Staff versus Physician Vaccine Protocols for Influenza Immunization During Pregnancy

Zakrzewski, Leanne; Sur, Denise K.C.; Agrawal, Nisha

doi:10.3122/jabfm.2014.01.130002

Cited by 10 publications

(4 citation statements)

References 10 publications

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“…As described above, Ogburn et al saw an increase from 3% during the first year of the intervention to 37% in the season in which standing orders were incorporated [70]. Zakrzewski et al did not implemental a standard standing order protocol but evaluated the impact of a nurse-driven recommendation protocol compared to a provider-driven recommendation protocol and found limited difference between the two [71].…”

Section: Standing Orders-standing Orders For Vaccination Represent a mentioning

confidence: 99%

Enhancing uptake of influenza maternal vaccine

Ellingson

Dudley

Limaye

et al. 2019

Expert Review of Vaccines

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Introduction: Influenza vaccination during pregnancy can offer many benefits to both mother and infant. Despite recommendations from the Advisory Committee on Immunization Practices, vaccine coverage rates among pregnant women during pregnancy are below 40% in the United States. There is a need for a greater understanding of what interventions can improve vaccine uptake among pregnant women. Areas covered: This review synthesizes the existing evidence on the effectiveness of interventions to improve maternal influenza vaccine uptake. These interventions are examined within the framework of the three psychological propositions: thoughts and feelings, social processes and changing behavior directly.

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Section: Standing Orders-standing Orders For Vaccination Represent a mentioning

confidence: 99%

Enhancing uptake of influenza maternal vaccine

Ellingson

Dudley

Limaye

et al. 2019

Expert Review of Vaccines

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show abstract

“…Interview topics were specific to maternal influenza and Tdap vaccination including office policies and procedures, provider and nurse efforts to increase rates, previous quality improvement (QI) initiatives, perceived barriers and facilitators. Interview topics and discussion guides were based on our related studies (Rand et al, 2020 ) and other maternal vaccination studies (Ault et al, 2012 ; Mouzoon et al, 2010 ; Zakrzewski et al, 2014 ). The interview guide was piloted, and suggested prompts continued to be refined after piloting.…”

Section: Methodsmentioning

confidence: 99%

Perspectives on Maternal Vaccination from Obstetrical Clinicians: A Qualitative Multi-site Study

Humiston

Szilâgyi

Bender

et al. 2022

Matern Child Health J

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Objectives Despite the seriousness of influenza and pertussis, availability of safe and effective vaccines against them, and long-standing maternal vaccination recommendations, US maternal influenza and Tdap vaccination rates have been low. To increase vaccination rates in obstetric offices, it is important to understand clinician perspectives and office processes. We conducted in-depth interviews with nurses and providers on these topics. Methods Interviewees worked in obstetric offices in one-of-four participating health systems in NY and CA. We audio-recorded and transcribed 20–30-min interviews. We used predetermined categories to code interviews with Dedoose, then iteratively refined codes and identified themes. Results We conducted 20 interviews between 4/2020 and 9/2020: 13 providers (physician or nurse midwife) (5 NY, 8 CA); 7 office nurses (6 NY, 1 CA). In almost all offices, patient refusal of influenza vaccine was considered the major vaccination barrier; Tdap was often deferred by patients until post-delivery. Nurse-only visits for either vaccine were rare. Vaccination outside the office was uncommon; few offices systematically documented vaccines given elsewhere in a retrievable manner. Participants emphasized patient education as key to prenatal care, but the number of topics left little time for immunizations. Few interviewees could identify an office “immunization champion,” knew their office vaccination rates, or had participated in vaccination quality improvement. Several interviewees indicated that they or another provider were good at persuading hesitant patients, but their method had not been shared with other clinicians. Conclusions for Practice Multiple practical barriers and maternal vaccine hesitancy limit maternal vaccination. Quality improvement strategies are needed.

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“…With an observational study, Zakrzewski et al 8 observed that the flu vaccine was less likely to be given to pregnant patients when initiated through a medical assistant-or nurse-driven protocol than a physician-based protocol, even though the vaccine was more frequently offered by nurses or medical assistants. Simply offering the vaccine is insufficient.…”

Section: Research By Family Physicians For Family Physicians Can Imprmentioning

confidence: 99%

Family Physicians are Complex Care Physicians and Quality of Care Advancement Experts

Bowman¹,

Neale²

2014

The Journal of the American Board of Family Medicine

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Sharma and coauthors 1 from the Graham Center present this issue's policy brief and suggest that family physicians should be considered "complex care physicians." The evidence? The majority of patients seeking care for 11 of 14 high-cost chronic conditions are more likely to see a primary care physician rather than the corresponding specialist physician, a fact that often is underappreciated. As we know, caring only for conditions requiring chronic care can be more than a full-time job; this article once again suggests that we do not have enough primary care physicians. At minimum, urgent, prevention, behavior change counseling, and health care coordination needs also must be met by this same workforce. In keeping with this theme of care across the spectrum, Cohen et al 2 show that family physicians are about 2.5 times more likely than obstetriciangynecologists to deal with additional nongynecologic health problems at the time of a preventive gynecologic visit. (Editors' note: but they are likely paid the same, which is unfortunate and inappropriate!) This suggests seeing an obstetrician-gynecologist for preventive gynecologic visits also would increase costs because the patient must then see another provider for the additional problems.

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Staff versus Physician Vaccine Protocols for Influenza Immunization During Pregnancy

Cited by 10 publications

References 10 publications

Enhancing uptake of influenza maternal vaccine

Enhancing uptake of influenza maternal vaccine

Perspectives on Maternal Vaccination from Obstetrical Clinicians: A Qualitative Multi-site Study

Family Physicians are Complex Care Physicians and Quality of Care Advancement Experts

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