Ms Jacqui Moustakas1, Dr Erin Vaughan1, Airisse Cortez1
1RPAH – Dialysis, Sydney, Australia
Biography:
Jacqui has been a renal for nurse for over 25years within the Sydney Local Health District. She is currently the Renal Nurse Practitioner of Dialysis at Royal Prince Alfred Hospital. Jacqui became endorsed as an NP in December 2017.
In her role, she assesses renal patients for complications of their disease and treatment and leads the vascular access surveillance program. She develops plans of care in collaboration with patients, their carers, their hospital teams and primary care teams. Jacqui has a keen interest in Vaccination and is a qualified Nurse Immuniser.
Abstract:
BACKGROUND:
Patients receiving maintenance haemodialysis are at increased risk of vaccine-preventable disease due to immune dysfunction, comorbidities and frequent healthcare exposure. Although immunisation is strongly recommended, uptake is often limited by fragmented care and need to attend further appointments. Dialysis units offer an opportunity to embed preventative care within routine treatment. Over a 10-year period, a nurse-led immunisation program was implemented in a metropolitan dialysis unit. The COVID-19 pandemic represented a major intervention point, introducing complex and evolving vaccination schedules.
AIM:
To evaluate vaccination uptake within a nurse-led dialysis immunisation program over 10-years and compare vaccine practices before and after the COVID-19 pandemic.
METHOD:
A retrospective quality audit was conducted in our unit. The audit period was divided into pre-COVID (2019) and post COVID (2020 onward) phases. Vaccines delivered during dialysis sessions included influenza, hepatitis B, COVID-19 (primary and booster doses) and herpes zoster (Shingrix ®). Vaccination data was extracted from electronic medical records and reported descriptively as proportions and percentages.
RESULTS:
Sustained high uptake was achieved for established vaccines over 10-years: Influenza ranged 90-95%, Hepatitis B ranged 85-95%, COVID-19 ranged 60-93% and Herpes Zoster (Shingrix ®) 80%.
Vaccination delivery within dialysis sessions was maintained before and after COVID-19. Patients report high satisfaction with convenience and nursing staff report increased confidence in immunisation delivery.
CONCLUSION:
A nurse-led, dialysis-based immunisation program is a feasible and sustainable strategy to support high vaccination uptake. COVID-19 represented a clear intervention point, increasing complexity but demonstrating the adaptability of embedded preventative care models.