Information

What is a Travel Clinic?

  • A Travel Clinic provides up to date, accurate information of the health and safety aspects of specific destinations, to travelers.
  • By applying specific interventions, it ensures that the traveler remains healthy during his travels and returns home healthy.

Type of Travel Clinic

  • Dedicated travel clinic
  • Part of GP practice
  • Pharmacy provided there is medical supervision by a travel medicine qualified doctor
  • Integrated immunisation service
  • Occupational health clinic i.e corporate health

Type of Service

  • Pre travel screening and advisory service only
  • Pre, intra- and post travel screening, treatment & advisory service

Staffing structure

  • Depending on the nature of the clinic & service provided:
  • Doctor only
  • Sister run under travel medicine doctor supervision
  • Pharmacist run under travel medicine doctor supervision
  • Dedicated receptionist
  • Bookeeper
  • Cleaner

Premises

  • Is there a need in the area?
  • Yellow fever licenses are granted in areas of need only
  • one or two consulting rooms depending on usage & need of the area
  • Reception area may be shared by other health care professionals
  • Kitchen area is important & vaccine fridge may not be used for milk
  • Visible to the public, passing trade & for referrals & appointments
  • Easily accessible e.g. parking available

Yellow Fever License Requirements

  • A licence can only be obtained from the Department Of Health (DoH) & is issued in accordance with the International Health Regulations Act No 28 of 1974
  • Enroll for the Travel Medicine Course or any other recognised Travel Medicine qualification
  • Enroll for a dispensing course to dispense malaria medication and treatment
  • Apply for Section 38A for nursing staff through the DoH.

Equipment - general

  • Telephone with extensions
  • Credit card machine
  • Desks and chairs
  • Filing cabinet
  • Examination couch
  • Computer (INTERNET ACCESS IS ESSENTIAL)
  • Fridge with freezer
  • Fridge thermometer

Emergency Equipment

  • Portable oxygen
  • Ambu bag and airways
  • Emergency drugs
  • - Adrenaline 1:1000 ampoules - Solu-cortef vials - Phenegan ampoules
  • I.V .equipment
  • Accessible emergency numbers

Health , Safety and Environment

  • Work area well ventilated, clean and neat
  • Medical waste disposed of according to protocols & standards
  • Protocols for staff developed i.e needle stick injury
  • Legal requirements fulfilled in terms of Occupational Health & Safety Act.

Supplies

  • Vaccines
  • Medicines
  • Pill containers (if dispensing)
  • Syringes &needles
  • Swabs
  • Sharps containers
  • Travel kits
  • Repellents containing DEET
  • Nets etc.
  • Stationery
  • Vaccination cards
  • Patient medical & travel forms
  • Patient information leaflets & teaching aids.

Suppliers

  • Reputable and reliable
  • Correct transportation and storage - cold chain
  • Prompt delivery
  • Credit facilities
  • Continuation of supply
  • Notification of shortages

Storage of Medicines/Vaccines

  • Medicines in cool, dry place under lock
  • Pill counter
  • Printed containers/pill packets
  • All package inserts available
  • Vaccines refrigerated (2-8 degrees)
  • Temperature measured and recorded daily
  • Stored in centre of fridge (not doors)
  • Rotate stock regularly placing short dated stock in front
  • Record batch number and expiry dates

Training

  • Counselling techniques
  • Emergency procedures
  • Telephone answering techniques & triage
  • Basic IT including Word & Excel
  • Regular medical & travel medicine updates

Counselling

  • Patient to complete comprehensive form including destination, length of travel and a full medical history.
  • Utilise a dedicated data base with listed health risks worldwide or access to WHO/CDC websites.
  • Staff trained in consulting & counselling procedures
  • Maps / Atlas used to indicate areas of high risk & ensure staff & patients familiar with areas visited
  • Product knowledge including indications, contra-indications & adverse reactions
  • Information brochures used as detail aids

Administering Vaccines

  • Ensure protocols & procedures available for staff regarding all vaccines
  • Explain procedure to patient
  • Awareness of fear
  • Patient to sit or lie as vaso-vagal reaction may occur often as a result of fear
  • Observe patient 20-30 minutes
  • Ensure correct route is used as efficacy of vaccine may be compromised

Accounting

  • Computerised accounting system
  • Include Nappi codes/ICD10 codes for medical aid claims on the statement
  • Decide between cash only or accounts/medical aid
  • Stock control done regularly to minimize stock loss

Patient Records

  • Must be retained for 10yrs (travel), 40 yrs (occupational health)
  • Accurate recording by staff, particularly phone calls
  • Accessible to staff but kept in lockable cabinet
  • Confidential
  • Name, age, destination and full medical history
  • Vaccines dispensed and batch numbers
  • Medication given with dosage and quantity
  • Adverse reactions clearly recorded
  • All follow up calls noted

Vaccination Cards

  • International Certificate of Vaccination Cards must be used for all Yellow Fever vaccinations.
  • For other vaccinations various other cards issued by pharmaceutical companies or your own designed card may be used.

International Certificate of Vaccination (Yellow Card)

  • Supplied by sanofi pasteur in accordance with the DoH. These cards are barcoded with a watermark
  • WHO format adhered to
  • Correctly completed in full including the following:
  • -Patients full name -Date of birth in full, sex -Patients signature -Date of admin written in full -Signature & designation -Manufacturer & Batch No. -Official stamp
  • Only issue after yellow fever vaccine given
  • Only issue a card if you have administered the vaccine
  • Advise traveler to travel with the yellow card (certificate)

Other services

  • Pre and post travel medical assessment
  • Post travel medical assistance e.g. malaria screening
  • Travel related products e.g travel wallets
  • Travel insurance
  • Telephonic travel helpline

Membership

  • Join SASTM so that you have regular information on disease outbreaks, maintaining competence and up to date information on what is happening in the travel medicine world