scholarly journals P04 A quality improvement initiative to improve influenza and pneumococcal vaccination rates in patients receiving biological DMARDS (bDMARDs) in the mid-west of Ireland

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Wan Lin Ng ◽  
Aqeel Anjum ◽  
Alwin Sebastian ◽  
Joe Devlin ◽  
Alexander Fraser
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Primary Care Physicians ◽  
Action Plan ◽  
Pneumococcal Vaccination ◽  
Vaccination Rate ◽  
Quality Improvement Initiative ◽  
Immunocompromised Patients ◽  
Vaccination Rates ◽  
Common Diagnosis

Abstract Background bDMARDs have been the panacea for rheumatic diseases but their use may increase the risk of infection. Morbidity and mortality in patients with chronic disease can be prevented with influenza and pneumococcal (PCV) vaccinations. Methods We implemented a multifaceted quality improvement (QI) approach at our infusion unit using the Plan-Do-Study-Act methodology. Interventions included training of rheumatology nurses, individual patient consultations and distribution of Arthritis UK booklet on vaccination. During the first cycle, patients on bDMARDs attending the rheumatology infusion unit between January to April 2018 were recruited. Initial data included patients’ demographics, diagnosis, bDMARD, their influenza and PCV vaccination statuses with reasons for not having vaccination. The second cycle was carried out from January to April 2019. Results 92 patients were recruited in the first cycle; mean age was 53.2 years with 63 (68.5%) females. The uptake of vaccination was 52 (56.5%) for influenza and 31 (33.7%) for PCV. More importantly, 39 (42.4%) patients did not receive either vaccination. Of the 18 (19.6%) patients aged ≥65 years, 5 (27.8%) received influenza vaccination alone and 8 (44.4%) received both. The most common diagnosis from our cohort was rheumatoid arthritis (37%), followed by spondylarthritis (13%), Behçet’s disease (9.8%) and others (40.2%). 48 (52.2%) were on rituximab, 37 (40.2%) on infliximab, 6 (6.5%) were on tocilizumab and 1 (1.1%) was on abatacept. 40 (43.5%) who did not receive the influenza vaccination stated that they were either unaware (45%), uninterested (25%), afraid of SEs (12.5%), forgotten (5%), unaware it was recommended (5%). Of the 61 (66.3%) patients who did not receive the PCV, 44 (72.1%) were unaware of its availability, 6 (9.8%) were uninterested, 8 (13.2%) were fearful of side effects (SEs) and 3 (4.9%) were unaware it was recommended. Patients who did not have vaccination were interviewed again during second cycle after QI interventions. There was satisfactory improvement in the vaccination rate of influenza vaccination (71.7%) and PCV (56.5%). The most common reason for the lack of vaccination were fear of SEs for influenza vaccination and unaware of its availability for PCV. 6 (9.7%) had serious infections in the preceding year requiring hospital admission; 3 had chest infections, 1 had urinary tract infection, 1 had cellulitis and 1 had necrotising fasciitis. Conclusion Although the baseline vaccination rate was suboptimal in our cohort, there was a significant improvement after the QI interventions. The lack of awareness is the main reason for failure to be vaccinated. There is a need of a more robust action plan involving both the rheumatology team and primary care physicians to ensure adequate vaccination in immunocompromised patients. In the next step, we also aim to implement these QI interventions to the immunocompromised patients attending outpatient clinics. Disclosures W. Ng None. A. Anjum None. A. Sebastian None. J. Devlin None. A. Fraser None.

scholarly journals Vaccinating in the Emergency Department, a Novel Approach to Improve Influenza Vaccination Rates via a Quality Improvement Initiative

2020 ◽  
Vol 5 (4) ◽  
pp. e322
Author(s):  
Shannon H. Baumer-Mouradian ◽  
Abigail Kleinschmidt ◽  
Ashley Servi ◽  
Brian Jaworski ◽  
Kimberly Lazarevic ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Influenza Vaccination ◽  
Quality Improvement Initiative ◽  
Vaccination Rates ◽  
Novel Approach

scholarly journals Comparison between cohorts vaccinated and unvaccinated against influenza and pneumococcal infection

2002 ◽  
Vol 129 (3) ◽  
pp. 515-524 ◽  
Author(s):  
B. CHRISTENSON ◽  
P. LUNDBERGH
Keyword(s):  
Influenza Vaccination ◽  
Chronic Diseases ◽  
Demographic Data ◽  
Pneumococcal Infection ◽  
Pneumococcal Vaccination ◽  
Vaccination Rate ◽  
Elderly Persons ◽  
Vaccination Rates ◽  
Myocardial Disease ◽  
Chronic Lung Diseases

