Evidence map›Paper›PMID 33411114›Full record

ArticleClinical and experimental nephrology2021

Improving hepatitis B vaccination rates for advanced chronic kidney disease patients: a quality improvement initiative.

Priyanka Mysore, Roaa M Khinkar, Donna McLaughlin, Sonali Desai, Gearoid M McMahon, Catherine Ulbricht, Mallika L Mendu

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and experimental nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 3 countries.

Priyanka MysoreDepartment of Nephrology, Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada.
Roaa M KhinkarDepartment of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia. rkhinkar@bwh.harvard.edu.ORCID http://orcid.org/0000-0002-5467-2000
Donna McLaughlinRenal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Sonali DesaiDepartment of Quality and Safety, Brigham and Women's Hospital, Harvard Medical School, One Brigham Circle, Second Floor, Office No. BC-2-WS 34, 1620 Tremont Street, Boston, MA, 02120, USA.
Gearoid M McMahonRenal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Catherine UlbrichtDepartment of Quality and Safety, Brigham and Women's Hospital, Harvard Medical School, One Brigham Circle, Second Floor, Office No. BC-2-WS 34, 1620 Tremont Street, Boston, MA, 02120, USA.
Mallika L MenduDepartment of Quality and Safety, Brigham and Women's Hospital, Harvard Medical School, One Brigham Circle, Second Floor, Office No. BC-2-WS 34, 1620 Tremont Street, Boston, MA, 02120, USA.
Brigham and Women's Hospital · USUniversity of Manitoba · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionChronic kidney disease (CKD) patients are vulnerable to hepatitis B, and immunization prior to end stage kidney disease is recommended to optimize seroconversion. Our institution undertook a process improvement approach to increase hepatitis B vaccination in stage 4 and 5 CKD patients.

methodsFour strategies were utilized such as: (1) Electronic health record (EHR)-based CKD registry to identify patients, (2) EHR-based physician/nurse reminders, (3) a co-located nurse appointment for vaccine administration, and (4) information sharing and provider awareness effort. The CKD registry was utilized to identify patients with stage 4 or 5 CKD, with at least two clinic visits in the prior 2 years, who had not received the hepatitis B vaccine or did not have serologic evidence of immunity. Target monthly vaccination rate was set at 75%, based on clinic leadership, nephrologist, and nurse consensus.

resultsA total of 239 patients were included in the study period, from November 2018 to January 2019 (observation period) and from February 2019 to September 2019 (intervention period). Monthly vaccination rate improved from 48% in November 2018 to the target rate of 75% by the end of the intervention (August and September 2019). There was a statistically significant increase from the rate of vaccination at a unique patient level in the first month of the baseline period, compared to the last month of the intervention period (51 vs. 75% p = 0.03).

conclusionsUtilizing a nurse-led approach to hepatitis B vaccination, coupled with EHR-based tools, along with continuous monitoring of performance, helped to improve hepatitis B vaccination among CKD stage 4 and 5 patients.

Indexed as

Hepatitis B VaccinesQuality ImprovementAgedAppointments and SchedulesElectronic Health RecordsFemaleHepatitis BHumansKidney Failure, ChronicMaleMiddle AgedNephrologyOutpatient Clinics, HospitalPractice Patterns, Nurses'RegistriesReminder SystemsHepatitis B VaccinesChronic kidney diseaseHepatitis B vaccinationNurse-driven initiativeQuality improvement

Identifiers

PMID33411114
PMCPMC7788540
OpenAlexW3121110606

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.