Department of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA.
Department of Public Health Sciences, University of California Davis, Davis, CA, USA.
Vaccine. 2023 Feb 24;41(9):1611-1615. doi: 10.1016/j.vaccine.2022.12.063. Epub 2023 Jan 2.
We aimed to evaluate the feasibility of implementing an emergency department (ED)-based Coronavirus Disease of 2019 (COVID-19) vaccination protocol in a population of unhoused patients.
On June 10, 2021, a best practice alert (BPA) was implemented that fired when an ED provider opened the charts of unhoused patients and prompted the provider to order COVID-19 vaccination for eligible patients. We downloaded electronic medical record data of patients who received a COVID-19 vaccine in the ED between June 10, 2021 and August 26, 2021. The outcomes of interest were the number of unhoused, and the total number of patients vaccinated for COVID-19 during the study period. Data were described with simple descriptive statistics.
There were 25,871 patient encounters in 19,992 unique patients (mean 1.3 visits/patient) in the emergency department during the study period. There were 1,474 (6% of total ED population) visits in 1,085 unique patients who were unhoused (mean 1.4 visits/patient). The BPA fired in 1,046 unhoused patient encounters (71% of PEH encounters) and was accepted in 79 (8%). Forty-three unhoused patients were vaccinated as a result of the BPA (4% of BPA fires) and 18 unhoused patients were vaccinated without BPA prompting. An additional 76 domiciled patients were vaccinated in the ED.
Implementing an ED-based COVID-19 vaccination program is feasible, however, only a small number of patients underwent COVID-19 vaccination. Further studies are needed to explore the utility of using the ED as a setting for COVID-19 vaccination.
我们旨在评估在无家可归患者人群中实施基于急诊科（ED）的 2019 年冠状病毒病（COVID-19）疫苗接种方案的可行性。
2021 年 6 月 10 日，实施了最佳实践警报（BPA），当 ED 提供者打开无家可归患者的图表时，该警报会触发，并提示提供者为符合条件的患者接种 COVID-19 疫苗。我们下载了 2021 年 6 月 10 日至 2021 年 8 月 26 日期间在 ED 接种 COVID-19 疫苗的患者的电子病历数据。主要结局指标为无家可归患者人数和研究期间 COVID-19 疫苗接种的总患者人数。数据用简单描述性统计进行描述。
在研究期间，急诊科共有 25871 次就诊，19992 名患者（每名患者平均就诊 1.3 次）。在 1085 名无家可归的独特患者中，有 1474 名患者（ED 总人群的 6%）就诊（每名患者平均就诊 1.4 次）。BPA 在 1046 名无家可归患者就诊中触发（PEH 就诊的 71%），并被 79 名患者接受（8%）。由于 BPA，43 名无家可归患者接种了疫苗（BPA 触发的 4%），18 名无家可归患者在没有 BPA 提示的情况下接种了疫苗。另外还有 76 名居住在国内的患者在 ED 接种了疫苗。
实施基于 ED 的 COVID-19 疫苗接种计划是可行的，但只有少数患者接受了 COVID-19 疫苗接种。需要进一步研究探索将 ED 作为 COVID-19 疫苗接种场所的效用。
