Travel Clinical Services

Policy

Category: Clinical Services
Subject: Travel Clinical Services
Division: Community Health and Wellness
Policy Number: CA.72.01.200
Effective Date:October 26, 2017

POLICY STATEMENT

Wellington-Dufferin-Guelph Public Health (WDGPH) offers a travel clinic to travellers with the focus of health promotion and disease prevention.  WDGPH professionals will provide specific health advice based on the health risk and the level of tolerance of the traveller.  WDGPH will inform and educate the traveller, and it is the responsibility of the traveller to act upon the information once potential risks are understood.

 At a minimum, travellers will receive information about:

  • Vaccine-preventable illness;
  • Avoidance of insects;
  • Use of chemoprophylactics against malaria;
  • Prevention and treatment of traveller’s diarrhea;
  • Personal behaviour and safety;
  • The importance of obtaining travel and evacuation insurance policies; and
  • Access to medical care during travel.

Individuals and families will be charged a consultation fee and WDGPH list fee for each non publicly-funded vaccine they choose. Group travel clinics can be offered to groups of travellers (10 or more people). The consultation fee will be waived for WDGPH employees, their partner and their children.

Travel advice is not provided over the phone. Callers are encouraged to book an appointment, review notable websites linked to the WDGPH website or book an appointment with their family physician to review their travel health needs.

SCOPE

This policy applies to all WDGPH nurses, receptionists and administrative support assigned to Clinical Services and student nurses working in these programs.

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Procedure:  CA.72.02.200 Travel Clinical Services
Guideline CA.31.04.600 Travel Booking Schedule

CONTACT FOR INQUIRIES

Director, Community Health and Wellness 

APPROVED BY

Director, Community Health and Wellness  


Procedure

Category: Clinical Services
Subject: Travel Clinical Services
Division: Community Health and Wellness 
Procedure Number: CA.72.02.200
Effective Date: April 2, 2013

PROCEDURE

When a traveller contacts Wellington-Dufferin-Guelph Public Health (WDGPH), the Receptionist will:

  • Book an appointment for the traveller and inform them of the consultation fee.  Length of appointment and consultation fee will be based on the current form CHDPTRL(F)5 Traveller Travel Fees. Inform the traveller that immunizations also carry a fee. See Guideline CA.31.04.600 Travel Booking Schedule for details.
  • Ask the traveller to visit www.wdghu.org/travel to complete the form CHDPTRL(F)10 Health History and Travel Itinerary a minimum of two weeks prior to the appointment date.  If the traveller does not have access to a computer, the Program Assistant will offer to mail a copy of the questionnaire to them or make a follow-up appointment with the traveller to complete it over the phone a minimum of two weeks prior to the appointment.
  • Inform the traveller to arrive 15 minutes prior to their appointment time.
  • Advise the traveller that WDGPH accepts cash, credit or debit for their appointment and immunizations.  A fee may be incurred if they do not complete the form CHDPTRL(F)10  Health History and Travel Itinerary two weeks prior to their appointment or do not show up for their appointment as schedule.

Prior to clinic day, the Receptionist/Clinic Clerk/Registration Clerk/ will:

  • Print out a Travax report for each traveller’s itinerary.
  • Prepare each traveller’s file with: the Travax report; a copy of the form CHDPTRL(F)10 Health History and Travel Itinerary; form CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record, and form CHDPTRL(F)5 Traveller Travel Fees.  

On the day of the clinic, the Receptionist/Clinic Clerk/Registration Clerk will:

  • Upon arrival, ask the traveller to complete the CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record form.
  • Coordinate the flow of travellers in the clinic.
  • Assist the Nurse in the case of an anaphylactic reaction as per policy CA.50.01.400 Identification and Treatment of Adverse Vaccine Reactions.
  • Complete clinic stats for Program Manager.
  • Following the traveller’s appointment, collect fees and write receipts.  Book future appointments as needed.  Stamp the International Certificate of Vaccination, as required.
  • Balance the receivables at the end of the clinic and complete Travel Monies Collected form.  Photocopy this form for the Program Manager and send the original to Finance with the money. Money will be locked in the safe until a Director or Manager transports the money to the business office.
  • ​Complete an inventory of the vaccines.  Number of vaccines given will be checked at the end of clinic and re-ordered as per inventory guidelines.

