부산대학교 도서관

Patients without spleens are at risk of septicaemia which is largely preventable by vaccination and prophylactic antibiotics as detailed in several recent guidelines. This study sought to identify all people, in one health district, with a previous splenectomy and treat them according to the guidelines on post‐splenectomy care. Patients without a spleen were identified by a variety of methods and targeted mailing, manipulation of the local press, opinion leaders, postgraduate meetings, peer pressure, disease‐ and patient‐specific reminders, feedback and patient empowerment were all used as dissemination and implementation strategies. The number of patients iden‐tified rose from 15 to 68. All were offered the opportunity to discuss their care, 80% took this opportunity and had pneumococcal vaccine, 77% were started on long‐term antibiotics, 75% discussed Hib and meningococcal vaccines and these were given to 54%. In summary the strategies used dramatically increased the numbers of patients identified and the improved care offered.