Dataset Information

Strategies to increase influenza vaccination rates: outcomes of a nationwide cross-sectional survey of UK general practice.

ABSTRACT:

Objective

To identify practice strategies associated with higher flu vaccination rates in primary care.

Design

Logistic regression analysis of data from a cross-sectional online questionnaire.

Setting

795 general practices across England.

Participants

569 practice managers, 335 nursing staff and 107 general practitioners.

Primary outcome measures

Flu vaccination rates achieved by each practice in different groups of at-risk patients.

Results

7 independent factors associated with higher vaccine uptake were identified. Having a lead staff member for planning the flu campaign and producing a written report of practice performance predicted an 8% higher vaccination rate for at-risk patients aged <65 years (OR 1.37, 95% CI 1.10 to 1.71). These strategies, plus sending a personal invitation to all eligible patients and only stopping vaccination when Quality and Outcomes Framework targets are reached, predicted a 7% higher vaccination rate (OR 1.45, 95% CI 1.10 to 1.92) in patients aged ?65 years. Using a lead member of staff for identifying eligible patients, with either a modified manufacturer's or in-house search programme for interrogating the practice IT system, independently predicted a 4% higher vaccination rate in patients aged ?65 years (OR 1.22, 95% CI 1.06 to 1.41/OR 1.20, 95% CI 1.03 to 1.40). The provision of flu vaccine by midwives was associated with a 4% higher vaccination rate in pregnant women (OR 1.19, 95% CI 1.02 to 1.40).

Conclusions

Clear leadership, effective communication about performance and methods used to identify and contact eligible patients were independently associated with significantly higher rates of flu vaccination. Financial targets appear to incentivise practices to work harder to maximise seasonal influenza vaccine uptake. The strategies identified here could help primary care providers to substantially increase their seasonal flu vaccination rates towards or even above the Chief Medical Officer's targets.

SUBMITTER: Dexter LJ

PROVIDER: S-EPMC3358626 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Strategies to increase influenza vaccination rates: outcomes of a nationwide cross-sectional survey of UK general practice.

Dexter Laura J LJ Teare M Dawn MD Dexter Matthew M Siriwardena A Niroshan AN Read Robert C RC

BMJ open 20120511 3

<h4>Objective</h4>To identify practice strategies associated with higher flu vaccination rates in primary care.<h4>Design</h4>Logistic regression analysis of data from a cross-sectional online questionnaire.<h4>Setting</h4>795 general practices across England.<h4>Participants</h4>569 practice managers, 335 nursing staff and 107 general practitioners.<h4>Primary outcome measures</h4>Flu vaccination rates achieved by each practice in different groups of at-risk patients.<h4>Results</h4>7 independe ...[more]

PMID: 22581793

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Project description:BACKGROUND: Low survey response rates in general practice are common and lead to loss of power, selection bias, unexpected budgetary constraints and time delays in research projects. METHODS: OBJECTIVE: To assess the effectiveness of recruitment strategies aimed at increasing survey response rates among GPs. DESIGN: Systematic review. SEARCH METHODS: MEDLINE (OVIDSP, 1948-2012), EMBASE (OVIDSP, 1980-2012), Evidence Based Medicine Reviews (OVIDSP, 2012) and references of included papers were searched. Major search terms included GPs, recruitment strategies, response rates, and randomised controlled trials (RCT). SELECTION CRITERIA: Cluster RCTs, RCTs and factorial trial designs that evaluate recruitment strategies aimed at increasing GP survey response rates. DATA COLLECTION AND ANALYSIS: Abstracts identified by the search strategy were reviewed and relevant articles were retrieved. Each full-text publication was examined to determine whether it met the predetermined inclusion criteria. Data extraction and study quality was assessed by using predetermined checklists. RESULTS: Monetary and nonmonetary incentives were more effective than no incentive with monetary incentives having a slightly bigger effect than nonmonetary incentives. Large incentives were more effective than small incentives, as were upfront monetary incentives compared to promised monetary incentives. Postal surveys were more effective than telephone or email surveys. One study demonstrated that sequentially mixed mode (online survey followed by a paper survey with a reminder) was more effective than an online survey or the combination of an online and paper survey sent similtaneously in the first mail out. Pre-contact with a phonecall from a peer, personalised packages, sending mail on Friday, and using registered mail also increased response rates in single studies. Pre-contact by letter or postcard almost reached statistical signficance. CONCLUSIONS: GP survey response rates may improve by using the following strategies: monetary and nonmonetary incentives, larger incentives, upfront monetary incentives, postal surveys, pre-contact with a phonecall from a peer, personalised packages, sending mail on Friday, and using registered mail. Mail pre-contact may also improve response rates and have low costs. Improved reporting and further trials, including sequential mixed mode trials and social media, are required to determine the effectiveness of recruitment strategies on GPs' response rates to surveys.

Project description:BACKGROUND:Maintaining effective oxygenation throughout the process of Pre-Hospital Emergency Anaesthesia (PHEA) is critical. There are multiple strategies available to clinicians to oxygenate patients both prior to and during PHEA. The optimal pre-oxygenation technique remains unclear, and it is unknown what techniques are being used by United Kingdom Helicopter Emergency Medical Services (HEMS). This study aimed to determine the current pre- and peri-PHEA oxygenation strategies used by UK HEMS services. METHODS:An electronic questionnaire survey was delivered to all UK HEMS services between 05 July and 26 December 2019. Questions investigated service standard operating procedures (SOPs) and individual clinician practice regarding oxygenation strategies prior to airway instrumentation (pre-oxygenation) and oxygenation strategies during airway instrumentation (apnoeic oxygenation). Service SOPs were obtained to corroborate questionnaire replies. RESULTS:Replies were received from all UK HEMS services (n?=?21) and 40 individual clinicians. All services specified oxygenation strategies within their PHEA/RSI SOP and most referred to pre-oxygenation as mandatory (81%), whilst apnoeic oxygenation was mandatory in eight (38%) SOPs. The most commonly identified pre-oxygenation strategies were bag-valve-mask without PEEP (95%), non-rebreathable face mask (81%), and nasal cannula at high flow (81%). Seven (33%) services used Mapleson C circuits, whilst there were eight services (38%) that did not carry bag-valve-masks with PEEP valve nor Mapleson C circuits. All clinicians frequently used pre-oxygenation, however there was variability in clinician use of apnoeic oxygenation by nasal cannula. Nearly all clinicians (95%) reported manually ventilating patients during the apnoeic phase, with over half (58%) stating this was their routine practice. Differences in clinician pre-hospital and in-hospital practice related to availability of humidified high flow nasal oxygenation and Mapleson C circuits. CONCLUSIONS:Pre-oxygenation is universal amongst UK HEMS services and is most frequently delivered by bag-valve-mask without PEEP or non-rebreathable face masks, whereas apnoeic oxygenation by nasal cannula is highly variable. Multiple services carry Mapleson C circuits, however many services are unable to deliver PEEP due to the equipment they carry. Clinicians are regularly manually ventilating patients during the apnoeic phase of PHEA. The identified variability in clinical practice may indicate uncertainty and further research is warranted to assess the impact of different strategies on clinical outcomes.

Dataset Information

Strategies to increase influenza vaccination rates: outcomes of a nationwide cross-sectional survey of UK general practice.

Objective

Design

Setting

Participants

Primary outcome measures

Results

Conclusions

Publications

Strategies to increase influenza vaccination rates: outcomes of a nationwide cross-sectional survey of UK general practice.

Similar Datasets

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