Pneumococcal vaccine administration associated with splenectomy: The need for improved education, documentation, and the use of a practical checklist

An audit was performed of the documentation of pneumococcal vaccination in splenectomy patients in three major hospitals involving a geographical popu lation base of 350,000 patients in British Columbia, Canada. Overall, 111 o f the 164 hospitalized splenectomy patients (68%) had received pneumococcal vaccination. Of elective splenectomy cases, only 11 of 55 (20%) had been v accinated prior to surgery, as is currently recommended. One hundred fifty- five patients (95%) had splenectomy status mentioned in the discharge summa ry. However, only 35 (21%) had mention of vaccination status, 10 (6%) menti on of the need for future revaccination, and only 8 (5%) notation of the po ssibility of future infectious risks. The rate of pneumococcal vaccination was as satisfactory as any reported in the literature to date. However, the re is need for improved education in relation to the timing of vaccination and discharge summary documentation. A checklist for potential splenectomy patients may aid in improving this situation as may geographically based sp lenectomy registries. (C) 2000 Wiley-Liss, Inc.