Incidence of adult immunization for influenza and pneumonia in a preadmission testing unit.

Health care-associated (nosocomial) infection is now more common in surgical patients than surgical-site or wound infection. Elderly patients and those having abdominal, neck, cardiac, or other thoracic procedures are at the highest risk. Pneumococcal pneumonia and influenza are the fifth leading cause of mortality in the elderly population. In the United States, only 54% of persons older than 65 years have received a pneumococcal vaccine, whereas approximately 67% have been immunized for influenza. In this study, interviews were conducted with 160 elderly patients seen in the preadmission testing unit of a large community hospital. Results showed immunization rates of 57% for pneumonia and 76% for influenza. Similar to findings of previous studies, minorities were less likely to be immunized than whites. Of those who were not immunized for pneumonia or could not recall their immunization status, 71% stated they had not been offered immunization. Sixty-four percent stated they would take the vaccine to prevent pneumonia if it were offered. Of those patients who were not immunized for influenza, 54% had not been offered this protection and 41% stated they would take the influenza vaccine if offered. Although vaccination rates of participants in the present study surpassed the 1998 national baseline for noninstitutionalized adults, there is much opportunity for improvement. Perianesthesia nurses have an important role in reducing surgical patients' risks of developing health care-associated pneumonia and invasive bacteremia by assessing the patient's immunization status and being proactive in helping surgical patients obtain appropriate vaccinations. Routine documentation of a vaccination history for pneumococcal pneumonia and influenza during preadmission testing and use of a standard protocol for educating and immunizing those who lack this protection are strategies that can be easily implemented by nurses practicing in perianesthesia settings such as ambulatory surgical sites and preadmission testing units. This practice would foster achievement of the Healthy People 2010 goal of 90% vaccination rates for persons at high risk for these deadly diseases.