Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative
| العنوان: | Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative |
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| المؤلفون: | Karen Warren, Jean M. Carroll, Jacquelyn R. Evans, Kristin McKenna, Huayan Zhang, Kathleen Nilan, Beatriz Milet, John Chuo |
| المصدر: | Hospital Pediatrics. 8:693-698 |
| بيانات النشر: | American Academy of Pediatrics (AAP), 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Lung Diseases, Male, Pediatrics, medicine.medical_specialty, Population, Infant, Premature, Diseases, Dexamethasone, Sepsis, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Fraction of inspired oxygen, medicine, Adrenal insufficiency, Humans, 030212 general & internal medicine, education, Glucocorticoids, Contraindication, education.field_of_study, business.industry, Vaccination, Infant, Newborn, Infant, General Medicine, medicine.disease, Quality Improvement, Immunization, Bronchiolitis, Chronic Disease, Practice Guidelines as Topic, Pediatrics, Perinatology and Child Health, Female, Health Services Research, Complication, business, Infant, Premature |
| الوصف: | OBJECTIVES: Immunizations provide important protection from serious childhood illnesses. Infant chronic lung disease (CLD) is a serious complication of prematurity and predisposes premature infants to respiratory morbidity, rehospitalization, and mortality. This high-risk group is especially vulnerable to infections, such as invasive pneumococcal disease, influenza, and bronchiolitis. Our purpose for this project was to increase 2-, 4-, and 6-month immunization rates in eligible infants with CLD in the NICU by 30% through December 2016. METHODS: A multidisciplinary team developed weekly targeted rounds to identify eligible patients with outstanding immunizations. Exclusion criteria included the following: (1) a fraction of inspired oxygen requirement of >80%, (2) pulmonary hypertensive crisis, (3) positive blood culture results or if within 48 hours of a sepsis evaluation, (4) if within 5 days of a surgical or interventional procedure, (5) receiving steroid treatment (not including a physiologic hydrocortisone dose for adrenal insufficiency), (6) a CLD team consensus of contraindication, and (7) parental refusal. RESULTS: The project managed 60 patients from March 2016 to December 2016. Immunization of eligible patients increased from 44% to 75% and was sustained for the next 6 months. The average number of days from admission to immunization record review decreased from 71 days at baseline to 27 days. CONCLUSIONS: The implementation of (1) an in-hospital immunization record review, (2) an e-mail reminder, (3) a weekly multidisciplinary eligibility discussion, and (4) an updated rounding tool was successful in increasing and sustaining immunization rates in this population of infants with CLD. The multidisciplinary CLD meeting was a novel opportunity to discuss immunization eligibility and safety monitoring. |
| تدمد: | 2154-1671 2154-1663 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2d0e99e66cd8a36d8e7a06c8e651fd14 https://doi.org/10.1542/hpeds.2018-0046 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....2d0e99e66cd8a36d8e7a06c8e651fd14 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21541671 21541663 |
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