Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117650

Salman Baghian, BS, Aubrey F. Lipham, BS, Dale M. Marioneaux, BS, MEd, Monica Pradhan, BS, MNS, and William M. Cassidy, MD. Department of Medicine, Louisiana State University Health Sciences Center, 5825 Airline Hwy., Baton Rouge, LA 70805, 225-354-2001, sbagh1@lsuhsc.edu

Background: We developed a system where paraprofessionals screen adult Emergency Department (ED) patients' risks for vaccine preventable diseases. Physicians review the screening form and order vaccinations. Last year there was excellent acceptance in an urban Baton Rouge teaching hospital. Unknown is physician acceptance in a different setting. Methods: The above model was used in December 2004 and January 2005 in 2 Baton Rouge area EDs. One of which was a private urban teaching hospital (UTH) and another was a rural non-teaching hospital (RH). This was year 2 in the UTH and year one in the RH. Afterwards, the number of flu vaccinations indicated and ordered was compared. Results: Despite patient acceptance of vaccine and physician approval of vaccination 6/143 (4.2%) UTH and 7/187 (3.7%) RH patients were discharged without vaccination. In the UTH, 9/143 (6.3%) and in the RH 41/187 (21.9%) of the vaccinations patients agreed to receive were denied by the physicians (P<0.001). Physician refusals typically were due to fear vaccination would complicate the patient's condition. Conclusion: Both hospitals successfully maintained a flu immunization program using paraprofessionals. Even though the screening form was designed to identify patients who should not be vaccinated, more patients were not vaccinated due to physician perceived contraindications at the rural hospital versus the urban teaching hospital. Physicians' practice significantly affected outcomes.

Learning Objectives:

• Utilize qualitative and quantitative information to determine strategy for maximizing immunization coverage and minimizing tasks associated with the process.

Keywords: Immunizations, Emergency Department/Room

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.