Improving Influenza Vaccination in Hospitalized Children With Asthma.

Autor:	Foradori DM; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas foradod@ccf.org., Sampayo EM; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas., Fanny SA; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas., Namireddy MK; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas., Kumar AM; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas., Lo HY; Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2020 Mar; Vol. 145 (3).
DOI:	10.1542/peds.2019-1735
Abstrakt:	Objectives: Children with asthma are at increased risk of complications from influenza; hospitalization represents an important opportunity for vaccination. We aimed to increase the influenza vaccination rate among eligible hospitalized patients with asthma on the pediatric hospital medicine (PHM) service from 13% to 80% over a 4-year period. Methods: Serial Plan-Do-Study-Act cycles were implemented to improve influenza vaccination rates among children admitted with status asthmaticus and included modifications to the electronic health record (EHR) and provider and family education. Success of the initial PHM pilot led to the development of a hospital-wide vaccination tracking tool and an institutional, nurse-driven vaccine protocol by a multidisciplinary team. Our primary outcome metric was the inpatient influenza vaccination rate among PHM patients admitted with status asthmaticus. Process measures included documentation of influenza vaccination status and use of the EHR asthma order set and a history and physical template. The balance measure was adverse vaccine reaction within 24 hours. Data analysis was performed by using statistical process control charts. Results: The inpatient influenza vaccination rate increased from 13% to 57% over 4 years; special cause variation was achieved. Overall, 50% of eligible patients were vaccinated during asthma hospitalization in the postintervention period. Documentation of influenza vaccination status significantly increased from 51% to 96%, and asthma history and physical and order set use also improved. No adverse vaccine reactions were documented. Conclusions: A bundle of interventions, including EHR modifications, provider and family education, hospital-wide tracking, and a nurse-driven vaccine protocol, increased influenza vaccination rates among eligible children hospitalized with status asthmaticus. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2020 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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