KEYWORDS:
Vaccine storage/handling, private provider, integrated delivery system, educational intervention, standardized guidelines

BACKGROUND:
To ensure a safe and potent supply, it is essential vaccines are stored and handled appropriately. The Immunization Project at Texas Children's Hospital (TCH) in Houston, Texas, has developed an Immunization Action Plan that includes education on vaccine storage/handling. TCH Integrated Delivery System (IDS) is in a unique position to evaluate systems aimed at improving standards of care.

OBJECTIVE(S):
To evaluate the effectiveness of an educational module focusing on improvement of vaccine storage/handling.

METHOD(S):
Project personnel, in conjunction with TCH Pharmacy and Houston Department of Health and Human Services, Vaccines for Children Program, developed a tool for assessing vaccine storage/handling practices (24 questions). Using the tool, project personnel assessed baseline practice at 43 private pediatrician offices and 3 health centers affiliated with TCHIDS. A video on appropriate practice, Ice, Champagne and Roses (California Department of Health, 1996), was then presented to practice representatives who in turn ensured relevant nursing personnel viewed the video. Written guidelines were also distributed. Thirteen months later, practices were re-evaluated using the original assessment tool.

RESULT(S):
Data were entered into Microsoft Excel 97 and analyzed using STATA. Analyses revealed significant improvement after implementation of educational module. Mean overall score increased from 79% to 89% (p<0.01). Significant improvement was also seen in: 1) personnel knowledge of power outage emergency plan (p<0.01), 2) correct warning signs on storage units (p<0.01, p<0.01), 3) temperature log maintenance (p<0.01, p<0.01), and 4) correct temperature range maintenance (p=0.013).

CONCLUSIONS(S):
Implementing an educational module can be an effective way to improve appropriate practice. Within TCHIDS, it is easy to gain access to the practices within the system to introduce standardized changes necessary to bring about significant improvement related to vaccine storage/handling.

LEARNING OBJECTIVES:
Identify strategies to improve vaccine storage/handling practice in private pediatric practices.