The Effect of Pharmacy-Driven Education on the Amount of Appropriately Administered Tetanus Vaccines in the Emergency Department
Journal Title: Hospital Pharmacy - Year , Vol 54, Issue 1
Abstract
Background: Tetanus vaccinations for wound prophylaxis are routinely administered in emergency departments (ED). Current recommendations from the Centers for Disease Control and Prevention (CDC) and Advisory Committee on Immunization Practices (ACIP) regarding tetanus administration for wound prophylaxis differentiate between the tetanus and diphtheria (Td) and the tetanus, diphtheria, acellular pertussis (Tdap) formulations and when they should be administered. Lack of knowledge regarding these recommendations, different formulations, and techniques to locate patient immunization history can lend to increased duplicate and inappropriate vaccinations. Objective: The purpose of this prospective, interventional study with a historical control was to evaluate the impact of a pharmacy-driven education series on the proportion of duplicate and inappropriate tetanus vaccinations administered in a level I trauma center ED. Methods: Three months of tetanus vaccinations administered in the ED after this education were analyzed and compared with a historical control. The primary outcome is the percentage of vaccinations considered duplicates (previous vaccination within the past 5 years) when patients’ medical record was reviewed for immunization history. Secondary end points include the percentage of vaccinations considered nonadherent (according to current CDC-ACIP guidelines), the total cost of all duplicate vaccinations, and the percentage of vaccination orders that had the wrong formulation administered. Results: The percentage of duplicate vaccinations decreased from 9.9% (25 vaccinations) to 5.5% (14 vaccinations) (P = .067) from the preintervention group to the postintervention group. Nonadherent vaccinations compiled 3.6% versus 2.8% of the vaccinations (P = .611) and incorrect formulations given were 18.2% versus 11.4% (P = .176) in the preintervention and postintervention groups, respectively. Conclusion: The study suggests that multiple formulations of tetanus vaccinations and fragmented documentation of immunizations increase the prevalence of medication errors related to tetanus vaccinations. It also indicates that interventions more enduring than education are required to prevent these errors.
Authors and Affiliations
Meghan Fletcher, Shannon Rankin, Preeyaporn Sarangarm
Keywords
Related Articles
- EP ID EP682459
- DOI 10.1177/0018578718769239
- Views 68
- Downloads 0
Physical Compatibility and Chemical Stability of Injectable and Oral Ranitidine Solutions
Objectives: The physical compatibility and chemical stability of ranitidine hydrochloride injectable solutions and oral syrup were studied to define beyond-use dates (BUDs). Methods: Ranitidine hydrochloride injectable s...
The Effect of Performance Transparency on Adherence to Barcode Scanning During Order Preparation in an Adult Inpatient Satellite Pharmacy
Purpose: The aim of this study was to investigate the effect of performance transparency and individualized feedback on pharmacy technician compliance with barcode verification technology during inpatient order preparati...
Cognitive Computing and Watson: Implications for Hospital Pharmacy
This installment explores the domain of cognitive computing, using the well-known Watson as an example. The migration of computer manufacturers from a focus on hardware to a focus on services suggests the potential of th...
The Assessment and Management Practices of Acute Alcohol Withdrawal: Results of a Nationwide Survey of Critical Care Pharmacists
Background: Alcohol withdrawal occurs commonly but diagnosis and therapies have not been described. Objective: To characterize practices regarding the assessment and treatment of acute severe alcohol withdrawal and descr...
A Survey of Opioid Medication Stewardship Practices at Academic Medical Centers
Purpose: The results of a survey of academic medical centers assessing the presence and description of opioid stewardship activities. Methods: Academic medical centers within the Vizient University Health System Consorti...