# Presentation: 241312

## Lessons learned from Cherokee, NC	

- Doris Bonilla, RN, BSN, MS, MPH

## Cherokee, NC

- Cherokee is the number one tourist destination in western North Carolina
- 14,061 tribal members
- Cherokee Indian Hospital was built specifically for the Eastern Band of Cherokee Indians
- Twenty bed hospital
- Hospital offers holistic care including adult and pediatric dentistry

## MISSIONCherokee Indian Hospital

- To continuously improve the status of the Eastern Band of the Cherokee Nation through a comprehensive health care system sensitive to the culture and values of the community

## HX of Employee Health

- Newly transferred from Ely, NV (Phoenix Area) 7/4/99 to direct Community Health Department
- Employee Health essentially non-existent
- Data totally unacceptable
- JCAHO was expected
- Urgent Employee Health be set up immediately

## Steps for Employee Health Initial Setup:  A Major Challenge

- We use RPMS to record Employee Health data, including immunizations
- Use employee telephone list to develop list for Employee Health each year
- Create Employee Health Template in QMAN
- This allows you to be able to look up this group and do searches for those who received flu vaccine, etc.
- Conduct Annual chart review for each employee to identify immunization/PPD needs

## Flu Education and Clinics

- Educational sessions re: influenza at Staff Forum meetings
- Flu clinics scheduled for several days of the week over many weeks, at different times of day
- Total number of HCP ~250
- Total number of clinics held 2007-2008: 25
- Percent of HCP vaccinated 2007-2008: 80%+

## Flu Clinic Set Up

- Generate a list of all employees using QMAN; cross reference with list of those who have received flu vaccine to track down the stragglers
- Consent forms – we developed a form that includes the screening for flu vaccine and also serves as a declination form. If employee refuses flu vaccine, must sign a declination and indicate reason for refusal

## Influenza Vaccine Consent 2008-2009 Form

## Flu Clinic, cont.

- Have “shooters” and “scribes”
- Use PCC Group Forms to record employees who receive flu vaccine for later RPMS data entry
- Enter all flu vaccines given elsewhere into RPMS as Historical

## Flu Clinic, cont.

- If available, use an overhead paging system to invite employees to come to the clinic
- Announce when there is no waiting period and no line to keep your clinic moving
- For the slackers, make a “last call” before the last 30 minutes of clinic

## Tips for Securing Additional Staff

- If you have pharmacist(s) on site, this is a great resource for you.  With their educational background, you can quickly teach them how to administer vaccines for you.  The Commissioned Corps pharmacists are very eager to learn as they earn ribbons for this skill.
- For supplies, as a cost-reduction factor, start with expired saline IV bags, demonstrate to the pharmacist how to draw up .5cc in a syringe.  Inject the syringe into an orange.  Repeat many times. Check their measurement of .5cc. Then show how to pull back on syringe checking that you have not entered a blood vessel.   If you have, blood will be visible in the barrel of the syringe.  Withdraw the syringe and move to another site.  The pharmacist can be great help during a pandemic.