The Nurse will:

  • In conference with the traveller, review and explore the information on the CHDPTRL(F)10 Health History and Travel Itinerary form.  In addition, review style of travel, anticipated travel activities and current immunization status.
  • Review Travax and offer recommendations:

- Regarding immunizations;
- Regarding Malaria Prophylaxis; and
​- About general health traveling (including food and water safety, STI’s and HIV, insect repellent, sunscreen, etc.).

  • Give the traveller a copy of the Travax Report.
  • Give all appropriate fact sheets as related to the needs of the traveller and their type of travel.
  • Provide teaching on the required/recommended vaccines and provide the fact sheets detailing information on these vaccines and other travel precautions, as per Travel Counseling Guidelines (attachment 1) and form CHDPTRL(F)3 Travel Counseling;
  • Indicate on the form Travel Immunization Consent and Vaccine Record CHDPTRL(F)11 which vaccines are recommended.
  • Should the traveller refuse any vaccine, the Nurse will document the traveller’s refusal on the form CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record.
  • Ensure that the traveller has signed the form CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record making sure he/she understands all facts given.
  • Administer the vaccines according to Medical Directive CA.40.01.105 Administration of Vaccine for each travel vaccine and the product monograph regarding injection techniques.
  • Complete and sign form CHDPTRL(F)11Travel Immunization Consent and Vaccine Record recording date, lot number, initials and site.
  • Complete the International Certificate of Vaccination and/or the yellow Ministry of Health and Long-Term Care Immunization Record.
  • Reinforce any possible side effects to observe for and advise traveller to report any serious side effect to WDGPH.
  • Assess need for malaria prophylaxis.
  • Provide a prescription for appropriate prophylaxis by phoning a prescription according to Medical Directive CA.40.01.114 Prescribing, Dispensing, Selling and Administering Pharmaceutical Products to pharmacy of traveller’s choice and give CHDPTRL(FS)18 Malaria – Facts to take with them.
  • Advise the traveller to remain at clinic for 15-20 minutes after vaccine administration (or 30 minutes if receiving Japanese Encephalitis vaccine) in case of reaction.

GROUP APPOINTMENTS:

1. Group travel clinics can be offered as follows:

  • WDGPH staff can attend caller’s site (school, church, etc.) to provide basic teaching about travel vaccines, sun, insect, sand, food and water precautions and then have travellers immunized at the WDGPH Travel Clinic (by appointment).
  • WDGPH can offer small group education at the nearest WDGPH office, Fergus, Orangeville or Guelph and follow group education with immunization for each traveller.
  • WDGPH staff can arrange to provide group education and immunization at their site providing cold chain and safety can be assured. The location should be within 15-20 minutes of the nearest hospital.

2. The coordinator (e.g. school teacher) for group travellers will be sent a package of questionnaires, and health history forms to be completed prior to the arranged clinic day. A copy of fees for travel vaccines will be sent with the package.

3. For group education, the Nurse will:

  • Review Travax and offer recommendations regarding immunizations and regarding Malaria Prophylaxis.
  • Talk about general health travelling (including food and water safety, STIs including HIV, insect repellent, sunscreen, etc.).
  • Give the traveller a Travax report.
  • Give all appropriate fact sheets as related to the needs of the travellers and their type of travel.
  • Provide teaching on the required/recommended vaccines and provide the fact sheets detailing information on these vaccines.

