The Feasibility of Pertussis Immunization in a Canadian Emergency Department

Study Overview
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Brief Summary
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Randomized controlled trial of 2 strategies to provide adults with the Tdap vaccine to patients presenting to the emergency department. Rates of vaccination as well as effects on department efficiency will be measured.

Detailed Description
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This study is a prospective randomized, controlled trial of two strategies to provide patients with the pertussis vaccine. Eligible adult patients with be offered pertussis vaccination in the Emergency Department vs. a referral to Public Health for pertussis vaccination. The effect of both strategies on triage time as well as measure of emergency department efficiency including length of stay, time to physician and left without being seen rates will be compared. At a four-month follow up, rates of pertussis vaccination will be measured.

Official Title
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The Feasibility of Pertussis Immunization in a Canadian Emergency Department

Conditions
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Pertussis

Intervention / Treatment
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* Behavioral: Tdap


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults age 18 and above Have not received Tdap vaccine as an adult (age 18 and above) or have not received Tdap vaccine within 10 years, or unsure of vaccination status Exclusion Criteria: Acute significant illness (Canadian Triage and Acuity Scale = 1) Deemed in too much distress by triage nurse Acute Febrile illness Allergy to vaccine or vaccine components Pts presenting for wound care (are normally given the vaccine as part of wound care) Pregnancy < 26 weeks

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Emergency Department vaccination group<br>Pertussis (Tdap) vaccine offered/administered in the Emergency Department | Behavioral: Tdap<br>* Randomized controlled trial of 2 strategies to provide adults with the Tdap vaccine<br>* Other names: Boostrix;|
| Experimental: Public Health referral group<br>Public Health referral for Pertussis (Tdap) vaccine administration offered | Behavioral: Tdap<br>* Randomized controlled trial of 2 strategies to provide adults with the Tdap vaccine<br>* Other names: Boostrix;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of immunization | Rate of patients receiving Tdap vaccine | One day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of Stay | Length of Stay (mins, secs) for all patients presenting to the emergency. department on study days. | One day | 
| Left with out being seen rate | Rate of patients leaving without being seen by a physician on study days. | One day | 
| Time to physician | Time to be seen by emergency physician after triage (mins, secs) on study days. | One day | 
| Patient refusals | Reasons for patient vaccination refusal | One day | 
| Nursing satisfaction | Five statements rated on 5 point likert scale (strongly disagree (1) to strongly agree (5)). The immunization strategy significantly increased my workload; patient care was negatively affected by the immunization strategy; I was unable to provide the standard of care because of the immunization strategy; patient flow within the department was negatively affected by the immunization strategy; the ED should implement the immunization strategy | One day | 
| Additional vaccine received | Additional vaccines administered in the Public Health referral arm | One day | 
| Triage time | Time (in seconds) required to triage eligible patients in the emergency department | One day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pertussis, Vaccination, Emergency Department