Poster Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2018

Programming electronic health records to include mandatory data field enhances pertussis vaccination rates in obstetric patients. (#70)

Roberto Orefice 1 , Julie Quinlivan 2 3
  1. Obstetrics and Gynaecology, Centenary Hospital for Women and Children, Canberra, ACT, Australia
  2. School of Medicine, Australian National University, Canberra, ACT, Australia
  3. Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia

INTRODUCTION: Electronic records have been widely introduced into clinical practice. The aim of the present study was to determine whether using a mandatory field in an electronic health record would improve compliance with an important quality indicator, namely antenatal pertussis vaccination.

METHODS: Two cohorts of women who delivered at Centenary Hospital for Women and Children between 1 to 31 July 2015 and 1 to 31 July 2017 were compared for compliance with the quality indicator of antenatal pertussis vaccination. The single point of difference between time points was programming the electronic record so the clinician could not close the patients file unless they inserted an answer into the box asking whether pertussis vaccination had been performed or declined. Data was audited and percentage compliance rates were compared.

RESULTS: A total of 275 and 299 women delivered in the two audit periods. There were no significant differences in maternal or neonatal characteristics between the two audited periods except for maternal age, which was younger in the second period (33.3 years versus 31.5 years p=0.001). Vaccination rates almost doubled between audit periods (52.7% versus 91.4% p<0.0001).

CONCLUSION: Introducing an electronic prompt or mandatory field into an electronic health record may increase compliance with steps considered best practice in maternity care. 

  1. [1] Maertens K, Cabore RN, Huygen K, Hens N, Van Damme P, Leuridan E. Pertussis vaccination during pregnancy in Belgium: Results of a prospectice controlled cohort study. Vaccine 2016 (34) 142-150
  2. [2] Pilsbury A, Quinn HE, McIntyre PB. Australian vaccine preventable disease epidemiological review series: pertussis 2006-2012. Commun Dis Intell 2014 38(3): E179-94
  3. [3] Spokes PJ, Quinn HE, McAnulty JM. Review of the 2008-2009 pertussis epidemic in NSW. Notification and hospitalization. NSW Public Health Bulletin 2010; 21(7-8); 167-173
  4. [4] McMillan M, Clarke M, Parella A, Fell DB, Amirthalingam G, Marcsall HS. Safety of Tetanus Diptheria, and Pertussis Vaccination During Pregnancy. Obstetrics and Gynecology 2017; 129(3) Mar; 560-573
  5. [5] Leuridan E, Hens N, Peeters N, de Witte L, Van der Meeren O, Van Damme P. Effect of a prepregnancy pertussis booster dose on maternal antibody titers in young infants. Pediatr Infect Dis j. 2011;30(7):608-10
  6. [6] Halperin BA, Haperin SA. The reemergence of pertussis and infant deaths: is it time to immunize pregnant women? Future Microbiol. 2011;6(4) 367-9
  7. [7] Amirthalingam G. Strategies to control pertussis in infants. Arch Dis Child. 2013;98(7):552-5
  8. [8] Maertens K, Cabore RN, Huygen K, Hens N, Van Damme P, Leuridan E. Pertussis vaccination during pregnancy in Belgium: Results of a prospective controlled cohort study. Vaccine 2016; 34: 142-150
  9. [9] Khodr Z, Bukowinski AT, Gumbs GR, Conlin AMS. Tetanus, diphtheria and acellular pertussis vaccination during pregnancy and reduced risk of infant acute respiratory infections. Vaccine. 2017;35;5603-5610
  10. [10] Naidu MA, Muljadi R, Davies-Tuck ML, Wallace EM, Giles ML. The optimal gestation for pertussis vaccination during pregnancy: a prospective cohort study. American Journal of Obstetrics and Gynecology 2016; 215:237; e1-6
  11. [11] Koermer J, Forinash AB, Yancey AM. Administration rates of dTAP vaccine in obstetrics patients. Annals of pharmacotherapy 2018
  12. [12] Beard FH. Pertussis immunization in pregnancy: a summary of funded Australian State and Territory programs. Communicable Diseases Intelligence. Sept 2015; 39(3)
  13. [13] MacDougall DM, Halperin SA. Improving rates of maternal immunization: Challenges and opportunities. Human Vaccines and Immunotherapeutics. 2016;12(4);857-865
  14. [14] Yuen CYS, Tarant M. Determinents of uptake of influenza vaccination among pregnant woman – A systematic review. Vaccine.2914;32(36); 4602-4613
  15. [15] Boedecker B, Waker O, Reiter S, Wichman O. Cross sectional study on factors associated with influenza vaccine uptake and pertussis vaccination status among pregnant women in Germany. Vaccine. 2014 12(4); 857-865
  16. [16] Chamberlain AT, Seib K, Auit KA, Rosenberg ES, Frew PM, Cortes M, Whitney EAS, Berkelman RL, Orenstein WA, Omer SB. Improving influenza and Tdap vaccination during pregnancy: A cluster –randomised trial of a multi-component antenatal vaccine promotion package in later influenza season. Vaccine 2015; 33; 3571-3579
  17. [17] Payakachat N, Hadden KB, Ragland D. Promoting Tdap immunization in pregnancy: Associations between maternal perception and vaccination rates. Vaccine; 2016; 34; 179-186
  18. [18] Quinlivan JA, Lyons S, Petersen RW. Attitudes of pregnant women towards personally controlled electronic, hospital-held, and patient-held medical records system: a survey study. Telemedicine and e-health. 2014; 20(9): 810-815 DOI 10.1089/tmj.2013.0342
  19. [19]
  20. [20] Wong VWY ,Fong DYT, Tarrant M. Brief education to increase uptake of influenza vaccine among pregnant women: a study protocol for a randomised controlled trial. BMC Pregnancy Childbirth. 2014;14(19);1-7
  21. [21] Li WHC, Wang MP, Cheung YTY, Cheung YT, Ho Y. Brief intervention to propmote smoking cessation and improve glycemic control in smokers with Type 2 diabetes: a randomised controlled trial. Scientific Reports;7(45902);1-11
  22. [22] White P, Kenton K. Use of electronic medical record-based tools to improve compliance with cervical cancer screening guidelines. Effect of an educational intervention on physician practice patterns. Obstetrics and Gynecology.2013;17(2); 175-181
  23. [23] Hawley G, Jackson C, Hopworth J, Wilkinson S. Sharing of clinical data in a maternity setting: How do paper hand-held records and electronic health records compare?. BMC Health Services Research. 2014; 14:850 DOI 10.118/s12913-014-0650-x