Dw. Coyne et al., Network 12 hepatitis B vaccination quality improvement program: An educational program directed at physicians, staff, and patients, ADV RENAL R, 7(4), 2000, pp. S71-S75
Hepatitis B is easily spread via contact with infected blood. Hemodialysis
patients and staff are particularly at risk for acquiring hepatitis B. Cons
equently, vaccination of hemodialysis patients and staff is strongly recomm
ended. However, the vaccination rate among dialysis patients in this countr
y remains below 50%. End-Stage Renal Disease (ESRD) Network 12 developed a
quality improvement project directed at increasing patient vaccination by r
egular surveys, reports, and education of physicians, staff, and patients.
Seventy-seven percent of facilities in the 4-state Network participated. Ov
erall vaccination rate increased from 66.9% to 73.2% over 18 months (P < .0
5). The greatest improvement was seen among units with less than 60% of pat
ients vaccinated initially, with mean facility vaccination rate increasing
from 31.2 <plus/minus> 20.5% to 57.5 +/- 30.1% in the last available data p
eriod (P < .001). Only 3 of these 29 units failed to improve. The 90 units
that had 60% to 97% vaccination rates initially improved significantly from
79.8 <plus/minus> 9.6% to 82.4 +/- 15% (P = .015). Three quarters of these
units showed improvement. Only units with 100% vaccination deteriorated, b
ut still maintained vaccination rates of 74.5 +/- 25.6%. An education-based
quality improvement project can improve the hepatitis B Vaccination rate o
f hemodialysis patients. (C) 2000 by the National Kidney Foundation, Inc.