Abigail Shefer, National Immunization Program/Health Services Research Evaluation Branch, Centers for Disease Control, 1600 Clifton Road NE, MS E-52, Atlanta, GA, USA, Linda J. McKibben, CDC/EPO/DPRAM/Office of Health Care Partnerships, 4770 Buford Hwy, Mailstop K-73, Atlanta, Georgia, USA, Henry Roberts, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS E-62, Atlanta, USA, Barbara H. Bardenheier, NIP/ISD/HSREB, CDC, 1600 Clifton Rd, NE, MS-E52, Atlanta, GA, USA, and Dale W. Bratzler, Oklahoma Foundation for Medical Quality, 5801 Broadway Extension, Suite 400, Oklahoma City, Oklahoma, USA.
KEYWORD1:
long term care facilities, nursing homes, vaccination, standing order programs
BACKGROUND:
Standing order programs (SOPs) are effective immunization-promoting interventions in which nurses or pharmacists are authorized to vaccinate by institution-approved protocol without a physician order or exam. During 1999-2002, an inter-agency demonstration project was conducted in long-term care facilities (LTCFs) to promote the use of SOPs for influenza and pneumococcal vaccination.
OBJECTIVE:
To describe the use of SOPs in LTCFs and determine characteristics of LTCFs associated with their use.
METHOD:
Nursing home characteristics and immunization program types were collected from a self-administered survey sent to every Medicare certified LTCF in 13 states. Data from this survey were linked to the On-line Survey and Certification Reporting System (OSCAR), an administrative database of all Medicare or Medicaid licensed LTCFs in the country. All variables significant at p<.05 on bivariate were put into a backward logistic regression model.
RESULT:
3,467 of 4,461 (78%) LTCFs had complete survey and OSCAR data. Less than 10%of facilities used SOPs for influenza or pneumococcal vaccination. Characteristics most strongly associated with use of SOPs for both vaccines were being a government owned facility (ownership), being a dually certified skilled nursing facility (facility type), and not being part of a multi-facility organization (organization). LTCFs with a lower resident care or acuity index (ACUINDEX) were more likely to use SOPs for influenza vaccine. LTCFs with a consistent place in the resident’s chart to record vaccination status, a centralized system for tracking resident vaccination status, and having a lower proportion of Medicare-payer residents were more likely to use SOPs for pneumococcal vaccine. Using logistic regression, factors that remained significant for both vaccines were ownership and facility type.
CONCLUSION:
LTCFs should be encouraged to implement SOPs to improve the vaccination status of their resident population. For both vaccines, SOPs were used more often in government owned or skilled nursing facilities.
LEARNINGOBJECTIVES:
1. Learn what is the status of use of SOPs in LTCFs currently.
2. Know the characteristics of LTCFs that are more or less likely to use SOPs.
See more of What Factors are Associated with Vaccination Coverage in Nursing Homes, and do Influenza and Pneumococcal Vaccines Really Prevent Disease Among Nursing Home Residents?
See more of The 37th National Immunization Conference
