A Group-Randomized Evaluation of a Quality Improvement Intervention to Improve Influenza Vaccination Rates in Dialysis Centers

作者：Bond T Christopher^*; Patel Priti R; Krisher Jenna; Sauls Leighann; Deane Jan; Strott Karen; McClellan William

来源：American Journal of Kidney Diseases, 2011, 57(2): 283-290.

DOI：10.1053/j.ajkd.2010.09.019

• End-stage renal disease
• group-randomized evaluation
• influenza immunization
• quality improvement intervention

Background: Patients with end-stage renal disease (ESRD) are at high risk of complications from influenza, but many dialysis centers report <50% influenza immunization coverage.
Study Design: A group-randomized evaluation of a multicomponent intervention to increase influenza vaccination rates in poorly performing dialysis centers in ESRD Networks 6, 11, and 15.
Setting & Participants: Facilities with the lowest immunization percentages in 2006-2007 were selected from each network and randomly assigned to a standard (n = 39) or intensive intervention (n = 38).
Intervention: Standard intervention included a feedback report with comparison to other centers in their network and educational materials for staff and patients. Intensive-intervention centers also received 3 educational seminars, assistance with and review of center-specific action plans, and monthly monitoring of vaccination plan and rates.
Outcomes: Change in vaccination rate in following year.
Measurements: Dialysis center records of patient vaccination status.
Results: There was an 8.9% (P = 0.04) adjusted mean absolute difference in improvement between intensive-and standard-intervention centers.
Limitations: Some vaccinations were self-reported by patients. The vaccination data form does not have an option for patient data unavailable, which may have caused patients without data to be coded as unvaccinated.
Conclusions: Multicomponent interventions may serve as a successful strategy to increase influenza vaccination rates at poorly performing centers, with a benefit beyond that provided by usual oversight and support. Am J Kidney Dis. 57(2):283-290.

• 出版日期2011-2