Vaccination Programs: Standing Orders

CDC

An Evidence-Based Practice

Description

Standing orders authorize nurses, pharmacists, and other healthcare providers where allowed by state law, to assess a client's immunization status and administer vaccinations according to a protocol approved by an institution, physician, or other authorized provider.

Standing orders can be established for the administration of one or more specific vaccines to clients in healthcare settings such as clinics, hospitals, pharmacies, and long-term care facilities. In settings that require attending provider signatures for all orders, standing order protocols allow assessment and vaccination in advance of the provider signature.

Impact

The Community Preventive Services Task Force (CPSTF) recommends standing orders for vaccinations—when used alone or when combined with additional interventions—to increase vaccination rates among adults and children from different populations or settings.

Results / Accomplishments

The CPSTF finding is based on evidence from a Community Guide systematic review completed in 2009 (29 studies, search period 1997-2009) combined with more recent evidence (6 studies, search period 2009-February 2012).

The systematic review included 35 studies.

Overall, vaccination rates increased by a median of 24 percentage points (27 studies).
-Standing orders used alone increased vaccination rates by a median of 16 percentage points (9 studies).
-Standing orders used in combination with additional interventions increased vaccination rates by a median of 27 percentage points (19 studies).

Standing orders increased vaccination rates among children by a median of 28 percentage points (4 studies).

All of the studies that did not provide a common measure of change for vaccination rates reported favorable results (7 studies).

About this Promising Practice

Primary Contact
The Community Guide
1600 Clifton Rd, NE
MS V25-5
Atlanta, GA 30329
(404) 498-1827
communityguide@cdc.gov
https://www.thecommunityguide.org/
Topics
Health / Immunizations & Infectious Diseases
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