Hepatitis B birth dose vaccination patterns in the Military Health System, 2014–2018

Deerin, Jessica Fung; Clifton, Rebecca G.; Elmi, Angelo; Lewis, Paul E.; Kuo, Irene

doi:10.1016/j.vaccine.2021.03.010

Cited by 1 publication

(1 citation statement)

References 27 publications

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“…2,3 However, some units struggle to achieve on-time administration, potentially related to system processes, provider opinion, and/or parental preference or refusal. [4][5][6][7] Newborns admitted to neonatal intensive care units (NICUs) are at risk for immunization delays. 8,9 These delays occur for infants born prematurely and term infants admitted with congenital anomalies or other problems.…”

Section: Introductionmentioning

confidence: 99%

Improving On-time Administration of the Initial Hepatitis B Vaccine in the NICU

Gontasz,

Chalk,

Liang

2023

Pediatric Quality &Amp; Safety

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Introduction: Despite the updated American Academy of Pediatrics recommendation for universal administration of the hepatitis B vaccine for newborns, delays in routine prophylaxis are common in the Neonatal Intensive Care Unit (NICU). Delayed immunization can increase perinatal acquisition risks and lead to subsequent delays in routine childhood immunization. This study aimed to increase the on-time administration of the birth dose of the hepatitis B vaccine from 46% to ≥70% at a level III and level IV NICU within the same health system. Methods: The stakeholder group developed project interventions using quality improvement methods, including implementing unit guidelines and a prompt in the progress note template. The outcome measure was the percent on-time administration of the initial hepatitis B vaccine for inborn NICU patients born to hepatitis B-negative mothers. The process measure was the percent on-time administration or a valid reason to delay immunization following the guidelines. Statistical process control P-charts graphically represented the measures to assess for change from January 2019 to May 2021. Results: In total, 2192 patients were included. The percent on-time administration improved from 48% to 57%. The percentage of on-time administration or valid reason to delay increased from 76% to 80%. Conclusions: Quality improvement methodology facilitated the identification of barriers to on-time hepatitis B prophylaxis in the NICU and the improvement of the timeliness of administration across 2 sites. Guidelines tailored to this population and changes to the progress note template successfully created and sustained change and may benefit other NICUs.

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