Gardner, Emily
Immunization Rates of NICU Infants
Faculty Mentor: Janelle Macintosh
Introduction
The goal of this project was to determine the vaccination rates of infants in the
Neonatal Intensive Care Unit (NICU) of various hospitals throughout the Wasatch Front in Utah.
We collected data related to possible reasons why infants may not receive their immunizations
during their stay at the facility. Many are uninformed of the recommendation from the American
Academy of Pediatrics (AAP) which states that that preterm and low birth weight babies should
receive all immunizations at the same chronological age as full term infants. Yet, many pre term
infants fail to be immunized. Preterm infants are at an increased risk for infection, because the
majority of immunoglobulins transferred from mother to baby are given to the baby during the
third trimester of pregnancy. Often, despite this recommendation that the administration of
vaccines not be delayed, physicians and parents often delay immunizations, putting these
children at risk for vaccine-preventable diseases. This study was designed to determine what
factors could cause parents and physicians to delay the immunization schedule. This study was
also designed to determine the impact that the martial statues of the mother whether or not an
infant was immunized.
Methodology
Sample
At each of the locations where data was collected, the sample consisted of
infants 60 days of age or older who have been discharged from a NICU. Infants discharged
between January 1, 2010 and July 31, 2015. These infants were considered qualified for the
study.
Setting
This descriptive study was performed as a retrospective chart review performed
on the following hospitals: Primary Children’s Hospital, Intermountain Medical Center, and
Utah Valley Regional Medical Center. This project is still in progress, because we are still
waiting for approval/available charts from: St. Mark’s Hospital, University of Utah Hospital,
Dixie Regional Medical Center, and Timpanogos Regional Medical Center.
Procedures
The data was collected using the paper records from Primary Children’s
Hospital, Intermountain Medical Center, and Utah Valley Regional Medical Center.
Measurement/Instrumentation
Data from the paper charts was entered directly into a cloud based electronic data capture program.
Data Analysis
Descriptive statistics will be calculated for each of the variables collected
after data has been collected from each hospital included in the study. No data has been finalized
up to this point because the study has not been fully completed.
Results
No results have been calculated at this time, because not all data has been collected
from all hospitals. We are still waiting for approval from various hospitals.
Discussion
Although the study has not been completed in full, there was much gained form the
research performed. As a nursing student, I became more familiar with different charting systems
of various hospitals. I also came to realize how many factors may impact the immunization rates
of these vulnerable neonates. I am still involved in the data collection as hospitals approve our
data collection and look forward to the data analysis information that will determine the
correlation between marital status of the mother and the immunization rate of the infant. One
limitation we encountered in this study was the amount of time it has taken to receive approval
from hospitals. Although we began the approval process with many hospitals as the ORCA
application was submitted, some hospitals approved quickly, while others had never encountered
researchers in their hospitals before and were weary of letting us collect data. Some hospitals
outright disapproved our data collection and we had to cut these hospitals out of the study. For
the hospitals we were still waiting for approval on, there are particular standards that must be
met, unique to each hospital, and it has been an extended process to continue to seek approval.
With time, we will seek to receive approval from each of the hospitals in our study and analyze
the related data.
Conclusion
The American Academy of Pediatrics (AAP) recommendations about
immunizations for preterm infants are based on valid research and should be followed by
physicians and parents alike. I am still interested to know how/if the marital status of the mother
predicts whether or not an infant will receive his vaccinations, and if so, to what degree this
influences immunization rates. The correlation between marital status of the mother and
immunization rate of the baby will be determined once all data has been collected from the
assigned hospitals in our study.