Implementing an electronically based, nurse-driven pneumococcal vaccination protocol for inpatients

Purpose. The development and implementation of an electronically based, nurse-driven pneumococcal vaccination protocol for hospitalized patients are described. Summary. A multidisciplinary team was formed to address the development, implementation, and management of an automatic pneumococcal vaccination program. Screening of patients was performed by the nursing staff on admission to the hospital; the screening process was streamlined using computer-generated assessment forms. The electronic program enabled systematic identification of patients eligible for vaccination, standardization of vaccine order instructions, documentation of vaccinations in a centralized electronic database, automatic documentation of vaccinations on patients'discharge instructions, and collection of vaccination data for future analysis. If vaccination was indicated, an electronic order was automatically generated for the vaccine to be administered within 24 hours. The electronic order appeared on the electronic medication administration record like any other medication. Given the prominent role of nursing in the protocol, the largest training effort was in the nursing department, with education targeting 1200 nurses. Precautions were taken to minimize unintended duplicate vaccine administration. Patients were excluded from the vaccination protocol if they were younger than age 65 years, had a fever, were still in an intensive care unit, had an acute neurologic disorder, or had any condition for which there was doubt about the safety or appropriateness of the vaccination. Multidisciplinary resources are used to further reevaluate and refine the vaccine protocol. Conclusion. A multidisciplinary team successfully developed and implemented an electronically based, nurse-driven pneumococcal vaccination protocol for hospitalized patients in a teaching hospital.