Meeting Patients Where They Are: A Nurse-Driven Quality Improvement Project to Provide Influenza Vaccinations in the Emergency Department

Hunsaker, Stacie; Garrett, Larry; Merrill, Katreena Collette; Rhodes, Rachelle

doi:10.1016/j.jen.2023.02.002

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…The study suggests that by promoting knowledge and educating patients, social and medical workers can enhance the vaccination rates among diabetic individuals [ 29 ]. Another intervention project study about delivering influenza vaccinations in emergency departments has demonstrated that educating nurses was valuable in enhancing nurses’ knowledge and positive attitudes about providing influenza vaccines to patients [ 30 ]. In our study, all participants were drawn from the diabetes education nursing department.…”

Section: Discussionmentioning

confidence: 99%

The Uptake of Pneumococcal and Seasonal Influenza Vaccinations Based on Perceptions and Attitudes Toward the COVID-19 Vaccine Among Patients With Diabetes

Mercan Baspinar,

Demirali

2024

Cureus

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Objective In this study, we aimed to assess the rates of pneumococcal and seasonal influenza vaccinations among elderly and nonelderly diabetes patients and examine their perceptions and attitudes toward the coronavirus disease 2019 (COVID-19) vaccine. Methods A single-center study was conducted among patients with diabetes, employing a structured survey encompassing sociodemographic data, vaccination records, and the COVID-19 vaccine perception and attitude scale. Results Among the 280 diabetes patients in our study, the vaccination rates for COVID-19, seasonal influenza, and pneumococcal vaccines were 96.1%, 16.8%, and 17.5%, respectively. A higher cumulative dosage of the COVID-19 vaccine was associated with older age (r = 0.463; p<0.001), increased safety score (r = 0.479; p<0.001), and lower conspiracy theory score (r = -0.336; p<0.001). Participants who had received COVID-19 and influenza vaccines were observed to have significantly higher safety scores related to COVID-19 vaccines (p<0.001; d = 2.381 and p = 0.008; d = 0.525, respectively). Notably, vaccination rates for influenza and pneumococcus were significantly different between nonelderly and elderly patients (8.7% vs. 29.6%; p<0.001 and 13.4% vs. 24.1%; p = 0.022). Elderly patients with diabetes were 3.3 times more likely to receive the influenza vaccine than nonelderly participants [odds ratio (OR) = 3.319; 95% confidence interval (CI) = 1.592 - 6.920; p = 0.001] and had a higher safety score related to COVID-19 vaccines (OR = 1.076; 95% CI = 1.011 - 1.146; p = 0.021). Conclusions Both influenza and pneumococcal vaccination rates were below the desired targets in this study. The vaccination rates among the nonelderly diabetes population suggest that this group may be more likely to neglect to receive vaccination compared to the elderly diabetes population. The association between vaccination rates and post-pandemic safety perceptions highlights the critical need to implement public health strategies specifically designed to address and improve safety-related information dissemination.

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Section: Discussionmentioning

confidence: 99%

The Uptake of Pneumococcal and Seasonal Influenza Vaccinations Based on Perceptions and Attitudes Toward the COVID-19 Vaccine Among Patients With Diabetes

Mercan Baspinar,

Demirali

2024

Cureus

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Implementation of Immunization Services Through a Pediatric Urgent Care Clinic

Gordon,

Vega,

Aulakh

et al. 2024

Pediatrics

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BACKGROUND AND OBJECTIVES: Pediatric urgent care (PUC) centers may bolster immunization campaigns by offering vaccination during acute care visits, but few such programs have been described. METHODS: We conducted a quality improvement initiative at an academically affiliated federally qualified health center that provides primary, specialty, and PUC services to children. Our PUC began offering routine immunizations in July 2020. The percentage of visits by eligible patients age ≤21 years during which immunization screening (process) and administration (outcome) occurred was measured from March 1, 2021, to February 19, 2023. Administration rates were measured across age, sex, race, language, and medical home groups. Data were analyzed with statistical process control methods. Grievance and adverse event data were monitored (balancing). RESULTS: We completed 4 plan-do-study-act cycles. Provider-facing bundles that included training, decision support, electronic health record signaling, and financial incentives were not associated with meaningful changes in screening and administration (cycles 1–3). A dedicated nurse vaccinator (DNV) was added on October 31, 2022 (cycle 4). The mean screening rate increased from 44.7% to 67.4% during the DNV period, and the mean administration rate increased from 26.5% to 50.8%. Lower administration rates were observed during visits by Black and English-speaking patients, and by patients empaneled outside our site. CONCLUSIONS: Provider-facing interventions alone were not effective at increasing vaccine screening and administration in our PUC, but marked improvement was observed with the addition of a DNV. Future interventions are needed to address disparities. Additional investigation is needed to determine whether our results are reproducible in other PUCs with access to vaccines.

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The Influence of Electronic Health Records on Nursing Practice within Hospital Settings

Kademane,

Kumar,

Chaudhary

2023

Salud, Ciencia y Tecnología

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Los problemas de usabilidad de las historias clínicas electrónicas (HCE) representan una amenaza creciente para la salud de enfermeras y pacientes, a pesar de que pocos estudios han examinado estas correlaciones en profundidad. El objetivo de este estudio era investigar cómo ha afectado el uso de las historias clínicas electrónicas a la práctica de la enfermería en el ámbito hospitalario. La adopción de la HCE y la calidad asistencial aún no se han estudiado en profundidad. Se utilizaron datos de la Asociación Americana de Hospitales (AHA), altas estatales de pacientes y una encuesta a enfermeras para realizar estudios transversales. La muestra incluye 1.281.848 pacientes quirúrgicos, 12.004 enfermeras y 343 hospitales. Se utilizaron modelos de regresión logística para los estudios aleatorizados no controlados que examinaban la correlación entre la usabilidad de la HCE y los resultados. Mediante modelos de regresión logística, se analizó la relación entre los resultados de calidad de la atención evaluados por las enfermeras y el uso de los sistemas de historia clínica electrónica más básicos. Las enfermeras que trabajaban en centros equipados incluso con las HCE más básicas declararon un número significativamente menor de incidencias que sus colegas de hospitales sin HCE; obtuvieron peores resultados en seguridad del paciente y otras medidas de calidad. Implantar incluso una HCE mínima podría mejorar la calidad de los cuidados de enfermería, facilitar una coordinación asistencial más eficaz y aumentar la seguridad de los pacientes.

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Meeting Patients Where They Are: A Nurse-Driven Quality Improvement Project to Provide Influenza Vaccinations in the Emergency Department

Cited by 3 publications

References 16 publications

The Uptake of Pneumococcal and Seasonal Influenza Vaccinations Based on Perceptions and Attitudes Toward the COVID-19 Vaccine Among Patients With Diabetes

The Uptake of Pneumococcal and Seasonal Influenza Vaccinations Based on Perceptions and Attitudes Toward the COVID-19 Vaccine Among Patients With Diabetes

Implementation of Immunization Services Through a Pediatric Urgent Care Clinic

The Influence of Electronic Health Records on Nursing Practice within Hospital Settings

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