A Pilot Program to Improve Vaccination Status for Hospitalized Children

Pahud, Barbara; Clark, Shannon; Herigon, Joshua C.; Sherman, Ashley; Lynch, Daryl A.; Hoffman, Amber; Jackson, Mary Anne

doi:10.1542/hpeds.2014-0027

Cited by 28 publications

(50 citation statements)

References 16 publications

(14 reference statements)

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“…A pilot program to improve vaccination status for hospitalized children. 52 O: Series initiation after 1 month M: Observational study. Randomly selected hospitalized children/adolescents were enrolled in the study.…”

Section: Resultsmentioning

confidence: 99%

Interventions to increase HPV vaccination coverage: A systematic review

Smulian

Mitchell

Stokley

2016

Human Vaccines & Immunotherapeutics

135

108

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We reviewed intervention studies designed to increase human papillomavirus (HPV) vaccination coverage to further understand the impact interventions can have on HPV vaccination coverage. We searched 5 databases for intervention studies published from June 2006 to May 2015. Studies were included if they quantitatively measured HPV vaccination coverage as an outcome and were conducted in the United States. We abstracted outcomes, methods, and results from each study and classified by type of intervention conducted. Findings from 34 studies suggest many types of intervention strategies can increase HPV vaccination coverage in different settings, and with modest cost. Interventions were effective especially when implemented in combination at both provider and community levels. However, not all interventions showed significant effects on coverage. More research is needed to identify the best methods for widespread implementation of effective strategies.

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Section: Resultsmentioning

confidence: 99%

Interventions to increase HPV vaccination coverage: A systematic review

Smulian

Mitchell

Stokley

2016

Human Vaccines & Immunotherapeutics

135

108

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“…Few studies have been focused on hospitalization and postdischarge visits as an opportunity for immunization, nor have researchers explored the barriers contributing to such missed opportunities for catch-up immunizations. 21,22,32 Small studies have revealed promise in engaging families at the time of hospitalization to promote catch-up immunizations, although the lack of integration of IISs has made gathering accurate immunization records resource intensive. 21,22 Although a better integration of IISs and EMRs would improve the identification of children who are not UTD at the time of hospitalization, the recognition of underimmunization status may not be enough to promote catch-up immunizations postdischarge.…”

Section: Discussionmentioning

confidence: 99%

“…21,22,32 Small studies have revealed promise in engaging families at the time of hospitalization to promote catch-up immunizations, although the lack of integration of IISs has made gathering accurate immunization records resource intensive. 21,22 Although a better integration of IISs and EMRs would improve the identification of children who are not UTD at the time of hospitalization, the recognition of underimmunization status may not be enough to promote catch-up immunizations postdischarge. There is likely a need for better communication between acute and primary care settings regarding vaccines and the evaluation of this critical time frame as an opportunity to promote catch-up immunizations in this high-risk population.…”

Section: Discussionmentioning

confidence: 99%

“…21 The recognition of missed opportunities during hospitalization shows promise for interventions that are implemented to promote immunization posthospitalization; however it is unknown how IISs may be used for this purpose. 21,22 Our primary objective in this study is to assess the accuracy of provider-documented immunization status of children presenting to the hospital with acute respiratory illnesses in the IIS era. Many previous studies in which researchers detail the inaccuracy of parent report were conducted before the integration of IISs into clinical care.…”

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confidence: 99%

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Accuracy of Provider-Documented Child Immunization Status at Hospital Presentation for Acute Respiratory Illness

