pneumococcal vaccination

Hi,

I'm interested in hearing from anyone regarding a successful and consistent pneumococcal vaccination program at your hospital. We are having difficulty meeting goals on a consistent year-around basis. The nurses either do not fill out the screening sheet, or they forget to offer the vaccine prior to patient discharge. What works at your institution?

Thanks,

golfnurse

We started printing the sheets on green paper and put them on the front of the MAR's clipboard. It's a nursing responsibility to initiate the vaccine based on criteria or not. When the sheet is filled out it is faxed to Pharmacy and they send up a single dose of Pneumovax, but if someone is discharged suddenly waiting for the vaccine to show up delays their discharge. Pharmacy is working on sending a multidose vial so we always have the vaccine on the floor.

each pt is assessed on admit, all pts over 65 are asked if they have had the vac in last five years, if not they are scheduled to get vac at 0800 the next morning. so far we have had great complience per pi.

We include a vaccine screening page with each admission, if the vaccine is indicated the order is scanned to pharmacy and the nurse adds it to the MAR to be given the next day at 0800. The screening tool is then placed in the MD orders and allows them a time to reject the vaccine in 12 hours, if not rejected the vaccine is given

we screen at admission and again at discharge. the form at discharge is required to be filled out this forms has flu and pneumonia on it so during the season of flu. So everyone is asked twice or at least once. (hopefully)

During recent hospitalizations, I was screened for both flu and pneu vaccs. I indicated that I desired both, and was expecting them during one of these visits. However, the nurse made an excuse for not giving me the vaccs when I got discharged. She said it was not flu season yet. My thoughts: Don't screen, don't offer the vaccs, don't bother, if you have no intention of following through. As far as I am concerned, they were just going through the motions to meet some requirement.

Yes, they are meeting "some requirement" - namely, core measures as set forth by medicare. It is not flu season, so giving you a flu shot anytime after March and before October is contraindicated. Nurses make mistakes. Generally the pnemococcal and influenza screening tools are combined and sometimes nurses forget that it's not 'flu season'. You are right. They should not offer them if they are not indicated because (clearly) the general public does not understand "indicated vs not indicated" - they think as you: don't offer if it is not indicated. Also, if you are under 65 and do not have any chronic disease you are not a candidate for pnemonia vac either. If you would like both, you should see your PCP - immunizations are really best given by your PCP who knows your history and follows it.

This is the first time in history that hospitals and physicians are being offered MORE incentive to "do the right thing". Of course there is more controversy over telling physicians what best practices are - patients and illnesses are unique and sometimes 'standing orders' don't meet all needs. There are pluses and minuses here - the good thing is that it is a concern in our legislature and our medical community and I believe that really, everyone wants what's best for the patient in the long run. Generally medical folk don't go after people to hurt them or make lives miserable, ya know?