Goldstein Adam O, Kincade Jean E, Resnick Jennifer E, Gamble George, Bearman Rachel S
Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC 27599, USA.
Am J Infect Control. 2005 Oct;33(8):463-8. doi: 10.1016/j.ajic.2005.01.008.
The objective of this study was to understand better the status of and ways to improve dissemination of influenza and pneumococcal standing-order vaccination policies to at-risk adults in health care institutions.
A statewide sample of 5 different types of institutions serving at-risk elderly persons in North Carolina was surveyed. A 45-question telephone survey was administered to infection control nurses or facility directors at 267 (86% response rate) health care facilities involved in direct patient care.
A majority of respondents reported that influenza (81%) and pneumococcal (59%) diseases were important to their facility, and 63% stated that the influenza vaccine was very effective versus 47% for pneumococcal. Except nursing homes, few facilities reported adoption of standing-order policies to vaccinate routinely the at-risk adults. Over 70% of respondents stated that their facilities might consider adopting standing-order policies for influenza and pneumococcal disease. A majority of respondents also supported a state law that requires such vaccines for high-risk patients unless contraindicated or the patient refuses.
Respondents across diverse health care institutions appear interested in adopting standing-order policies to increase influenza and pneumococcal vaccination rates and are more likely to do so if provided with appropriate administrative and/or financial support for implementation.
本研究的目的是更深入地了解向医疗机构中的高危成年人传播流感和肺炎球菌预订单疫苗接种政策的现状及改进方法。
对北卡罗来纳州为高危老年人提供服务的5种不同类型机构进行全州范围抽样调查。对参与直接患者护理的267家医疗机构（回复率86%）的感染控制护士或机构主任进行了一项包含45个问题的电话调查。
大多数受访者报告称，流感（81%）和肺炎球菌疾病（59%）对其机构很重要，63%的人表示流感疫苗非常有效，而肺炎球菌疫苗为47%。除养老院外，很少有机构报告采用预订单政策为高危成年人进行常规接种。超过70%的受访者表示，其机构可能会考虑采用流感和肺炎球菌疾病预订单政策。大多数受访者还支持一项州法律，该法律要求为高危患者接种此类疫苗，除非有禁忌或患者拒绝。
不同医疗机构的受访者似乎有兴趣采用预订单政策来提高流感和肺炎球菌疫苗接种率，如果在实施过程中能获得适当的行政和/或财政支持，则更有可能这样做。
