Inpatient Computer-Based Standing Orders vs Physician Reminders to Increase Influenza and Pneumococcal Vaccination Rates: A Randomized Trial
CONTEXT Computerized reminder systems increase influenza and pneumococcal vaccination rates, but computerized standing order systems have not been previously described or evaluated. OBJECTIVE To determine the effects of computerized physician standing orders compared with physician reminders on inpa...
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Published in | JAMA : the journal of the American Medical Association Vol. 292; no. 19; pp. 2366 - 2371 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Chicago, IL
American Medical Association
17.11.2004
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Subjects | |
Online Access | Get full text |
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Summary: | CONTEXT Computerized reminder systems increase influenza and pneumococcal vaccination
rates, but computerized standing order systems have not been previously described
or evaluated. OBJECTIVE To determine the effects of computerized physician standing orders compared
with physician reminders on inpatient vaccination rates. DESIGN, SETTING, AND PATIENTS Randomized trial of 3777 general medicine patients discharged from 1
of 6 study wards during a 14-month period (November 1, 1998, through December
31, 1999) composed of 2 overlapping influenza seasons at an urban public teaching
hospital. INTERVENTIONS The hospital’s computerized physician order entry system identified
inpatients eligible for influenza and pneumococcal vaccination. For patients
with standing orders, the system automatically produced vaccine orders directed
to nurses at the time of patient discharge. For patients with reminders, the
computer system provided reminders to physicians that included vaccine orders
during routine order entry sessions. MAIN OUTCOME MEASURE Vaccine administration. RESULTS During the approximately 6 months of the influenza season, 50% of all
hospitalized patients were identified as eligible for influenza vaccination.
Twenty-two percent of patients hospitalized during the entire 14 months of
the study were found eligible for pneumococcal vaccination. Patients with
standing orders received an influenza vaccine significantly more often (42%)
than those patients with reminders (30%) (P <.001).
Patients with standing orders received a pneumococcal vaccine significantly
more often (51%) than those with reminders (31%) (P <.001). CONCLUSIONS Computerized standing orders were more effective than computerized reminders
for increasing both influenza and pneumococcal vaccine administration. Our
findings suggest that computerized standing orders should be used more widely
for this purpose. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23 |
ISSN: | 0098-7484 1538-3598 |
DOI: | 10.1001/jama.292.19.2366 |