Role of student pharmacist interns in hospital-based standing orders pneumococcal vaccination program (original) (raw)
Hospital Pharmacy, 2009
Purpose A Medical Board-approved pharmacy-based inpatient STanding Orders Protocol (STOP) for influenza and pneumococcal vaccination was designed and implemented at Montefiore Medical Center in response to federal and state regulations put in place in 2006. This vaccination program aims to improve historically poor vaccination rates in a complex, urban patient population. Developing this initiative in a large health care system with high turnover and a diverse (many non-English speaking) population represented a formidable challenge. Methods In 2006 the institution initiated a program to improve patient care. The program involved a clinical pharmacist rounding on patient care units specifically to encourage the acceptance of the pneumococcal and influenza vaccine in patients at least 65 years of age at 1 of the 2 campus sites in the Bronx, New York. Medical residents were also employed to facilitate the pharmacist and achieve national standards. Registered nurses and licensed practi...
Journal of Student-Run Clinics, 2022
Background: To streamline workflow during peak influenza season in our weekly student-led free Interprofessional Community Clinic (ICC), an additional pharmacist shift solely responsible for providing immunization services was implemented from October 2018 to February 2019. The objective of this study was to determine the impact of adding an immunizing pharmacist, in addition to a clinical pharmacist, on adherence to Centers for Disease Control and Prevention (CDC) vaccine recommendations and overall immunization rates at ICC. Methods: A retrospective chart review of patient visits from October 2017 to February 2019 was conducted. Vaccination rates and CDC recommendation adherence were compared to a historical control when an immunizing pharmacist was not scheduled. Chi-square analysis was performed on categorical data; Fisher's exact test was used to assess impact of an immunizing pharmacist on vaccination rates and adherence to CDC recommendations. A p-value of <0.05 was considered statistically significant. Results: A total of 78 patient visits and 58 unique patients were included. There was a significant increase in the adherence to CDC recommendations for pneumococcal vaccine when an immunizing pharmacist was present (p=0.02). There was no significant difference in the adherence to CDC recommendations for all other vaccines and overall vaccine rate between the two groups (p>0.05). Conclusion: Implementation of an immunizing pharmacist in an interprofessional clinic significantly impacts the adherence to CDC recommendations for pneumococcal vaccine without significantly impacting the overall vaccine rate. Benefit of an additional pharmacist dedicated to vaccinations should be weighed for workflow improvement versus impact on vaccine adherence and rate.
BMC Family Practice, 2012
Background: Standing orders programs (SOPs) allow non-physician medical staff to assess eligibility and administer vaccines without a specific physician's order. SOPs increase vaccination rates but are underutilized. Method: In 2009, correlates of SOPs use for influenza vaccine and pneumococcal polysaccharide vaccination (PPV) were assessed in a nationally representative, stratified random sample of U.S. physicians (n = 880) in family and internal medicine who provided office immunization. The response rate was 67%. Physicians reporting no SOPs, only influenza SOPs, and joint influenza and PPV SOPs were compared using multinomial and logistic regression models to examine individual and practice-level correlates. Results: 23% reported using SOPs consistently for both influenza vaccine and PPV, and 20% for influenza vaccination only, with the remainder not using SOPs. Practice-level factors that distinguished practices with joint influenza-PPV SOPs included perceived practice openness to change, strong practice teamwork, access to an electronic medical record, presence of an immunization champion in the practice, and access to nurse/physician assistant staff as opposed to medical assistants alone. Discussion: Physicians in practices with SOPs for both vaccines reported greater awareness of ACIP recommendations and/or Medicare regulations and were more likely to agree that SOPs are an effective way to boost vaccination coverage. However, implementation of both influenza and PPV SOPs was also associated with a variety of practice-level factors, including teamwork, the presence of an immunization champion, and greater availability of clinical assistants with advanced training. Conclusions: Practice-level factors are critical for the adoption of more complex SOPs, such as joint SOPs for influenza and PPV.
Journal of Contemporary Pharmacy Practice, 2021
Background Intern pharmacists are likely an underutilized resource for addressing immunization barriers and improving immunization rates. Studies have addressed methods that pharmacists use to improve immunization rates, but few have focused on the role of intern pharmacists, with particular emphasis on non-influenza immunizations. Methods An online survey was distributed through email listservs associated with California pharmacy schools and organizations. Data collected included title (“pharmacist” or “intern pharmacist”), practice setting, perceptions of the intern pharmacists’ role in improving immunization rates (strongly agree to strongly disagree using a 5-point Likert scale), and opinions regarding potential implementations. Immunization barriers were assessed using a 9-point scale, from least to most feasible to be addressed. Statistical comparisons between intern pharmacist and pharmacist responses were made using chi-square or Fisher’s exact tests. Results A total of 133 ...
