Increasing Pneumococcal Vaccination Rates Among Residents of Long-Term–Care Facilities: Provider-Based Improvement Strategies Implemented by Peer-Review Organizations in Four Western States

Abstract

Simple and straightforward vaccination strategies implemented in LTCFs over a short period of time can have a significant impact on vaccination rates. Collaborative efforts between state PROs and LTCFs enhance implementation of these strategies and can result in the achievement of national vaccination objectives. Standing orders appear to be one intervention effective in sustaining successful vaccination efforts. Regardless of the specific interventions employed, PROs played a significant role in facilitating vaccination program development and intervention implementation.

Guidelines for the management of adult lower respiratory tract infections

“…Interventions to increase vaccine uptake, e.g. standing orders, chart stickers and the provision of reminders, have also been shown to be effective in hospitalised patients, both in acute care settings [344] and in long-term facilities [345]. Improvement in influenza vaccine coverage in healthcare personnel seems to be difficult.…”

A Multifaceted Intervention to Implement Guidelines Improved Treatment of Nursing Home–Acquired Pneumonia in a State Veterans Home

“…Other studies have confirmed that it is possible to improve vaccination rates in nursing homes. [31][32][33] Improvements in antibiotic prescribing in this study parallel academic detailing studies that have demonstrated improvement in nursing home prescribing practices for nonsteroidal antiinflammatory drugs and neuroleptics. [17][18][19] Influenza vaccination rates and use of chest x-rays improved significantly between baseline and the end of the intervention period in the intervention home, whereas in the control home, timeliness of antibiotic delivery and use of chest x-rays declined significantly.…”

Influenza and pneumococcal vaccine uptake among nursing home residents in Nottingham, England: a postal questionnaire survey

“…Whether this effect was sustained beyond the 6 month study period is unknown [11]. A study of 133 long term care facilities in North America used a number of interventions including 'standing orders' (whereby nurses or pharmacists are authorised to administer vaccinations according to a pre-approved protocol), to increase pneumococcal vaccination rates from 40% to 75% [13]. Likewise, in Canada a pharmacist-centred standing orders intervention increased pneumococcal vaccine uptake among residents in the two care homes studied from 4.2% to 83% and from 1.9% to 83% [14].…”