ust for the fact that some of the patients had received a vaccine unbeknownst to the computer, delivering the computer's "suggestions" about influenza and pneumonia vaccine administration to nurses as standing orders, the percent of eligible patients who get their influenza vaccine goes up to 52 percent in the standing orders group and to 36 percent in the physician reminders group," said Dr. McDonald. "Moreover, standing orders for nurses could be much easier to carry out than physician reminders because the former can be implemented within nurse order management systems which are used widely in U.S. hospitals, while physician reminders require physician order entry systems -- which are deployed in very few US hospitals -- as their basis."

A surprisingly large number of eligible patients from both groups refused the shots.

"Overall nearly a quarter of eligible patients refused a vaccine when it was offered by a nurse and this refusal accounted for about two-thirds of the patients who did not get their vaccination despite standing nurse orders," said Dr. Dexter. "To get closer to 100 percent immunization rates, the medical community will have to work, especially within the older urban population, to change negative beliefs about these vaccinations."

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Contact: Cindy Fox Aisen
caisen@iupui.edu
317-274-7722
Indiana University
16-Nov-2004

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