title: Impact of pharmacist integration in a pediatric primary care clinic on vaccination errors: a retrospective review.
abstract: OBJECTIVE
  To measure the impact of ambulatory clinical pharmacist integration in a pediatric primary care clinic on vaccination error rates and to evaluate missed opportunities.
  
  
  METHODS
  A retrospective, quasi-experimental review of electronic medical records of visit encounters during a 3-month period compared vaccine error rates and missed opportunities between two pediatric residency primary care clinics. The intervention clinic has a full-time ambulatory clinical pharmacist integrated into the health care team. Pharmacy services were not provided at the comparison clinic. A vaccine error was defined as follows: doses administered before minimum recommended age, doses administered before minimum recommended spacing from a previous dose, doses administered unnecessarily, live virus vaccination administered too close to a previous live vaccine, and doses invalid for combinations of these reasons.
  
  
  RESULTS
  900 encounters were randomly selected and reviewed. The error rate was found to be 0.28% in the intervention clinic and 2.7% in the comparison clinic. The difference in error rates was found to be significant (P = 0.0021). The number of encounters with greater than or equal to one missed opportunity was significantly higher in the comparison clinic compared with the intervention clinic (29.3% vs. 10.2%; P <0.0001).
  
  
  CONCLUSIONS
  The pediatric primary care clinic with a pharmacist had reductions in vaccination errors as well as missed opportunities. Pharmacists play a key role in the pediatric primary care team to improve the appropriate use of vaccines.
authors.forename: Anna
authors.initials: A
authors.lastname: Haas-Gehres
authors.forename: Sonya
authors.initials: S
authors.lastname: Sebastian
authors.forename: Kristen
authors.initials: K
authors.lastname: Lamberjack
mesh_terms: D000554:Ambulatory Care Facilities; D057286:Electronic Health Records; D006801:Humans; D008508:Medication Errors; D010372:Pediatrics; D010593:Pharmaceutical Services; D010595:Pharmacists; D011320:Primary Health Care; D012189:Retrospective Studies; D014611:Vaccination; D014612:Vaccines / Q000276:immunology
chemical_list: D014612:Vaccines