Improving influenza and pneumococcal vaccination uptake among incident peritoneal dialysis patients: a quality improvement initiative

Tan, Hui Zhuan; Phang, Chee Chin; Wu, Sin Yan; Sim, Mui Hian; Law, Michelle Meixin; Foo, Marjorie Wai Yin; Htay, Htay

doi:10.1007/s11255-021-02817-7

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…A total of 45 separate CDSSs were reported in the 42 articles included as shown in Table 2 . The most commonly reported CDSSs were electronic prescribing or order sets (12/42, 29%) [ 65 , 69 , 70 , 75 , 76 , 79 - 81 , 83 , 88 , 94 , 98 ], followed by checklists, forms, or clinical guidelines (11/42, 26%) [ 63 , 66 , 73 , 82 , 89 , 92 , 93 , 95 , 102 , 104 ] and electronic alerts or reminders (9/42, 21%) [ 67 , 68 , 77 , 78 , 84 , 86 , 91 , 100 , 101 ]. Commonly, CDSSs were implemented in pharmacy or prescription services (17/42, 41%).…”

Section: Resultsmentioning

confidence: 99%

“…Rationales included removing the burden from clinicians in complex situations (eg, monitoring antibiotic use [ 77 ]). Other rationales cited for implementing a CDSS included the following: the CDSS as a separate intervention to address a clinical need or context (eg, reducing the incidence of hospital-acquired infections [ 64 ]), increasing workflow efficacy [ 79 ], improving adherence to clinical guidelines [ 82 ], transforming time-consuming paper versions of a CDSS to a digital version [ 81 , 87 , 104 ], engaging or collaborating with health care workers [ 78 ], and decreasing duplication of tests or health resource waste (eg, duplicates of magnetic resonance imaging scans) [ 84 ]. Other authors noted that their study was a scale-up or modification of an initial pilot of a CDSS [ 80 , 82 , 98 ], that there was existing evidence that validated the use of a CDSS [ 66 ], and contextual factors of the health system (eg, rapid turnover of clinicians) required the implementation of a CDSS [ 70 ].…”

Section: Resultsmentioning

confidence: 99%

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Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review

Fernando,

Abell,

Tyack

et al. 2023

J Med Internet Res

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Background Computerized clinical decision support systems (CDSSs) are essential components of modern health system service delivery, particularly within acute care settings such as hospitals. Theories, models, and frameworks may assist in facilitating the implementation processes associated with CDSS innovation and its use within these care settings. These processes include context assessments to identify key determinants, implementation plans for adoption, promoting ongoing uptake, adherence, and long-term evaluation. However, there has been no prior review synthesizing the literature regarding the theories, models, and frameworks that have informed the implementation and adoption of CDSSs within hospitals. Objective This scoping review aims to identify the theory, model, and framework approaches that have been used to facilitate the implementation and adoption of CDSSs in tertiary health care settings, including hospitals. The rationales reported for selecting these approaches, including the limitations and strengths, are described. Methods A total of 5 electronic databases were searched (CINAHL via EBSCOhost, PubMed, Scopus, PsycINFO, and Embase) to identify studies that implemented or adopted a CDSS in a tertiary health care setting using an implementation theory, model, or framework. No date or language limits were applied. A narrative synthesis was conducted using full-text publications and abstracts. Implementation phases were classified according to the “Active Implementation Framework stages”: exploration (feasibility and organizational readiness), installation (organizational preparation), initial implementation (initiating implementation, ie, training), full implementation (sustainment), and nontranslational effectiveness studies. Results A total of 81 records (42 full text and 39 abstracts) were included. Full-text studies and abstracts are reported separately. For full-text studies, models (18/42, 43%), followed by determinants frameworks (14/42,33%), were most frequently used to guide adoption and evaluation strategies. Most studies (36/42, 86%) did not list the limitations associated with applying a specific theory, model, or framework. Conclusions Models and related quality improvement methods were most frequently used to inform CDSS adoption. Models were not typically combined with each other or with theory to inform full-cycle implementation strategies. The findings highlight a gap in the application of implementation methods including theories, models, and frameworks to facilitate full-cycle implementation strategies for hospital CDSSs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review

