Abstract
Clinics staffed by nurses were established in community pharmacies to increase access to flu shots. Almost 3000 flu shots were given across 42 clinics in Halifax and the surrounding area. Most recipients (80%) preferred getting their flu shot at the pharmacy-based clinics. The clinics were such a success that expanding the program province-wide is being considered for next year.
Problem Statement:
Influenza remains a serious public health problem, associated with significant morbidity and mortality, especially among those at high risk of influenza-related complications. Annual influenza vaccine remains the most effective strategy for reducing complications, but vaccination rates remain below national targets in many jurisdictions. Increasing access to influenza immunization through community pharmacy—based programs has been shown to enhance immunization rates in high-risk populations. We report our experience with a pilot program of community pharmacy—based clinics in one Nova Scotia District Health Authority.
Practice Innovation:
Each participating pharmacy was responsible for promoting awareness of the clinics and referring high-risk patients, who were identified by screening medication profiles. Registered nursing staff administered all immunizations.
Implementation:
The program was implemented in the fall of 2003, with a total of 42 clinics held within the Capital District Health Authority (CDHA). CDHA Public Health Services supplied vaccines for all clinics and funded nursing staff and supplies at 10 clinics. At the remaining 32 clinics, pharmacies contracted private-agency nurses and covered the cost of supplies. All patients attending clinics were asked to complete a feedback survey and were encouraged to provide additional comments. A total of 2828 adult patients were immunized at the 42 clinics, averaging 67 per clinic. One in five reported not having been previously immunized. Half of the 2828 patients immunized were considered at high risk for influenza-related complications (29% > 65 years, 21% < 65 years), 26% were household contacts of high-risk persons, 12% were health care professionals/first responders, and 12% were non-high-risk persons who chose to pay out of pocket. Eighty percent of those attending the 42 clinics reported that pharmacy-based clinics were their preferred site for receiving immunization. The most frequently cited reasons for this were convenience, less waiting time, not having to make an appointment, and easier parking. Identified opportunities for improvement included holding clinics in an area of the pharmacy that provided more privacy and increasing clinic hours. There were no complaints from local physicians about the pharmacy-based clinics, and many doctors referred patients to them.
Implications for Practice: