Lisa Gaines

Date on Paper

7-2021

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Nash, Whitney

Committee Member

McRae, Emily

Author's Keywords

Quality improvement; intervention; flu; influenza vaccination; uptake; ACIP

Abstract

Background: Internal and external evidence demonstrates that there is a suboptimal uptake of influenza vaccination (flu vaccine) in all settings, despite national objectives to achieve 80%- 90% immunization rates across all populations. In 2002, the Advisory Committee on Immunization Practices (ACIP) issued a recommendation that all children 6 months of age and older be immunized annually with the influenza vaccine. Despite these recommendations, influenza vaccination is not required for school entry in the Commonwealth of Kentucky and immunization rates continue to fall below local, state, and national targets. Being considered an optional vaccine leaves the decision to vaccinate (or not) up to the discretion of the parent(s). Many parents choose not to vaccinate their child(ren) with the flu vaccine, leaving those children vulnerable to infection during flu season (approximately October – May). Setting: This project will take place at a private pediatric practice located in Louisville, KY. This practice currently has three providers: one physician (MD) and two physician assistants (PA). The target population will be all pediatric patients eligible to receive influenza vaccination (6 months – 17 years of age) that present to the clinic during the QI project period. All interventions will take place within the current flu season, a designated time block between October and May. Purpose: The purpose of this quality improvement (QI) project is to increase influenza vaccination uptake among all pediatric patients eligible to receive the vaccine. Measures to enhance uptake will include: providing all parents with an educational piece addressing influenza infection and vaccination, addressing erroneous attitudes and beliefs surrounding the vaccine, and targeted provider communication to vaccine-hesitant parents. Methods: This 6-week quality improvement (QI) project is separated into a 3-week preintervention period and a 3-week intervention period. Upon checking into the clinic, patients will be screened for flu vaccine eligibility and given an educational pamphlet regarding influenza infection and vaccination. Vaccine-eligible patients will be prompted for intent to vaccinate during current visit, tracked during the visit, and marked for further intervention by providers (during intervention period). Vaccination rates will be recorded and compared between pre-intervention period (does not include provider-prompted intervention) and intervention period. Measures: Outcomes measured in this project will include number of patients that received the flu vaccine (subdivided by intent to vaccinate at check-in) during intervention and preintervention periods. Statistics will be tracked as an aggregate and also by provider.

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