title: Clinician outreach to improve the quality of rabies postexposure prophylaxis administration: Maryland's experience, 2010-2011.
abstract: Errors in the administration of rabies postexposure prophylaxis (PEP) are known to occur despite guidelines promulgated by the Advisory Committee on Immunization Practices (ACIP). In addition to elevating a patient's PEP failure risk, errors in administration increase medical expenses. A record review conducted at a local health department in Maryland revealed that ∼8% of reported PEPs deviated from ACIP guidelines. Physicians surveyed at a local hospital also demonstrated knowledge gaps concerning use of rabies immune globulin and special indications for the five-dose PEP series. In response, we implemented an intervention to raise clinician awareness and adherence to recommended protocols. Activities included development of a patient fact sheet, hospital-based poster, and online training course targeted to a diverse group of healthcare providers. We also explored the use of hospital informatics in delivering PEP guidance. Clinician outreach by using a multipronged approach might increase adherence to recommended protocols.
authors.affiliation: 1 U.S. Department of Agriculture, Washington, DC.
authors.forename: Kis
authors.initials: K
authors.lastname: Robertson
authors.forename: Katherine
authors.initials: K
authors.lastname: Feldman
mesh_terms: D000465:Algorithms; D000818:Animals; D001733:Bites and Stings / Q000150:complications; D003625:Data Collection; D006266:Health Education; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D008396:Maryland; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data; D056990:Post-Exposure Prophylaxis / Q000592:standards; D011818:Rabies / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000008:administration & dosage*; D011820:Rabies virus / Q000276:immunology; D014611:Vaccination
chemical_list: D007136:Immunoglobulins; D011819:Rabies Vaccines
keywords: Awareness; Education; Medical errors; Physicians; Postexposure prophylaxis; Rabies