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1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease

BACKGROUND: Pneumococcal disease causes significant morbidity and mortality in children. Routine childhood immunizations protect for 13 or 15 pneumococcal serotypes via two pneumococcal conjugated vaccines. Patients with immunocompromising and chronic medical conditions are at high risk of invasive...

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Autores principales: Lyon, Edward, Wetzel, Tracey, Wirtz, Ann, Swanson, Doug, Moran, Rachel R, Peters, Jessica, Symes, Christine A, Olarte, Liset, El Feghaly, Rana E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678018/
http://dx.doi.org/10.1093/ofid/ofad500.1562
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author Lyon, Edward
Wetzel, Tracey
Wirtz, Ann
Swanson, Doug
Moran, Rachel R
Peters, Jessica
Symes, Christine A
Olarte, Liset
El Feghaly, Rana E
author_facet Lyon, Edward
Wetzel, Tracey
Wirtz, Ann
Swanson, Doug
Moran, Rachel R
Peters, Jessica
Symes, Christine A
Olarte, Liset
El Feghaly, Rana E
author_sort Lyon, Edward
collection PubMed
description BACKGROUND: Pneumococcal disease causes significant morbidity and mortality in children. Routine childhood immunizations protect for 13 or 15 pneumococcal serotypes via two pneumococcal conjugated vaccines. Patients with immunocompromising and chronic medical conditions are at high risk of invasive pneumococcal disease. A 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended in these patients to protect against more pneumococcal serotypes, but many patients have not received it. Our AIM is to increase PPSV23 vaccination rates among eligible patients in both the inpatient and outpatient infectious diseases (ID) settings from a baseline of 44% to 55% by October 2024. METHODS: In collaboration with Children’s Mercy integrated care solutions, we created a report of eligible patients evaluated by ID in the inpatient and outpatient settings. This report captures pneumococcal immunization history of patients eligible for PPSV23. In October 2022, we formed a multi-disciplinary team of ID nurses, a pharmacist, providers, and a patient advocate. We identified several potential causes of low PPSV23 vaccination rate and developed countermeasures (figure 1). Since October 2022, we have discussed the project weekly during our divisional huddle. In January 2023, we matched outpatient and inpatient reports to include maximal information and created a 2-way communication strategy where outpatient nursing staff notifies ID providers of patients who qualify for PPSV23. In February 2023, we created an EMR shared phrase to include in ID provider notes and a badge buddy with qualifying conditions for PPSV23 vaccination. [Figure: see text] RESULTS: Following the initiation of the project we have seen an increase in qualifying patients who have received PPSV23 that has so far been sustained for 6 months (48-56%); we also see narrowing of the control limits implying improved process (figure 2). [Figure: see text] CONCLUSION: We were able to increase PPSV23 vaccination of eligible high-risk patients in both the outpatient and inpatient settings. If this trend is sustained, we will be able to move our center line in 2 months. We have multiple additional plan-do-study-act cycles planned over the next several months to include electronic medical record changes, collaboration with different specialties and family education. DISCLOSURES: Doug Swanson, MD, Merck: Grant/Research Support|Sanofi: Grant/Research Support Liset Olarte, MD, MSc, GSK: Grant/Research Support|Merck: Grant/Research Support|Pfizer: Grant/Research Support|Sanofi: Grant/Research Support
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spelling pubmed-106780182023-11-27 1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease Lyon, Edward Wetzel, Tracey Wirtz, Ann Swanson, Doug Moran, Rachel R Peters, Jessica Symes, Christine A Olarte, Liset El Feghaly, Rana E Open Forum Infect Dis Abstract BACKGROUND: Pneumococcal disease causes significant morbidity and mortality in children. Routine childhood immunizations protect for 13 or 15 pneumococcal serotypes via two pneumococcal conjugated vaccines. Patients with immunocompromising and chronic medical conditions are at high risk of invasive pneumococcal disease. A 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended in these patients to protect against more pneumococcal serotypes, but many patients have not received it. Our AIM is to increase PPSV23 vaccination rates among eligible patients in both the inpatient and outpatient infectious diseases (ID) settings from a baseline of 44% to 55% by October 2024. METHODS: In collaboration with Children’s Mercy integrated care solutions, we created a report of eligible patients evaluated by ID in the inpatient and outpatient settings. This report captures pneumococcal immunization history of patients eligible for PPSV23. In October 2022, we formed a multi-disciplinary team of ID nurses, a pharmacist, providers, and a patient advocate. We identified several potential causes of low PPSV23 vaccination rate and developed countermeasures (figure 1). Since October 2022, we have discussed the project weekly during our divisional huddle. In January 2023, we matched outpatient and inpatient reports to include maximal information and created a 2-way communication strategy where outpatient nursing staff notifies ID providers of patients who qualify for PPSV23. In February 2023, we created an EMR shared phrase to include in ID provider notes and a badge buddy with qualifying conditions for PPSV23 vaccination. [Figure: see text] RESULTS: Following the initiation of the project we have seen an increase in qualifying patients who have received PPSV23 that has so far been sustained for 6 months (48-56%); we also see narrowing of the control limits implying improved process (figure 2). [Figure: see text] CONCLUSION: We were able to increase PPSV23 vaccination of eligible high-risk patients in both the outpatient and inpatient settings. If this trend is sustained, we will be able to move our center line in 2 months. We have multiple additional plan-do-study-act cycles planned over the next several months to include electronic medical record changes, collaboration with different specialties and family education. DISCLOSURES: Doug Swanson, MD, Merck: Grant/Research Support|Sanofi: Grant/Research Support Liset Olarte, MD, MSc, GSK: Grant/Research Support|Merck: Grant/Research Support|Pfizer: Grant/Research Support|Sanofi: Grant/Research Support Oxford University Press 2023-11-27 /pmc/articles/PMC10678018/ http://dx.doi.org/10.1093/ofid/ofad500.1562 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Lyon, Edward
Wetzel, Tracey
Wirtz, Ann
Swanson, Doug
Moran, Rachel R
Peters, Jessica
Symes, Christine A
Olarte, Liset
El Feghaly, Rana E
1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease
title 1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease
title_full 1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease
title_fullStr 1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease
title_full_unstemmed 1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease
title_short 1730. Increasing Vaccination Rates of 23-valent Pneumococcal Polysaccharide Vaccine Among Patients at High-Risk for Invasive Pneumococcal Disease
title_sort 1730. increasing vaccination rates of 23-valent pneumococcal polysaccharide vaccine among patients at high-risk for invasive pneumococcal disease
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678018/
http://dx.doi.org/10.1093/ofid/ofad500.1562
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