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J Gen Intern Med. 1999 Jun;14(6):351-6.

Improving pneumococcal vaccine rates. Nurse protocols versus clinical reminders.

Author information

1
Department of Medicine, UCLA, Los Angeles, CA, USA.

Abstract

OBJECTIVE:

To compare the effectiveness of three interventions designed to improve the pneumococcal vaccination rate.

DESIGN:

A prospective controlled trial.

SETTING:

Department of Veterans Affairs ambulatory care clinic.

PATIENTS/PARTICIPANTS:

There were 3, 502 outpatients with scheduled visits divided into three clinic teams (A, B, or C).

INTERVENTIONS:

During a 12-week period, each clinic team received one intervention: (A) nurse standing orders with comparative feedback as well as patient and clinician reminders; (B) nurse standing orders with compliance reminders as well as patient and clinician reminders; and (C) patient and clinician reminders alone. Team A nurses (comparative feedback group) received information on their vaccine rates relative to those of team B nurses. Team B nurses (compliance reminders group) received reminders to vaccinate but no information on vaccine rates.

MEASUREMENTS AND MAIN RESULTS:

Team A nurses assessed more patients than team B nurses (39% vs 34%, p =.009). However, vaccination rates per total patient population were similar (22% vs 25%, p =.09). The vaccination rates for both team A and team B were significantly higher than the 5% vaccination rate for team C (p <.001).

CONCLUSIONS:

Nurse-initiated vaccine protocols raised vaccination rates substantially more than a physician and patient reminder system. The nurse-initiated protocol with comparative feedback modestly improved the assessment rate compared with the protocol with compliance reminders, but overall vaccination rates were similar.

PMID:
10354255
PMCID:
PMC1496588
[Indexed for MEDLINE]
Free PMC Article
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