Background
Infection remains a significant cause of morbidity and mortality post haematopoietic stem cell transplant (HSCT), despite advances in supportive care. Many studies have shown that the levels of antibodies to vaccine-preventable diseases decline significantly following HSCT if patients are not revaccinated. Therefore, routinely revaccinating patients who have undergone HSCT needs to be standard practice to regain immune competence.
Challenges to immunising HSCT patients include absence of standard care plan, lack of patient awareness, vaccine availability, and lack of knowledge and need for training among health professionals. As such, there are still wide variations in immnuisation practices in post-HSCT patients and deviations from guidelines continue to occur in clinical practice.
Aim
To prepare and implement an evidence-based guideline for vaccination of immunocompromised patients after autologous HSCT, for use by healthcare professionals at oncology day hospital.
To improve quality of vaccination service delivery and prevent vaccine-preventable diseases.
Methods
A narrative literature review was conducted to design clear and effective post-HSCT vaccination guidelines at a private, oncology day hospital. These guidelines were developed to increase knowledge and improve consistency of practice among healthcare professionals. Additionally, a vaccine schedule checklist was developed as a complementary tool to the guidelines. This checklist was a step by step guide to help clinicians and pharmacists oversee the vaccination protocol throughout a whole treatment cycle. This checklist prevented any possible errors from occurring such as missing doses or administering in an incorrect schedule, as well as giving sufficient time to identify stock availability issues.
Results
12 months following the implementation of these guidelines, the record of the checklist tool has shown an achievement of 100% compliance rate in the vaccine treatment post-HSCT patients at this clinic.
Conclusion
This implementation has improved both the quality and quantity of vaccination service delivery at a private oncology day hospital.