title: Prevalence and trend in the use of hospital-based standing orders programs for influenza and pneumococcal vaccination.
abstract: BACKGROUND
  In 2002, federal regulations authorized the use of standing orders programs (SOPs) for promoting influenza and pneumococcal vaccination. In 2003, the New Jersey Hospital Association conducted a demonstration project illustrating the efficacy of SOPs, and the state health department informed healthcare facilities of their benefits. We describe the prevalence of reported use of SOPs in New Jersey hospitals in 2003 and 2005 and identify hospital characteristics associated with the use of SOPs.
  
  
  METHODS
  A survey was mailed to the directors of infection control at 117 New Jersey hospitals during the period from January to May 2005 (response rate, 90.6%). Data on hospital characteristics were obtained from hospital directories and online resources.
  
  
  RESULTS
  The prevalence of use of SOPs for influenza vaccination was 50% (95% confidence interval [CI], 40.1%-59.9%) in 2003, and it increased to 78.3% (95% CI, 69.2%-85.7%) in 2005. The prevalence of SOP use for pneumococcal vaccination was similar. In 2005, the reported rate of use of SOPs for inpatients (influenza vaccination, 76.4%; pneumococcal vaccination, 75.5%) was significantly higher than that for outpatients (influenza vaccination, 9.4%; pneumococcal vaccination, 8.5%). Prevalence ratios for SOP use comparing acute care and non-acute care hospitals were 1.71 (95% CI, 1.2-2.5) for influenza vaccination SOPs and 1.8 for (95% CI, 1.2-2.7) pneumococcal vaccination SOPs. Acute care hospitals with a ratio of admissions to total beds greater than 36.7 reported greater use of SOPs for pneumococcal vaccination, compared with those that had a ratio of less than 36.7.
  
  
  CONCLUSIONS
  The increase in the prevalence of reported use of SOPs among New Jersey hospitals in 2005, compared with 2003, was contemporaneous with SOP-related actions taken by the federal government, the state government, and the New Jersey Hospital Association. Opportunities persist for increased use of SOPs among non-acute care hospitals and for outpatients.
authors.affiliation: Department of Quantitative Methods and Epidemiology, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103, USA.
authors.forename: Sri Ram
authors.initials: SR
authors.lastname: Pentakota
authors.forename: William
authors.initials: W
authors.lastname: Halperin
mesh_terms: D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006742:Hospital Bed Capacity; D006761:Hospitals / Q000639:trends*; D006801:Humans; D017589:Immunization Programs; D007252:Influenza Vaccines / Q000008:administration & dosage*; D009515:New Jersey; D016134:Organizational Policy; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines