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  • Publication # 13-RA012

Pharmacy-based program improves flu immunization rates among health care workers in long-term care settings

Elderly Health/Long-Term Care

A new program using a pharmacy-based, voluntary health care worker influenza immunization approach is improving immunization rates in long-term care facilities, according to a new study. The approach uses a single, regional pharmacy to promote organizational change by having direct oversight and control over all immunization policies and processes in all facilities participating. 

Overall, immunization rates among health care workers rose from 58 percent to 76 percent in 5 years. Called Raising Immunizations Safely and Effectively (RISE), the quality improvement program involved 14 long-term care facilities in western Pennsylvania. Each facility agreed to transfer immunization policies and procedures from the domain of nursing to that of the long-term care pharmacy. Working collaboratively with the facilities, the pharmacy oversaw management of vaccine supply and ordering, process revisions, vaccine administration, record keeping, and data collection. Each facility also agreed to designate an immunization champion, guarantee leadership support, and attend educational activities.

Facilities also received written immunization policies, educational flyers, posters, and forms from the pharmacy. Health care workers were vaccinated, at no cost, during all three shifts, both on and off work units. 

The program eliminated written consent documents, making vaccination easier and more efficient. By the last season of the program, all facilities had reached a 60 percent immunization rate of their health care workers. Nearly two thirds reached a rate of 80 percent or better. Three facilities (20 percent) exceeded a rate of 90 percent or better, one of the goals of the Centers for Disease Control and Prevention Healthy People 2020 recommendations. The study was supported in part by AHRQ (HS18721).

See "Impact of the raising immunizations safely and effectively (RISE) program on healthcare worker influenza immunization rates in long term care settings," by David A. Nace, M.D., M.P.H., C.M.D., Steven M. Handler, M.D., Ph.D., C.M.D., Erika L. Hoffman, M.D., and Subashan Perera, Ph.D., in the Journal of the American Medical Directors Association 13, pp. 806-810, 2012.


Page last reviewed September 2013
Internet Citation: Pharmacy-based program improves flu immunization rates among health care workers in long-term care settings: Elderly Health/Long-Term Care. September 2013. Agency for Healthcare Research and Quality, Rockville, MD.


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