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An initiative to improve pneumococcal immunization counseling in children with nephrotic syndrome

Ibrahim Sandokji1,2, Linda S Anderson3, Jillian K Warejko3

  • 1Department of Pediatrics, Section of Nephrology, Clinical and Translational Research Accelerator, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06520-8064, USA. isandokji@gmail.com.

Pediatric Nephrology (Berlin, Germany)
|November 4, 2021
PubMed

Insights

Children with nephrotic syndrome need pneumococcal polysaccharide vaccine (PPSV23) to prevent infections. Quality improvement efforts significantly increased PPSV23 counseling rates from 12% to 86% through provider education and EHR reminders.

Area of Science:

  • Pediatric Nephrology
  • Immunology
  • Public Health

Background:

  • Pneumococcal infections pose a severe risk to children with nephrotic syndrome.
  • The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is crucial for this patient group.
  • Current guidelines are not consistently followed, leading to under-vaccination.

Purpose of the Study:

  • To improve the rate of PPSV23 counseling in children with nephrotic syndrome.
  • To achieve a counseling rate exceeding 70% within 12 months.
  • To identify effective interventions for increasing vaccine adherence.

Main Methods:

  • A quality improvement project was implemented in a nephrology clinic.
  • Interventions included enhancing provider awareness, improving communication, and increasing adherence.
  • Data was collected via electronic health records (EHR) and tracked using control charts.

Main Results:

  • Adherence to PPSV23 counseling increased from a baseline of 12% to 86%.
  • Provider awareness and EHR reminders were key effective interventions.
  • Sustained adherence was observed throughout the project duration.

Conclusions:

  • Addressing provider knowledge gaps and utilizing EHR reminders are effective strategies.
  • These interventions can improve PPSV23 counseling adherence in children with nephrotic syndrome.
  • The approach may be applicable to other immunocompromised pediatric populations requiring specific vaccinations.
Abstract

Keywords:
Electronic health recordsImmunizationNephrotic syndromePediatricsPneumococcalQuality improvement

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