What is a Travel Clinic?

A Travel Clinic provides up to date, accurate information of the health and safety aspects of specific destinations, to travellers.

By applying specific interventions, it ensures that the traveler remains healthy during his travels and returns home healthy.

Type of Service

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

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

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

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

Training

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

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

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)

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

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 / Book-keeper / Cleaner

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.

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.

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

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

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

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