INFLUENZA VACCINATIONS FOR ELIGIBLE PATIENTS
IMM-2
PATIENTS RECEIVING IMMUNIZATION FOR INFLUENZA

Over 3 million people get infected with the flu each year. Nosocomial infections from community acquired infections can increase hospital lengths of stay and even result in death. The Centers for Disease Control (CDC) and the Center for Medicare and Medicaid Services strongly recommend facilities develop a process for screening, educating and immunizing patients entering facilities seeking care and treatment.

This measure evaluates the facility’s effectiveness in screening and offering influenza vaccinations to their patients. Below is a list of best practices for implementation and reinforcement of this measure which is evaluated with discharges beginning October 1st and running through March 31st.

BEST PRACTICES:

• Make plans with Nursing, Pharmacy and Physicians on upcoming immunization campaign for eligible patients.
• Begin educating the staff on the Immunization Campaign for patients in the summer with a major communication the week before October 1 to assure readiness on October 1st for appropriate screening and vaccination.
• Establish a nurse-driven standing order or protocol which allows for screening and administration of vaccine to all eligible patients without a physician’s order (See Section on Physician Orders).
• Collaborate with pharmacy to have vaccine available in ED and Inpatient units.
• Identify strategy to address patients who decline.
• Consider use of THAF/ARCHI flu tracking spreadsheets (Appendix A)
• Conduct daily review of patients’ administration status (see form below) (See printable form in Appendix B - IMM-2 Quality Audit Checklist
• Review status at discharge for completeness (see form below) (See printable form in Appendix B - IMM-2 Quality Audit Checklist

Physician Orders/Standing Order Sets

Develop Standing Delegated Medical Orders for Immunizations on all patients seen in ED or Inpatient (See Appendix C)

• Another resource https://www.thecommunityguide.org/findings/vaccination-programs-standing-orders
• Add order for “Immunize on Admission” to all Admission order sets

Informatics

• For those hospitals on an electronic health record, work with your IT department/vendor to develop a Best Practice Alert to fire on admission, every 12 hours and upon discharge.
• Embed assessment or prompt in EHR/paper medical record

Concurrent Data

This measure is best managed for concurrent review while the patient is hospitalized. Daily review of the patient’s status during huddles and nursing shift to shift reporting will best facilitate monitoring and action for each eligible patient.

Appendix A provides tracking forms (manual or electronic) to collect and analyze your performance in immunizing patients in real time.

• Consider use of THAF/ARCHI flu tracking spreadsheets (Appendix A)

Quality Audit Form for Concurrent Review of Patient’s Immunization Status

Another alternative to collect quality data in real time is the use of the audit form. The goal for any improvement effort is for the necessary processes to be hard-wired into the daily regimen. To assist in hard-wiring the process for screening and vaccination, develop a plan to ensure all patients are screened at each shift until the measure has been fulfilled. Knowing that hospitals are complex environments, forms are often helpful to drive compliance. The sample form (Appendix A IMM-2 Quality Audit Checklist), could become part of the admission paperwork and attached to the front of the chart during ED Visits and on admissions to the facility. This form should not become a part of the patient’s medical record but should be forwarded to the quality department upon discharge of the patient to help the quality department monitor concurrent compliance and reporting. (See Appendix B IMM-2 Quality Audit Checklist)

Community Involvement

• Partner with local voting precincts to give flu vaccinations to those arriving to vote.
• Provide each participant with a card indicating they have received the immunization
• Partner with local physician offices, long-term care facilities, home health agencies and community health clinics to host an immunization fair and to develop methods to receive patient immunization records when patient is admitted. https://www.thecommunityguide.org/stories/good-shot-reaching-immunization-targets-duval-county