Impact of an encounter-based prompting system on resident vaccine administration performance and immunization knowledge

Objectives. To evaluate an encounter-based immunization prompting system on resident performance in administering vaccines and knowledge of immunizati on guidelines. Design/Methods. Prospective randomized, controlled trial. Subjects were fir st- and second-year pediatric residents in a hospital-based continuity clin ic. The intervention group received manual prompts of immunizations due. Po stclinic chart review compared immunizations due with those administered. A cceptable and unacceptable reasons for not administering vaccines were assi gned. Resident knowledge was measured by a 70-item examination. Results. The intervention group had significantly less missed opportunities /vaccine administration errors (11.4% vs 21.6%). The most common reason for unacceptable errors in the intervention group: vaccine was given too early ; in the control group: vaccine was postponed to next visit. Pre- and posti ntervention knowledge scores were similar: intervention group (75.5% vs 80. 7%, control group; 76.5% vs 81.3%). Conclusion. An immunization prompting system in a hospital-based pediatric resident continuity clinic reduced missed opportunities/vaccine administrat ion errors without significantly impacting resident knowledge of immunizati on guidelines.