25 April 2012
YFVC Self Audit
From 1st April 2012, NaTHNaC requires all YFVCs to complete an online Self Audit at least once every two years, although NaTHNaC recommends that Self Audit of practice is carried out annually.
The Self Audit Instrument (SAI) has been developed to help all YFVCs ensure their centre is working within a clinical governance framework, necessary for the provision of a safe and effective service (see Code of Practice). The audit is split into two sections:
- Section 1 - Use and storage of vaccine,
- Section 2 - Administration of yellow fever (YF) vaccine and record keeping.
The SAI should be completed by the designated physician or a nominated member of the clinical staff who is responsible for the administration of YF vaccine within the YFVC, e.g. lead nurse or pharmacist.
Completion may be more easily facilitated by first completing the YFVC self-assessment checklist. This can be accessed on the NaTHNaC website.
A YFVC should be able to complete sections 1 & 2 of the SAI in approximately 10 to 15 minutes. During the Self Audit, reference will be made to the following:
• management of the cold chain
• anaphylaxis and cardiopulmonary resuscitation
• managing critical incidents
• disposal of vaccines and sharps
• evidence that demonstrates that YF vaccine is administered appropriately
• staff training records
The SAI can be accessed at http://www.surveygizmo.com/s3/826645/NaTHNaC-Self-Audit-2012
Feedback and guidance will be given on less than ideal answers. A YFVC will be expected to review their policies and procedures as appropriate and refer to the relevant NaTHNaC guidance.
NaTHNaC will monitor that all YFVCs are up to date with their audit requirements on a regular basis. All Audit results will be stored on a secure database which NaTHNaC will be able to access for future reference in case of any possible breach of the ‘Code of Practice’ as signed by the YFVC on becoming a YFVC and on renewal.. Failure to comply with the requirement to undertake the Self Audit will initiate the de-designation process.