Increasing Vaccination Rates in a Pediatric Chronic Hemodialysis Unit

Area of Science:

• Pediatric Nephrology
• Public Health
• Nursing Quality Improvement

Background:

• Children with chronic kidney disease (CKD) have a heightened susceptibility to severe outcomes from vaccine-preventable illnesses.
• Vaccination rates in pediatric CKD patients, particularly those on dialysis, are often suboptimal.
• Multifactorial barriers impede timely immunizations in this vulnerable population.

Purpose of the Study:

• To describe an advanced practice registered nurse (APRN)-led quality improvement initiative aimed at achieving 100% vaccination rates.
• To address and overcome barriers to vaccination in pediatric patients undergoing hemodialysis.
• To establish a sustainable system for monitoring and improving immunization coverage.

Main Methods:

• Implementation of a systematic immunization review process upon admission to hemodialysis and annually.
• Leveraging the role of the APRN as a key stakeholder and "wellness champion" for pediatric patients.
• A quality improvement framework guiding the project over a two-year period.

Main Results:

• Significant improvement in immunization rates within the studied pediatric hemodialysis population.
• Demonstrated feasibility of achieving high vaccination coverage through a structured approach.
• Successful identification and mitigation of specific barriers to pediatric vaccination.

Conclusions:

• APRNs can effectively lead quality improvement projects to enhance vaccination rates in pediatric CKD patients.
• Systematic monitoring and intervention are crucial for improving vaccine uptake in children on hemodialysis.
• Targeted strategies can overcome barriers and ensure adequate protection against vaccine-preventable diseases in this high-risk group.