Be inFLUential: Evaluation of a multifaceted intervention to increase influenza vaccination rates among pediatric inpatients
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Published on: April 14, 2011
Suchitra Rao1, Sonja I Ziniel2, Isra'a Khan2
1Department of Pediatrics (Infectious Diseases, Hospital Medicine and Epidemiology), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
Insights
A new intervention significantly boosted influenza vaccination rates in hospitalized children. The program used education, reminders, and incentives for healthcare staff, leading to more children receiving the flu vaccine before discharge.
Area of Science:
- Pediatric Hospital Medicine
- Infectious Disease Prevention
- Public Health Interventions
Background:
- Annual influenza vaccination is recommended for children aged 6 months and older.
- Vaccination rates in the US remain below national targets.
- Inpatient settings offer a potential opportunity to increase influenza vaccination coverage.
Purpose of the Study:
- To evaluate the effectiveness of a multifaceted intervention to increase influenza vaccination rates among pediatric inpatients.
- To assess the impact of targeting nurses and providers with educational modules, reminders, and incentives.
Main Methods:
- A pre-post interventional study was conducted on medical inpatient units.
- The intervention included web-based education, huddles, electronic health record reminders, and financial incentives.
- Outcomes measured were influenza vaccine ordering rates and vaccination rates at discharge.
Main Results:
- The vaccine ordering rate increased from 28.8% to 50.2% (p < 0.001).
- The intervention was associated with higher odds of vaccination screening (1.23), vaccine ordering (2.27), and vaccination at discharge (1.39) (all p < 0.001).
- Residents and medical providers were more likely to order vaccines than nurses.
Conclusions:
- A multifaceted intervention targeting healthcare professionals is effective in improving influenza vaccine ordering.
- This approach leads to higher inpatient influenza vaccination rates among pediatric patients.
- The study highlights the potential of hospital-based interventions to enhance public health goals.
Background And Objective:
Annual influenza vaccination is recommended for individual ≥6 months of age, yet vaccination rates remain below national targets in the US. Hospitalization provides another medical setting for influenza vaccination, but the effectiveness of inpatient interventions has not been well studied. Our objective was to evaluate the effectiveness of a multifaceted intervention to increase influenza vaccination rates among pediatric inpatients.
Methods:
We conducted a pre-post interventional study on medical inpatient units at Children's Hospital Colorado from September 2016-April 2017 (pre-intervention) and September 2017-April 2018 (intervention). The intervention targeted nurses (web-based education modules, huddles and reminders) and providers (vaccination lists in the electronic health record, reminders, vaccination reports and financial incentives for residents). Outcomes were influenza vaccine ordering rates, and influenza vaccination rates at discharge. We analyzed data using descriptive statistics, bivariate and logistic regression.
Results:
Among 4,050 inpatients in 2016-2017 and 4,523 inpatients in 2017 aged ≥ 6 months, vaccination status was documented for 2,902/4,050 (71.7%) and 3,431/4,523 (75.9%) children aged > 6 months of age hospitalized during the study period. The vaccine ordering rate among eligible children was 28.8% in the pre-intervention season versus 50.2% in the intervention season (p < 0.001). The intervention was associated with 1.23 (95% CI 1.11-1.35) times higher odds of appropriate vaccination screening on admission, 2.27 (95% CI 2.01-2.56) times higher odds of a vaccination being ordered, and 1.39 (95% CI 1.27-1.53) times higher odds of a child being vaccinated against influenza at discharge (all p < 0.001). Residents (56%) and medical providers (39%) were more likely to order vaccines compared with nurses (5%), p = 0.014).
Conclusion:
A multifaceted intervention targeting nurses, residents and providers comprising education, visual reminders, vaccination reports and financial incentives is an effective way of improving influenza vaccine ordering, resulting in higher inpatient influenza vaccination rates.
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