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Improved influenza and pneumococcal vaccination in rheumatology patients taking immunosuppressants using an electronic health record best practice alert
Arthritis Care and Research , 11/03/09
Ledwich LJ et al. – The use of a BPA significantly increased influenza and pneumococcal vaccination and documentation rates in rheumatology patients taking immunosuppressants. A nurse-driven process offered higher efficacy. An EHR programmed to alert providers is an effective tool for improving quality of care for patients receiving immunosuppressants.
Methods- Vaccination BPA developed based on immunosuppressant treatment, age, and prior vaccinations
- Site 1, a hospital-based academic practice, physicians ordered vaccinations
- Site 2, a community-based practice, physicians signed orders placed by nurses
- Demographics, vaccination rates, and documentation were obtained
- Chi-square and Fisher's exact test analysis compared vaccination and documentation rates for October 1 through December 31, 2006 (preBPA), and October 1 through December 31, 2007
- Breslow-Day statistics tested odds ratio of improvement across years between sites
- PostBPA influenza vaccination rates significantly increased
- PostBPA pneumococcal vaccination rates likewise significantly increased
- PostBPA documentation rates for influenza and pneumococcal vaccinations also increased significantly
- Site 2 (nurse-driven) had significantly higher preBPA vaccination rates for influenza than pneumococcal
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