Madigan Elizabeth A, Kenneley Irena
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
Home Health Care Manag Pract. 2015 Feb;27(1):13-17. doi: 10.1177/1084822314530993. Epub 2014 Apr 28.
The recommendations for influenza and pneumococcal vaccines are widely known yet the rates of both immunizations for home health care patients are 70 percent or less. The purpose of this study was to identify the facilitators and barriers to immunizations ultimately to improve vaccination rates among home health care patients. Using a multi-case study approach with five agencies and one group of administrators, facilitators included providing patients with a vaccine "card" and using the agency electronic medical record (EMR) for decision support/reminders. We determined that there were patient barriers (misperceptions about vaccines in general, difficulty in recalling vaccine status) and provider barriers (misperceptions about vaccines among health care workers, home health care agencies not receiving accurate information from other providers or difficulty in determining vaccine status).
流感疫苗和肺炎球菌疫苗的接种建议广为人知，但家庭保健患者的这两种疫苗接种率均为70%或更低。本研究的目的是确定疫苗接种的促进因素和障碍，最终提高家庭保健患者的疫苗接种率。采用多案例研究方法，涉及五个机构和一组管理人员，促进因素包括为患者提供疫苗“卡”，并使用机构电子病历（EMR）进行决策支持/提醒。我们确定存在患者障碍（对疫苗总体存在误解、难以回忆疫苗接种情况）和提供者障碍（医护人员对疫苗存在误解、家庭保健机构未从其他提供者处获得准确信息或难以确定疫苗接种情况）。
