Vaccination of patients subjected to hematopoietic stem cell transplant: 7 years after the implementation of the project

BACKGROUND: The patients subjected to Hematopoietic Stem Cell Transplant (HSC) show dysfunction of the immune system that continues through time, being that, after the first year after the HSC (autologous/allogenic) a decrease of the antibodies is confirmed for diseases prevented by vaccinations . In 2012, as an Intervention Project, we tried to identify the patients subjected to the bone marrow transplant in the HSC unit, with medical conditions to start the vaccination. We arranged a protocol of vaccination nursing visits which aimed to inform and direct the patient to the Local Health Unit, to start the National Vaccination Plan (NVP). In the end, we validated the fulfilment of the NVP and the existing inter competition during the same. OBJECTIVE: This study has the aim of showing the results of the quality indicators of the project of vaccination of the patients subjected to HSC. METHODS: As a method we resorted to the quantitative analysis retrospectively of the application of the methodology of the Project, through the indicator of the quality of the defined result – vaccination rate of patients subjected to HSC with the National Vaccination Plan. As a sample of this study, we used the technique of convenience sampling. We included all patients subjected to HSC in medical condition to start the vaccination. The period between 2017 and 2018, the indicator of quality of the procedure was defined by the number of telephone contacts gathered in the scope of the vaccination and the analysis of its contents was done. RESULTS: Were part of a study 358 patients, of which 229 were subjected to HSC allogenic and 129 autologous. We obtained vaccination rates of 100% in the last years. The project started in 2012, with a rate of 87%, mainly due to the improvement of the articulation with the Local Health Units. Of the 290 telephone contacts registered, 38% corresponds to the contacts carried out by the Hospital Nursing Team to the local Health Unit and 62% from the Local Health Unit to the hospital. The topics approached were mainly the following issues: (i) if patients over 40 years of age need vaccination against HPV (27%), (ii) the authorized date to start the NVP (13%), (iii) the reason for updating the NVP (19%), (iv) the number of the vaccines to be administered by contact (39%); (v) the adequate date for the administration of the vaccine VASPR (2%). CONCLUSIONS: The applicability of the quality indicators permitted the improvement of the project intervention strategies and the efficacy of the same. The contacts proved to be fundamental in sharing, explanation of doubts and discussion about the vaccination of these patients, warning them for fundamental issues which should be explained in the first contact. Through the implementation of the project we were able to increase the rate of vaccination decreasing the vulnerability of infection of these patients. This project is innovative by approaching the vaccination area of these patients seeing that this was not being re-established in a systematic way. It is reinforced by the articulation of the care by the Local Health Unit promoting its contact with the patient, achieving his loyalty thus guaranteeing the continuation of health care.