Details:

Alternative Title:
BMC Fam Pract
Publisher's site:
http://dx.doi.org/10.1186/1471-2296-13-22
Personal Author:
Albert, Steven M ; Nowalk, Mary Patricia ; Yonas, Michael A ; Zimmerman, Richard K ; Ahmed, Faruque
Albert, Steven M ; Nowalk, Mary Patricia ; Yonas, Michael A ; Zimmerman, Richard K ; Ahmed, Faruque Less -
Description:
Background

Standing orders programs (SOPs) allow non-physician medical staff to assess eligibility and administer vaccines without a specific physician's order. SOPs increase vaccination rates but are underutilized.

Method

In 2009, correlates of SOPs use for influenza vaccine and pneumococcal polysaccharide vaccination (PPV) were assessed in a nationally representative, stratified random sample of U.S. physicians (n = 880) in family and internal medicine who provided office immunization. The response rate was 67%. Physicians reporting no SOPs, only influenza SOPs, and joint influenza and PPV SOPs were compared using multinomial and logistic regression models to examine individual and practice-level correlates.

Results

23% reported using SOPs consistently for both influenza vaccine and PPV, and 20% for influenza vaccination only, with the remainder not using SOPs. Practice-level factors that distinguished practices with joint influenza-PPV SOPs included perceived practice openness to change, strong practice teamwork, access to an electronic medical record, presence of an immunization champion in the practice, and access to nurse/physician assistant staff as opposed to medical assistants alone.

Discussion

Physicians in practices with SOPs for both vaccines reported greater awareness of ACIP recommendations and/or Medicare regulations and were more likely to agree that SOPs are an effective way to boost vaccination coverage. However, implementation of both influenza and PPV SOPs was also associated with a variety of practice-level factors, including teamwork, the presence of an immunization champion, and greater availability of clinical assistants with advanced training.

Conclusions

Practice-level factors are critical for the adoption of more complex SOPs, such as joint SOPs for influenza and PPV.


Subject:
[+]
Female
Guideline Adherence
Health Care Surveys
Humans
Immunization Programs
Influenza Vaccines
Logistic Models
Male
Medical Staff
Pneumococcal Vaccines
Primary Health Care

Source:
BMC Fam Pract. 2012; 13:22.
Pubmed ID:
22433118
Pubmed Central ID:
PMC3324392
Document Type:
Journal Article
Funding:
KL2 TR000146/TR/NCATS NIH HHS/United States ; P30 AG024827/AG/NIA NIH HHS/United States ; U50 CD300-860-21/CD/ODCDC CDC HHS/United States ; UL1 RR024153/RR/NCRR NIH HHS/United States ; UL1 TR000005/TR/NCATS NIH HHS/United States
KL2 TR000146/TR/NCATS NIH HHS/United States ; P30 AG024827/AG/NIA NIH HHS/United States ; U50 CD300-860-21/CD/ODCDC CDC HHS/United States ; UL1 RR024153/RR/NCRR NIH HHS/United States ; UL1 TR000005/TR/NCATS NIH HHS/United States Less -
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:7a6a60a7023d17c35e42403306fb60607d29e9c8b51bd39c43f8c6d90b2b5758
File Type:

Supporting Files

• 	1471-2296-13-22-1.gif	gif
  	1471-2296-13-22-1.jpg	jpeg
  	1471-2296-13-22-S1.DOC	doc
  	1471-2296-13-22.nxml	txt
  	license.txt	txt

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