Fernando,

Abell,

Tyack

et al. 2023

J Med Internet Res

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Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review (Preprint)

Fernando,

Abell,

Tyack

et al. 2022

Preprint

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BACKGROUND Computerized clinical decision support systems (CDSSs) are essential components of modern health system service delivery, particularly within acute care settings such as hospitals. Theories, models, and frameworks may assist in facilitating the implementation processes associated with CDSS innovation and its use within these care settings. These processes include context assessments to identify key determinants, implementation plans for adoption, promoting ongoing uptake, adherence, and long-term evaluation. However, there has been no prior review synthesizing the literature regarding the theories, models, and frameworks that have informed the implementation and adoption of CDSSs within hospitals. OBJECTIVE This scoping review aims to identify the theory, model, and framework approaches that have been used to facilitate the implementation and adoption of CDSSs in tertiary health care settings, including hospitals. The rationales reported for selecting these approaches, including the limitations and strengths, are described. METHODS A total of 5 electronic databases were searched (CINAHL via EBSCOhost, PubMed, Scopus, PsycINFO, and Embase) to identify studies that implemented or adopted a CDSS in a tertiary health care setting using an implementation theory, model, or framework. No date or language limits were applied. A narrative synthesis was conducted using full-text publications and abstracts. Implementation phases were classified according to the “Active Implementation Framework stages”: exploration (feasibility and organizational readiness), installation (organizational preparation), initial implementation (initiating implementation, ie, training), full implementation (sustainment), and nontranslational effectiveness studies. RESULTS A total of 81 records (42 full text and 39 abstracts) were included. Full-text studies and abstracts are reported separately. For full-text studies, models (18/42, 43%), followed by determinants frameworks (14/42,33%), were most frequently used to guide adoption and evaluation strategies. Most studies (36/42, 86%) did not list the limitations associated with applying a specific theory, model, or framework. CONCLUSIONS Models and related quality improvement methods were most frequently used to inform CDSS adoption. Models were not typically combined with each other or with theory to inform full-cycle implementation strategies. The findings highlight a gap in the application of implementation methods including theories, models, and frameworks to facilitate full-cycle implementation strategies for hospital CDSSs.

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Awareness and rates of vaccination in hemodialysis patients

YAZICI,

GÜNEY,

YÜREKLİ

et al. 2023

Journal of Medicine and Palliative Care

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Aims: Vaccination is main risk reducing strategy for vaccine-preventable infections in chronic kidney disease (CKD) patients, but vaccination rates in hemodialysis patients are not at the desired level. In this study, we aimed to search the rates of influenza, pneumococcal, hepatitis B and coronavirus disease-2019 (COVID-19) vaccination, the vaccination awareness and the reasons for not taking vaccination in hemodialysis patients. Methods: In this cross-sectional study, 232 CKD patients undergoing hemodialysis in two centers for at least six months were included. The patients completed the questionnaire about vaccination. The data about patients’ history of vaccination regarding influenza, pneumococcal, hepatitis B and COVID-19 vaccines; patients’ attitudes and knowledge about vaccination; the source of information about vaccination were collected via this questionnaire. Results: The rates of pneumococcal, influenza, hepatitis B and COVID-19 vaccination were 9.9%, 56.6%, 38.8% and 87.1%, respectively. In patients with missing vaccination, the main reasons for not taking vaccination were lack of knowledge about vaccination (48.7%), the thought that the vaccine is not beneficial (12.5%) and fear of adverse effects (3.4%). The main sources of information about vaccination were healthcare workers (90.5%), radio/televison (1.7%) and internet (1.7%). Conclusion: Our findings showed that the rates of influenza, pneumococcal and hepatitis B vaccination were below the targeted levels and the main reason was the lack of information about vaccination and the main source of information about vaccination was health personnel. Strategies should be developed to increase the awareness and rate of vaccination for vaccine-preventable infections in CKD patients.

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Improving influenza and pneumococcal vaccination uptake among incident peritoneal dialysis patients: a quality improvement initiative

Cited by 3 publications

References 25 publications

Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review

Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review

Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review (Preprint)

Awareness and rates of vaccination in hemodialysis patients

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