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改善农村医院中老年人肺炎球菌疫苗接种覆盖率:基于计划-做-研究-行为 (PDSA) 的质量改进项目
Ryuichi Ohta1, Koki Kato2, Chiaki Sano3
1Community Care, Unnan City Hospital, Unnan, JPN.
Cureus
|December 22, 2025
概括
日本农村的一个质量改善项目显著提高了老年人肺炎球菌疫苗接种率. 通过教育和电子提醒的干预,在三个月内,覆盖率从17.4%增加到65.0%.
科学领域:
- 公共卫生 公共卫生
- 老年病的医生 老年病的医生
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 肺炎球菌性肺炎对老年人来说是一个主要的健康问题,特别是在获得医疗保健有限的农村地区.
- 尽管有国家建议,但日本农村地区的肺炎球菌肺炎疫苗接种率仍低于最佳水平.
- 患者教育,提醒系统和工作流程改进可以提高门诊机构的预防性护理.
研究的目的:
- 实施和评估一个质量改善项目,在日本农村医院的老年患者中,在三个月内将肺炎球菌疫苗接种率提高至少20%.
- 评估基于电子病历 (EMR) 的提醒,患者教育和专业间合作的多组件干预措施的可行性和可扩展性.
主要方法:
- 在2025年2月至4月期间,乌南市医院使用了计划-做-研究-行动 (PDSA) 框架.
- 干预措施包括患者和工作人员的教育小册子,基于EMR的提醒,以及为65岁以上的慢性病患者提供标准化疫苗接种流程表.
- 使用中断时间序列分析 (ITSA) 来评估疫苗接种率,医生推率和提醒率的变化.
主要成果:
- 基线肺炎球菌疫苗接种覆盖率为17.4%;在干预后三个月内增加到65.0%.
- ITSA显示,每周接种疫苗率显著增加3.97个百分点 (p < 0.001).
- 医生推率从24%上升到83%,提醒率超过91%,员工满意度有所提高.
结论:
- 一项多组分干预措施显著增加了农村医院老年人肺炎球菌疫苗接种率.
- 整合EMR提醒,患者教育和协作实践是一个可行的和可扩展的模型,以加强农村环境中的成年人疫苗接种.
- 这个QI项目为改善类似医疗保健环境中的疫苗接种覆盖率提供了实际框架.
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