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Kazi B, Talukdar Z, Schriefer J. Quality Improvement Interventions to Enhance Vaccine Uptake in Cancer Patients: A Systematic Review. J Healthc Qual 2024; 46:81-94. [PMID: 38421906 DOI: 10.1097/jhq.0000000000000422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Cancer patients, because of their compromised immune responses, face a higher risk of preventable infections, leading to increased morbidity and mortality. Despite this, vaccination rates among these patients are suboptimal, and research on effective interventions to improve vaccination rates is limited. METHODS We conducted a comprehensive search in PubMed and Cochrane Library for studies investigating quality improvement (QI) interventions targeting vaccine uptake in cancer patients. Two authors independently screened, extracted data, and analyzed studies, resolving any discrepancies through consensus. RESULTS Thirteen studies met the inclusion criteria, published between 2014 and 2022. Seven studies focused on the influenza vaccine, five on the pneumococcal vaccine, and one on both. Twelve studies used multiple interventions, whereas one used a single intervention. Most interventions aimed to enhance patient and family knowledge and identify eligible patients before their appointments. All studies demonstrated improved vaccine uptake after implementing the interventions. CONCLUSIONS A variety of QI interventions have effectively increased pneumococcal and influenza vaccine uptake among cancer patients. Future research should address roadblocks to implementation and explore the effect of these interventions on other vaccines.
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Cooley ME, Biedrzycki B, Brant JM, Hammer MJ, Lally RM, Tucker S, Ginex PK. Translation of Evidence-Based Interventions Into Oncology Care Settings: An Integrative Review. Cancer Nurs 2023; 46:E110-E121. [PMID: 36480276 DOI: 10.1097/ncc.0000000000001109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adoption of evidence remains slow, leading to variations in practices and quality of care. Examining evidence-based interventions implemented within oncology settings can guide knowledge translation efforts. OBJECTIVE This integrative review aimed to (1) identify topics implemented for oncology-related evidence-based practice (EBP) change; (2) describe frameworks, guidelines, and implementation strategies used to guide change; and (3) evaluate project quality. METHODS PubMed and CINAHL were searched to identify published practice change projects. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. Fifty articles met the inclusion criteria. Data were extracted; content analysis was conducted. The Quality Improvement Minimum Quality Criteria Set guided quality assessment. RESULTS Topics included infection control/prevention (n = 18), pain/palliative care (n = 13), psychosocial assessment (n = 11), and medication adherence (n = 8). Among the projects, Plan, Do, Study, Act (n = 8) and Lean Six Sigma (n = 6) frameworks were used most. Thirty-six projects identified guidelines that directed interventions. Multiple implementation strategies were reported in all articles with planning, education, and restructuring the most common. Reach, sustainability, and ability to be replicated were identified as quality gaps across projects. CONCLUSION The EBP topics that emerged are consistent with the oncology nursing priorities, including facilitating integration of EBP into practice. The studies identified used national guidelines and implementation strategies to move evidence into practice. Heterogeneity in measurement made synthesis of findings difficult across studies, although individual studies showed improvement in patient outcomes. IMPLICATIONS FOR PRACTICE Development of an interprofessional oncology consortium could facilitate a standardized approach to implementation of high-priority topics that target improved patient outcomes, harmonize measures, and accelerate translation of evidence into practice.
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Affiliation(s)
- Mary E Cooley
- Author Affiliations: Dana-Farber Cancer Institute, Boston, Massachusetts (Drs Cooley and Hammer); Formerly of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (Dr Biedrzycki); Billings Clinic, Montana (Dr Brant); University of Nebraska Medical Center, Omaha (Dr Lally); The Ohio State University, Columbus (Dr Tucker); and Oncology Nursing Society, Pittsburgh, Pennsylvania (Dr Ginex)
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McGinnis JM, Jones R, Hillis C, Kokus H, Thomas H, Thomas J, Alyafi M, Bernard L, Eiriksson LR, Elit LM, Hirte H, Jimenez W, Reade CJ, Kumar Tyagi N, Helpman L. A pneumococcal pneumonia and influenza vaccination quality improvement program for women receiving chemotherapy for gynecologic cancers at a major tertiary cancer Centre. Gynecol Oncol 2021; 161:236-243. [PMID: 33526258 DOI: 10.1016/j.ygyno.2021.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/13/2021] [Indexed: 01/20/2023]
Abstract
OBJECTIVE International guidelines recommend pneumococcal pneumonia and influenza vaccination for all patients with solid organ malignancies prior to initiating chemotherapy. Baseline vaccination rates (March 2019) for pneumococcal pneumonia and influenza at our tertiary cancer centre were 8% and 40%, respectively. The aim of this study was to increase the number of gynecologic chemotherapy patients receiving pneumococcal and influenza vaccinations to 80% by March 2020. METHODS We performed an interrupted time series study using structured quality improvement methodology. Three interventions were introduced to address vaccination barriers: an in-house vaccination program, a staff education campaign, and a patient care bundle (pre-printed prescription, information brochure, vaccine record booklet). Process and outcome data were collected by patient survey and pharmacy audit and analyzed on statistical process control charts. RESULTS We identified 195 eligible patients. Pneumococcal and influenza vaccination rates rose significantly from 5% to a monthly mean of 61% and from 36% to a monthly mean of 67%, respectively. The 80% target was reached for both vaccines during one or more months of study. The in-house vaccination and staff education programs were major contributors to the improvement, whereas the information brochure and record booklet were minor contributors. CONCLUSIONS Three interventions to promote pneumococcal and influenza vaccination among chemotherapy patients resulted in significantly improved vaccination rates. Lessons learned about promoting vaccine uptake may be generalizable to different populations and vaccine types. In response to the global COVID-19 pandemic, initiatives to expand the program to all chemotherapy patients at our centre are underway.
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Affiliation(s)
- Justin M McGinnis
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada.
| | - Rebecca Jones
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Christopher Hillis
- Department of Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Heather Kokus
- Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Heidi Thomas
- Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Jason Thomas
- Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Mohammad Alyafi
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Laurence Bernard
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Lua R Eiriksson
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Lorraine M Elit
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Hal Hirte
- Department of Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Waldo Jimenez
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Clare J Reade
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Nidhi Kumar Tyagi
- Department of Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
| | - Limor Helpman
- Division of Gynecologic Oncology, McMaster University, Juravinski Hospital & Cancer Centre, Hamilton, ON, Canada
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Abstract
This article tests low cost interventions to increase influenza vaccination rates. By changing an email announcement sent out to employees in 2014 (n > 30,000), the following interventions are tested: incentives, attention to the negative impacts of not get vaccinated, and showing a map to the vaccination centers at the end of the email announcement. Only the map condition helped increase influenza vaccination rates. The use of low-cost interventions can improve influenza vaccination rates though not all interventions work as well as others in the field. In particular, while including maps helped increase vaccination rates, other factors such as negative impact reminders and incentives, which previous studies have found to be successful in the laboratory, did not.
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Affiliation(s)
- Ernest Baskin
- Department of Food Marketing, Haub School of Business, Saint Joseph’s University, Philadelphia, Pennsylvania, United States of America
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