1503. Implementing Pneumococcal Vaccination in Hospitalized Adults With COPD, Asthma, Current Smokers, And/Or Over Age 65 years. A Performance Improvement Project.
Session: Poster Abstract Session: Pneumococcal Immunization in Adults
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • IDSA.pdf (4.9 MB)
  • Background: Pneumonia is a common illness in COPD and asthma. Readmissions due to disease exacerbations have a substantial impact on resource utilization. Efforts to increase the awareness of recommended pneumonia prevention strategies are supported to minimize these exacerbations and eventually to decrease morbidity and mortality.

    Methods: In March 2017, our team of medical residents initiated a quality improvement (QI) project to improve the vaccination status of hospitalized patients. The team provided education to inpatient care providers on medical floors regarding pneumonia vaccination guidelines. Questionnaire based data regarding pneumonia vaccination status was collected from the admitted patients with documented diagnoses of COPD, Asthma, current smokers and those ≥ 65 years from April to May, 2017. Based on the survey, Pneumococcal conjugate vaccine (PCV13) or Pneumococcal polysaccharide vaccine (PPSV23) was offered to the patients. Faculty from divisions of Pulmonary Medicine and Geriatrics supervised the team. The project is ongoing; expected goal of 400 patients to be targeted prior to presentation.

    Results: Our study had 100 patients of which 45 confirmed they were not immunized. 21 of these were given PCV13 based on age (> 65 years) while 12 received PPSV23.

      

    Age (n) 

    in years 

      Vaccination status prior to admission (n) 

     Patient aware of difference between PCV13 & PPSV23 vaccines (%) 

      Vaccination status at discharge (n) 

     

     <65 

     

     65 

     

     Up to date  

      

     

    Not up to date 

     

     

     Unsure 

    If vaccinated 

     Vaccinated but uncertain about year or type of vaccination 

     

      Aware 

     

     Not aware 

     


     Not asked or not able to assess 

     

     

    Vaccination indicated with certainty 

     

     Vaccinated 

     

    Not vaccinated due to refusal 

     38 

     62 

     42 

     

     45 

     


     3  

     

     10 

      

     85 

     10 

     45 

     33  

     

    12  

     

    Conclusion:

    Optimization of vaccination in COPD and Asthma patients requires a multidisciplinary collaboration of primary care providers, patient awareness and willingness to accept vaccination 

    This pilot QI project results indicate that many patients were not aware of the difference between the vaccines they received or when they received; this made successful vaccination difficult.

    Majority of patients agreed for vaccination once counseled regarding indications. 

    Saad Bin Jamil, MD1, Faran Ahmad, MD2, Ajay Patel, MD2, Shruti Polo, MD2, Talat Syed, MD2, Shakera Syed, MD2, Theodore Casper, MD3 and Ts Dharmarajan, MD/ FACP/AGSF4, (1)Montefiore Medical Center, Wakefield Campus, Bronx, NY, (2)Dept of Internal Medicine, Montefiore Medical Center, Wakefield Campus, Bronx, NY, (3)Dept of Internal Medicine, Dept of Pulmonary Medicine, Montefiore Medical Center, Wakefield Campus, Bronx, NY, (4)Dept of Internal Medicine, Dept of Geriatrics, Montefiore Medical Center, Wakefield Campus, Bronx, NY

    Disclosures:

    S. B. Jamil, None

    F. Ahmad, None

    A. Patel, None

    S. Polo, None

    T. Syed, None

    S. Syed, None

    T. Casper, None

    T. Dharmarajan, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.