title: Opportunistic immunisation in the emergency department: a survey of staff knowledge, opinion and practices.
abstract: OBJECTIVE
  The aim of this study was to identify (a) emergency department staff knowledge, opinion and practices in relation to childhood vaccines and opportunistic immunisation in the emergency department and (b) differences between nursing and medical staff knowledge, opinion and self reported practices.
  
  
  METHODS
  A self-administered, cross-sectional survey was offered to a convenience sample of medical and nursing staff (n=86) working in a tertiary paediatric emergency department. Variables of interest were described using frequencies and odds ratios to report differences between medical and nursing staff responses.
  
  
  RESULTS
  An 87% survey response was achieved. The majority of staff agreed that childhood vaccines were safe (96%), effective (99%) and necessary (97%). Less than half (45%) of the staff correctly identified that there is no association between measles, mumps and rubella (MMR) vaccine and autism. Medical staff were more likely than nurses to disagree that giving multiple vaccines overloads the immune system (p<0.01), or that complementary therapies reduced the need for a child to be vaccinated (p<0.006). These knowledge deficits exist despite a reported awareness of immunisation resources. The majority (96%) of those surveyed reported that the Australian Immunisation Handbook was as a useful resource.
  
  
  CONCLUSIONS
  Overall, the majority of staff agreed vaccines are safe, effective and necessary. This study highlighted that staff knowledge deficits and misconceptions about vaccines and vaccine management may be barriers to promoting opportunistic immunisation practices in ED.
authors.affiliation: Royal Children's Hospital, Herston Road, Brisbane, Australia; Centre for Health Practice Innovation, Griffith University, Australia. Electronic address: leanne_philips@health.qld.gov.au.
authors.forename: Leanne
authors.initials: L
authors.lastname: Philips
authors.affiliation: Royal Children's Hospital, Herston Road, Brisbane, Australia; Centre for Health Practice Innovation, Griffith University, Australia; School of Nursing and Midwifery, University of the Sunshine Coast, Australia; University of Queensland, Australia. Electronic address: jyoung4@usc.edu.au.
authors.forename: Jeanine
authors.initials: J
authors.lastname: Young
authors.affiliation: University of Queensland, Australia. Electronic address: lesley.williams@uq.edu.au.
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Williams
authors.affiliation: School of Nursing and Midwifery, University of the Sunshine Coast, Australia. Electronic address: m.cooke@griffith.edu.au.
authors.forename: Marie
authors.initials: M
authors.lastname: Cooke
authors.affiliation: School of Nursing and Midwifery, University of the Sunshine Coast, Australia. Electronic address: c.rickard@griffith.edu.au.
authors.forename: Claire
authors.initials: C
authors.lastname: Rickard
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002648:Child; D002669:Child Welfare; D002983:Clinical Competence / Q000592:standards; D000075202:Contraindications; D003430:Cross-Sectional Studies; D016529:Emergency Nursing / Q000379:methods; D004636:Emergency Service, Hospital; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007114:Immunization / Q000379:methods* / Q000523:psychology; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D011364:Professional Practice / Q000592:standards; D014611:Vaccination / Q000379:methods / Q000523:psychology
keywords: Australia; Emergency service, hospital; Health knowledge, attitudes, practice; Healthy people programs; Immunisation