Introducing printed postpartum orders for measles-mumps-rubella vaccination: a qualitative study

Area of Science:

• Public Health
• Immunization
• Maternal Health

Background:

• Postpartum is a critical period for assessing and updating maternal immunization status.
• Low vaccination rates in susceptible women pose a risk for preventable diseases like measles, mumps, and rubella.
• Standardized protocols can improve healthcare delivery and patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of printed postpartum orders in increasing measles-mumps-rubella (MMR) vaccination rates.
• To identify facilitators and barriers to implementing postpartum MMR vaccination policies.
• To provide insights for broader adoption in other healthcare settings.

Main Methods:

• Qualitative study utilizing semi-structured interviews with healthcare professionals (physicians, nurses, ward clerk).
• Thematic analysis of transcribed interviews to identify strengths and weaknesses of the printed order sheet approach.
• Retrospective review of vaccination rates before and after implementation.

Main Results:

• Vaccination rates for susceptible women increased significantly from 12.1% to 81.7% after implementing printed postpartum orders (RR 6.8, 95% CI 3.3, 13.7).
• Healthcare staff broadly supported the initiative.
• Key needs identified include comprehensive protocols for nurses and timely availability of antenatal records.

Conclusions:

• Printed postpartum orders are effective in increasing MMR vaccination rates among susceptible women.
• Successful implementation requires robust infrastructure, clear protocols, and efficient information systems.
• The findings support the substantiation of standing orders for postpartum vaccination.