Improving rates of pneumococcal vaccination on discharge from a tertiary center medical teaching unit: A prospective intervention

BACKGROUND: Pneumococcal disease causes significant morbidity and mortality in at-risk individuals, and is complicated by emerging antibiotic resistance. An effective, safe and cost-effective vaccine is available, but despite this many patients who would benefit from pneumococcal vaccination remain unvaccinated. The purpose of this study was to determine the rates of missed opportunities to provide pneumococcal vaccination to patients being discharged from a tertiary center medical teaching unit and to determine if a nurse coordinator-based intervention would increase rates of pneumococcal vaccination prior to discharge home. METHODS: We conducted a prospective, controlled study in the setting of a Medical Teaching Unit at a tertiary care centre to assess the impact of a nurse coordinator based intervention on the rates of vaccination of eligible patients on discharge home. The rates of vaccination during an eight-week usual-care period (February 20 to April 16, 2002) and an eight-week intervention period (April 22 to June 16, 2002) were compared. RESULTS: Prior to the intervention none of thirty-eight eligible patients were vaccinated prior to discharge home from the Medical Teaching Unit. After the intervention 27 (54%) of fifty eligible patients were vaccinated prior to discharge. CONCLUSION: There are significant missed opportunities to provide pneumococcal vaccination to inpatients who are discharged home from a medical unit. Using a patient care coordinator we were able to significantly improve the rates of vaccination on discharge.