Electronic Immunization Alerts and Spillover Effects on Other Preventive Care

Kim, Julia M.; Rivera, M. Patricia; Persing, Nichole; Bundy, David G.; Psoter, Kevin J.; Ghazarian, Sharon R.; Miller, Marlene R.; Solomon, Barry S.

doi:10.1177/0009922817715935

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…This was evident from the fact that nurses who worked in paediatric care had more exposure to computers and electronic health information recording than nurses working in other areas. Kim et al (2017) note that the adoption of EHRs improves the efficiency and quality of childhood immunisation through EHR-based clinical alert systems and results in higher immunisation rates in paediatrics. Nurses working in such settings were therefore exposed to computers on a daily basis.…”

Section: Discussionmentioning

confidence: 99%

Primary healthcare nurses' perceptions about their ability to utilise electronic health records

Tengeh

Bimerew

2022

Obzor Zdrav Neg

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Introduction:The implementation, adoption and use of electronic health records remains a global challenge despite the numerous advantages associated with their use. This paper explores primary healthcare nurses' perceptions regarding their skill levels in using EHRs. Methods: Data were collected using a self-administered questionnaire from a sample of 71 nurses (63% response rate) in selected primary health care (PHC) facilities of the Northern-Tygerberg substructure, Cape Town. Results:The overall results show that 59 respondents (83%) believed that they were skilled in using EHRs in PHC. Nearly two thirds of all nurses (46 or 64.8%) reported using EHRs for nursing documentation, 45 nurses (63%) reported using EHRs to store, retrieve and transfer data, 44 (62%) reported being able to design a flow chart, 38 (53.5%) reported being able to access databases and 38 (52.1%) reported being able to convert electronic files for various applications. However, 33 nurses (46.5%) were unsure of their computer skills in creating multimedia files. This varied from service department to service department, with 62 respondents (87.3%) in pediatric care and 59 respondents (83.1%) in family planning, adult nursing and HIV management reporting having EHR skills. Enrolled nurses rated their EHR skills significantly lower (58%) than registered nurses (92%) (p = 0.028). Discussion and conclusion: Although most respondents in this study reported being skilled in using EHRs in PHC, better computer accessibility and continuous training are important ongoing requirements. Further qualitative research is needed to better understand some of the problems and barriers which affect nurses' ability to use EHRs in PHC settings. IZVLEČEKUvod: Uvedba in uporaba elektronskih zdravstvenih kartotek (EZK) predstavlja globalen izziv kljub številnim prednostim, povezanim z njihovo uporabo. Namen raziskave je bil raziskati sposobnosti uporabe EZK medicinskih sester v primarni zdravstveni dejavnosti. Metode: Za zbiranje podatkov smo uporabili lasten vprašalnik na vzorcu 71 medicinskih sester (63-odstotna stopnja odziva) v izbranih ustanovah primarnega zdravstvenega varstva v podstrukturi Northern-Tygerberg, v mestu Cape Town. Rezultati: Rezultati raziskave kažejo, da 59 anketirancev (83 %) ocenjuje, da so vešči uporabe EZK v primarni zdravstveni dejavnosti. Skoraj dve tretjini medicinskih sester (46 oz. 4,8 %) uporablja EZK za potrebe zdravstvene dokumentacije, 45 (63 %) medicinskih sester uporablja EZK za shranjevanje, pridobivanje in prenos podatkov, 44 (62 %) medicinskih sester je sposobnih oblikovati diagram poteka, 38 (53,5 %) medicinskih sester zna dostopati do baz podatkov in 38 (52,1 %) medicinskih sester zna pretvarjati elektronske datoteke za rabo z različnimi aplikacijami. Vendar pa kar 33 (46,5 %) medicinskih sester ni bilo prepričanih o svojih računalniških spretnostih za ustvarjanje večpredstavnostnih datotek. Rezultati se razlikujejo po posameznih oddelkih zdravstvene nege. Kar 62 (87,3 %) anketirancev v pediatrični oskrbi in 59 (83,1 %) a...

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Section: Discussionmentioning

confidence: 99%

Primary healthcare nurses' perceptions about their ability to utilise electronic health records

Tengeh

Bimerew

2022

Obzor Zdrav Neg

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“…Additionally, future studies could evaluate the impact of inpatient immunization interventions on outpatient primary care delivery. 25 Several studies have highlighted the importance of communication and collaboration between clinicians in inpatient and outpatient settings to ensure that children are fully immunized. [8][9][10]15,16 These studies have successfully increased inpatient pediatric immunization rates by accurately reviewing immunization records during hospitalization, effectively addressing parental concerns, and informing parents and PCPs about needed catch-up doses.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Hospitalizations: Are We Missing an Opportunity to Immunize?

