Boddington Nicola L, Simons Hilary, Launders Naomi, Hill David R
University College, London, UK.
Qual Prim Care. 2011;19(6):391-8.
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).
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.
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.
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.
英国公共卫生机构国家旅行健康网络与中心（NaTHNaC）负责在英格兰、威尔士和北爱尔兰（EWNI）指定近3500个黄热病疫苗接种中心（YFVCs）。2005年，NaTHNaC根据《国际卫生条例》（IHR，2005）的授权，为YFVCs制定了注册、培训、临床标准和审核计划。
由于黄热病（YF）流行病学的变化以及接种疫苗后罕见、严重不良事件的风险，黄热病疫苗的接种管理较为复杂。此外，对旅行医学提供者几乎没有正式评估，尤其是在黄热病疫苗接种领域。2004年，在推出其计划之前，NaTHNaC向英格兰所有YFVCs发送了一份问卷，以评估他们的做法。这突出表明需要进行培训并制定标准，以加强疫苗接种的最佳实践以及有关黄热病的知识。
2005年，NaTHNaC为所有YFVCs推出了其计划。预计培训、遵守标准和获取资源将使黄热病疫苗提供者的信心增强，实践更加一致。
2009年，向EWNI所有YFVCs发送了一份问卷，以评估NaTHNaC计划的影响。在参加NaTHNaC培训的受访者中，95.8%的受访者表示培训提高了他们对黄热病疫苗接种的信心。此外，68.5%的中心改变了他们的做法，并且观察到对核心标准的遵守有所改善。
NaTHNaC计划提高了YFVCs的标准，并增强了接种黄热病疫苗的卫生专业人员的信心。尽管尚未对此进行测试，但预计这将转化为为国际旅行者提供更一致、更好的护理。NaTHNaC计划的要素可以成为改善临床标准以及其他国家寻求实施《国际卫生条例》（2005）和改善旅行医学实践的典范。
