Wednesday, May 12, 2004 - 11:45 AM
5007

Long-Term Care Facility Characteristics Predictive of Increased Influenza and Pneumococcal Vaccination Coverage for Residents

Barbara H. Bardenheier, NIP/ISD/HSREB, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS-E52, Atlanta, GA, USA, Abigail Shefer, National Immunization Program, Centers for Disease Control and Prevention, 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, and Dale W. Bratzler, Oklahoma Foundation for Medical Quality, 14000 Quail Springs Parkway, Suite 400, Oklahoma City, OK, USA.


BACKGROUND:
Residency in long-term care facilities (LTCFs) is a risk factor for vaccine-preventable diseases. During 1999-2002, a multi-state demonstration project was conducted in LTCFs to encourage implementation of standing orders programs (SOP) as evidence-based vaccine delivery strategies to increase influenza and pneumococcal vaccination coverage in LTCFs.

OBJECTIVE:
Identify LTCF characteristics associated with increased vaccination coverage.

METHOD:
Data on LTCF characteristics were collected by self-administered surveys of facilities in 14 states and from OSCAR (On-line Survey Certification and Reporting System). Immunization coverage was abstracted from residents’ medical charts from a sample of 20 LTCFs in each of 9 intervention and 5 control states in 2000 for baseline and in 2002 for post-intervention. Multivariate linear regression analysis will be used to determine independent predictors of change in facility influenza and pneumococcal vaccination coverage.

RESULT:
215 (91.9%) facilities participated in the survey both years. 106(50%) of the facilities’ coverage increased for both vaccines. Influenza vaccination coverage increased 0.73% average, range: -47.5%-68.9% (ns); Factors associated with an increase included: 1) Adoption of requirement in written immunization protocol to document refusals (+5.28% vs -0.14%); 2) Documentation of influenza vaccinations in a consistent place using a standard form (vaccine history could not be removed) (+1.17% vs -7.94%). Pneumococcal vaccination coverage increased 2.13% average, range: -95.8% - 87.5% (ns); Factors associated with an increase included: 1) Adoption of centralized tracking of pneumococcal immunizations (+9.05% vs -0.19%); 2) Adoption of recording pneumococcal immunizations in a consistent place (+14.55% vs -0.25%).

CONCLUSION:
To improve the health of LTCF residents, strategies should be considered that increase immunization coverage including: centralized tracking systems, documenting vaccination status in a consistent place using a standardized form such that vaccine history cannot be removed, and use of SOPs when possible.

LEARNING OBJECTIVES:
Identify LTCF characteristics associated with increase in influenza and pneumococcal vaccination coverage.

See more of What is the Impact of Immunization Programs and Other Facility and Resident Characteristics on Vaccination Coverage in Long-Term Care Facilities?
See more of The 38th National Immunization Conference