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Quality Improvement Project to Reduce Delayed Vaccinations in Preterm Infants
1Department of Pediatrics, Children's Mercy Kansas City and University of Missouri-Kansas City School of Medicine, Kansas City, MO (Dr Cuna); and Department of Pediatrics, Children's of Alabama and University of Alabama at Birmingham, Birmingham, AL (Dr Winter).
Insights
Vaccination delays in preterm infants are common. Implementing simple interventions using the Plan-Do-Study-Act model significantly improved on-time vaccinations for vulnerable infants, increasing rates from 36% to 82%.
Area of Science:
- Neonatal care
- Pediatric infectious diseases
- Quality improvement in healthcare
Background:
- Preterm infants face heightened vulnerability to infectious diseases.
- Vaccinations are crucial for protecting preterm infants from preventable illnesses.
- Delays in vaccination schedules for preterm infants are a recognized challenge.
Purpose of the Study:
- To enhance the timeliness of vaccinations for preterm infants admitted to the neonatal intensive care unit.
- To implement and evaluate quality improvement strategies for infant immunization.
Main Methods:
- The Plan-Do-Study-Act (PDSA) model guided the development and testing of interventions.
- Interventions focused on improving the administration of vaccinations according to recommended schedules.
- On-time vaccination was defined as receiving immunizations within two weeks of the scheduled date.
Main Results:
- The baseline rate for on-time vaccinations among eligible preterm infants was 36%.
- Following multiple PDSA cycles, a substantial increase in timely vaccinations was observed.
- The project successfully established a new baseline rate of 82% for on-time vaccinations.
Conclusions:
- The Plan-Do-Study-Act model provides an effective framework for implementing interventions to improve vaccination rates in preterm infants.
- Simple, targeted interventions can significantly overcome barriers to timely infant immunization.
- Further research is recommended to solidify vaccine safety and efficacy data in preterm populations and explore dissemination strategies.
Background:
Preterm infants are especially vulnerable to infectious diseases. Although vaccinations are a safe and effective measure to protect preterm infants from vaccine-preventable diseases, delays in vaccinations are not uncommon.
Purpose:
The goal of this quality improvement project was to improve on time vaccinations of preterm infants hospitalized in the neonatal intensive care unit.
Methods:
The Plan-Do-Study-Act model of quality improvement was adopted to develop, test, and implement interventions aimed at improving timely vaccination of preterm infants. The primary outcome measure of interest was the rate of on time vaccination, which was defined as the proportion of medically eligible preterm infants who received vaccinations within 2 weeks of the recommended schedule.
Results:
Baseline on time vaccination rate was only 36%. Following several Plan-Do-Study-Act cycles, a steady increase in on time vaccinations of eligible infants was observed, and a new baseline on time vaccination rate of 82% was achieved.
Implications For Practice:
Simple interventions implemented within the context of Plan-Do-Study-Act cycles are effective in improving timely vaccinations among preterm infants.
Implications For Research:
Future research that focuses on vaccinations in preterm infants is needed to further reinforce the safety and efficacy of vaccines. Effective methods on how to disseminate and apply this knowledge to practice should also be studied.Video Abstract available at http://links.lww.com/ANC/A27.