Gotta keep ‘em vaccinated: Improving PPSV 23 vaccination rates among high-risk adults at a Middle GA Residency Clinic

Location

Suwanee, GA

Start Date

14-5-2019 1:00 PM

End Date

14-5-2019 4:00 PM

Description

Background: Due to the large burden of care for many high-risk patients, pneumococcal vaccine rates for 19-64 year olds at our clinic have been low. Hypothesis: Shifting the bulk of responsibility to nursing staff, via nurse-supervised “vaccine clinics,” will improve PPSV23 vaccination rates.

Methods: The EMR algorithm searched for patients who had indications to receive PPSV23 vaccines, by CDC guidelines. These patients were called by a designated nurse who reviewed their vaccination indication and scheduled them to receive it. We designated a 6 month pre-intervention period that was compared to our 6 intervention time-period, and compared changes in percentages of vaccinated patients. A total of 66 of 123 eligible patients were able to be contacted by phone. The remaining 57 patients received a letter describing their vaccination indication(s) and were asked to call back to have their vaccination scheduled. Patients who refused vaccination were asked why they did not want to receive it, and their answers were recorded.

Results: The percentage of patients vaccinated over the 6 month time interval prior to the project was 23.3% (23/99) vs. those who received vaccines during the project being 30% (52/173). The p-value was calculated to be 0.0001. Zero, (0/57) patients that received a letter were vaccinated. The #1 reason that patients did not want to receive the vaccine was “cost,” at 43.9% (29/66)—most of these (27/29) being self-pay patients. The second most common response was just simply “not at this time” for 15.1% (10/66) of patients, followed by “concerns with adverse effects of vaccine” at 12.1% (8/66).

Conclusion: There was a statistically significant change in vaccination rates with the intervention. However, despite the success of this short-term study, long term viability of such a process is in question. Improving education for both residents and nurses vs. vaccination protocols for nursing may show more improvement in the long-term. Further study of such options in comparison to this study would be advisable. Additionally, it appears that providing free vaccinations for self-pay patients would improve this outcome.

Embargo Period

1-28-2020

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COinS
 
May 14th, 1:00 PM May 14th, 4:00 PM

Gotta keep ‘em vaccinated: Improving PPSV 23 vaccination rates among high-risk adults at a Middle GA Residency Clinic

Suwanee, GA

Background: Due to the large burden of care for many high-risk patients, pneumococcal vaccine rates for 19-64 year olds at our clinic have been low. Hypothesis: Shifting the bulk of responsibility to nursing staff, via nurse-supervised “vaccine clinics,” will improve PPSV23 vaccination rates.

Methods: The EMR algorithm searched for patients who had indications to receive PPSV23 vaccines, by CDC guidelines. These patients were called by a designated nurse who reviewed their vaccination indication and scheduled them to receive it. We designated a 6 month pre-intervention period that was compared to our 6 intervention time-period, and compared changes in percentages of vaccinated patients. A total of 66 of 123 eligible patients were able to be contacted by phone. The remaining 57 patients received a letter describing their vaccination indication(s) and were asked to call back to have their vaccination scheduled. Patients who refused vaccination were asked why they did not want to receive it, and their answers were recorded.

Results: The percentage of patients vaccinated over the 6 month time interval prior to the project was 23.3% (23/99) vs. those who received vaccines during the project being 30% (52/173). The p-value was calculated to be 0.0001. Zero, (0/57) patients that received a letter were vaccinated. The #1 reason that patients did not want to receive the vaccine was “cost,” at 43.9% (29/66)—most of these (27/29) being self-pay patients. The second most common response was just simply “not at this time” for 15.1% (10/66) of patients, followed by “concerns with adverse effects of vaccine” at 12.1% (8/66).

Conclusion: There was a statistically significant change in vaccination rates with the intervention. However, despite the success of this short-term study, long term viability of such a process is in question. Improving education for both residents and nurses vs. vaccination protocols for nursing may show more improvement in the long-term. Further study of such options in comparison to this study would be advisable. Additionally, it appears that providing free vaccinations for self-pay patients would improve this outcome.