This study characterizes possible confounders that might make cohorts vaccinated and unvaccinated against influenza and pneumococcal infection different at baseline, with the hypothesis that the two cohorts are comparable. The similarity between health and demographic data was analysed by a randomized, multivariant study addressed to 10 000 persons aged 65 years and older in Stockholm County and was carried out in the form of a postal inquiry during the period December 2000 to May 2001. The study-population response rate was 78%. Of these, 66% (5120 persons) had been given at least one influenza vaccination during the 3-year study period (1998–2000), 50% (3780) had received one pneumococcal vaccination and 78% had received both vaccines during the period. The vaccination rate was lower in the age group 65–69 years (60%), compared with elderly cohorts aged over 70 years (67–72%, P<0·001). Elderly persons living in nursing homes or institutions had higher vaccination rates than persons living in their own households (72 vs. 67%). Persons with underlying chronic diseases had higher vaccination rates (71%, P<0·001) than those without underlying chronic diseases. Vaccine recipients had fewer days in hospital, compared with non-recipients. Unvaccinated persons with myocardial disease had nine times more days in hospital than vaccinated persons with myocardial disease. Vaccination against pneumococcal infection had an additional effect with influenza vaccination in reducing hospitalization for chronic lung diseases; influenza vaccination alone did not have this effect. In conclusion, the influenza and pneumococcal-vaccine recipients were older and had significantly more chronic lung and heart conditions than the unvaccinated cohort.

scholarly journals A Quality Improvement Project to Increase the Rate of HPV Vaccination Initiation in Adolescents

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Quality Improvement ◽  
Hpv Vaccination ◽  
Vaccination Rate ◽  
Quality Improvement Project ◽  
Human Papilloma Virus Vaccine ◽  
Quality Improvement Initiative ◽  
Initiation Rate ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Implementation Period

The vaccination rate of the human papilloma virus vaccine [9vHPV] is low, with only 63% of eligible females and 50% eligible males receiving the vaccine in 2016. The aim of this quality improvement project was to increase the initiation rate of HPV vaccination at Smyrna Pediatrics by 20%, from 3.6% to 4.3% over four weeks. Two physicians, one nurse practitioner, and two medical assistants implemented this quality improvement initiative. There is a lack of education and standardized communication about HPV and 9vHPV to prevent against the virus. A standardized script was created so that all conversations between healthcare professionals and patients and their parents or guardians included the wording of the 9vHPV being recommended rather than optional. Educational material from the CDC was the standard handout given to each adolescent and their parent or guardian. Standardized education and communication was to be provided at each adolescent visit of the 125 eligible adolescents seen during the four-week implementation period, 4% (n = 5) agreed to receive the 9vHPV vaccine. With a baseline of 3.6% (n = 4), there was an 11.1% increase of initiation of 9vHPV. The use of standardized education documents presented to all patients and their parents or guardians established health education as the mainstay of the project and provided information about the importance of prevention and protection from the virus that the vaccine prevents. The implementation of results over a longer period of time may prove to be more effective for the practice’s increase of vaccination rates overall.

Improving Influenza Vaccination of Healthcare Workers by Means of Quality Improvement Tools

2011 ◽  
Vol 32 (6) ◽  
pp. 616-618 ◽  
Author(s):  
Jose Cadena ◽  
Teresa Prigmore ◽  
Jason Bowling ◽  
Beth Ann Ayala ◽  
Leni Kirkman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Healthcare Worker ◽  
Healthcare Workers ◽  
Seasonal Influenza ◽  
Vaccination Rate ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Grand Rounds ◽  
Voluntary Vaccination

For a healthcare worker seasonal influenza vaccination quality improvement project, interventions included support of leadership, distribution of vaccine kits, grand rounds, an influenza website, a Screensaver, e-mails, phone messages, and audit feedback. Vaccination rates increased from 58.8% to 76.6% (P < .01). Quality improvement increased the voluntary vaccination rate but did not achieve a rate more than 80%.

scholarly journals 16. An Ambulatory Quality Improvement Initiative to Optimize Influenza Vaccination Amongst Adults Living with HIV During the COVID-19 Pandemic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S132-S133
Author(s):  
Deborah A Kahal ◽  
Christopher James ◽  
Brian Wharton ◽  
Sherine Eaddy ◽  
Elizabeth Gaines ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Lessons Learned ◽  
Virtual Space ◽  
Quality Improvement Initiative ◽  
People Living With Hiv ◽  
Vaccination Rates ◽  
Increased Risk ◽  
Living With Hiv

