title: A test of the feasibility of pneumococcal vaccination in the emergency department.
abstract: OBJECTIVE
  To test the feasibility of pneumococcal immunization in an ED.
  
  
  METHODS
  Cook County Hospital has an annual ED census of 120,000. Patients are 75% black and 15% Hispanic. Eighty-two percent of patients are uninsured. Seventy-three percent report no primary physician. Between May 27, 1997, and July 26, 1997, nurses had standing orders that patients meeting CDC-recommended criteria were to be offered pneumococcal immunization. Immunization was recorded in the system-wide registration computer.
  
  
  RESULTS
  During the study period, 1,833 patient screenings encounters (13% of all patients) identified 1,493 high-risk patients. Only 10% of screened high-risk patients reported previous pneumococcal immunization. 1,173 were immunized against pneumococcus. Median number of immunizations per nurse per shift was 1.62. Patient through-put was not altered.
  
  
  CONCLUSIONS
  Pneumococcal immunization is both necessary and feasible in a busy ED serving patients with little access to other immunization services.
authors.affiliation: Cook County Hospital, Rush University Department of Emergency Medicine, University of Illinois School of Public Health, Chicago 60612, USA. davids@uic.edu
authors.forename: D
authors.initials: D
authors.lastname: Slobodkin
authors.forename: J L
authors.initials: JL
authors.lastname: Kitlas
authors.forename: P G
authors.initials: PG
authors.lastname: Zielske
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002641:Chicago; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D006801:Humans; D017589:Immunization Programs / Q000592:standards* / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D008875:Middle Aged; D008913:Minority Groups; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010865:Pilot Projects; D011008:Pneumococcal Infections / Q000517:prevention & control*; D018401:Sample Size; D019037:Urban Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D014611:Vaccination