Improving Influenza Vaccination Rates Among Pediatric Hematology and Oncology Inpatients
Background: Children are extremely vulnerable to complications of influenza, and the most effective prevention strategy is receiving the vaccine annually. The Centers for Disease Control and Prevention (CDC) recommends that all providers offer the influenza vaccine to unvaccinated children during routine health care visits and hospitalizations.
Local Problem: The CDC reported only 59.3% of children in the United States received the influenza vaccine during the 2015-2016 flu season. A large academic pediatric hospital inpatient hematology/oncology unit was identified as having an inadequate influenza vaccine screening and administration process.
Interventions: An influenza vaccine screening tool served to identify eligible patients and allow electronic access to notify providers to order influenza vaccines by generating a physician order notification. Education was provided. An interprofessional approach was taken, and collaboration between all departments – nursing, providers, pharmacy, and information technology – was significant in enhancing the process.
Results: Data analyses revealed the rate of influenza vaccine administration among eligible hematology/oncology patients was 5.88% pre-intervention and 43.9% post-intervention. The System Usability Scale (SUS) by Brooke (1996) was used to gain feedback from nurses and evaluate the quality improvement (QI) initiative. Each SUS was calculated; scores ranged from 30 to 100. These results are variable, and thus, indicate that the process steps could be further streamlined to improve ease and efficiency.
Conclusion: Implementation of a well-designed influenza vaccine screening tool combined with an automatic trigger to communicate with the provider increases the likelihood that the patient will receive the influenza vaccine. Implications for healthcare providers should focus on use of the electronic health record to improve the influenza vaccine screening and administration process for pediatric inpatients, especially immunocompromised patients.