A Improving Birth-dose Hepatitis-B Vaccination in a Tertiary Level IV Neonatal Intensive Care Unit

Area of Science:

• Public Health
• Immunization Practices
• Neonatal Care

Background:

• Perinatal hepatitis B is a significant global health issue.
• Hepatitis B vaccine (HBV) is recommended for infants within 24 hours of birth.
• Infants in neonatal intensive care units (NICUs) often missed timely HBV vaccination.

Purpose of the Study:

• To implement a quality improvement (QI) initiative to increase birth dose HBV immunization rates in a level IV NICU.
• To address missed HBV vaccinations in NICU infants weighing over 2000g.
• To improve timely HBV administration for eligible neonates.

Main Methods:

• A multidisciplinary QI team identified barriers using an Ishikawa cause-and-effect diagram.
• Interventions included enhanced collaboration, EMR reminders, education, and improved communication.
• Four Plan-Do-Study-Act cycles were conducted over 19 months.

Main Results:

• The rate of birth dose HBV administration within 12 hours increased from 24% to 56%.
• The rate within 24 hours improved from 31% to 64%.
• Process measure compliance exceeded the 25% improvement target and demonstrated sustained results.

Conclusions:

• The QI initiative effectively improved timely HBV administration for eligible infants in the NICU.
• This initiative can serve as a model for other institutions to enhance HBV immunization rates.
• Improved vaccination rates contribute to reducing perinatal hepatitis B transmission.