Effect of an Electronic Order Set on Newborn Hepatitis B Immunization Rates


West Florida


Oak Hill Hospital

Document Type


Publication Date



Community Health and Preventive Medicine | Family Medicine


Hepatitis B is a highly infectious DNA virus transmitted through blood and bodily fluids via percutaneous or mucosal contact. Immunization is vital as there is no cure or treatment for Hepatitis B, thus prevention of morbidity and mortality is based on a strategy of primary prevention. Recent changes to national recommendations made by the CDC include every stable newborn weighing =2,000g with a negative hepatitis B status mother receiving hepatitis B immunization within 24 hours of birth. This quality and practice improvement project evaluated the effect of making simple EMR newborn admission order set changes in line with new national recommendations. It then tracked subsequent immunization rates and compared them to rates prior to the new EMR changes. There was a dramatic difference noted. Immunization rates increased from only 9% prior to EMR changes, to 90% of newborns receiving hepatitis B birth dose after the changes were made. This project serves as a clear example of how changing order sets can have a powerful effect on ordering practices and therefore allow rapid quality improvement.

Publisher or Conference

Society of Teachers of Family Medicine Conference on Quality Improvement