Bryan

Hofstetter

deHart

et al. 2018

Hospital Pediatrics

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A B S T R A C TOBJECTIVES: To assess (1) the accuracy of child immunization status documented by providers at hospital presentation for acute respiratory illness and (2) the association of provider-documented up-to-date (UTD) status with immunization receipt during and after hospitalization. METHODS:We conducted a retrospective cohort analysis of children #16 years old treated for asthma, croup, bronchiolitis, or pneumonia at a children's hospital between July 2014 and June 2016. Demographics, clinical characteristics, and provider-documented UTD immunization status (yes or no) at presentation were obtained from the medical record. We compared provider-documented UTD status to the gold standard: the child's UTD status as documented in the Washington State Immunization Information System (WAIIS). The sensitivity, specificity, and positive predictive value of provider-documented UTD status were calculated. We assessed the association of providerdocumented UTD status and immunization during and within 30 days posthospitalization using multivariable logistic regression. RESULTS:Among 478 eligible children, 450 (94%) had provider-documented UTD status at hospital presentation and an active WAIIS record. Overall, 92% and 42% were UTD by provider documentation and WAIIS records, respectively, with provider-documented UTD status having 98.4% sensitivity (95% confidence interval [CI]: 95.4%-99.7%), 12.2% specificity (95% CI: 8.5%-16.8%), and 44.6% positive predictive value (95% CI: 39.7%-49.5%). Per WAIIS records, 20% and 44% of children who were due for vaccines received a vaccine during or within 30 days posthospitalization, respectively. There was no significant association between provider-documented UTD status and immunization during or after hospitalization.CONCLUSIONS: Provider-documented UTD immunization status at hospital presentation for children with respiratory illnesses overestimates UTD status, creating missed opportunities for immunization during and after hospitalization.

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“…Hospitalization is an opportune time to assess immunization status and ensure up-to-date immunizations. 3,4 In this setting, a reliable review process of the patient' s immunization record can decrease the risk of missed immunization opportunities and allow providers to answer parent' s questions on the benefits, risks, and safety of immunizations. Preterm infants with severe CLD are often severely ill and require respiratory support and prolonged hospitalization in the NICU during a time that often overlaps with the American Academy of Pediatrics immunization opportunity windows.…”

mentioning

confidence: 99%

Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative

Milet

Chuo

Nilan

et al. 2018

Hospital Pediatrics

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A B S T R A C TOBJECTIVES: Immunizations provide important protection from serious childhood illnesses. Infant chronic lung disease (CLD) is a serious complication of prematurity and predisposes premature infants to respiratory morbidity, rehospitalization, and mortality. This high-risk group is especially vulnerable to infections, such as invasive pneumococcal disease, influenza, and bronchiolitis. Our purpose for this project was to increase 2-, 4-, and 6-month immunization rates in eligible infants with CLD in the NICU by 30% through December 2016. METHODS:A multidisciplinary team developed weekly targeted rounds to identify eligible patients with outstanding immunizations. Exclusion criteria included the following: (1) a fraction of inspired oxygen requirement of .80%, (2) pulmonary hypertensive crisis, (3) positive blood culture results or if within 48 hours of a sepsis evaluation, (4) if within 5 days of a surgical or interventional procedure, (5) receiving steroid treatment (not including a physiologic hydrocortisone dose for adrenal insufficiency), (6) a CLD team consensus of contraindication, and (7) parental refusal. RESULTS:The project managed 60 patients from March 2016 to December 2016. Immunization of eligible patients increased from 44% to 75% and was sustained for the next 6 months. The average number of days from admission to immunization record review decreased from 71 days at baseline to 27 days. CONCLUSIONS:The implementation of (1) an in-hospital immunization record review, (2) an e-mail reminder, (3) a weekly multidisciplinary eligibility discussion, and (4) an updated rounding tool was successful in increasing and sustaining immunization rates in this population of infants with CLD. The multidisciplinary CLD meeting was a novel opportunity to discuss immunization eligibility and safety monitoring.

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A Pilot Program to Improve Vaccination Status for Hospitalized Children

Cited by 28 publications

References 16 publications

Interventions to increase HPV vaccination coverage: A systematic review

Interventions to increase HPV vaccination coverage: A systematic review

Accuracy of Provider-Documented Child Immunization Status at Hospital Presentation for Acute Respiratory Illness

Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative

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