| Principal Investigator: | Heather A. Scroggins, RN, BSN |
| Co-Principal Investigator/Collaborator: | Sara E. Meadors, Sue “Sudie” Smith |
| Organization: | JPS Health Network |
Abstract
Problem
Process analysis and staff interviews revealed several barriers to appropriate adult vaccination. Standing delegation orders for the administration of both flu and Pneumovax vaccines have been utilized for many years. Surveying the staff, however, revealed that few knew about the standing orders and even fewer were comfortable using them. Most staff was unaware of Pneumovax administration year round.
Evidence
Pneumonia mortality rate is a staggering 5–36 percent in adults and 18-60 percent in the elderly (Zimmerman, Tabbrah, & Norwalk 2005). It is undeniably important that qualifying patients are vaccinated.
Strategy
A multidisciplinary group was organized to look at these issues. From this group an algorithmic form was developed making it easy to evaluate the patient’s need for the vaccination. Documentation was made available to report refusal, contraindication or a vaccine given outside the hospital network. A round report was developed so an overview of the entire unit and immunization needs could be identified.
Change Evaluation
A massive education campaign driven by the quality department and staff developers aided in communicating the change. The vaccination round report made it easy for nursing team leaders, managers and quality improvement staff to evaluate compliance daily.
Results
An evaluation of the outcomes has proven successful. Last year at the same time compliance for the targeted inpatient population was approximately 6%. After implementations, the compliance rate increased to 58.3 %. The organization is very confident the rates will continue to increase. More importantly, the nurses feel comfortable giving the vaccinations translating in more patients receiving them.
Recommendations
This project would not have had the success, if it was not for the collaborative effort. It is important to incorporate many disciplines with projects such as this one. Education and nursing accountability also played a huge role in the success of this implementation.
Bibliography
- Zimmerman, M.D., Tabbarah, M., Norwalk, M..,(2005). Clinical recommendations for pneumonia vaccination play a key role in vaccination rates. American Journal of Geriatric Pharmacology 3(3), pp 149–159.