The following article features coverage from the 2018 Oncology Nursing Society’s Annual Conference in Washington, DC. Click here to read more of Oncology Nurse Advisor‘s conference coverage. 

WASHINGTON, DC — A nurse-driven protocol to increase the rate of pneumonia and influenza vaccine administration in the outpatient setting leads to improved outcomes for patients with cancer, according to an oral presentation at the 2018 Oncology Nursing Society (ONS) Annual Congress.

The Center for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices recommends that all patients with high risk factors, such as cancer, get vaccinated for pneumonia and influenza. However, an in-house study showed that more than 90% of patients who develop pneumonia at the Memorial Sloan Kettering Cancer Center (MSKCC) are not vaccinated, leading to severe complications and delays in treatment. 

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“Our goal,” said Elizabeth Rodriguez, DNP, RN, OCN, “was to reduce the rate of hospitalizations and deaths in our patients by implementing CDC guidelines that all cancer patients receive flu and pneumococcal vaccinations.”

For this study, a multidisciplinary team expanded the currently existing inpatient protocols so vaccination orders would automatically generate for all eligible patients at the 2 largest outpatient clinics at MSKCC between November 2016 and May 2017. Investigators assessed the number of vaccine doses administered, time to pharmacy verification of orders, and clinic room-in and room-out times. 

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Results showed that there were significant improvements in the number of administered vaccinations. The number of influenza vaccines increased 97%; there were 1504 vaccinations after protocol implementation compared with 762 the previous year. The increase in pneumococcal vaccines was even more drastic; there was a 684% increase in vaccine administration after protocol expansion (229 vs 1797).

Furthermore, this increase occurred without negative effects on patient in-room times and pharmacy or patient flow, which were concerns initially expressed by the medical board.

Rodriguez concluded, “A nurse driven protocol for vaccination can increase the uptake in cancer patients. Based on the success of the pilot, all outpatient locations will go live this year.”


Rodriguez E, Garcia J, Gordon J, Connor M, Kamboj M. Improving vaccination rates for influenza and pneumococcus through a nurse driven protocol. Oral presentation at: 43rdONS Annual Congress; May 17-20, 2018; Washington, DC.