Vaccine, 1994
Pneumococcal infection is a leading cause of adult morbidity and mortality in the United States. Immunization against this infection is a valuable strategy in preventive medicine. An effective pneumococcal vaccine has been available in this country for over a decade, but it remains poorly utilized. The purpose of the present investigation was to analyse the factors that affect the use and administration of the pneumococcal vaccine and to identify barriers to use. Upper-level internal medicine residents (n = 33) from two medical clinics associated with an academic medical centre completed an explanatory survey. This explored the levels of house-staff knowledge, perception and attitudes regarding the vaccine and the existence of practical barriers against its utilization. Z 2 analyses and z tests were carried out to determine sign~cance, where appropriate. The majority of the house staff (22, 66.7%) answered correctly regarding vaccine target groups, and all residents indicated that they generally obtain a vaccination history in adult patient evaluation. However, a sizeable number (14, 42.4%) did not indicate a time of the year when they routinely administered vaccines to patients. They were not confident about their knowledge regarding vaccine guidelines (23, 69.7%) and had an exaggerated fear of hypersensitivity reactions from immunization (20, 60.6%). Neither the expense of the vaccine nor adverse publicity were impediments to immunization (24, 72.7% and 28, 84.8%, respectively). Although most physicians knew of the usefulness of the vaccine (31, 93.9%), many failed to translate this knowledge into clinical practice (22, 66.7%). 'Pressing'clinical issues were viewed as barriers to vaccination (18, 54.5%) and placed the practice of preventive medicine in a subordinate position. The results show that greater emphasis on prevention needs to be instituted in internal medicine residency programmes. The physicians in training need to be assured that the vaccine is safe and well tolerated by most patients for all practical purposes. Educational reinforcement may be useful in enhancing resident confidence in vaccine usage.
A Review of the Pharmacist as Vaccinator
INNOVATIONS in pharmacy, 2019
The aim of this study is to review literature about how the pharmacist's role as vaccination providers has been financially and clinically measured. Methods: A broad literature search was conducted up to May 2016 to identify economic or clinical data on pharmacy vaccinations. MEDLINE® and PUBMED databases were searched for publications useful or potentially useful for this review. The NIH and CDC websites were also searched for relevant materials. Search terms included vaccination, pharmacist, economic, pharmacoeconomics, cost, benefits cost-effectiveness, physicians, immunizations, vaccinations, pharmacy vaccines, cost, physician vaccines, financial, benefit, ambulatory pharmacist vaccination, clinical pharmacist, economics, pharmacist vaccine impact. Results: The search yielded a total of 68 articles of which 12 met the criteria to be included in this review. After examining articles for relevance to pharmacy vaccinations, two tables were created to highlight the clinical and economic advantages of the pharmacist as a vaccinator. Conclusion: Pharmacists who administer vaccines are an underutilized provider. This literature review reveals a pattern among studies measuring the pharmacist's impact on vaccination rates, patient preferences, and cost savings. Pharmacists have a history of demonstrated dependability, accuracy, and cost effectiveness. State laws, collaborative agreements, and health plans have continued to prevent patients from using the pharmacy to receive the CDC recommended vaccines. These barriers ultimately delay the Healthy People 2020 goals. Introduction/Background Increasing vaccination rates to reduce infectious diseases remains one of the Healthy People 2020 objectives set forth by the United States Office of Disease Prevention and Health Promotion. 1, 2 Vaccine innovation and increased vaccination rates were linked with increased survival in the 20 th century. However, certain infectious diseases that can be prevented by vaccines, still remain a major cause of morbidity and mortality. 2 Currently there are 17 vaccine-preventable diseases in the United States 1 , including influenza. Although preventable, influenza is one of the leading infections in the United States and accounts for substantial spending on the consequences associated with the virus. 2 Vaccines remain the most cost-effective intervention in clinical prevention of infectious disease and their proper use is essential. 2 Specifically, children's vaccination programs yield a higher return on investment. Children receiving their vaccinations according to the CDC schedule saves 33,000 lives, prevents 14 million instances of disease, reduces health care cost by 9.9billion,andsaves9.9 billion, and saves 9.9billion,andsaves33.4 billion in indirect cost. In spite of the available vaccines, about 42,000 of adults and 300 children die each year from vaccine preventable diseases. 2 The pharmacists' role as vaccinators dates back to the 1800's. The first organized formal vaccination training for pharmacists
SKIN The Journal of Cutaneous Medicine, 2021
Purpose: To determine whether clinician-led immunization education with immediate onsite vaccination availability will increase pneumococcal immunizations during specialty care. Methods: We designed a controlled before and after QI project quasi-experimental design to retrospectively evaluate the QI effectiveness. The QI setting included two clinics. Clinic #1 was a part of the county hospital system and offered comprehensive care. Clinic #2 was a university clinic that hosted a private practice and a dermatology resident continuity clinic. 201 patients with planned or existing immunosuppressive medication regimens attending an initial or follow-up dermatology visit participated in the study. The intervention included clinician provided verbal immunization recommendations. Patients were then given the opportunity for immediate immunization. The main measure of outcome was pneumococcal immunization status after QI intervention. Results: Our analysis included 201 patients with planned...