Emergency Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Universitaire Paris Nord Val de Seine, Paris, France.
EA 7334, "Recherche Clinique Coordonnée Ville-Hôpital, Méthodologies et Société (REMES)", Sorbonne Paris Cité, Université Paris Diderot, Paris, France.
Intern Emerg Med. 2018 Aug;13(5):673-678. doi: 10.1007/s11739-018-1852-8. Epub 2018 May 25.
To evaluate the impact of an influenza vaccination (IV) coverage (IVC) in a vaccination campaign of an Emergency Department (EDVC) and its impact on ED time interval quality indicators. We conducted a 4 year observational study, with an intervention during the 4th year. IVC was calculated during pre-and early-epidemic periods. During the final period, a 12 weeks EDVC was implemented. Physicians and nurses were trained and sensitized in the importance of vaccination, and their role in the prevention of severe forms of influenza was reinforced. The vaccine was proposed by physicians and nurses, and delivered by them. Repeated measures ANOVA is a validated method for related not independent groups ( https://statistics.laerd.com/statistical-guides/repeated-measures-anova-statistical-guide.php ). Overall, IVC was 987/3191 (30.9%) with an increasing trend from 28.8 to 33.2%. In the fourth period, out of 868 patients identified with IV indication, 288 had already been vaccinated (IVC 33.2%). After excluding patients presenting criteria of exclusion, IV was proposed to 475 patients: 317 (66.7%) accepted. The vaccination rate after patient's acceptance was 89.6% (288/317). At the end of the EDVC, influenza vaccination coverage was 572 (284 + 288)/868 (65.9%). The delay between arrival at the ED and seeing the triage nurse and physician as well as the overall ED length of stay were not modified during the study period and before and during EDVC. EDVC effectively doubled the influenza vaccination coverage, without modifying ED time interval quality indicators.
评估急诊科疫苗接种活动中流感疫苗接种覆盖率(IVC)及其对急诊科时间间隔质量指标的影响。我们进行了一项为期 4 年的观察性研究,在第 4 年进行了干预。在流行前期和早期计算 IVC。在最后一个时期,实施了为期 12 周的 EDVC。培训和提高了医生和护士对疫苗接种重要性的认识,并加强了他们在预防严重流感方面的作用。疫苗由医生和护士提出,并由他们提供。重复测量方差分析是一种针对相关但非独立组的有效方法(https://statistics.laerd.com/statistical-guides/repeated-measures-anova-statistical-guide.php)。总体而言,IVC 为 3191 例中的 987 例(30.9%),呈从 28.8%增加到 33.2%的趋势。在第四期,在 868 例有 IV 指征的患者中,288 例已经接种了疫苗(IVC33.2%)。在排除有排除标准的患者后,向 475 例患者提出了 IV 建议:317 例(66.7%)接受了建议。接受患者后的接种率为 89.6%(288/317)。在 EDVC 结束时,流感疫苗接种覆盖率为 572 例(284+288)/868(65.9%)。在研究期间以及 EDVC 之前和期间,到达急诊科与分诊护士和医生见面以及整体急诊科停留时间没有改变。EDVC 有效地将流感疫苗接种覆盖率提高了一倍,而没有改变 ED 时间间隔质量指标。