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Regional Epi Meeting – Hepatitis B Vaccine Pilot

Regional Epi Meeting – Hepatitis B Vaccine Pilot. Colandra Holiday, Vic Landa, Whitney Griffith TN Dept. Health – Regional Epi Meeting April 29, 2014. Overview. Purpose: Reduce the incidence of adults that become infected with hepatitis B virus (HBV) Goal:

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Regional Epi Meeting – Hepatitis B Vaccine Pilot

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  1. Regional Epi Meeting –Hepatitis B Vaccine Pilot ColandraHoliday, Vic Landa, Whitney Griffith TN Dept. Health – Regional Epi Meeting April 29, 2014

  2. Overview • Purpose: • Reduce the incidence of adults that become infected with hepatitis B virus (HBV) • Goal: • Achieved through vaccination of high-risk adults… • …seeking STD services in 38 county health department clinics • …incarcerated in select county jails

  3. Participating Sites • STD services in public health clinics • Memphis/Shelby Packer STI Clinic • Upper Cumberland Region (UCR) • East TN Region (ETR) • Northeast Region (NER) • County jails • East TN Region (ETR) • Northeast Region (NER)

  4. East TN Region (ETR) – Jails • 4 initial sites recruited, clinics established (Claiborne, Hamblen, Campbell, Blount) • 2 additional sites identified for future clinics (Sevier & Anderson)

  5. East TN Region (ETR) – Jails Timeframe Oct 2013 – April 2014

  6. East TN Region (ETR) – Jails Timeframe Oct 2013 – April 2014

  7. Northeast Region (NER) – Jails • 5 initial sites recruited, clinics established (Washington, Greene, Johnson City, Hancock, Johnson) • 3 sites recruited, 1st clinic pending (Carter, Unicoi, Hawkins)

  8. Northeast Region (NER) – Jails Timeframe Oct 2013 – March 2014

  9. Northeast Region (NER) – Jails Timeframe Oct 2013 – March 2014

  10. Vaccination* – Jails (ETR/NER) * Doses of monovalent hep B vaccine; for timeframe Sept 2012 – Dec 2013 **Completion rates underrepresented

  11. Accomplishments – Eastern TN • Additional staff dedicated to project • Data collection tools • Risk factor questionnaires, REDCap • Vaccination efforts implemented in… • …most public health clinics across region • …10 county jails across 2 regions, with 4 additional sites pending • Tracking of evaluation metrics required by CDC

  12. Pilot Support – Eastern TN • Public health clinics & county jails • Vaccine inventory • Risk assessment questionnaires • Assisting staff with administrative clinic support • Providing & sending reminder cards • County Jails • Data entry (PTBMIS, REDCap)

  13. Pilot Challenges – Eastern TN • Tracking of Doses Administered • Having access to PTBMIS to view all supported regions from one access point • Not all records are loaded into TWIS from PTBMIS • PTBMIS does not retrieve all data from TWIS

  14. Vaccination – Packer STI Clinic • Experience gained from previous hepatitis B vaccine efforts • Offer of vaccine made part of nurse chart audit • Recognition of nurses with most doses given

  15. Vaccination – Packer STI Clinic • Addition of Fast Track STI services – a unique opportunity • Patients without symptoms or exposure seen by M.A. only • Patients offered urine GC/chlamydia and HIV/RPR • Call back in 7 business days for results from hotline

  16. Vaccination – Packer STI Clinic • Introduction of new program • Designated RN hired to recruit and educate patients • Fast Track patients referred from the M.A. to the hepatitis B nurse • Patients for standard services referred from nurse after exam completed • Hepatitis B nurse enters information into REDCap and provides follow-up calls for subsequent doses.

  17. Vaccination – Packer STI Clinic • Lessons learned • Designated nurse integral to program success • Month prior to program introduction – 8 doses given. Month after inception – 137 doses given. • Compliance with completion of series more than doubled with designated nurse making reminder calls. • Patients seen by the designated nurse rarely refuse vaccination once educated

  18. Vaccination – Packer STI Clinic • Lessons learned (cont.) • Special education efforts help • Vaccine education posters in waiting room and exam rooms • Vaccine information video created and shown in waiting room

  19. Vaccination* – STD Services * Doses of monovalent hep B vaccine; for timeframe Sept 2012 – Dec 2013 **Completion rates underrepresented

  20. Are we reaching our high-risk population?

  21. Population Characteristics*

  22. Population Characteristics*

  23. Population Characteristics*

  24. Population Characteristics*

  25. Population Characteristics*

  26. Reported Risk Factors*

  27. Reported Risk Factors*

  28. Reported Risk Factors*

  29. Questions

  30. Contact Information – Central Office: • Jennifer Ward, MS • Epidemiologist, Viral Hepatitis Team Lead • jennifer.ward@tn.gov • 615-253-8662 • Dana Jackson, BSN • RN, Viral Hepatitis Prevention Coordinator • Dana.jackson@tn.gov • 615-253-1361

  31. Contact Information – Satellite Office: • Whitney Griffith, • RN, Hepatitis B Coordinator • whitney.griffith@tn.gov • 865-549-5277 • Henning “Vic” Landa, MBA • Administrative Service Assistant • vic.landa@tn.gov • 865-549-5282

  32. Contact Information – Memphis: • Colandra Holliday, xxx • RN, Hepatitis B Coordinator • colandra.holiday@shelbycountytn.gov • 901-222-9356 • Donna Freeman, FNP-BC • RN, Nurse Supervisor • Donna.freeman@shelbycountytn.gov • 901-222-9417

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