Amid widespread concerns about Australia’s ailing COVID-19 vaccination rollout, much can be learnt from the “all hands on deck” approaches successfully used in the United Kingdom and United States, according to nursing leaders.
The article below is from Linda Shields, Honorary Professor at the University of Queensland, Dr Julie Stuckey, a Doctor of Nursing Practice and a nurse practitioner who is running her own clinic in Texas, and Judith Hunter, a registered nurse and experienced nurse immuniser working in NHS clinics in the north of England.
Perhaps it could be shared with those attending the newly convened regular meetings of Australia’s national cabinet, “as the Government battles to get its slow and problem-laden vaccine rollout back on course”.
Linda Shields writes:
Australia has done well with COVID-19, with fewer than 1,000 deaths so far, and far fewer cases than most other countries. Nonetheless, cracks are showing in our approach to the rollout of the vaccination programme. Because of our community success in prevention of disease spread, we have, perhaps, some flexibility in time to make sure the rollout is successful.
And while state governments are planning mass rollouts, the Federal Government seems to have really lost its way. At this second stage of the rollout, vaccines are being given by general practitioners (or at least, they are being given in GP surgeries, usually by registered nurses (RNs) employed by the GPs).
GP clinics are busy at the best of times – adding this work is a huge burden on most of them, and some argue that the financial recompense goes nowhere towards meeting the actual costs.
Given widespread concerns about the Federal Government’s planning for vaccine rollout, I thought it would be useful to learn from the experience of colleagues in the United Kingdom and United States, where there have been highly successful mass rollouts of the vaccine.
Thank you to my colleagues, Dr Julie Stuckey and Judith Hunter for sharing their experiences below, describing very successful roll outs, with massive positive response from the public, and minimal adverse reactions.
Julie Stuckey writes:
Here in Texas our goal is to get as many of the 29.8 million residents in a geographic area of 696,200 square km vaccinated quickly as possible.
The vaccine effort has been coordinated through the Texas Health and Human Services and the USA Centers for Disease Control (CDC). The first vaccines were administered to the frontline workers, followed by the elderly and most vulnerable.
The vaccination program is now open to anyone who wishes to have a vaccine. The state has a link where one can sign up and it will notify the resident when and where a vaccine is available for them to receive it. Health departments in 254 counties and countless cities’ health departments are also vaccinating.
We have trained and empowered a large team of care providers of all disciplines: nurses, nurse practitioners, physicians’ assistants, pharmacists, emergency personnel, medical personnel and health care students of all disciplines, to administer the vaccines as well as the technology and administrative experts. Each bring their own unique skills to contribute to the greater C-19 vaccine effort that serves the vast and culturally diverse communities of Texas.
We are creative in our approaches to the access to vaccines by vaccinating in community centres, churches, school gyms, on the numerous university campus, pharmacies, mobile clinics, shopping malls, and parking lots. There are walk-in clinics and drive through clinics.
Texas has new legislation pending which will allow home health nurses and hospice nurses to vaccinate the home bound and their caregivers.
At the end of each day, it is rewarding to see the numbers of friends and family who are getting vaccinated in each area of Texas.
Here are two examples of how clinics are set up.
Bulverde clinic – a rural area of central Texas
Social media, local news, and churches are notified of the vaccination dates and how to sign up.
- People send a text, email or phone call to get the appointment.
- There is a mobile clinic for those drawing up the vaccine.
- People arrive in their cars (and trucks in Texas) at their designated time and are given the documentation and consents for vaccination. Volunteers work as screeners and they help check the pre-screen questions.
- People drive up to the next station where they are vaccinated in their automobile.
- The person drives forward to where documentation is reviewed once again and collected, and they are given the vaccine.
Volunteers give them water and a snack and by this time the required 15-minute post vaccination has passed.
University of Incarnate Word, San Antonio
The university is hosting a vaccine clinic with a host of trained multidisciplinary teams providing the vaccine.
The Director of Health Services on the campus Health Clinic was the driver of the initiative, which is a collaboration with the School of Pharmacy, School of Osteopathic Medicine, Interprofessional Initiatives Committee, the Nursing School, retired medical professionals, the technology department, the marketing department and other faculty and staff. It has been amazing to see so many professional health care providers work collaboratively for a common goal.
The university used their department of marketing to get the information out to the community. Then they used technology to compile the necessary appointment time slots and vaccination documentation. They utilised a large building that had a walk-in entrance and an exit. Stations were set up to check in, get the vaccination, and there was an area for the 15-minute post vaccination wait.
By bringing the individual experiences and expertise of each of the departments to a collective goal, they were able to focus on caring for the university as a whole, and hope to soon be focusing on the education of domestic and foreign students.
Judith Hunter writes:
The clinics in the UK are organised by the NHS and there’s a been a strategic approach through a tiered system to ensure our population receive their vaccines. The elderly and healthcare professionals were first to be vaccinated due to the enormous risks posed to them by COVID-19.
The approach to delivering the vaccine is multi-disciplinary and I’m working alongside RNs, physiotherapists, podiatrists, radiographers, midwives, doctors, pharmacists, medical scientists and medical students, as well as volunteers.
The vaccines are being administered in hospital education centres/converted clinics and at our local football stadium. We’ve trained up healthcare professionals who don’t normally vaccinate to be able to do so – and the interdisciplinary work in the future will be really interesting given the relationships that have developed.
If people can’t access a clinic, a home visit is provided by the GP/District Nursing Team. Local GPs and/or nursing staff are visiting people who live in care/nursing homes to administer vaccines.
It’s a whole team effort with the local police/fire brigade/volunteers working to manage queues.
Our GPs are delivering vaccines alongside the many clinics being run by NHS hospitals – but note, we are not working out of the normal hospital buildings. We are in portable cabins, community pharmacies, halls converted to accommodate vaccinations, churches – anywhere that it’s possible to enter through one door and out another – and follow a route that is one way only. Furniture is cleaned down between people and the whole process takes minutes.
The vaccine programme has to be a whole team effort and embraced by all healthcare professionals, including GPs – it’s essential we work together. It’s a great challenge but really rewarding, and each evening the BBC News programme reports the vaccination uptake for the previous 24 hours alongside other COVID-19 data.
Linda Shields writes:
These examples show how mass vaccinations can be given efficiently and safely, and the methods could easily be employed in Australia.
Add to that the fact that once it was known that the vaccine was coming, an army of Australian registered nurses undertook, at their own expense, the qualifications to become nurse immunisers (meaning they can run clinics independently – something that happens each year for flu vaccinations) and have also done the specific COVID vaccination qualification.
These nurses are ready and waiting to be called into action as soon as governments get their acts together.
The vaccines might be in short supply now, but we need to get everything in place to go to maximum effect when they do hit the fridges.
Further reading from the BMJ, asking Can the success of the NHS vaccination rollout be applied in other areas of healthcare?
See our Croakey archive of stories on vaccination.
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