Overcoming barriers to establishing an inpatient vaccination program for pneumococcus using standing orders
Overcoming barriers to establishing an inpatient vaccination program for pneumococcus using standing orders
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DOI：
10.1086/502511
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发表时间：
2005-11-01
影响因子：
4.5
通讯作者：
Lin, CJ
中科院分区：
文献类型：
--
作者：
Middleton, DB;Fox, DE;Lin, CJ
目标：识别并分类在急症护理住院设施中建立成人肺炎球菌疫苗接种常规计划 (SOP) 的障碍，并提供克服这些障碍的建议。具有标准操作程序的医院的疫苗接种率通常高于需要个人医生处方的医院。根据我们在不同医院环境中的经验得出的一系列解决方案应允许多种类型的机构预见并克服障碍，从而实现住院肺炎球菌疫苗接种从启动到成功实施的顺利过渡。 SOPDESIGN：对匹兹堡大学医学中心卫生系统 (UPMC) 的三所医院和科学文献中实施肺炎球菌疫苗接种 SOP 过程中遇到的障碍和解决方案进行描述性研究。设置：截至 2004 年，两家 UPMC三级护理医院和一家 UPMC 社区医院已将 SOP 纳入现有的医生医嘱驱动的住院患者肺炎球菌多糖疫苗疫苗接种计划中。结果：在实施的每个步骤中都确定了障碍，并将障碍分为患者相关、提供者相关或机构相关。基于针对遇到的障碍对我们的计划进行持续审查和修订的过程，我们采取了措施来克服这些障碍。 结论： 设施管理中的关键人员（包括一名医生倡导者）做出了坚定的承诺；持续不断地努力教育和培训工作人员，并密切监测疫苗接种率，对于成功实施符合条件的住院患者肺炎球菌疫苗接种标准操作程序至关重要。法律法规和外部医院评级协会对疫苗接种计划有效性的评估是其成功的主要推动因素。
OBJECTIVES: To identify and classify barriers to establishing a standing orders program (SOP) for adult pneumococcal vaccination in acute care inpatient facilities and to provide recommendations for overcoming these roadblocks. Vaccination rates in hospitals with SOPs are generally higher than those in hospitals that require individual physician orders. The array of solutions drawn from our experience in different hospital settings should permit many types of facilities to anticipate and overcome barriers, allowing a smoother transition from initiation to successful implementation of an inpatient pneumococcal vaccination SOPDESIGN: Descriptive study of barriers and solutions encountered during implementation of a pneumococcal vaccination SOP in three hospitals of the University of Pittsburgh Medical Center Health System (UPMC) and in the scientific literature.SETTING: As of 2004, two UPMC tertiary-care hospitals and one UPMC community hospital bad incorporated SOPs into existing physician order-driven programs for inpatient vaccination with pneumococcal polysaccharide vaccine.RESULTS: Barriers were identified at each step of implementation and categorized as patient related, provider related, or institutional. Based on a process of continual review and revision of our programs in response to encountered barriers, steps were taken to overcome these impediments.CONCLUSIONS: A strong commitment by key individuals in the facility's administration including a physician champion; ongoing, persistent efforts to educate and train staff, and close monitoring of the vaccination rate were essential for successful implementation of a SOP for pneumococcal vaccination of eligible inpatients. Legal statutes and evaluations of external hospital-rating associations regarding the effectiveness of the vaccination program were major motivating factors in its success.