Immunization Status of NICU Graduates at a Tertiary Care Children's Hospital

Macintosh, Janelle L. B.; Huggins, L. J.; Eden, Lacey M.; Merrill, Katreena Collette; Luthy, Karlen E.

doi:10.1097/anc.0000000000000357

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…This study shows that immunization alerts in an EMR significantly improve two-month immunization rates in infants hospitalized in the NICU. Other studies have found NICU immunization rates at discharge to be between 51% [13] and 74% [14] which is similar to our baseline of 71%. Our findings show that the two-month immunization rate at the time of hospital discharge increased to 94% after the electronic immunization alert was implemented.…”

Section: Discussionsupporting

confidence: 90%

Electronic Alerts Improve Immunization Rates in Two-month-old Premature Infants Hospitalized in the Neonatal Intensive Care Unit

Ernst

2017

Appl Clin Inform

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Summary Objective: To determine if an electronic alert improves 2 month immunization rates in infants remaining hospitalized in the neonatal intensive care unit. Methods: Institutional Review Board-approved retrospective chart review of 261 infants with birth weights <2 kg and still hospitalized at58 days. Charts were reviewed between 2009 and 2013, before and after the 2011 electronic alert was instituted in the electronic medical record from days 56 to 67 to remind providers that immunizations were due. Order and administration dates of two-month vaccine components (Diphtheria, Haemophilus influenza B, Hepatitis B Pertussis, Pneumococcal, Polio, Tetanus) were determined, and infants were considered fully immunized, partially immunized, or unimmunized by day 90 or discharge, whichever came first. Results: After the alert, the timing of vaccine orders decreased from day 67 to day 61 (p<0.0001) and vaccine administration decreased from day 71 to day 64 (p<0.0001). Missing vaccine orders decreased from 14% [17/121] to 3% [4/140] (p=0.001) with missing administrations decreasing from 21% [26/121] to 4% [6/140] (p<0.0001). Fully immunized rates increased from 71% [86/121] to 94% [132/140] (p<0.0001). Conclusions: A significant improvement in immunization rates in two-month-old infants in the neonatal intensive care unit occurred by 90 days after implementing an alert in the electronic medical record.

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Section: Discussionsupporting

confidence: 90%

Electronic Alerts Improve Immunization Rates in Two-month-old Premature Infants Hospitalized in the Neonatal Intensive Care Unit

Ernst

2017

Appl Clin Inform

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Infant Immunizations in Pediatric Critical Care: A Quality Improvement Project

Schniepp¹,

Cassidy²,

Godfrey³

2019

Journal of Pediatric Health Care

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NICU Nurses' Knowledge and Attitudes Regarding 2-Month Immunizations

Macintosh

Eden²,

Luthy³

et al. 2020

Advances in Neonatal Care

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Background: Nurses are an integral part of the healthcare team. Parents rely on nurses for information regarding the plan of care for their child. Medically stable infants under supervision in a newborn intensive care unit (NICU) can and should be immunized. Purpose: The purpose of this study was to explore attitudes and knowledge in NICU nurses regarding 2-month immunizations. Methods: Participants were attendees of the National Association of Neonatal Nurses (NAAN) 33rd Annual Conference. Participants responded to a survey that focused on knowledge and attitudes regarding 2-month immunizations. Findings/Results: A total of 188 nurses attending the NAAN conference completed the survey. Most nurses had positive attitudes regarding immunizations. A majority (n = 117, 62.5%) of NICU nurses knew that immunizations should be given to medically stable infants in a NICU. However, as few as 27% of participants were able to identify recommended 2-month immunizations. Almost two-thirds of participants (n = 115, 61.1%) did not know current guidelines regarding minimum age at the time of administration of immunizations, although NPs were more likely to know current guidelines. Nurse practitioners were more comfortable talking family about immunizations and were more likely to view that the illnesses prevented by vaccines as serious. Implications for Practice: NICU nurses would benefit from continued education focused on Centers for Disease Control and Prevention (CDC) guidelines for 2-month immunizations. Additionally, as a primary source of information for parents, NICU nurses should be encouraged to practice teaching parents and family about immunizations. This practice could reinforce nurse knowledge. Implications for Research: Further research regarding the effect of education, simulation, and yearly reinforcement of CDC guidelines could further enlighten our knowledge on this topic.

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Immunization Status of NICU Graduates at a Tertiary Care Children's Hospital

Abstract: Future studies should focus on samples from diverse hospitals and levels of NICUs. Qualitative studies exploring and describing parent and provider knowledge of current AAP guidelines will strengthen our understanding of potential barriers to immunization.

Cited by 3 publications

References 18 publications

Electronic Alerts Improve Immunization Rates in Two-month-old Premature Infants Hospitalized in the Neonatal Intensive Care Unit

Electronic Alerts Improve Immunization Rates in Two-month-old Premature Infants Hospitalized in the Neonatal Intensive Care Unit

Infant Immunizations in Pediatric Critical Care: A Quality Improvement Project

NICU Nurses' Knowledge and Attitudes Regarding 2-Month Immunizations

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