通过儿科急诊诊所实施免疫服务
David M Gordon1,2, Tonia Vega1, Sabreen Aulakh2
1Children's Health Center, Zuckerberg San Francisco General Hospital, San Francisco, California.
Pediatrics
|November 14, 2024
概括
实施专门的护士疫苗接种器显著改善了儿科急诊机构的免疫率. 仅仅以提供者为中心的干预措施并没有在疫苗查或管理方面带来实质性的变化.
科学领域:
- 提高儿科医疗保健质量 提高儿科医疗保健质量
- 公共卫生免疫战略 公共卫生免疫战略
- 紧急护理药物 紧急护理药物
背景情况:
- 儿科急诊中心 (PUC) 提供了一个增强免疫覆盖率的机会.
- 很少有研究记录了PUC环境中的疫苗接种计划的实施情况.
研究的目的:
- 评估质量改善倡议对儿童急诊中心免疫查和管理的影响.
- 评估面向提供者的干预措施的有效性,并增加一个专门的护士疫苗接种员.
主要方法:
- 在一个学术联邦合格健康中心进行了质量改善计划.
- 使用统计过程控制,在两年内测量了免疫查和注射率.
- 干预措施包括提供者培训,EHR支持和财务激励,随后增加了一名专门的护士疫苗接种员.
主要成果:
- 面向医疗服务提供者的干预措施没有显著增加查或管理率.
- 专门接种疫苗的护士的引入导致了平均查率 (44.7%至67.4%) 和给药率 (26.5%至50.8%) 的大幅增加.
- 在不同种族,语言和患者入学群体中,在药物使用率上发现了差异.
结论:
- 仅仅以提供者为中心的干预措施不足以改善PUC的疫苗接种率.
- 一个专门的护士疫苗接种模型显著提高了儿童急诊机构的免疫接种.
- 需要进一步的研究来解决发现的差异,并确认在其他PUCs的可复制性.
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