Search

Pediatric patients with chronic kidney disease (CKD) have an increased risk of developing vaccine-preventable diseases due to reduced immunization coverage. Studies have demonstrated that reduced immunization coverage in this population is related to barriers, such as frequent hospitalization, lack of knowledge, and concerns about safety and efficacy. This article examines a nurse practitioner-led quality improvement project (QIP) conducted in an outpatient pediatric nephrology clinic. The QIP focused on educating pediatric providers related to age-appropriate immunizations for children with CKD or nephrotic syndrome, and those who are renal transplant candidates and recipients. A process is now in place to review immunization records upon initial visit and annually, and to notify primary care providers of current recommendations for this population. [ABSTRACT FROM AUTHOR]

Influenza has a significant impact on the health of Americans and the U.S. economy. Annual influenza immunization can decrease the burden of influenza-related illnesses for both employees and employers. This project evaluated a nurse practitioner–led intervention to increase influenza immunization rates among retail employees from August through December of the 2015-2016 influenza season. The sample included employees from retail locations with on-site convenience care clinics staffed by nurse practitioners. This quality improvement project used a pre–post implementation evaluation design and compared influenza immunization rates of employees, before and after an intervention, at one worksite, and influenza immunization rates of employees, who did not receive the same intervention, at a comparison site. The intervention site employees were immunized at a higher rate than employees at the comparison site. Interventions, including health care professional–led education, program promotion, on-site access to and no-cost immunizations, choice of immunization delivery, and incentives, should be considered to increase immunization rates among employees. [ABSTRACT FROM AUTHOR]

Objectives Sources of immunization data include state registries or immunization information systems (IIS), medical records, and surveys. Little is known about the quality of these data sources or the feasibility of using IIS data for research. We assessed the feasibility of collecting immunization information for a national children's health study by accessing existing IIS data and comparing the completeness of these data against medical record abstractions (MRA) and parent report. Staff time needed to obtain IIS and MRA data was assessed. Methods We administered a questionnaire to state-level IIS representatives to ascertain availability and completeness of their data for research and gather information about data formats. We evaluated quality of data from IIS, medical records, and reports from parents of 119 National Children's Study participants at three locations. Results IIS data were comparable to MRA data and both were more complete than parental report. Agreement between IIS and MRA data was greater than between parental report and MRA, suggesting IIS and MRA are better sources than parental report. Obtaining IIS data took less staff time than chart review, making IIS data linkage for research a preferred choice. Conclusions IIS survey results indicate data can be obtained by researchers using data linkages. IIS are an accessible and feasible child immunization information source and these registries reduce reliance on parental report or medical record abstraction. Researchers seeking to link IIS data with large multi-site studies should consider acquiring IIS data, but may need strategies to overcome barriers to data completeness and linkage. [ABSTRACT FROM AUTHOR]

Objectives: To describe the characteristics of pharmacist immunizers and pharmacist-based immunization services In North Carolina based on immunizing pharmacist survey responses and to identify barriers and challenges to pharmacist-based immunization services in North Carolina. Design: Descriptive, nonexpertmental, cross-sectional study. Participants: All pharmacists with an active pharmacist license in North Carolina in early 2007. Intervention: Electronic survey. Main outcome measures: Settings in which pharmacist respondents practiced, types of immunization services offered, level of participation in immunization services, and perceptions of possible barriers and challenges to providing pharmacist-based Immunization services. Results: 1,274 (12.8%) responses were included in the final analysis. Approximately 22% of respondents (n = 286) had completed an immunization certificate training program. Of these respondents, more than half (n = 148) had administered vaccinations in the past year (active immunizers). The majority (52%) of active immunizers had been in practice for fewer than 10 years and worked in either community chain or independent pharmacies. Almost all respondents actively involved in administering immunizations offered Inactivated influenza immunizations (95.9%). A smaller percentage of pharmacists (39.2%) offered pneumococcal vaccinations at their practice site. All respondents were likely to perceive time and area/space as barriers to providing immunization services; each group also had several distinct perceived barriers. Many factors were perceived as barriers to pharmacists' ability to provide care by active immunizers. The majority of active immunizers were willing to provide additional vaccine types. Conclusion: This research has provided information about the number of pharmacists providing Immunization services and characteristics of the services they provide. The demographics and settings of pharmacists in relationship to their engagement in immunization services are also provided. Last, the current work helps assess the perceived barriers to providing immunization services and pharmacist interest in expanded opportunities. [ABSTRACT FROM AUTHOR]

Objective: To determine whether family practice physicians are aware that pharmacists can administer vaccines and assess their support of pharmacists as vaccinators.Design: Cross-sectional study.Setting: North Carolina.Participants: 571 family practice physicians.Interventions: Mail survey.Main Outcome Measures: Physician attitudes toward pharmacists' involvement with a variety of vaccines and patient populations.Results: A total of 25% of physicians correctly reported that pharmacists could administer vaccines in North Carolina, a state that had recently passed legislation permitting this practice. Almost 50% of the physicians supported pharmacists administering the influenza vaccine. Pharmacist administration of other vaccines received less support. Physicians who were newer to family practice had more positive attitudes than physicians who were in practice for longer periods of time.Conclusion: While agreeing that the role of the pharmacist in patient care is becoming more important, physicians were neither very knowledgeable about nor supportive of pharmacists as vaccinators. [ABSTRACT FROM AUTHOR]

Purpose: To assess North Carolina pharmacists' level of support for expanded authority to administer human papillomavirus (HPV) vaccines to identify concerns/benefits about expanded authority and to understand what factors predict support for expanded authority., Method: A 16-item electronic survey was e-mailed to all the pharmacists registered with the North Carolina Board of Pharmacy (n = 9502) between January and February 2011 (1600 pharmacists responded). The survey assessed HPV knowledge, level of support for expanded authority, and comfort level of HPV vaccine administration., Results: Many (64%) pharmacists were supportive of a rule change/legislation that would authorize pharmacists to administer HPV vaccines. Younger pharmacists were more supportive of expansion when compared to older pharmacists (r = -.138, P < .001). Pharmacists with higher knowledge scores were more supportive of expansion (r = .223, P < .001). Reporting a higher level of comfort in administering HPV vaccines at their pharmacy was significantly and positively correlated with higher level of support for expansion (r = .624, P < .001). In the multivariate analysis, HPV knowledge, comfort level in administering vaccine, patient age, and type of pharmacy were all predictive of higher level of support for expanded authority where employed., Conclusion: A large proportion of pharmacists were supportive of an expanded role in providing HPV vaccines. Exploring alternate delivery mechanisms like this one is advantageous.