Research
Perceptions of Participating Emergency Nurses Regarding an ED Seasonal Influenza Vaccination Program

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Introduction

Numerous professional organizations have recommended that emergency departments provide influenza vaccine to patients. However, no study has reported on the perceptions of participating emergency nurses regarding ED influenza vaccination programs.

Methods

We conducted an anonymous Web-based survey to assess the post-participation perceptions of emergency nurses regarding an ED influenza vaccination protocol. The vaccination protocol occurred at an urban, academic emergency department and was designed to be performed by emergency nurses without added staffing resources by using ED Electronic Medical Record technology. Data from the Web-based survey were analyzed using descriptive statistics and χ2 analysis to assess significant associations of where emergency nurses believed the protocol was time inefficient.

Results

The ED influenza vaccination protocol was in effect from October 1-25, 2009, with 3091 eligible ED visits and 613 patients receiving ED seasonal influenza vaccination. Fifty-eight of 59 participating emergency nurses (98%) responded to the survey. Significant findings were that 59% of responding emergency nurses found the protocol too time consuming and believed it was inappropriate in the ED setting. Responding emergency nurses reported that protocol efficiency could be improved by adding staff, simplifying screening and vaccination documentation requirements, and improving vaccine supply and stocking procedures in the emergency department.

Conclusion

A majority of surveyed emergency nurses who had participated in an ED influenza vaccination program reported that the protocol was too time consuming and inappropriate for the ED setting. Surveyed emergency nurses expressed the opinion that such protocols required added staff, simplified patient consent/vaccination documentation requirements, and improved vaccine supply and stocking processes.

Section snippets

Setting and protocol description

The study was conducted at the emergency department of an urban, academic, level I trauma medical center with an emergency medicine and a combined emergency medicine-internal medicine residency program. Emergency nursing staffing is as follows: 7-11 am, 9 nurses; 11 am to 3 pm, 12 nurses; 3-7 pm, 13 nurses; 7-11 pm, 13 nurses; 11 pm to 3 am, 10 nurses; and 3-7 am, 9 nurses.

From October 1, 2009, until October 25, 2009, when seasonal influenza vaccine supplies at this center were exhausted

Results

During the protocol trial, there were 3091 eligible patient visits by 2874 patients, with 2884 visits eligible for vaccination screening. A total of 2270 patients (79%) were successfully screened and 613 (20%) received seasonal influenza vaccination in the emergency department. An additional 59 patients received vaccination based on the screening protocol–generated vaccination order upon the patient's arrival at the inpatient nursing unit. In comparison, 90 of 3900 visits (2%) resulted in

Discussion

We report the first survey data of emergency nurses who have participated in a protocol to screen and provide seasonal influenza vaccine to ED patients without additional staffing resources. Unlike previous ED influenza vaccine studies,5, 6, 7, 8, 9, 10 this protocol was designed to leverage the ED EMR with automated protocol ordering to facilitate vaccination in a manner that might be translated to other emergency departments that may not have additional staff or resources for this service.

Conclusion

We report the first evaluation of an ED seasonal influenza vaccination program by emergency nurses. Influenza vaccination programs provide public health benefit to ED patients and can be profitable. However, emergency nurses should be included in the preparation of the protocols to enhance their acceptance, sustainability, and efficient execution. Our data suggest that adding staff or devising simple screening and documentation requirements will aid in the successful implementation of ED

Acknowledgment

We thank the emergency nurses at Allegheny General Hospital for their great efforts during this trial.

Arvind Venkat, Member, Western Pennsylvania Chapter 061, is Director of Research, Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, PA.

References (11)

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Arvind Venkat, Member, Western Pennsylvania Chapter 061, is Director of Research, Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, PA.

Roger Hunter is Emergency Department Nursing Director, Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, PA.

Gajanan G. Hegde is Associate Professor of Business Administration, Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA.

Noreen H. Chan-Tompkins is Clinical Pharmacy Specialist, Department of Pharmacy Services, Allegheny General Hospital, Pittsburgh, PA.

David M. Chuirazzi is Medical Director, Information Technology, West Penn Allegheny Health System, Pittsburgh, PA.

Jillian M. Szczesiul is Clinical Pharmacy Specialist, Department of Pharmacy Services, Allegheny General Hospital, Pittsburgh, PA.

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