Knocking Down Barriers and Evaluating Adult Pneumococcal Vaccination Policy in Los Angeles County Department of Health Services Clinics

Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to identify barriers associated with the implementation of policies promoting pneumococcal polysaccharide vaccine (PPV) use in in-patient and out-patient healthcare facilities.

Background:
In 1999, Policy 334 was established to increase PPV use at Los Angeles County Department of Health Services (LAC-DHS) hospitals and clinics. The policy requires that unvaccinated persons ≥ 2 years of age with high-risk medical conditions and unvaccinated adults ≥ 65 years of age be offered PPV. In 2006, LAC-DHS hospitals and clinics were surveyed to evaluate the extent of implementation of policy 334.

Setting:
LAC-DHS hospitals and ambulatory-care clinics.

Population:
Nurse managers (NMs), infection control practitioners (ICPs), and some line staff at LAC-DHS hospitals and ambulatory-care clinics.

Project Description:
The LAC Immunization Program (LACIP) nurses utilized a survey tool to interview NMs, ICPS, and line staff at 7 LAC-DHS facilities to evaluate implementation of Policy 334, quality assurance measures around the policy, and the staff's knowledge of the policy.

Results/Lessons Learned:
The survey revealed that 82% of staff was knowledgeable about Policy 334. However, barriers affecting the policy's implementation were identified. Fifty-five percent (55%) of surveyed individuals stated that lack of an assessment tool to screen for persons recommended to receive PPV was the greatest barrier to implementation of the policy. Other barriers identified for implementation of the policy were unavailability of PPV and insufficient funding for vaccine purchase. As a result of the survey, a standardized tool to assess eligibility for receipt of PPV was developed and will be implemented at the clinics whose staff participated in the survey.