Preventive care measures including vaccinations are underutilized. The Emergency Department (ED) environment has been recommended to be a feasible environment to offer pneumococcal vaccination; however, the ED is a challenging setting for implementing a sustainable vaccination program. We designed, implemented, and evaluated a closed-loop, computerized reminder system in the ED that integrated four different computer systems. The computerized triage application screened patients for eligibility with information from the electronic patient record. The computerized provider order entry system reminded clinicians to order the vaccination for eligible patients, which was passed to the order tracker application. Documentation of vaccine administration was then added to the electronic patient record. During a two-month, prospective study 433 (51.9%) patients 65 years and older were up-to-date with pneumococcal vaccination, and 271 (32.5%) declined to receive the vaccine during their ED visit. From the physician prompts, 94 (11.2%) declined to order the vaccine; 37 (4.4%) patients received the vaccine. The computerized reminder system increased vaccination rate from 51.9% to 56.4 % (p < 0.01). The closed-loop informatics solution seems to be a feasible and sustainable model to increase vaccination rates in a challenging ED environment.
| Identifer | oai:union.ndltd.org:VANDERBILT/oai:VANDERBILTETD:etd-05262006-112956 |
| Date | 07 June 2006 |
| Creators | Dexheimer, Judith W |
| Contributors | Dominik Aronsky, William Gregg, Thomas Talbot, Yu Shyr |
| Publisher | VANDERBILT |
| Source Sets | Vanderbilt University Theses |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.vanderbilt.edu/available/etd-05262006-112956/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Vanderbilt University or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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