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Improving influenza vaccination rates among adults in acute care using a standing order form by exception
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Vol. 33 No. 5
CONCLUSIONS: Light-duty nursing personnel can be an important adjunct to IC departments when monitoring infection control practice. An additional 48 hours/week for 12 weeks (equivalent IC practitioner salary value of $16,883) were devoted to monitoring HH compliance and data entry by light-duty nursing staff. This effectively relieved the IC department staff from the data collection burden and allowed IC staff time to focus on interventions. The additional resources were IC budget-neutral and allowed us to obtain a level of detail that would otherwise not have been possible given our current IC staffing. The experience provided the opportunity to develop additional IC resources as well as provide immediate feedback for staff regarding HH practice. In addition, the data collected will serve as the basis for current and future interventions to improve HH compliance at our institution.
Abstract ID 52573 Monday, June 20
Improving influenza vaccination rates among adults in acute care using a standing order form by exception K Wroten J Piper K Couch L Freeman D Wolfe Christiana Care Health System, Newark, Delaware ISSUE: Influenza is the sixth leading cause of death in adults, with approximately 36,000 deaths each year. Vaccinating adults at risk is the single most effective method of preventing the development and spread of influenza. Historically, in our acute care hospitals, the vaccination rates were low as a result of physicians not using the current influenza order form. To address the issue, infection control initiated a process of implementing a new influenza standing order form. PROJECT: In 2002, baseline data provided by the hospital pharmacy showed that influenza vaccination rates were suboptimal using the current order form that required a physician signature to initiate the process. As a result, infection control and several committees worked together to develop a new standing order form ‘‘by exception.’’ By using this form, all adult patients who met the Centers for Disease Control and Prevention (CDC) criteria listed on the form automatically received the vaccine on the day of discharge unless a physician signed the form or wrote an order not to administer. This change in practice required specific education for both nurses and physicians. Education addressed patient assessment, patient education, and pertinent information regarding vaccine safety and use of the form. Periodic reminders were sent to the nurse managers during the flu season encouraging them to support the program. The program was evaluated at the end of the influenza season to assess the impact of the new form. RESULTS: The number of influenza vaccine doses administered during the baseline period 2002, prior to initiating the new standing order form, was 302. In October 2003, the new order form was initiated and 392 doses were administered. The second year of the program was most successful, with 990 doses administered in the first 3½ months of the annual program. LESSONS LEARNED: A coordinated systems approach that includes the pharmacy, physician committees, and administration is vital when initiating such a process change. Providing feedback and education to the users of the form will also enhance compliance. As with all medications, drug shortages affect the ability to provide medications as during the 2003 influenza season. We recognize that this new standing order form is just one part of an integrated process to improve influenza vaccination rates in our acute adult patients.
Vol. 33 No. 5
CONCLUSIONS: Light-duty nursing personnel can be an important adjunct to IC departments when monitoring infection control practice. An additional 48 hours/week for 12 weeks (equivalent IC practitioner salary value of $16,883) were devoted to monitoring HH compliance and data entry by light-duty nursing staff. This effectively relieved the IC department staff from the data collection burden and allowed IC staff time to focus on interventions. The additional resources were IC budget-neutral and allowed us to obtain a level of detail that would otherwise not have been possible given our current IC staffing. The experience provided the opportunity to develop additional IC resources as well as provide immediate feedback for staff regarding HH practice. In addition, the data collected will serve as the basis for current and future interventions to improve HH compliance at our institution.
Abstract ID 52573 Monday, June 20
Improving influenza vaccination rates among adults in acute care using a standing order form by exception K Wroten J Piper K Couch L Freeman D Wolfe Christiana Care Health System, Newark, Delaware ISSUE: Influenza is the sixth leading cause of death in adults, with approximately 36,000 deaths each year. Vaccinating adults at risk is the single most effective method of preventing the development and spread of influenza. Historically, in our acute care hospitals, the vaccination rates were low as a result of physicians not using the current influenza order form. To address the issue, infection control initiated a process of implementing a new influenza standing order form. PROJECT: In 2002, baseline data provided by the hospital pharmacy showed that influenza vaccination rates were suboptimal using the current order form that required a physician signature to initiate the process. As a result, infection control and several committees worked together to develop a new standing order form ‘‘by exception.’’ By using this form, all adult patients who met the Centers for Disease Control and Prevention (CDC) criteria listed on the form automatically received the vaccine on the day of discharge unless a physician signed the form or wrote an order not to administer. This change in practice required specific education for both nurses and physicians. Education addressed patient assessment, patient education, and pertinent information regarding vaccine safety and use of the form. Periodic reminders were sent to the nurse managers during the flu season encouraging them to support the program. The program was evaluated at the end of the influenza season to assess the impact of the new form. RESULTS: The number of influenza vaccine doses administered during the baseline period 2002, prior to initiating the new standing order form, was 302. In October 2003, the new order form was initiated and 392 doses were administered. The second year of the program was most successful, with 990 doses administered in the first 3½ months of the annual program. LESSONS LEARNED: A coordinated systems approach that includes the pharmacy, physician committees, and administration is vital when initiating such a process change. Providing feedback and education to the users of the form will also enhance compliance. As with all medications, drug shortages affect the ability to provide medications as during the 2003 influenza season. We recognize that this new standing order form is just one part of an integrated process to improve influenza vaccination rates in our acute adult patients.