Vaccinations are a key component of keeping residents, patients, staff and our communities safe. Studies show health care providers are the most trusted source of vaccine information. Research also shows when a strong recommendation is given by a health care provider, a patient is four to five times more likely to be vaccinated.¹
The hospital discharge planning process should start at admission. Upon admission, there is an opportunity to identify key information regarding the individual’s health status and plan.
- What is the plan for discharge?
- What was the base line before becoming ill or injured?
- Does the individual have a safe environment to be discharged to?
- Will he/she need someone to care for them?
- Is the individual at risk for a fall?
- Is the individual at risk for infection?
- Is he/she up-to-date on vaccinations?
Often times, the first opportunity an individual has been offered an influenza or pneumococcal vaccine is during a hospital visit. At admission, the patient, or representative, should be asked about vaccinations. If vaccination status is unknown, the hospital staff can access the patient’s vaccinations via the state’s immunization information system. If proof of vaccination is not found, and there are no contraindications for the patient to receive the vaccination, the patient should be educated and offered the vaccination during their hospital stay. Another opportunity to verify vaccine status is prior to discharge. Documentation should include whether the vaccination was given or offered and refused. If offered and refused, vaccine information should be sent home with the patient upon discharge.
Immunization Information System (IIS) contact information for North Dakota and South Dakota included below.
A way to increase the likelihood of nursing home residents receiving vaccinations prior to being admitted from a hospital is by the discharging hospital having a process in place. This should be a best practice by the hospital for all qualifying patients prior to discharge, no matter where they are being discharged to.
Great Plains QIN is working with nursing homes to improve influenza and pneumococcal vaccination rates in our region. While reviewing vaccination data, we identified a few long-term care facilities that had a vaccination rate of 100 percent (Q1 2019 – Q32021). Pembilier Nursing Center in Walhalla, North Dakota, is one facility that had achieved this goal. This is quite an accomplishment.
Sara Lykken, RN, has been the Director of Nursing at Pembilier Nursing Center for eight years. When asked what the formula for success has been, she replied, “Part of our success is our smaller size/number of residents. We are a 37-bed facility, which can be a blessing and a curse when it comes to quality measures. We hold an annual flu vaccination clinic in the Fall each year; we have always had a very high acceptance rate among residents and their families.”
Lykken continued, “We do screen all residents, upon admission, for the pneumococcal vaccine and will order and administer it right away if the resident is not vaccinated. Again, we are fortunate to have a fairly receptive clientele here. I find that most residents have not received vaccines usually due to the inconvenience of going out and/or scheduling issues. When I offer and provide it here, most residents are willing to be vaccinated.”
She added, “The COVID vaccine has been a little trickier; individuals are either for it or against it and there is really no changing their minds at this point. We have monitored our quality measures and worked to keep our numbers as high as possible. Again, I do not really have a magic formula beyond making the vaccinations accessible, offering education and encouragement and offering myself as a resource for support if needed. If all else fails, I will have our Medical Director make a plug during our monthly rounds.”
Vaccinations are a key component of keeping residents, patients, staff and our communities safe. If we work together to coordinate care, share resources and improve communication, we can collectively combat vaccine hesitancy and increase vaccine confidence in our nursing homes and the community at large.
North Dakota Immunization Information System
The North Dakota Immunization Information System (NDIIS) is a confidential, population-based, computerized information system that attempts to collect vaccination data about all North Dakotans. The NDIIS is an important tool to increase and sustain high vaccination coverage by consolidating vaccination records of children from multiple providers, generating reminder and recall vaccination notices for each child and providing official vaccination forms and vaccination coverage assessments. Children are entered into the NDIIS at birth through a linkage with electronic birth records. An NDIIS vaccination record also can be initiated by a healthcare provider at the time of the child’s first immunization. The NDIIS has the capability of collecting vaccination data on adult patients as well as children.
South Dakota Immunization Program
The South Dakota Immunization Program aims to protect all South Dakotans against vaccine preventable disease by increasing immunization coverage levels of children and adults. The program provides vaccine, materials, training, and support to both public and private immunization providers throughout the state. It increases public awareness of immunizations by providing educational materials to all vaccine providers and working in partnership with local and statewide coalitions. The program also monitors immunization levels of children in South Dakota and is involved with vaccine preventable disease surveillance and outbreak control. Within the program is the South Dakota Immunization Information System (SDIIS), a computer software system that allows health care providers to share immunization records.
Getting an Immunization Record – SD Dept. of Health