The Utilization of Splenectomy Post-Op Clinical Vaccinations Order Set to Enhance Adherence and Timeliness of Vaccinations in Emergency Splenectomy Patients: A Pre-and-Post Intervention Study

Abstract

Background: Asplenic patients are at increased risk of serious and life-threatening infections, especially by encapsulated pathogens. These infections are easily prevented with appropriate vaccinations post-splenectomy. The Splenectomy Post-Op Clinical Vaccinations Order Set is one of the first initiatives to harmonized practice between sites at our organization.

Objectives: This is a pre and post-intervention study aimed to assess the impact of the Splenectomy Order Set to improve practice adherence to recommended vaccination protocols outlined by the Canadian Immunization Guidelines among patients undergoing emergency splenectomy.

Methods: A 5-year retrospective chart review was conducted in 2013 for the pre-intervention vaccination rates. Another 5-year retrospective chart review was conducted in 2018 to determine post-intervention rates. The quantitative results were then tallied and analyzed.

Results: Overall, 46 patients were included in the pre-intervention group and 40 patients in the post-intervention group. Prior to the implementation of the Splenectomy Post-Op Clinical Vaccinations Order Set, 61% of patients at the organization received the required vaccinations. Post-intervention, vaccination rates increased to 93%. There is a statistically significant difference between the two groups with a p value less than 0.01. Similarly, in terms of appropriate timing, pre-intervention, 48% of patients received the vaccines in the right timeframe and post-intervention, this rate increased to 80%. This difference did not reach statistical significantly due to a smaller sample size.

Conclusion: This quality improvement study showed that a multidisciplinary and evidence-based order set can significantly improve appropriate drug prescribing and patient care while sustaining improved outcomes.