ArticlePediatric quality & safety
Improvement in Palivizumab Administration in Severely Immunocompromised Children: A Single-institution Quality Improvement Initiative.
Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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.
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Palivizumab reduces severe respiratory syncytial virus (RSV) infection risk in immunocompromised children. However, guidance on palivizumab prophylaxis for immunocompromised children has remained vague. We developed an institutional program to allocate palivizumab in a predefined high-risk group of patients. Methods: We aimed to increase provider adherence to palivizumab administration in profoundly immunocompromised children through education, identifying clinical pharmacists, and informing primary providers of eligible patients. The primary process metric was palivizumab guideline adherence, indicated by the percentage of patients receiving all recommended doses each season. The primary metric was the percentage of eligible patients receiving monthly follow-up doses. Balancing metrics were the percentage of inappropriate doses and patients not meeting our definition of profoundly immunocompromised who did not receive palivizumab prophylaxis and had severe RSV infection. A statistical process control P-chart analyzed the outcome metric before program implementation (baseline: 2009-2013) and throughout interventions (seasons 1-8; 2014-2021). Results: More than 80% of patients received all expected monthly doses, with 89% (584 of 656) of eligible monthly palivizumab doses administered over 8 RSV seasons. The percentage of eligible patients receiving all recommended palivizumab doses increased from 30% to 99% in season 3, remaining more than 95%. Before intervention, 21 patients received palivizumab without meeting criteria; this decreased to 4 during season 1 postimplementation and to 0 thereafter. No profoundly immunocompromised patients meeting the operational definition or receiving palivizumab experienced severe RSV. Conclusions: We improved adherence to palivizumab administration guidelines for profoundly immunocompromised children over 8 consecutive RSV seasons without increasing RSV infection incidence or severity.
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