Moerland Wendy, Koeman Susan C, van den Hoek Anneke, Warris-Versteegen Anita A, Inspector Health, Overbosch David, Sonder Gerard J B
LCR, National Coordination Center for Travelers Health Advice, Amsterdam, The Netherlands.
J Travel Med. 2006 Nov-Dec;13(6):356-60. doi: 10.1111/j.1708-8305.2006.00071.x.
In 1996, the Dutch National Coordination Center for Travelers' Health Advice (LCR) was established to improve uniformity in health advice to travelers and in the quality of national vaccination centers. In this study, we evaluate the influence of LCR guidelines on the quality of travel clinics in the Netherlands.
In 1997 and 2001, questionnaires regarding implementation of LCR quality criteria were sent to the Dutch travel clinics where most travel advice is given. In 2003, the Health Care Inspectorate surveyed all Dutch yellow fever vaccination centers including those surveyed in 1997 and 2001. The data yielded by all three surveys were included in our assessment.
The response rate was 78, 84, and 100% in 1997, 2001, and 2003, respectively. Between 1997 and 2001, the number of travel clinics with 5,000 visitors or more increased. The LCR quality criteria are widely implemented: of the criteria surveyed in this study, 11/14 (79%) were implemented in more than 80% of the clinics in 2003. Between 1997 and 2003, vaccine management improved (eg, registration of batch numbers and monitoring of refrigerators); in more clinics, physicians were present in case of emergency and advice given by nurses was more often checked daily, but this is still only in 52% of the travel clinics. Although two thirds of the professionals working in travel medicine are nurses, only 55% of them were adequately trained in this specialty.
Between 1997 and 2003, the LCR quality guidelines are widely implemented, but implementation can still be improved. To further improve the quality of travel clinic staff, the LCR recently started certification of basic and refresher courses for physicians and nurses working in travel medicine and now registers those completing such courses.
1996年，荷兰国家旅行者健康咨询协调中心（LCR）成立，旨在提高针对旅行者的健康咨询以及国家疫苗接种中心的服务质量的一致性。在本研究中，我们评估了LCR指南对荷兰旅行诊所质量的影响。
1997年和2001年，向提供大部分旅行咨询服务的荷兰旅行诊所发送了关于LCR质量标准实施情况的问卷。2003年，医疗保健检查局对所有荷兰黄热病疫苗接种中心进行了调查，包括1997年和2001年接受过调查的中心。我们的评估纳入了这三次调查所产生的数据。
1997年、2001年和2003年的回复率分别为78%、84%和100%。1997年至2001年期间，接待游客5000人及以上的旅行诊所数量有所增加。LCR质量标准得到广泛实施：在本研究调查的标准中，2003年超过80%的诊所实施了11/14（79%）项标准。1997年至2003年期间，疫苗管理得到改善（例如，批号登记和冰箱监测）；更多诊所配备了应急医生，护士提供建议的情况也更常每日接受检查，但这一比例仍仅为52%的旅行诊所。尽管从事旅行医学工作的专业人员中有三分之二是护士，但其中只有55%接受过该专业的充分培训。
1997年至2003年期间，LCR质量指南得到广泛实施，但实施情况仍有改进空间。为了进一步提高旅行诊所工作人员的素质，LCR最近开始对从事旅行医学工作的医生和护士的基础课程和进修课程进行认证，并为完成此类课程的人员进行登记。
