Clinical StudiesTen-year durability and success of an organized program to increase influenza and pneumococcal vaccination rates among high-risk adults
Section snippets
Setting and vaccination program
The Minneapolis VA Medical Center is a 400-bed university-affiliated teaching hospital providing primary and tertiary care to more than 40,000 patients each year. In 1986 the Medical Center developed a standing order policy for administering influenza vaccine to elderly patients followed in the general medicine clinics (12). For the 1987–88 vaccination season, an annual institution-wide influenza vaccination program was first implemented at the medical center (13). This program was designed to
Results
Response rates to the annual outpatient surveys have exceeded 75% each year for the largely elderly and high-risk respondents (Table 1). Influenza vaccination rates for all high-risk survey respondents (age ≥65 years or having heart disease, lung disease, diabetes, or other serious illness) have increased during the 10 years in which we have had the institution-wide program from 58% in 1987–88 to 84% in 1996–97 (P < 0.001; Table 2). Vaccination rates for high-risk patients less than 65 years
Discussion
Experience spanning more than a decade at the Minneapolis VA Medical Center illustrates how a systems approach that emphasizes administrative and organizational changes to clinical practice to enhance influenza and pneumococcal vaccination rates for adults can be successful and durable. This simple, multifaceted program includes an annual educational/publicity mailing to patients, standing orders for nurses, and a walk-in clinic during the autumn. It has exceeded the program goal with 84% of
References (45)
Influenza and pneumococcal immunization strategies for physicians
Chest
(1987)- et al.
Achieving the national health objective for influenza immunizationsuccess of an institution-wide vaccination program
Am J Med
(1990) Improving influenza vaccination rates for high-risk inpatients
Am J Med
(1991)- et al.
Estimation of outpatient risk characteristics and influenza vaccination statusvalidation of a self-administered questionnaire
Am J Prev Med
(1991) Developing effective systems for delivery of vaccines
Infect Dis Clin NA
(1990)- et al.
Delivery rates for preventive services in 44 midwestern clinics
Mayo Clin Proc
(1997) - et al.
The impact of vaccination strategy and methods of information on influenza and pneumococcal vaccination coverage in the elderly population
Vaccine
(1997) Adult immunization. Summary of the National Vaccine Advisory Committee Report
JAMA
(1994)- et al.
Immunization policies and vaccine coverage among adultsthe risk for missed opportunities
Ann Intern Med
(1988) Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices
MMWR
(1997)
Prevention of pneumococcal disease. Recommendations of the Advisory Committee on Immunization Practices
MMWR
Pneumococcal and influenza vaccination levels among adults aged ≥65 years—United States, 1995
MMWR
Influenza immunization of the elderlyknowledge and attitude do not explain physician behavior
Am J Public Health
Prevention of respiratory infections in adults. Influenza and pneumococcal vaccines
Arch Intern Med
Clinical practice and public policy for influenza and pneumococcal vaccination of the elderly
Clin Geriatr Med
Improved preventive care following an intervention during an ambulatory care rotationcarryover to a second setting
J Gen Intern Med
Organizational strategies to improve influenza vaccine deliverya standing order in a general medicine clinic
Arch Intern Med
Long-term success with the national health objective for influenza vaccinationan institution-wide model
J Gen Intern Med
Exporting a successful influenza vaccination program from a teaching hospital to a community outpatient setting
J Am Geriatr Soc
Cited by (105)
A review of hospital-based interventions to improve inpatient influenza vaccination uptake for high-risk adults
2021, VaccineCitation Excerpt :An SOP is a mandate in which healthcare workers have authority to administer vaccinations to eligible patients without physician supervision or acceptance. Of the seven SOP studies identified in this review, six were nurse-led programs [10,14,16–19] and one was pharmacist-led [15]. Statistical significance was only reported for three of the seven studies, all showing significantly higher vaccination rates following SOPs [14,17,18].
Safety of Influenza Vaccination Administered During Hospitalization
2019, Mayo Clinic ProceedingsA review of acute care interventions to improve inpatient pneumococcal vaccination
2014, Preventive MedicineCitation Excerpt :Two studies were conducted over a decade (Nichol, 1998; Robke and Woods, 2010). One of them implemented SOP along with annual educational sessions for hospital staff, followed-up by mailing a reminder to the patient, walk-in clinics during the immunization season, and the use of standardized documentation and medical record keeping (Nichol, 1998). The admitting nurse selected inpatients with one or more indications for pneumococcal vaccination in the other study, and pharmacists were authorized to write vaccine orders for eligible candidates (Robke and Woods, 2010).
Trends in racial/ethnic disparities in influenza vaccination coverage among adults during the 2007-08 through 2011-12 seasons
2014, American Journal of Infection ControlEffectiveness of hospital-based postpartum procedures on pertussis vaccination among postpartum women
2014, American Journal of Obstetrics and Gynecology