Offering Influenza and Pneumococcal Vaccine to Patients Being Evaluated in the Emergency Department
试验速览
- 阶段
- 2 期
- 试验地点
- 4
- 主要终点
- Acceptance of vaccinations
研究概览
简要总结
According to the Advisory Committee on Immunization Practices (ACIP), all people aged 50 years or older and persons aged less than 50 years who have medical conditions that put them at increased risk for serious influenza disease should receive an annual influenza vaccination. However, since the mid-1990s, vaccination rates and racial disparities have mostly remained static, and there has been limited progress towards the Healthy People 2010 objectives for influenza vaccination coverage.
The purpose of this study is to determine what proportion of previously unvaccinated persons in target groups for whom influenza and pneumococcal vaccine are recommended will accept and receive influenza and/or pneumococcal vaccine in an urban emergency department (ED), and to estimate the potential impact of ED vaccination on population-based vaccination coverage. The intervention will utilize a combination of assessment survey, vaccine information and pre-printed vaccine order sheets.
The target population for influenza vaccinations includes all patients aged 18 years and older for whom influenza vaccine is recommended by the ACIP. This includes all persons aged 50 years and older and persons aged 18 to 49 years who are in one of the following groups: 1) health care workers, 2) pregnant women, 3) residents of long-term care facilities, 4) household contacts and out-of-home caregivers of children aged 0 to 23 months, or 5) persons with underlying chronic medical conditions which increase their risk of influenza-related complications. The target population for pneumococcal vaccination includes all patients aged 65 years or older who have not previously been vaccinated against pneumococcus or have not received the vaccine within 5 years (and were less than 65 years at the time of vaccination).
详细描述
PROTOCOL - Baton Rouge General Medical Center
Background
According to the Institute of Medicine, non-institutionalized high-risk adults may present the greatest challenge to adult immunizations. There are a number of barriers to implementation of comprehensive strategies for vaccinating adults:
- Routine preventive health visits are infrequent and transient
- Individuals lack knowledge of the vaccines required during adulthood
- Primary care providers may lack time, knowledge, or ability to perform a vaccination assessment, or it may not be part of their standard practice pattern
- Primary care providers lack the infrastructure (especially time and personnel) to assist with adequately assessing and documenting immunization status
Emergency departments represent ideal settings for vaccination efforts because each year millions of adults who have no or limited access to traditional primary care visit hospital EDs for medical and surgical problems that are non-life threatening. Such EDs often already provide other medical screening and preventive care services in the management of their patients. Almost one-quarter of adults aged 65 years and older make one or more visits to an emergency department each year. Patients who use EDs as their usual source of care are more likely to be members of minority groups and uninsured. These characteristics suggest that vaccination programs in EDs could have a significant impact in correcting disparities in vaccination coverage among patients in older age groups.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged 18 years and older who are seeking medical care in the ED
排除标准
- •All patients under 18 years of age will be excluded. Any patient with a medically unstable condition, altered mental status, or language barrier will also be excluded. Patients who present with a contraindication to influenza vaccination (acute febrile illness or a history of allergic reaction to eggs) or pneumococcal vaccine will not be eligible for receipt of those vaccines.
- •Our Lady of the Lake Regional Medical Center
- •Inclusion Criteria:
- •Patients aged 50 years and older who are seeking medical care in the ED
- •Exclusion Criteria:
- •All patients under 50 years of age will be excluded. Any patient with a medically unstable condition, altered mental status, or language barrier will also be excluded. Patients who present with a contraindication to influenza vaccination (acute febrile illness or a history of allergic reaction to eggs) or pneumococcal vaccine will not be eligible for receipt of those vaccines
结局指标
主要结局
Acceptance of vaccinations
Receipt of vaccination
次要结局
- Reasons vaccines were refused
- Reasons vaccines were not administered