Hospital-Based Community Initiative to Reduce Pertussis In Mothers

Purpose for the program: Pertussis is a highly contagious bacterial disease that can be fatal for infants. In recent years there has been a significant increase in cases due to waning of immunization with inadequate numbers receiving boosters. This is problematic for the vulnerable newborn that does not have adequate immunity until 6 months. The purpose of this project was to develop a program to provide maternal pertussis immunization prior to discharge from the hospital.

Proposed change: Childhood immunity for pertussis wanes over time. Most adults are not fully immunized despite the strong recommendations from the Center for Disease Prevention (CDC), the recent epidemic or near epidemic rates of infant pertussis in some states, and the relative ease of preventing infant infection through parental vaccination. It would be advantageous to provide the vaccine while the mother is still in the hospital after birth; however, most insurance will not reimburse for this service. We wanted to be able to provide this service but had to develop a proposal to adopt the practice without financial reimbursement and then develop a strategy to implement the inpatient maternal pertussis vaccination program.

Implementation, outcomes and evaluation: The business plan for the pertussis immunization program provided a costing of the vaccine, equipment, and professional time. This cost (~$40.00) is low compared to the cost of caring for a sick newborn. Administration accepted this proposal as a service to the community aimed at improving public health.  Educational brochures were created to help families learn the importance of vaccination and a video was placed on the education channel for families to view. The staff was educated on this initiative prior to starting the program.  The obstetricians, pediatricians, nurses, and technical staff were involved in creating a standing order in the electronic medical records for the vaccines. Monthly reporting of patient assessment for pertussis vaccination and booster administration can be obtained.

Implications for nursing practice: Providing vaccinations to enhance the health of mothers, newborns and their families is an important intervention to decrease the incidence of pertussis in our community.  While it is difficult to assess community outcomes there has been an overall decrease of pertussis in our county.

Keywords: pertussis, immunization, vaccination