Vaccination Rates in Patients With Medical Indications for the Pneumococcal Polysaccharide Vaccine in a Family Medicine Clinic

Trovato, Anthony; Gunning, Karen; Pippitt, Karly

doi:10.1177/0897190017745411

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Trovato et al determined in a retrospective review that the 3 principal reasons for nonvaccination of patients with a medical indication for vaccination with PPSV23 were (1) vaccination was not addressed during the visit, (2) the provider misclassified high-risk patients as low-risk patients for infection, and (3) the patient refused the vaccine. 9 These data suggest that most barriers are linked to lack of knowledge among providers and that if providers were better advocates, rates of vaccination could be higher. Page et al demonstrated that pharmacist education increased PPSV23 vaccination rates at 3 grocery chain pharmacies, and the primary barrier to vaccination they identified was that patients wanted to discuss the recommendation with their provider.…”

Section: Discussionmentioning

confidence: 99%

Improving Pneumococcal Vaccination Rates in an Inpatient Pediatric Diabetic Population

Mirza

Jagadish

Trimble

et al. 2022

TOJ

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Background: Diabetes is an immunocompromising condition, and diabetic children should receive the 23-valent pneumococcal polysaccharide (PPSV23) vaccine as part of their preventive care because of their increased risk for invasive pneumococcal disease. This recommendation is often not followed, however, and at our institution, we discovered that a factor limiting vaccine administration was lack of knowledge about the recommendation among residents. Methods: Our objective with this quality improvement initiative was to improve pneumococcal vaccination rates among the inpatient pediatric diabetic population to 70% in 6 months. Three education and awareness initiatives were conducted during the postintervention period of March 2021 to August 2021 at St. Mary Medical Center in Shreveport, Louisiana. All pediatric diabetic patients from age 2 to 18 years who were admitted to the inpatient general pediatrics or critical care services were included. The primary outcome was vaccination with PPSV23. Results: We studied 63 pediatric patients with a mean age of 12.7 years. The vaccination ordering rate during the 6 months prior to the implementation of the quality improvement initiatives was 41%. In the 6 months postintervention, the overall vaccination ordering rate improved to 81%. During data collection, however, we discovered that even though the residents were assessing for vaccine eligibility and ordering the vaccines, not all vaccines were administered prior to discharge. In the preintervention period, the overall vaccine administration rate was 27%, improving to 42% in the postintervention period. Conclusion: Simple interventions that included resident education, development of a smart phrase in the electronic medical record, and liaison with pharmacy led to an increase in the pneumococcal vaccination ordering rate for pediatric patients with diabetes. However, we did not anticipate that the vaccination ordering and administration rates would be different when we initiated the project and had therefore focused our interventions on resident education only. Our discovery of the difference between vaccination ordering and vaccination administration helped identify 2 other areas for improvement: nursing education and additional improvement of the electronic medical record.

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Section: Discussionmentioning

confidence: 99%

Improving Pneumococcal Vaccination Rates in an Inpatient Pediatric Diabetic Population

Mirza

Jagadish

Trimble

et al. 2022

TOJ

View full text Add to dashboard Cite

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“…The main reasons for not receiving the vaccine were the vaccine not being addressed during visit, incorrect classification of a high-risk patient as low-risk, and vaccine refusal by patient. [6] The goals of this study were to determine and improve the vaccination rates of PPSV23 in subjects with DM hospitalized at CHOC from April 2015 to April 2016 after the initiation of a quality improvement (QI) project and to identify differences in characteristics of vaccinated and unvaccinated subjects. The results will enhance systems and education at CHOC and elsewhere to further increase vaccination rates of PPSV23 in patients with DM.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Vaccination Rates of 23-Valent Pneumococcal Polysaccharide Vaccine after Quality Improvement Project in Hospitalized Patients with Diabetes Mellitus

Seagroves

Reh

Bischoff

et al. 2019

Global Journal on Quality and Safety in Healthcare

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Introduction: Since 2014, the American Academy of Pediatrics has recommended that patients over two years with diabetes mellitus (DM) receive the 23-valent pneumococcal polysaccharide vaccine (PPSV23). Methods: Retrospective chart review was initiated by a quality improvement (QI) project to determine PPSV23 administration rates for inpatients with DM at Children's Hospital of Orange County (CHOC). The QI project included education for staff and families regarding need for PPSV23 in patients with DM. Electronic medical record (EMR) order sets for DM were updated with PPSV23 vaccine. Data were collected from EMR to identify differences in subjects who were vaccinated with PPSV23 and unvaccinated from April 2015 to April 2016. Results: Before April 2015, PPSV23 was not being given to inpatients with DM. There were 199 individual subjects admitted to CHOC with DM from April 2015 to April 2016. Of those, 78 subjects (39.1%) received vaccine. Data were categorized to identify if vaccine was ordered (n = 152) or not (n = 47). Univariate logistic regression analysis performed on whether PPSV23 was ordered showed age, location (pediatric intensive care unit [PICU] vs. floor), hemoglobin A1c (HbA1c), primary DM admission, and insulin pump vs. injection usage were significant factors (P < 0.05). Multivariate logistic regression showed that those with higher HbA1c (P = 0.014), new-onset DM (P = 0.009), and those admitted for primary DM-related issues (P = 0.007) were more likely to have PPSV23 ordered. No significant subject factors identified differences in why vaccine was not administered (n = 74) once ordered. Conclusion: PPSV23 rates for pediatric inpatients with DM increased from 0% to 39% during one year following education and EMR modifications.

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A case-based learning exercise to increase students' understanding of the pharmacist's role in public health interventions for individual patients

Dodd

Rafi

Jakeman

et al. 2020

Currents in Pharmacy Teaching and Learning

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Vaccination Rates in Patients With Medical Indications for the Pneumococcal Polysaccharide Vaccine in a Family Medicine Clinic

Cited by 3 publications

References 10 publications

Improving Pneumococcal Vaccination Rates in an Inpatient Pediatric Diabetic Population

Improving Pneumococcal Vaccination Rates in an Inpatient Pediatric Diabetic Population

Analysis of Vaccination Rates of 23-Valent Pneumococcal Polysaccharide Vaccine after Quality Improvement Project in Hospitalized Patients with Diabetes Mellitus

A case-based learning exercise to increase students' understanding of the pharmacist's role in public health interventions for individual patients

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