Factors Predictive of Increased Influenza and Pneumococcal Vaccination Coverage in Long-term Care Facilities: The CMS-CDC Standing Orders Program Project
| Autor: | Abigail Shefer, Dale W. Bratzler, David C. Rhew, Linda McKibben, Henry Roberts, Barbara H. Bardenheier |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Quality management Pneumococcal Infections Pneumococcal Vaccines symbols.namesake Sex Factors Predictive Value of Tests Risk Factors Surveys and Questionnaires Influenza Human Homes for the Aged Humans Medicine Poisson regression General Nursing Aged Aged 80 and over Immunization Programs business.industry Incidence Health Policy Medical record Vaccination Age Factors General Medicine medicine.disease Long-Term Care United States Nursing Homes Long-term care ROC Curve Immunization Influenza Vaccines Health Care Surveys Family medicine Multivariate Analysis Pneumococcal vaccination Quality of Life symbols Female Medical emergency Centers for Disease Control and Prevention U.S Geriatrics and Gerontology business Program Evaluation |
| Zdroj: | Journal of the American Medical Directors Association. 6:291-299 |
| ISSN: | 1525-8610 |
| DOI: | 10.1016/j.jamda.2005.06.007 |
| Popis: | Background Between 1999 and 2002, a multistate demonstration project was conducted in long-term care facilities (LTCFs) to encourage implementation of standing orders programs (SOP) as evidence-based vaccine delivery strategies to increase influenza and pneumococcal vaccination coverage in LTCFs. Objective Examine predictors of increase in influenza and pneumococcal vaccination coverage in LTCFs. Design Intervention study. Self-administered surveys of LTCFs merged with data from OSCAR (On-line Survey Certification and Reporting System) and immunization coverage was abstracted from residents’ medical charts in LTCFs. Setting and Participants Twenty LTCFs were sampled from 9 intervention and 5 control states in the 2000 to 2001 influenza season for baseline and during the 2001 to 2002 influenza season for postintervention. Intervention Each state’s quality improvement organization (QIO) promoted the use of standing orders for immunizations as well as other strategies to increase immunization coverage among LTCF residents. Main Outcome Measures Multivariate analysis included Poisson regression to determine independent predictors of at least a 10 percentage-point increase in facility influenza and pneumococcal vaccination coverage. Results Forty-two (20%) and 59 (28%) of the facilities had at least a 10 percentage-point increase in influenza and pneumococcal immunizations, respectively. In the multivariate analysis, predictors associated with increase in influenza vaccination coverage included adoption of requirement in written immunization protocol to document refusals, less-demanding consent requirements, lower baseline influenza coverage, and small facility size. Factors associated with increase in pneumococcal vaccination coverage included adoption of recording pneumococcal immunizations in a consistent place, affiliation with a multifacility chain, and provision of resource materials. Conclusions To improve the health of LTCF residents, strategies should be considered that increase immunization coverage, including written protocol for immunizations and documentation of refusals, documenting vaccination status in a consistent place in medical records, and minimal consent requirements for vaccinations. |
| Databáze: | OpenAIRE |
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