Abstract Background Seasonal influenza vaccination decreases individual and population-level morbidity and mortality, mitigates risk of acquiring influenza-like illness, and prevents healthcare system overburdening. Vaccination is important for people living with HIV (PLWH) who have increased risk for severe disease, hospitalization, and poor outcomes. Moreover, influenza vaccination has been associated with decreased COVID-19 mortality in older patients. Historical annual adult influenza vaccinations rates at the study site were 65%, exceeding local and national benchmarks. Amidst COVID-19, we recognized a need to increase influenza vaccination rates. Methods A multifaceted, bundled quality improvement (QI) initiative aimed to achieve ≥ 80% influenza vaccination coverage for the 2020-21 season in PLWH ≥18 years of age at our Wilmington site (N=750). Stakeholders were identified, and a voluntary multidisciplinary team formed to lead the initiative (Fig. 1). Fishbone diagram outlined clear, rapidly implementable, and reproducible levers for change (Fig. 2). Physical and virtual space changes included: diverse clinical displays (visuals, patient materials), phone messaging, and virtual platform use. Staff education and updates were consistently provided by the team. Institutional Review Board exemption was received, and electronic medical record and CareWare data were extracted from 1 Oct 2020 through 31 March 2021. All external vaccinations were confirmed. Overall and eligible in-clinic vaccination rates were updated and displayed weekly. Results 86% vaccination coverage was achieved (Fig. 3) with a median weekly in-clinic vaccination rate of 67% (Fig. 4). Conclusion A QI project to improve 2020-21 influenza vaccination rates exceeded our goal in adult PLWH at an urban mid-Atlantic HIV clinic during the COVID-19 pandemic. A multidisciplinary approach that engaged stakeholders was vital to success. Rapid roll-out of changes was challenging, requiring flexibility and clear communication. Data collection was consistent, albeit imperfect, and needs enhancement. Elucidating the effects of each change and the COVID-19 pandemic on vaccination rates is not yet known. Lessons learned may be applicable to other ambulatory settings and will inform future vaccination efforts. Disclosures Deborah A. Kahal, MD,MPH, FACP, Gilead (Speaker’s Bureau)Viiv (Speaker’s Bureau)

Carrots and Sticks: Achieving High Healthcare Personnel Influenza Vaccination Rates without a Mandate

2015 ◽  
Vol 36 (6) ◽  
pp. 717-724 ◽  
Author(s):  
Marci Drees ◽  
Kathleen Wroten ◽  
Mary Smedley ◽  
Tabe Mase ◽  
J. Sanford Schwartz
Keyword(s):  
Influenza Vaccination ◽  
Financial Incentives ◽  
Vaccination Campaign ◽  
Peer Pressure ◽  
Vaccination Rate ◽  
Healthcare Personnel ◽  
Quality Improvement Initiative ◽  
Vice Presidents ◽  
Healthcare Organizations ◽  
Vaccination Rates

OBJECTIVEAchieving high healthcare personnel (HCP) influenza vaccination rates has typically required mandating vaccination, which is often challenging to implement. Our objective was to achieve >90% employee influenza vaccination without a mandate.DESIGNProspective quality improvement initiativeSETTING AND PARTICIPANTSAll employees of a 2-hospital, 1,100-bed, community-based academic healthcare system.METHODSThe multimodal HCP vaccination campaign consisted of a mandatory declination policy, mask-wearing for non-vaccinated HCP, highly visible “I’m vaccinated” hanging badges, improved vaccination tracking, weekly compliance reports to managers and vice presidents, disciplinary measures for noncompliant HCP, vaccination stations at facility entrances, and inclusion of a target employee vaccination rate (>75%) metric in the annual employee bonus program. The campaign was implemented in the 2011–2012 influenza season and continued throughout the 2012–2013 through 2014–2015 influenza seasons. Employee compliance, vaccination, exemption and declination rates were calculated and compared with those of the seasons prior to the intervention.RESULTSCompared with vaccination rates of 57%–72% in the 3 years preceding the intervention, employee influenza vaccination increased to 92% in year 1 and 93% in years 2–4 (P<.001). The proportion of employees declaring medical/religious exemptions or declining vaccination decreased during the 4 years of the program (respectively, 1.2% to 0.5%,P<.001; 4.4% to 3.8%,P=.001).CONCLUSIONSAn integrated multimodal approach incorporating peer pressure, accountability, and financial incentives was associated with increased employee vaccination rate from ≤72% to ≥92%, which has been sustained for 4 influenza seasons. Such programs may provide a model for behavioral change within healthcare organizations.Infect Control Hosp Epidemiol2015;00(0): 1–8

Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

2013 ◽  
Vol 34 (7) ◽  
pp. 723-729 ◽  
Author(s):  
Kayla L. Fricke ◽  
Mariella M. Gastañaduy ◽  
Renee Klos ◽  
Rodolfo E. Bégué
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Influenza Vaccination ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Healthcare Personnel ◽  
Patient Contact ◽  
Hospital Type ◽  
Vaccination Rates ◽  
Item Questionnaire

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

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