Genies

Lopez²,

Schenk³

et al. 2019

Hospital Pediatrics

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Fewer than half of children receive all recommended immunizations on time. Hospitalizations may be opportunities to address delayed immunizations. Our objectives were to assess (1) prevalence of delayed immunizations among hospitalized patients, (2) missed opportunities to administer delayed immunizations, and (3) time to catch up after discharge. METHODS:We conducted a retrospective cohort study investigating immunization status of patients 0 to 21 years of age admitted to an academic children's center from 2012 to 2013 at the time of admission, at discharge, and 18 months postdischarge. Immunization catch-up at 18 months postdischarge was defined as having received immunizations due on discharge per Centers for Disease Control and Prevention recommendations. x 2 and t test analyses compared characteristics among patients caught up and not caught up at 18 months postdischarge. Analysis of variance and logistic regression analyses compared mean number of immunizations needed and odds of immunization catch-up among age groups. Kaplan-Meier and Cox proportional hazards analyses compared catch-up time by age, race, sex, and insurance.RESULTS: Among 166 hospitalized patients, 80 were not up to date on immunizations at admission, and only 1 received catch-up immunizations before discharge. Ninety-nine percent (79 of 80) were not up to date on discharge per Centers for Disease Control and Prevention recommendations. Thirty percent (24 of 79), mostly adolescents, were not caught up at 18 months postdischarge. Median postdischarge catch-up time was 3.5 months (range: 0.03-18.0 months). Patients 0 to 35 months of age were more likely to catch up compared with those of other ages (hazard ratio 5 2.73; P 5 .001), with no differences seen when comparing race, sex, or insurance.CONCLUSIONS: Pediatric hospitalizations provide important opportunities to screen and immunize children.

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The effects of on-screen, point of care computer reminders on processes and outcomes of care

Shojania

Jennings²,

Mayhew

et al. 2009

Cochrane Database of Systematic Reviews

363

339

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Background The opportunity to improve care by delivering decision support to clinicians at the point of care represents one of the main incentives for implementing sophisticated clinical information systems. Previous reviews of computer reminder and decision support systems have reported mixed effects, possibly because they did not distinguish point of care computer reminders from e-mail alerts, computer-generated paper reminders, and other modes of delivering ‘computer reminders’. Objectives To evaluate the effects on processes and outcomes of care attributable to on-screen computer reminders delivered to clinicians at the point of care. Search methods We searched the Cochrane EPOC Group Trials register, MEDLINE, EMBASE and CINAHL and CENTRAL to July 2008, and scanned bibliographies from key articles. Selection criteria Studies of a reminder delivered via a computer system routinely used by clinicians, with a randomised or quasi-randomised design and reporting at least one outcome involving a clinical endpoint or adherence to a recommended process of care. Data collection and analysis Two authors independently screened studies for eligibility and abstracted data. For each study, we calculated the median improvement in adherence to target processes of care and also identified the outcome with the largest such improvement. We then calculated the median absolute improvement in process adherence across all studies using both the median outcome from each study and the best outcome. Main results Twenty-eight studies (reporting a total of thirty-two comparisons) were included. Computer reminders achieved a median improvement in process adherence of 4.2% (interquartile range (IQR): 0.8% to 18.8%) across all reported process outcomes, 3.3% (IQR: 0.5% to 10.6%) for medication ordering, 3.8% (IQR: 0.5% to 6.6%) for vaccinations, and 3.8% (IQR: 0.4% to 16.3%) for test ordering. In a sensitivity analysis using the best outcome from each study, the median improvement was 5.6% (IQR: 2.0% to 19.2%) across all process measures and 6.2% (IQR: 3.0% to 28.0%) across measures of medication ordering. In the eight comparisons that reported dichotomous clinical endpoints, intervention patients experienced a median absolute improvement of 2.5% (IQR: 1.3% to 4.2%). Blood pressure was the most commonly reported clinical endpoint, with intervention patients experiencing a median reduction in their systolic blood pressure of 1.0 mmHg (IQR: 2.3 mmHg reduction to 2.0 mmHg increase). Authors’ conclusions Point of care computer reminders generally achieve small to modest improvements in provider behaviour. A minority of interventions showed larger effects, but no specific reminder or contextual features were significantly associated with effect magnitude. Further research must identify design features and contextual factors consistently associated with larger improvements in provider behaviour if computer reminders are to succeed on more than a trial and error basis.

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Electronic Immunization Alerts and Spillover Effects on Other Preventive Care

Cited by 3 publications

References 37 publications

Primary healthcare nurses' perceptions about their ability to utilise electronic health records

Primary healthcare nurses' perceptions about their ability to utilise electronic health records

Pediatric Hospitalizations: Are We Missing an Opportunity to Immunize?

The effects of on-screen, point of care computer reminders on processes and outcomes of care

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