Effectiveness of chart prompt about immunizations in an urban health center.
OBJECTIVE
To determine whether a nurse-initiated chart review and prompt to physicians is an effective method to increase immunization rates.


METHODS
This study was a controlled trial with systematic assignment of children to intervention or control groups based on chart number. Each day, a nurse reviewed the charts of children to be seen that day who were in the intervention group. The nurse prepared a 1-page form about the child's immunization status that requested permission from the physician to administer needed vaccines and attached the form to the chart. The duration of the study period was 1 year.


METHODS
Nine hundred ninety-seven pediatric patients attending 2 inner-city primary care health centers.


METHODS
On-time immunization rates in both groups.


RESULTS
Among children eligible to receive vaccines during the study period, a higher percentage in the intervention group received on-time vaccines for diphtheria/tetanus/pertussis-4 (DTP4; 51% vs 36%; P=.03), oral polio vaccine-3 (OPV3; 70% vs 56%, P=.04), and measles/mumps/rubella-1 (42% vs 26%; P=.01) than did children in the control group. No statistically significant differences were noted for DTP3, DTP5, hepatitis B3, or OPV4. No statistically significant difference was noted for the combined series (ie, all age-appropriate immunizations as recommended by the 1995 Childhood Immunization Schedule of the Centers for Disease Control and Prevention).


CONCLUSIONS
The chart prompt increased on-time immunizations for some antigens.
Burns
Ilene Timko
IT
Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh, Pennsylvania 15261, USA. ileneb@pitt.edu
Zimmerman
Richard Kent
RK
Santibanez
Tammy A
TA
D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D017325:Hepatitis B Vaccines; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D022542:Measles-Mumps-Rubella Vaccine; D009819:Office Visits; D010414:Pennsylvania; D011055:Poliovirus Vaccine, Oral; D011320:Primary Health Care / Q000706:statistics & numerical data; D017010:Reminder Systems; D019037:Urban Health Services / Q000706:statistics & numerical data; D014505:Urban Population
D015721:Diphtheria-Tetanus-Pertussis Vaccine; D017325:Hepatitis B Vaccines; D022542:Measles-Mumps-Rubella Vaccine; D011055:Poliovirus Vaccine, Oral