Ardens has a updated the "Childhood Immunisations" template so that it can now be used, not only to capture the correct vaccination codes but also to provide a 'smart' overview page to indicate when the scheduled routine immunisations are due for children aged 10 and under. The template is based on the UK Childhood Immunisation Schedule.


It is important to note that although the template can be used by any user, it has been designed to support the nursing team in administrating childhood immunisations at time of consultation. 


The template can be launched by using the Nursing Procedures template launcher protocol, from the F12 key. For full details on how to set this up, please see this support article 



Alternatively, Open a new consultation and select the Run Template option (alternatively select the option Add > Data Using Template option from outside of a consultation). 


Once launched, the first page of the template will display the overview page. The name of the page will be dependent on the current age of the patient e.g. 8w - <12w, 12w - <16w, 16w - <1y, 1y - 3y4mths, 3y4mths - <5years and 5y  - <10y. 




The 'Scheduled routine immunisations' section of the overview page will display the patient's vaccination status. 


The example below shows a patient at 8 weeks old who has had none of their primary immunisations:





The example below shows a patient at 8 weeks old that has had all of their primary immunisations. 



If a patient has vaccines outstanding, for which they are still eligible to catch up, this will be shown with a red triangle symbol as in the example below:



There will also be a section for Immunisation History. This section will show any previous childhood immunisations given as part of the UK schedule and will be indicated by a green tick: 




Declined and Contraindications Vaccinations


If a patient has declined a vaccine and this has been appropriately coded, this will be indicated within the scheduled routine immunisation section with a blue information symbol. It will display along with other immunisations that are due and have not been declined: 



If a patient has a coded contraindication, this will also show in the scheduled routine immunisation section, indicated by a red information symbol as this is more important to highlight.

 


If a patient has declined AND contraindicated the same vaccination, then the scheduled routine immunisation section will indicate this, together with a red information symbol:



Missing Vaccinations 

If there are missing or incomplete vaccinations, these will be shown. 


For example, if a patient who is still eligible has not had their first 6in1 vaccine but had their 1st MenB and 1st dose of Rotavirus and the patient is still of eligible age, this will be indicated with a red action symbol and green ticks accordingly:



Note - if the patient has missed a previous routine vaccination, and can still catch up within the UK schedule, this will be indicated:  



Where there is a mixed vaccine history, with some previous doses missing, the Schedule routine immunisation section will alert you to this also:



However, if a patient has not had the first course of a vaccine, for example first 6in1, and have contraindications to this vaccine when they are due the second course, the catch-up section will NOT appear. It would not be appropriate to do a catch up vaccine due to the contraindication. When contraindications have been added, this will stop the catch up section from being displayed for any further course of that vaccine. 



For some vaccines, e.g. Rotavirus Immunisation, where a first dose has been missed and they are no longer eligible due to their age, then a second dose should not be given. In this instance the catch up page will NOT be displayed, but the scheduled immunisation section will display a red cross with guidance:



For patients born before 1/8/2017, it is appropriate that they received the 5-in-1 vaccine rather than 6-in-1. When this is the case, the template will check that they have had the appropriate vaccine courses for their age and will display anything which appears to be missing, as in this case a complete course of Hp B containing vaccine.




Important - Status Unclear Page

For 6in1 and MenB three-dose courses, it is important that they are coded with a dose number i.e. “1st 6in1”, rather than “administration of 6in1”.

 

It is also important that combined vaccines are recorded as a combined dose, rather than as several individual ones e.g. "1st MMR" rather than a measles code, a mumps code, and a rubella code.

 

When coding has not been done correctly, the template cannot safely flag that these immunisations have been completed. Therefore, the overview page will be replaced by a Status Unclear page.

 

This will display guidance indicated by a red information symbol that the vaccination status of these vaccines is not clear and will show the vaccines that have not been coded with an episode code and/or a single vaccine code in place of a combined one:

 

Single component code warning:

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Dose number warning:

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It is important to review the coding of these immunisations on the patients record and correct, where appropriate, to the relevant episode codes.


If you require any further assistance on the process above, please contact Ardens support on: support-emis@ardens.org.uk