Combining Evidence and Diffusion of Innovation Theory to Enhance Influenza Immunization
Authors: Britto, Maria T.; Pandzik, Geralyn M.; Meeks, Connie S.; Kotagal, Uma R.
Source: Joint Commission Journal on Quality and Patient Safety, Volume 32, Number 8, August 2006 , pp. 426-432(7)
Publisher: Joint Commission Resources
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Abstract:
Background: Children and adolescents with chronic conditions such as asthma, diabetes, and HIV are at high risk of influenza-related morbidity, and there are recommendations to immunize these populations annually. At Cincinnati Children's Hospital Medical Center, the influenza immunization rate increased to 90.4% (5% declined) among 200 patients with cystic fibrosis (CF). Diffusion of innovation theory was used to guide the design and implementation of spread to other clinics.Method: The main intervention strategies were: (1) engagement of interested, nurse-led teams, (2) A collaborative learning session, (3) A tool kit including literature, sample goals, reminder postcards, communication strategies, and team member roles and processes, (4) open-access scheduling and standing orders (5) A simple Web-based registry, (6) facilitated vaccine ordering, (7) recall phone calls, and (8) weekly results posting.Results: Clinic-specific immunization rates ranged from 32.7% to 92.8%, with the highest rate reported in the CF clinic. All teams used multiple strategies; with six of the seven using four or more. Overall, 60.0% (762/1,269) of the population was immunized. Barriers included vaccine shortages, lack of time for reminder calls, and lack of physician support in one clinic.Discussion: A combination of interventions, guided by evidence and diffusion of innovation theory, led to immunization rates higher than those reported in the literature.Document Type: Research article
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