Improving Immunization Information System Implementation in Community Pharmacies

改进社区药房免疫信息系统实施

• 批准号: 10453032
• 负责人: Tessa J. Hastings
• 金额: $ 19.64万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-10 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10453032
• 关键词: Address; Adult; COVID-19 vaccine; Cluster randomized trial; Collaborations; Community Pharmacy; Data; Disease; Disease Outbreaks; Documentation; Effectiveness; Enrollment; Ensure; Feedback; Foundations; Geographic Locations; Goals; Health Personnel; Human Resources; Immunization; Individual; Influentials; Information Systems; Interview; Knowledge; Maps; Measurement; Medically Underserved Area; Methods; Modification; Monitor; Outcome; Patients; Pharmacists; Pharmacy facility; Population; Process; Provider; Public Health; Recommendation; Records; Reporting; Research; Research Design; Research Methodology; Rural; Rural Community; South Carolina; Taxonomy; Testing; Time; Training; Vaccinated; Vaccination; Vaccines; base; clinical care; design; expectation; human centered design; implementation cost; implementation evaluation; implementation framework; implementation outcomes; implementation process; implementation science; implementation strategy; improved; member; pandemic disease; post implementation; prevent; response; success; vaccine acceptance; vaccine hesitancy

PROJECT SUMMARY Strong health care provider recommendations are the single most influential factor in patient acceptance of vaccination. However, as the number of providers administering vaccines increases, there is a concern of fragmented immunization records in state Immunization Information Systems (IISs), a serious issue at both the provider and state levels. Complete immunization records provided through IISs are necessary at both the point of clinical care, to determine appropriate vaccinations the patient may need and ensure that individuals are not over or under-vaccinated, as well as the population level, to monitor vaccination rates and facilitate outbreak response efforts and recalls. To effectively use IISs, it is critical that each immunization provider administering vaccines 1) assesses immunization status using the IIS and 2) reports each time a vaccine is administered to a patient in the IIS. Previous research has shown significant increases in vaccination rates when IIS is used by immunization providers. Lack of pharmacy participation in IISs has been identified as a serious concern, with only 35% of pharmacists nationwide entering administered vaccination information into an IIS, and even fewer checking the IIS before administering a vaccine. This is important for routine vaccinations and becomes critical in pandemic response efforts, including distribution of COVID-19 vaccines as well as catch up vaccinations that were unable to be administered during the pandemic. Multi-faceted strategies mapped to identified determinants are needed to incorporate IIS into pharmacy workflow including assessing immunization status, recommending needed vaccines, and documenting administered vaccines. The objective of this study is to use an Implementation Mapping framework to identify determinants of and refine strategies to improve IIS implementation in the community pharmacy setting, which will then be evaluated using the Taxonomy of Implementation Outcomes. This will help to achieve the long-term goal, to improve the use of IISs to assess immunization status and recommend vaccines in the rural community pharmacy setting, thereby improving vaccination coverage, response efforts, and making the provision of immunizations safe and efficient. The specific aims are to 1) identify community pharmacy specific determinants to integration of IIS reporting and assessment into pharmacy workflow, 2) tailor IIS Informed Pharmacy Immunization Process implementation strategies using a human-centered design approach, and 3) evaluate selected implementation strategies in a community pharmacy setting. The proposed study will use an explanatory sequential mixed-methods research design to identify and refine pharmacy-specific implementation strategies to improve integration of IISs. Results from this study will serve as the foundation for a large stepped wedge cluster randomized trial among pharmacies in rural South Carolina and other southeastern states, assessing multiple relevant outcomes such as fidelity, effectiveness (immunizations administered), sustainability, and implementation costs.

项目摘要 强有力的医疗保健提供者建议是患者接受的最具影响力的因素 疫苗接种。但是，随着管理疫苗的提供者的数量增加，关注 州免疫信息系统（IISS）中的零散免疫记录，这是一个严重的问题 提供者和州级。在这两个方面都必须通过IISS提供的完整免疫记录 临床护理，为了确定患者可能需要的适当疫苗接种，并确保个人不是 超过或疫苗不足的人口水平，以监测疫苗接种率并促进爆发 响应工作和召回。要有效地使用IISS，至关重要的是每个免疫提供者管理 疫苗1）使用IIS评估免疫状态和2）每次给疫苗施用疫苗时报告 IIS的病人。先前的研究表明，当IIS使用IIS时，疫苗接种率显着提高 免疫提供者。缺乏药房参与IISS已被确定为一个严重的问题， 全国只有35％的药剂师进入IIS的管理疫苗接种信息，甚至更少 在服用疫苗之前检查IIS。这对于常规疫苗很重要，并且变得至关重要 在大流行的反应工作中，包括分布共同疫苗，并赶上疫苗接种 在大流行期间无法管理。映射到确定的决定因素的多面策略 需要将IIS纳入药学工作流程，包括评估免疫状态，建议 需要疫苗，并记录管理的疫苗。这项研究的目的是使用 实施映射框架以识别和完善改进IIS的策略的决定因素 在社区药房环境中实施，然后将使用该分类法进行评估 实施结果。这将有助于实现长期目标，以提高IIS的使用来评估 免疫状况并在农村社区药房环境中推荐疫苗，从而改善 疫苗接种覆盖范围，反应工作以及使免疫的安全有效。这 具体目的是1）确定社区药房特定的决定因素以整合IIS报告 2）评估药房工作流程，2）量身定制IIS知情药房免疫过程 使用以人为本的设计方法实施策略，3）评估选定的 在社区药房环境中实施策略。拟议的研究将使用解释性 顺序混合方法研究设计，以识别和完善药房特定的实施 改善IISS整合的策略。这项研究的结果将成为大型步进的基础 楔形集群在南卡罗来纳州农村和其他东南州的药房中随机试验， 评估多种相关结果，例如忠诚，有效性（管理的免疫），可持续性， 和实施成本。