A test of the feasibility of pneumococcal vaccination in the emergency department.

Abstract

To test the feasibility of pneumococcal immunization in an ED. Cook County Hospital has an annual ED census of 120,000. Patients are 75% black and 15% Hispanic. Eighty-two percent of patients are uninsured. Seventy-three percent report no primary physician. Between May 27, 1997, and July 26, 1997, nurses had standing orders that patients meeting CDC-recommended criteria were to be offered pneumococcal immunization. Immunization was recorded in the system-wide registration computer. During the study period, 1,833 patient screenings encounters (13% of all patients) identified 1,493 high-risk patients. Only 10% of screened high-risk patients reported previous pneumococcal immunization. 1,173 were immunized against pneumococcus. Median number of immunizations per nurse per shift was 1.62. Patient through-put was not altered. Pneumococcal immunization is both necessary and feasible in a busy ED serving patients with little access to other immunization services.