tetano
Editor, Senior Moderator
Hosp Pediatr. 2018 Nov;8(11):693-698. doi: 10.1542/hpeds.2018-0046.
[h=1]Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative.[/h] Milet B[SUP]1,[/SUP][SUP]2[/SUP], Chuo J[SUP]3[/SUP], Nilan K[SUP]3[/SUP], Warren K[SUP]3[/SUP], McKenna K[SUP]3[/SUP], Carroll JM[SUP]3[/SUP], Evans J[SUP]3[/SUP], Zhang H[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] 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.
[h=4]METHODS:[/h] 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.
[h=4]RESULTS:[/h] 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.
[h=4]CONCLUSIONS:[/h] 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.
Copyright ? 2018 by the American Academy of Pediatrics.
PMID: 30373887 DOI: 10.1542/hpeds.2018-0046
[h=1]Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative.[/h] Milet B[SUP]1,[/SUP][SUP]2[/SUP], Chuo J[SUP]3[/SUP], Nilan K[SUP]3[/SUP], Warren K[SUP]3[/SUP], McKenna K[SUP]3[/SUP], Carroll JM[SUP]3[/SUP], Evans J[SUP]3[/SUP], Zhang H[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] 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.
[h=4]METHODS:[/h] 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.
[h=4]RESULTS:[/h] 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.
[h=4]CONCLUSIONS:[/h] 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.
Copyright ? 2018 by the American Academy of Pediatrics.
PMID: 30373887 DOI: 10.1542/hpeds.2018-0046