Submitting/Presenting Author

Henry S. Jeng Dr, CMHFollow

Presenter Status

Fellow

Abstract Type

QI

Primary Mentor

Dr. Ryan McDonough

Start Date

10-5-2021 11:30 AM

End Date

10-5-2021 1:30 PM

Presentation Type

Poster Presentation

Description

Background/Project Intent (Aim Statement): The routine use of PCV-13 has resulted in a dramatic reduction in the incidence of pneumococcal infections among young children. However, serious pneumococcal infections caused by additional vaccine serotypes continue to occur in older children with high-risk conditions.1 As per the CDC, children with Diabetes should receive the PPSV-23 vaccine beginning at 2 years of age and at least 8 weeks after their last indicated dose of PCV-13.2 A review of division data from March 2016 to November 2018 revealed that only 2.6% of the eligible patient population with Diabetes have received the PPSV-23 vaccine. More recent data analysis from October 2019 to September 2020 showed an increase to 3.4%. The aim of this project is to establish a protocol to set up tracking for the eligibility and administration of PPSV-23 and improve the vaccination rate to > 10% by July 2021.

Methods (include PDSA cycles): Data reports are received on a bi-weekly basis from Integrative Care Solutions for each patient with an upcoming Diabetes Clinic appointment, in order to track their vaccine eligibility. From there, vaccine orders can be placed and its administration status could be documented for tracking among eligible patients. The barriers that have contributed to the low vaccination rate include lack of family awareness of the vaccine, establishment of the tasks/responsibilities of the providers and ancillary staff in being alerted to patient eligibility for the vaccine and in vaccine administration. From a data analysis standpoint, tracking of the vaccination rates is underway. PDSA cycles have been implemented to take steps in addressing the aforementioned barriers and to track the amount of patients eligible for the vaccine and have completed the PCV-13 series prior to Diabetes clinic visit, who have then subsequently received PPSV-23 vaccine on a weekly basis.

Results: Review of data so far between 06/2020 thru 12/2020 had shown a weekly average of 8.39% of eligible patients who have completed PCV-13 vaccine series prior to the visit, to have received the PPSV-23 vaccine. Also accounted for in the data analysis included patients who have previously received the PPSV-23 vaccine prior to the visit, as well as whether the upcoming eligible patients had no-showed or had rescheduled their appointment.

Conclusions: After extensive discussions and meetings with the providers and ancillary staff in the department, many of the barriers above have been addressed, including allocation of duties in regards to placing orders for the vaccine and in putting measures in place to alert providers of patients eligible to receive the vaccine. One challenge will be continuing the project to also account for Diabetes patients who have not completed the PCV-13 vaccine series prior to visit, in order to then be eligible for PPSV-23 vaccination at time of Diabetes clinic visit

MeSH Keywords

vaccination, Diabetes, adolescents, Pneumococcal polysaccharide

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May 10th, 11:30 AM May 10th, 1:30 PM

Improving the rate of PPSV-23 vaccination in children with Type I Diabetes

Background/Project Intent (Aim Statement): The routine use of PCV-13 has resulted in a dramatic reduction in the incidence of pneumococcal infections among young children. However, serious pneumococcal infections caused by additional vaccine serotypes continue to occur in older children with high-risk conditions.1 As per the CDC, children with Diabetes should receive the PPSV-23 vaccine beginning at 2 years of age and at least 8 weeks after their last indicated dose of PCV-13.2 A review of division data from March 2016 to November 2018 revealed that only 2.6% of the eligible patient population with Diabetes have received the PPSV-23 vaccine. More recent data analysis from October 2019 to September 2020 showed an increase to 3.4%. The aim of this project is to establish a protocol to set up tracking for the eligibility and administration of PPSV-23 and improve the vaccination rate to > 10% by July 2021.

Methods (include PDSA cycles): Data reports are received on a bi-weekly basis from Integrative Care Solutions for each patient with an upcoming Diabetes Clinic appointment, in order to track their vaccine eligibility. From there, vaccine orders can be placed and its administration status could be documented for tracking among eligible patients. The barriers that have contributed to the low vaccination rate include lack of family awareness of the vaccine, establishment of the tasks/responsibilities of the providers and ancillary staff in being alerted to patient eligibility for the vaccine and in vaccine administration. From a data analysis standpoint, tracking of the vaccination rates is underway. PDSA cycles have been implemented to take steps in addressing the aforementioned barriers and to track the amount of patients eligible for the vaccine and have completed the PCV-13 series prior to Diabetes clinic visit, who have then subsequently received PPSV-23 vaccine on a weekly basis.

Results: Review of data so far between 06/2020 thru 12/2020 had shown a weekly average of 8.39% of eligible patients who have completed PCV-13 vaccine series prior to the visit, to have received the PPSV-23 vaccine. Also accounted for in the data analysis included patients who have previously received the PPSV-23 vaccine prior to the visit, as well as whether the upcoming eligible patients had no-showed or had rescheduled their appointment.

Conclusions: After extensive discussions and meetings with the providers and ancillary staff in the department, many of the barriers above have been addressed, including allocation of duties in regards to placing orders for the vaccine and in putting measures in place to alert providers of patients eligible to receive the vaccine. One challenge will be continuing the project to also account for Diabetes patients who have not completed the PCV-13 vaccine series prior to visit, in order to then be eligible for PPSV-23 vaccination at time of Diabetes clinic visit