BREAKING BARRIERS OF VACCINATION

Submitted by: Sadikshya Bhattarai

December 03, 2013

Introduction

• Clinical Rotation

• Justification of Needs

• National Significance

• Immunization Tool

• ACE Star Model

• Conclusion

Clinical Rotation

• Facility name: Chevy Chase Pediatrics• Address: 5225 Connecticut Ave

Washington, DC, 20015• Preceptor: Gay Ohlrich, RN, BSN• Duration of Practicum:

Spring, Fall 2013

Justification of Needs• Curiosity• Parent’s refusal to vaccinate due to lack of information

regarding side effects• Parents do not have time for extended education

session• Vaccine administered not complying to the Center for

Disease Control and Prevention (CDC) guidelines• Delaying vaccine until the child turns two years of age

National Significance• 62.8% of US children are fully immunized with all the

recommended vaccine. (NNII, 2010)• The 2012 outbreak of whooping cough infected more

than 42,000 people (CDC, 2013).• According to Pediatric Academic Society, childhood

vaccinations in the US prevent about 10.5 million cases of infectious illness and 33,000 deaths per year.

Immunization ToolRationale for Immunization Tool• Need for patient education(Healy & Pickering, 2011)• Effective communication with parents (Walther, 2011)• Assessment and feedback for vaccination provider. (CDC,

2011)• Completing the whole series of vaccine will reduce infectious

disease (Leuridan & Damme, 2011)

Immunization Tool FOR NURSES

• Vaccine tracking System

• Vaccine Review Checklist

FOR THE FAMILIES

• Package for the family

Vaccination Tracking System (2 month Period)

Name

Initial of Patient’s

last name

Date Initiated

Review of the Vaccination

DTP HIB Hep MMR ROTAIPV PCV B VZV VIRUS

Evaluation

Nurse 1 A

Nurse 2 B

Nurse 3 C

Nurse 4 D

Nurse 5 E

Vaccination Review ChecklistPatient Name:Date of Birth:Name of Nurse:Date reviewed:

Evaluation/ Comment

Vaccines Dose 1 Dose 2 Dose 3 Dose 4 Dose 5

DTaP

Polio

Hib

Hep B

MMR

VZV

PCV

Rotavius

Package for Family

1. Recommended Immunization Schedule

Package cont…

• Vaccine Information Sheet• Reminder Appointment Card• Client held medical records

5th Stage (Evaluation):• Semi Annual Meeting• Survey for Nurses (Questionnaires)• Survey for Parents (Questionnaires)

ACE Star Model

Conclusion

• Re-emphasis on importance of vaccination

• Increase routine vaccination coverage

• Decrease vaccine preventable infection

References

• American Academy of Pediatrics. (2013). Documenting parental refusal to have their children vaccinated. Retrieved from http://www2.aap.org/immunization/pediatricians/pdf/refusaltovaccinate.pdf

• Centers for Disease Control and Prevention (2009). If you chose not to vaccinate your child, understand the risk and responsibilities. Retrieved April 22, 2013, from http://www.cdc.gov/vaccines/hcp/patient-ed/conversations/downloads/not-vacc-risks-bw-office.pdf

• Center for prevention and disease control. (2011). Immunization strategies for healthcare practices and providers. Retrieved October 2, 2013, from http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/strat.pdf

• Center for Disease Control and Prevention (2013). Pertussis outbreak trends. Retrieved October 2, 2013, fromhttp://www.cdc.gov/pertussis/outbreaks/trends.html

References

• Healy, C., Pickering, L. (2011) How to communicate with vaccine-hesitant parents. American Academy of Pediatrics.

• Leuridan, E., & Damme, P. (2011, 1).. Hepatitis B and the Need for a Booster Dose. Oxford Journals | Medicine | Clinical Infectious Diseases Retrieved April 21, 2013, from http://cid.oxfordjournals.org/content/53/1/68.full.pdf+html

• NNii. (2009). Concerns about vaccine safety. National Network for Immunization Info. Retrieved from http://www.immunizationinfo.org/issues/vaccine-safety/concerns-about-vaccine-safety

• Shan, Y. (2011). Primary Health Care, 21(2), 16-21. Retrieved October 3, 2013, from http://search.proquest.com/docview/858023172?accountid=28903

• Walther, S. (2011). A parent’s decision on immunization: making the right choice. Retrieved October 3, 2013, from

• http://pediatrics.aappublications.org/content/127/Supplement_1/S5.full.pdf+html

Thank You!