title: Patient education and recall regarding postsplenectomy immunizations.
abstract: BACKGROUND
  The purpose of this study was to determine the rates of initial vaccinations after splenectomy for trauma, assess the effectiveness of patient education on reimmunizations, and evaluate patients' utilization of their knowledge regarding immunization after discharge.
  
  
  METHODS
  From June 1996-December 2011, 144 patients underwent splenectomy after traumatic injury. A telephone survey was completed in 100 of 144 splenectomized patients (69%) at a mean of 7.9 y after their splenectomy. Questions were directed to determine the quality of patients' recall of the implications of splenectomy, the need for vaccinations, and the quality of the health information administered. Research electronic data capture tool was used for collecting data, and data were analyzed with Stata 11.2.
  
  
  RESULTS
  Only 27% of participants recall receiving education on postsplenectomy vaccination and 41% of those patients rated their education as poor or minimal. Ninety-one percent of patients indicated that they would like more information in the form of a brochure. Our overall initial vaccination rates among patients who had splenectomy from 1996-2011 were 76%, 75%, and 68% for Streptococcus pneumoniae, Neisseria meningitidis, and Hemophilus influenza type b, respectively. Since 2004, 95% of those who had splenectomy between 2004 and 2007 received all three vaccines. Since 2008, our institution has maintained 100% initial vaccination rates for all three vaccines. The revaccination rates in this group of patients (from 1996-2007) were 39% and 15% for pneumococcal and meningococcal vaccines, respectively.
  
  
  CONCLUSIONS
  Patients had poor recall of the information provided during hospitalization for splenectomy. There were low revaccination rates in our patient cohort. Specific educational and vaccination surveillance strategies are required to improve vaccination rates.
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address: gerald-kealey@uiowa.edu.
authors.forename: Gerald P
authors.initials: GP
authors.lastname: Kealey
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Vinayak
authors.initials: V
authors.lastname: Dhungel
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Wideroff
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Junlin
authors.initials: J
authors.lastname: Liao
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Kent
authors.initials: K
authors.lastname: Choi
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Dionne A
authors.initials: DA
authors.lastname: Skeete
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Michele A
authors.initials: MA
authors.lastname: Lilienthal
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Janelle
authors.initials: J
authors.lastname: Born
authors.affiliation: Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Graeme
authors.initials: G
authors.lastname: Pitcher
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D011183:Postoperative Complications / Q000517:prevention & control*; D013156:Splenectomy / Q000009:adverse effects*; D055815:Young Adult
keywords: Postsplenectomy immunization; Revaccination rates