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

• Published in: American journal of kidney diseases Vol. 57; no. 2; pp. 283 - 290
• Main Authors: Bond, T. Christopher, PhD, Patel, Priti R., MD, MPH, Krisher, Jenna, BS, Sauls, Leighann, RN, CDN, Deane, Jan, RN, CNN, Strott, Karen, BSN, RN, CPHQ, McClellan, William, MD, MPH
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2011; Elsevier
• Subjects: Biological and medical sciences; End-stage renal disease; Female; group-randomized evaluation; Health Facilities; Human viral diseases; Humans; Immunization Programs; Infectious diseases; influenza immunization; Influenza Vaccines - therapeutic use; Influenza, Human - prevention & control; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Nephrology; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Patient Education as Topic; Quality Assurance, Health Care; quality improvement intervention; Renal Dialysis; Renal failure; Retrospective Studies; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; quality improvement intervention; End-stage renal disease; group-randomized evaluation; influenza immunization; Kidney disease; Evaluation; Center; Immunization; Nephrology; Urinary system disease; Chronic renal failure; Vaccination; Terminal stage; Urology; Infection; Randomization; Vaccination coverage; Viral disease; Influenza; Quality; Renal failure; Dialysis
• ISSN: 0272-6386; 1523-6838
• DOI: 10.1053/j.ajkd.2010.09.019

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.