Development of an outpatient clinic to provide pertussis vaccinations to maternity patients and family members.

PURPOSE: The implementation of a hospital-based outpatient pertussis prevention program targeting maternity patients and family members is described. SUMMARY: Faced with a rising incidence of pertussis statewide, a large Ohio hospital formed a multidisciplinary team to ensure hospital compliance with current guidelines calling for administration of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine to all maternity patients as well as previously unvaccinated family members and likely neonatal caregivers (i.e., "cocooning"). The team had regularly scheduled meetings to identify and address fiscal, logistic, and practice-related challenges throughout the implementation process. Key challenges included (1) determining the availability of insurance reimbursement for Tdap vaccination services, (2) cultivating support for the vaccination initiative among obstetrics and maternal-fetal medicine specialists, (3) coordinating development and dissemination of educational information to patients and their families at specified points of contact, and (4) establishing an efficient registration process for family members. The outpatient vaccination clinic was located adjacent to the hospital's maternity center in order to provide convenient access. Despite limited clinic hours (three hours daily on weekdays only) and ongoing reimbursement and funding challenges, the program has improved Tdap vaccination rates in the target population and is considered a successful demonstration of the cocooning concept. CONCLUSION: Implementation of an outpatient clinic for neonatal pertussis prevention was well accepted by family members of newborns, and Tdap vaccinations were administered to 329 family members during the first 11 months of clinic operations.

Implementation of a training program to improve pharmacy services for high-risk neonatal and maternal populations.

PURPOSE: A training program aimed at increasing pharmacists' role in the care of high-risk maternal, neonatal, and pediatric patients is described. SUMMARY: In preparation for the planned expansion of a large Ohio hospital's maternal and neonatal critical care services, the pharmacy department developed a training program to increase the knowledge and skill sets of staff pharmacists, especially those who lacked residency training. The program also supported the department's transition to an integrated patient-centered pharmacy practice model. Clinical practice guidelines, policy statements, and other sources were used to develop a series of 57 one-hour lectures on a wide range of topics in maternal-neonatal critical care. The lectures were delivered one morning each week, every other week, over 30 months, with additional case-based homework assigned; a passing score (80%) on all module examinations and homework assignments was required for continued course participation. Trainees who completed the voluntary program earned a certificate from the department head and continuing-education credit from the Ohio State Board of Pharmacy, and they were eligible to engage in expanded rounding and patient counseling activities. The program appeared to have a positive impact on patient satisfaction and efforts to reduce medication misadventures in the neonatal intensive care unit. CONCLUSION: The implementation of a training program to educate non-residency-trained pharmacists in selected areas of maternal, neonatal, and pediatric health care helped enable the expansion of pharmacy services to include admission, daily, and discharge counseling.