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

Indirapriya Avulakunta1, Palanikumar Balasundaram2, Alma Rechnitzer3

  • 1From the Division of Neonatology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Ark.

Pediatric Quality & Safety
|October 11, 2023
PubMed

Insights

A quality improvement initiative successfully increased Hepatitis B vaccine (HBV) rates in a neonatal intensive care unit (NICU). Eligible infants received timely HBV immunization, improving public health outcomes.

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.
Abstract

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