Abstract
Pneumococcal disease is one of the leading causes of hospitalizations and mortality in the United States. Pneumococcal disease results in approximately 4,800 deaths annually. The Centers for Disease Control and Prevention (CDC) recommends routine use of the 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccines (PPSV23) in 6-12 months among adults aged ≥65 years. Despite the current guidelines and recommendations from CDC, percent of adults 65 years and over who had ever received a pneumococcal vaccination is only 61.3%. The purpose of this project was to increase pneumococcal pneumonia vaccination rate among adults 65 years and older who present to a small Midwestern primary care clinic (Sancta Familia Medical Apostolate) by implementing nursing standing order protocol. The design of the study was quasi-experimental and included pre and post pneumococcal vaccination rate. The odds ratio was used to measure the significance of differences between pre-intervention pneumococcal vaccination rate and post-intervention rate. Pre-implementation pneumococcal vaccination rate was 38.94%. Following implementation of the standing order, the pneumococcal vaccination rate was 47.11%. Implementation of standing order for pneumococcal vaccination rate increased staff awareness of the importance of pneumococcal vaccine (PV) among adults 65 years or older. Although the rate of PV went up, there was not a significant difference in the odds of receiving a vaccine between retrospective and prospective patients. Future attempts at implementing a standing order protocol should include proper education and training to employees including receptionist, weekly assessment of the intervention, and electronic reminder system to both nurses and providers.