4. In conference with a traveller, the Nurse will:

  • Review and explore the information on the form CHDPTRL(F)10 Health History and Travel Itinerary. In addition, review style of travel, anticipated travel activities and current immunization status.
  • Indicate on the form CHDPTRL(F)11Travel Immunization Consent and Vaccine Record which vaccines are recommended.
  • Document on the form CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record any vaccine(s) traveller refuses.
  • Ensure that the traveller understands all relevant facts prior to signing the form CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record.
  • Administer the vaccines according to Medical Directive CA.40.01.105 Administration of Vaccine and product monograph regarding each travel vaccine and injection techniques.
  • Complete and sign the form CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record recording date, site, lot number, and expiry date for each vaccine given.
  • Complete the Travel Immunization Record and/or the Ministry of Health and Long-Term Care Immunization Record.
  • Reinforce any possible side effects to observe for and advise traveller to report any serious side effect(s) to WDGPH.
  • Assess need for Malaria Prophylaxis for travellers over age 12 years.
  • ​Provide a prescription for appropriate prophylaxis by phoning a prescription to the pharmacy, according to Medical Directive CA.40.01.105 Administration of Vaccine, to pharmacy of traveller’s choice and give fact sheet CHDPTRL(FS)18 Malaria.
  • Advise the traveller to remain at clinic for 15-20 minutes after vaccine administration (or 30 minutes if receiving Japanese Encephalitis or Twinrix vaccine) in case of reaction.
  • Complete the form CHDPTRL(F)3 Travel Counseling.

5. The Receptionist/Clinic Clerk/Registration Clerk will:

  • Book future appointments as needed for more immunizations. There is no clinic fee at return appointments – only the fee for the necessary vaccine(s).
  • Collect fees (cash, credit card or direct debit) and write receipts.
  • Be responsible for stamping the Travel Immunization Record.
  • Balance the receivables at the end of the clinic and complete form CHDPTRL(F)6 Travel Monies Collected to send to the Finance with money and credit/debit receipts. Money will be locked in the safe until a Director or Manager with WDGPH will transport deposit to the business office.
  • Collect completed clinic statistic forms from WDGPH Nurses.

DUPLICATE TRAVEL IMMUNIZATION RECORD:

When a traveller that has been previously assessed and immunized in one of the WDGPH offices calls for a duplicate record of his/her travel immunization:

The Receptionist/Clinic Clerk/Registration Clerk will:

  • Record the request and verify which office the traveller received immunization from.  The Receptionist will record the full name of the traveller, the traveller’s date of birth and an approximate time the traveller received immunization at the clinic.  A telephone contact number for the traveller should also be obtained.  The traveller must be informed that seven days must be allowed for processing this request.
  • Retrieve the traveller’s travel immunization record and give it and a new International Certificate of Vaccination to a Nurse to complete.

The Nurse will:

  • Transcribe the immunizations received at the travel clinic into the immunization record recording: date, vaccine, lot number, dose, site of injection and the name of the clinic where the vaccine was received. The Nurse will also make a note on the record that this record is a duplicate and has been transcribed from the original file. A note should be written in the traveller’s file that a duplicate record has been completed at the traveller’s request.
  • Place the completed record into and seal an envelope with the traveller’s name and date of birth recorded on the outside with a notation “replacement record of travel immunization” and indicates the replacement fee as per current fee schedule.  This envelope will be left with the main reception staff.

When the traveller comes to pick up the record, the replacement fee may be paid by cash, direct debit or VISA and credited to the Travel Clinic.  If the traveller is calling to have the record sent to them a cheque for payment must be received by mail before the record will be created.

 

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Policy:  CA.72.01.200 Travel Clinical Services
Medical Directive CA.40.01.105 Administration of Vaccine
CA.50.01.400 Identification and Treatment of Adverse Vaccine Reactions
Guideline CA.31.04.600 Travel Booking Schedule
CHDPTRL(F)3 Travel Counseling
CHDPTRL(F)5 Traveller Travel Fees
CHDPTRL(F)6 Travel Monies Collected
CHDPTRL(F)10 Health History and Travel Itinerary
CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record
CHDPTRL(F)11 Travel Immunization Consent and Vaccine Record International Certificate of CHDPTRL(FS)18 Malaria – Facts
Travel Monies Collected
International Certificate of Vaccination
Ministry of Health and Long-Term Care Immunization Record
Pharmaceutical Products
Travel Immunization Record

APPROVED BY

Director, Community Health and Wellness