Antibacterial therapy in COVID-19 patients - an evidence based guideline
Routhier_Katelyn_Presentation
1. Evaluation of a Vaccine Patrol
Team to Increase Pneumococcal
Vaccination Rates among Adult
Inpatients at Fairview Hospital
Katelyn Routhier
Maureen King, MSN, CNP
Mary Beth Zeni, ScD, RN
2. Pneumonia is an infection of the lungs caused by
common bacteria which can be life-threatening
5. Background
Core Measures are standardized performance
practices for hospitals to provide the best
patient care. In 2012, immunizations (influenza
and pneumococcal) became one of these
Measures.
Healthy People 2020 goal is to increase the
percentage of adults vaccinated against
pneumococcal disease. 60% of adults’ ages 19-
64 years with high risk condition; 90% of adults’
ages 65 years or older.
6. Background
Annually, up to 50,000 American adults die
from vaccine preventable diseases,
representing an annual direct health care
burden of $10 billion.
Pneumonia carries a high morbidity and
mortality, is expensive to treat, and is
preventable through vaccination.
7. What is the impact of the addition of a
vaccine patrol team to Fairview Hospital’s
adult inpatients during a four week period
(June 4 – June 29, 2012) on the number of
pneumococcal vaccines administered?
Research Question
8. Data Collection
• 156 adult inpatients at Fairview Hospital
• Information gathered from:
- EPIC list created to include all patients
eligible to receive pneumovax
- EBI Dashboard
- Emails from RN in bed control
• Patients and nurses interviewed during real
time to identify possible vaccination barriers.
9. A checklist was developed to document the
processes of the EPIC protocol for pneumovax
administration and to determine barriers to
vaccine administration.
All data were de-identified for this quality research project.
10. Results
63 of 117 vaccines (54%) were administered to
adult inpatients between 18-64 years with chronic
conditions.
54 of 117 vaccines (46%) were administered to
adult inpatients above 65 years.
Adult Inpatients
between 18-64
years with Chronic
Condition(s)
Adult Inpatients
above 65 years
11. June
Data
Number of
patients above
65 years who
qualified for
vaccine
Number of
vaccines
given
Vaccination
rates
4%307122011
2012 617 54 9%
Vaccination rates to patients 65 years
and older increased from 4% in June
2011 to 9% in June 2012.
12. Results
• In June 2012, 117 pneumococcal vaccines were administered
to 156 adults who qualified for the pneumovax = 75%
vaccination rate.
• Common reasons for not administering the vaccine:
- RN unable to verbally communicate with intubated,
sedated, or demented patient
- RN forgot to order pneumovax
- RN interpreted patient’s status (medical history) as reason
not to administer vaccine
- Patient discharged before opportunity for administration
13. Conclusions
• Nurses are unable to correctly navigate
EPIC to determine the patient’s need for
vaccination.
• Vaccines administered at an outside facility
are often not documented. Nurses can not
spend great amounts of time to recover the
patient’s previous vaccination history.
14. Recommendations
• The vaccine patrol team recommends
modifying EPIC.
- Convert the single historical
immunization menu from two pull-down
options to one.
- Initiate an automatic order to administer
the pneumovax if the vaccine is indicated
per the nursing assessment.
- Employ a “stop gap” at discharge if the
nursing assessment is incomplete.
15. Vaccine Patrol Team
• In summary, the addition of a vaccine
patrol team would help:
- Educate patients
- Educate nurses
- Increase the number of pneumococcal
vaccines administered
- Stabilize the Immunization Core
Measure at 90-100%
16. Acknowledgements
• Office of Civic Education Initiatives
• Nedra Starling, MPH, ABD
• Rosalind Strickland
• Maureen King, MSN, CNP (mentor)
• Mary Beth Zeni, ScD, RN
• Marianela Zytkowski, DNP, MS, RN-BC
• Sherry A. Jakubiec, MHA/INF
