The Shoe-Maker’s Son Always Goes Barefoot: Low Application of Vaccines to Public Hospital Workers
<p><span style="line-height: 1.6em;">Although the audit highlighted the control mechanisms immunization plan, it stated that the staff has a very low adherence to the application of vaccines, even though they know they have a higher risk because of their profession. Moreover, while they do respond quickly to requests from hospitals they need better coordination and "should have more resources to improve the quality of service."</span></p> <div> </div>
A report of the Audit of the City of Buenos Aires (AGCBA, for its acronym in Spanish) emphasized the monitoring conducted by the Immunization Program of the Ministry of Health of the City of Buenos Aires on organizing the vaccination centers, cold chains, the existence of disposable material, and patient care, among other issues. These controls are for the agency "a considerable achievement of the program."
The audit’s goal, approved in 2011, was to evaluate the management of the Immunization Program of the Ministry of Health of the City, whose main purpose was the "disease prevention through the management of procurement and distribution of vaccines" to 20 public hospitals and 28 other vaccination centers that rely on community hospitals, health care, and the private sphere. Specifically, the watchdog analyzed the performance they had in 2009 on two of their programs: the Program for guests, aimed at "people who have a disease that expose them to greater risk for infection or high risk patients" and the Extended Biosafety program, which is focused on "staff working in health institutions with a higher risk of exposure" to certain diseases.
The AGCBA noted as strengths of the Immunization Program: the annual controls of the vaccination centers who are the recipients of the vaccines, "the answers without any delay that are provided by the demand of vaccines of the Promotion and Protection of Hospitals Services” and the "actions for promotion and training ". In addition, they also appreciated "the use of performance indicators, systematization, and analysis of information for assessments."
You win some, you lose some
The auditors identified low levels of vaccination in hospitals and noted that "there are difficulties in increasing levels of adherence to the vaccination of health staff." Auditors stated that "the degree of immunizing agents is unknown, since many of the hospitals do not have a system of registration of vaccines received by the staff." In this situation, the watchdog recommended" having a formal instrument for more accurate and uniform requirement "and quoted that they should "incorporate the vaccination card as a requirement for entry into the system and monitoring of the staff’s health".
Furthermore, the watchdog found “errors in consulting planning and coordination between hospitals and the central office" program. The origin of this observation is that "the vaccines that are purchased and distributed in hospitals have lower rates of application." For example, " 20,000 doses of Hepatitis B vaccine is bought, however only 2,647 were granted" regarding " the 9,120 doses of pneumococcal polysaccharide only 4252 were applied ." The latter, at first, "was meant to buy 8,000, but at the request of the hospitals they acquired over 1,120 more." Of the 600 Haemophilus vaccines acquired "only 177 were applied" of which 37.85% were given to people "who do not meet the guidelines recommended by the program." The Immunization Program "requires hospitals to send them (twice a month) a spreadsheet to control the amount of vaccines in stock as well as expiration dates." Although the average overall presentation is of 78.1%, the AGCBA noted that compliance "is uneven" among the various health centers and indicated that they "had lower levels of compliance in the Santojanni and Pirovano Hospitals with 45.8 %."
The report drew attention to the "Promotion and protection services" to each of the hospitals and that "they should be ranked" and should have "more human resources, computer equipment, telephone, fax, and in some cases, an adequate physical space to improve the quality of service."