Date Approved
4-22-2026
Graduate Degree Type
Dissertation
Degree Name
Nursing (D.N.P.)
Degree Program
College of Nursing
First Advisor
Christina Quick, DNP, APRN, CPNP-AC/PC, CHSE
Second Advisor
Allison E. Reynolds, DNP, CPNP-AC/PC, CCRN
Third Advisor
Stacy Allen, MSN, CPNP-PC
Academic Year
2025/2026
Abstract
Background: Pediatric patients with systemic lupus erythematosus (SLE) face elevated risk for invasive pneumococcal disease, yet fewer than 10% are estimated to be current on pneumococcal vaccine (PCV) recommendations.
Local Problem: This quality improvement (QI) project aimed to develop and implement a standardized pneumococcal immunization screening and counseling process in a pediatric rheumatology clinic.
Method: Three consecutive PDSA cycles guided implemention across a nine-week intervention period using a pre-post quasi-experimental design.
Interventions: A multicomponent strategy was employed, including a PCV decision algorithm, EHR Smart Phrase, PCP referral template, and patient education brochure.
Results: Pre-implementation PCV counseling was documented in 16.7% of eligible encounters. The aggregate intervention counseling rate was 31%, with progressive improvement from 0% in Cycle 1 to 37.5% in Cycle 2 and 60% in Cycle 3 (p=0.447).
Conclusions: A low-cost, multicomponent workflow can potentially meaningfully improve pneumococcal immunization counseling in subspecialty settings when supported by role clarity, end-user informed EHR design, and consistent documentation.
ScholarWorks Citation
Dettmann, Sarah, "Improving Pneumococcal Immunization Counseling in Children with Systemic Lupus Erythematous" (2026). Doctoral Dissertations. 81.
https://scholarworks.gvsu.edu/dissertations/81
