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2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)

BACKGROUND: Influenza and Tdap vaccines are recommended for pregnant women in every pregnancy. However, vaccine uptake remains suboptimal. Obstetrics practices need quality improvement models to improve their vaccination delivery programs. CDC’s AFIX program has been shown to be effective at increas...

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Autores principales: OLeary, Sean T, Ellingson, Mallory, Spina, Christine, Brewer, Sarah E, Quick, Lori, Chamberlain, Allison, Limaye, Rupali, Orenstein, Walter, Salmon, Daniel, Omer, Saad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809483/
http://dx.doi.org/10.1093/ofid/ofz360.2413
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author OLeary, Sean T
Ellingson, Mallory
Spina, Christine
Brewer, Sarah E
Quick, Lori
Chamberlain, Allison
Limaye, Rupali
Orenstein, Walter
Salmon, Daniel
Omer, Saad
author_facet OLeary, Sean T
Ellingson, Mallory
Spina, Christine
Brewer, Sarah E
Quick, Lori
Chamberlain, Allison
Limaye, Rupali
Orenstein, Walter
Salmon, Daniel
Omer, Saad
author_sort OLeary, Sean T
collection PubMed
description BACKGROUND: Influenza and Tdap vaccines are recommended for pregnant women in every pregnancy. However, vaccine uptake remains suboptimal. Obstetrics practices need quality improvement models to improve their vaccination delivery programs. CDC’s AFIX program has been shown to be effective at increasing vaccination uptake in primary care settings. Our objective was to adapt and evaluate CDC’s AFIX program in the obstetrical setting (AFIIX-OB). METHODS: An average of 40 charts per practice were randomly reviewed pre- and post-intervention. Baseline immunization rates and vaccine administration practices were collected in the Assessment phase. Feedback was provided at meetings conducted by study staff where baseline immunization rates were shared and practices selected quality improvement measures to implement. Practices were required to implement either standing orders for influenza and Tdap vaccines or improve their vaccine documentation. As an Incentive, providers could receive continuing medical education and maintenance of certification part IV credit. After implementing the practice specific measures for 6 months, practice-wide vaccine rates were assessed and a post-intervention meeting was held with providers and staff at each practice to eXchange the results. RESULTS: AFIX-OB was implemented in 11 obstetric practices: 5 in Georgia and 6 in Colorado. Practices were primarily urban, their patients largely Caucasian and African American and most patients carried private insurance. Baseline practice-level immunization rates ranged from 10% to 82.9% for influenza vaccine and 12.5% to 97.6% for Tdap. 4 practices implemened standing orders, 6 improved their vaccine documentation and 1 did both. After the 6 month follow-up period, all 11 practices saw improvements in their overall Tdap vaccine acceptance (3 with statistically significant increases, P < 0.05) with final rates ranging from 25% to 100%. 9 practices either maintained or improved their influenza vaccination rates (4 with statistically significant increases, P < 0.05) with final rates ranging from 32.5% to 85.0%. CONCLUSION: The AFIX-OB model provides a promising intervention to improve maternal immunization uptake that can be administered widely but still be tailored to the needs of individual clinics. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68094832019-10-28 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX) OLeary, Sean T Ellingson, Mallory Spina, Christine Brewer, Sarah E Quick, Lori Chamberlain, Allison Limaye, Rupali Orenstein, Walter Salmon, Daniel Omer, Saad Open Forum Infect Dis Abstracts BACKGROUND: Influenza and Tdap vaccines are recommended for pregnant women in every pregnancy. However, vaccine uptake remains suboptimal. Obstetrics practices need quality improvement models to improve their vaccination delivery programs. CDC’s AFIX program has been shown to be effective at increasing vaccination uptake in primary care settings. Our objective was to adapt and evaluate CDC’s AFIX program in the obstetrical setting (AFIIX-OB). METHODS: An average of 40 charts per practice were randomly reviewed pre- and post-intervention. Baseline immunization rates and vaccine administration practices were collected in the Assessment phase. Feedback was provided at meetings conducted by study staff where baseline immunization rates were shared and practices selected quality improvement measures to implement. Practices were required to implement either standing orders for influenza and Tdap vaccines or improve their vaccine documentation. As an Incentive, providers could receive continuing medical education and maintenance of certification part IV credit. After implementing the practice specific measures for 6 months, practice-wide vaccine rates were assessed and a post-intervention meeting was held with providers and staff at each practice to eXchange the results. RESULTS: AFIX-OB was implemented in 11 obstetric practices: 5 in Georgia and 6 in Colorado. Practices were primarily urban, their patients largely Caucasian and African American and most patients carried private insurance. Baseline practice-level immunization rates ranged from 10% to 82.9% for influenza vaccine and 12.5% to 97.6% for Tdap. 4 practices implemened standing orders, 6 improved their vaccine documentation and 1 did both. After the 6 month follow-up period, all 11 practices saw improvements in their overall Tdap vaccine acceptance (3 with statistically significant increases, P < 0.05) with final rates ranging from 25% to 100%. 9 practices either maintained or improved their influenza vaccination rates (4 with statistically significant increases, P < 0.05) with final rates ranging from 32.5% to 85.0%. CONCLUSION: The AFIX-OB model provides a promising intervention to improve maternal immunization uptake that can be administered widely but still be tailored to the needs of individual clinics. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809483/ http://dx.doi.org/10.1093/ofid/ofz360.2413 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
OLeary, Sean T
Ellingson, Mallory
Spina, Christine
Brewer, Sarah E
Quick, Lori
Chamberlain, Allison
Limaye, Rupali
Orenstein, Walter
Salmon, Daniel
Omer, Saad
2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)
title 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)
title_full 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)
title_fullStr 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)
title_full_unstemmed 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)
title_short 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)
title_sort 2735. improving uptake of maternal immunizations in the obstetric care setting through an adaptation of the cdc’s immunization quality improvement program (afix)
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809483/
http://dx.doi.org/10.1093/ofid/ofz360.2413
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