:Yellow Fever Vaccine