Strategies to increase pneumococcal vaccination in veterans: An integrative review

The current integrative review aimed to explore the extent to which pneumococcal pneumonia impacts the Veteran population and strategies to increase pneumococcal vaccination in this population. The search strategy began with three electronic databases (CINAHL, PubMed, and Embase). After analysis of 50 studies, considering inclusion and exclusion criteria, nine studies were selected for fi nal analysis. Three primary themes emerged from the literature: (a) decreased 1-year morbidity and mortality in Veterans with comorbid conditions who received pneumococcal vaccination, (b) signifi cant barriers in outpatient vaccination processes, and (c) the spectrum of pneumococcal disease in Veterans. In general, themes from this review could be useful for stimulating quality improvement initiatives to increase pneumococcal vaccination in Veterans. However, little is known about barriers to Veterans receiving outpatient pneumococcal vaccination. Future research should be directed toward staff education of consensus guidelines.