CMS-Mandated Immunization
Screening: Next Steps
Accomplishments
1. Immunization Screening section of Admit History is
“smarter”. If patient has documented Pneumovax
(P’Vax) or Flu vaccine:
–
–
Date(s) of vaccines display
Form remains “collapsed” so that staff do not see
immunization screening questions for vaccines already
completed.
2. The combined impact of Nursing Immunization
Protocol and Physician “Exit Check” have helped us
meet CMS benchmarks for percentage of target
populations having opportunity to receive P’Vax and
Flu shots.
Next Steps
1. Sept. 24 – Mar. 31: Flu screening will be
added back to Admission History
2. Admission History indicators will be reactivated asap (no later than end of 2012)
3. Use new HED functionality to prompt nurses
to enter VIS date, Manufacturer, Lot#, and
completion of Immunization education when
administering P’Vax or Flu shots. (Starts 9/24)
New Immunization fields in AdminRx
Review
Immunization Screening:
Requirements
Pneumovax is recommended for all adults * over age 65
and for patients < 65 years that have risk factors.
–
–
Patients < 65 years with risk factors should have
Pneumovax every 5 years
Patients 65 years or greater should have one Pneumovax
(but do not need re-immunization every 5 years)
Flu shots are recommended for most patients* every year
immediately prior to or during Flu Season (Oct. thru
April).
* For both of these vaccines, there are contraindications for patients with
allergies or previous reactions to the vaccine or its components.
Opportunities for Improvement
• Use nursing judgment in recording immunization
history of questionable accuracy
• Correct Immunization Record when a P’Vax or Flu
shot that has been documented in AdminRx is
deleted (deleting from AdminRx does NOT automatically
remove it from StarPanel Immunization Record)
• When Immunization screen is not completed on
admission, complete as soon as possible
• When immunization screen is NOT indicated
STOP and do NOT do further screening
Details
on next
4 slides
Common Issues/Solutions
Issue
•
Solution
Documentation of prior vaccines that seem
questionable (eg. Pt. < 65 w/o risk factors who
reports having had Pneumovax, vaccine admin.
Dates on holidays or weekends, more than one
Pneumovax in a 5 year period if < 65 yrs. Or
more than one after age 65, etc.)
•
•
Use nursing judgment to assess validity of
responses that don’t make sense. Verify with
other sources when possible. Don’t document
uncertified vaccines when in your judgment,
the information seems incorrect. Notify
provider of questionable vaccine history so
they can help verify accuracy.
Mark patient unable to provide history and
Stop further screening.
Users may no longer enter a free text date. When you click date box, calendar will
let you select a month/year or specific date. Do NOT enter unless minimum of
correct month and year are known.
Month/year known but NOT date
Common Issues/Solutions (cont.)
Issue
•
Vaccine documented on Immunization Record in
error (eg. Charted in AdminRx, not given, &
deleted in AdminRx but still on Immunization
Record)
Solution
•
•
In Immunization Record, select Show Age-View,
select vaccine to be removed, click Delete, click
OK, and click on New data entered – click here
to save changes (see screen shots below).
You may only delete vaccines you documented.
Corrections will NOT be necessary if
you follow correct steps using
AdminRx:
• Identify pt. w/ 2 identifiers
• Scan med bar code
• Scan patient wrist band bar code
• Address any warnings
• Administer vaccine
• Click Confirm button to save
If patient refuses before you click
confirm, document reason not given –
Patient refused and you will be done!
Common Issues/Solutions (cont.)
Issue
Solution
•
Unable to obtain Immunization history on
admission (ICU Patient, patient cannot provide,
family not present)
•
Save as Draft until patient or family can provide
•
Patient leaves ICU, can provide, or family can
provide
•
Complete Immunization History
•
At discharge, still unable to complete
Immunization Screen
•
Document Unable to complete Section 2 at this
time and save Admission History as Complete.
Common Issues/Solutions (cont.)
Issue
•
•
Doing further Immunization History when
patient is Up-to-date
Entering questionable uncertified vaccine when
up-to-date certified vaccine already
documented in StarPanel
Solution
•
Do NOT do further Immunization screening
when patient is current based on history.