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Immunizations

By: Lauren Kasperlik, Cory Tepatti, Megan


MacDermaid, Kaytlyn Jordan

Objectives:
Identify safety and quality in vaccinations throughout ones lifespan.
Explain evidence-based practice on vaccinations from a nursing point of
view.
Explain vaccinations from another discipline.
Explain the relationship between the research of vaccinations to Jean
Watsons theory and the Instructional Theory.
Explain a concept map on the impact and safety and quality of
vaccinations.
Explain the clinical implications of vaccinations.

Outcomes:
Increase awareness of vaccinations and how it affects
the population.
Demonstrate ethical awareness from a nurses point of
view.
Educate the population on the myths of vaccinations.

Introduction
Based on evidence-based research, we
promote immunizations throughout lifespan
development and create awareness in nursing
practice.

Facts
All major health organizations currently recommend that infants and children be
vaccinated against 14 communicable disease.
by age 6, children will have received 29 vaccinations
In the United States, most states have enacted laws that require proof of certain
vaccinations before allowing them to attend daycare or school.
All 50 states issue medical exemptions
48 states (excluding Mississippi and West Virginia) permit religious
exemptions.
There is a federal program called Vaccines for Children which provides free
vaccinations to children without health insurance.
The United States has one of the best safety programs in the world. Scientist
are constantly monitoring and studying vaccines before they are licensed to the
public.

PICO Question
Patient/population: Children (2 months and older) and parents,
individuals who oppose immunizations.
Intervention of Interest: Educate the patient about immunizations and the
effects.
Comparison on interest: Compared to children who have not been
vaccinated or adults who chose to forgo vaccinations.
Outcome of Interest: Prevent diseases and illness in the future.

Pros
Illnesses such as Diphtheria, Rubella, and Whooping Cough which once killed
thousands of infants annually are now prevented by vaccinations.
Studies from John Hopkins University School of Public Health and Centers for
Disease Control have proven that mercury based preservatives in vaccinations do
not cause autism
According to The American Academy of Pediatrics, most childhood vaccinations
are 90-99% effective in preventing disease.
Immunizing individual children also helps to protect the health of the community,
especially those who cannot be immunized. This includes:
o children less than a year old
o medical reasoning such as leukemia
o those that cannot make an adequate response to vaccinations

Cons
People argue that childrens immune systems can deal
with infections naturally
Side effects of vaccinations such as seizures, paralysis,
and death are not worth the risks of safeguarding
against diseases.
Vaccines may cause autism, ADHD, and multiple
sclerosis.

Vaccination Safety
Years of testing are required by the FDA before a vaccine can be licensed.
o This can take up to 10 years or longer
Vaccinations are continuously monitored for safety and efficacy.
Any problems with a vaccine prompts further investigation with the FDA
and the CDC.
If researchers find a vaccine may be causing possible side effects
appropriate actions will be taken. This includes:
o changing of vaccine labels or packaging
o distributing safety alerts
o revoking the vaccines license
o inspecting manufacturers facilities and records

Vaccination Safety Continued


AFIX is a quality improvement program to raise immunization coverage
levels, reduce missed opportunities to vaccinate and improve standards of
practice at the provider level.
o Assessment of the healthcare providers vaccination coverage levels
and immunization practices
o Feedback of results to the provider along with recommended quality
improvement strategies to improve process, immunization practices,
and coverage levels.
o Incentives to recognize and reward improved performance
o Exchange of information with providers to follow up on their progress
towards quality improvement in immunization services and
improvement in coverage levels.

Nursing Research
First Study: Improving Immunization Rates at 18 Months of
Age: Implications for Individual Practices.
Location: South Carolina
9 facilities were included, but only 6 facilities chose to
participate.
Number of doses & vaccine
types.
Results from the 6 practices.

Nursing Research
Second Study: Nurse Practitioner's Role in Providing
Evidence-Based Research on Childhood Vaccines
What is a healthcare providers role in providing information on
vaccinations?
Polio Vaccine became available in 1959 and no cases have occurred in the
United States for 20 years.
Healthcare providers face ethical dilemma with vaccines.
The CDC and schools have guidelines for vaccinations.
Reasons parents forgo vaccinations: side effects, religious beliefs, and the
fear of developing autism.

Nursing Research Continued


Autism debate first began in 1998.
Evidence shows little association between vaccines and autism.
Over the years there has been an increase of mothers who believe the
MMR vaccine is safe.
Patients look to healthcare providers for guidance to vaccinate their
children.
Vaccinations will always be controversial topic.

Other Discipline: Social Work


Child Immunization Status Among a Sample of Adolescent
Mother: Comparing the Validity of Measurement Strategies.
Our Family Services: Tucson, Arizona
Teen pregnancy: Postpartum
Social programs
Immunization records
Two self-report strategies
Study
Results

Nursing Theory: Jean Watson 1979


Theory of caring: Nursing is concerned with promoting and
restoring health, preventing illness, and caring for the sick.
Jean Watsons Theory:
Individualized care
Limitations of theories in community health nursing
Caring consists of carative factors that result in the satisfaction of certain
human needs
Effective caring promotes health and individual or family growth
Caring responses accept person not only as he or she is now but as what
he or she may become

Nursing Theory cont. & Clinical Implications


A caring environment is one that offers the development of potential while
allowing the person to choose the best action for himself or herself at a
given point in time
Caring is more healthogenic than is curing. A science of caring is
complementary to the science of curing
The practice of caring is central to nursing
Helping-trust relationship
Teaching-learning
To be a Nurse is to Care
Whether or not immunizations are given, it is our job to care for and provide for
each patient and circumstance individually and with the same respect

Theories of Moral Development-Lawrence


Kohlberg
Postconventional Level
Involves moral judgement that is rational
and internalized into ones standards or
values
Healthcare providers and parents are
faced with moral dilemmas regarding
vaccinations.
Providers need to respect the patients
decision and not be forceful.
The nurse must have moral judgement and
ethics with controversial topics such as
vaccines.

Impact on Safety and Quality

Summary of Research Findings


Healthcare facilities need to implicate vaccination
education.
Providers need to provide evidence-based research to
their patients when looking for advice about
vaccinations.
Vaccinations need to be more readily available to the
uninsured and single income families.
Different beliefs about vaccinations exist especially in
the home school population.

Questions

Conclusion
Evidence-based research is essential to providing
information and influencing safety and quality regarding
vaccinations.
Access to vaccines need to be more readily available to
the public.
Healthcare providers need to actively participate in their
patients decision regarding vaccinations.
A role of a nurse is to provide care and be a patient
advocate for health promotion.

Reference Page

AAP immunization best practices making flu vaccine accessible. (2013). American Academy of
Pediatrics. Retrieved April 21, 2014.
AFIX (Assessment, Feedback, Incentives, and Exchange). (2014, March 11). Centers for
Disease Control and Prevention. Retrieved April 21, 2014, from
http://www.cdc.gov/vaccines/programs/afix/index.html
Ayesha Khan. (June 13, 2013). Vaccines. Retrieved from
http://bionews-tx.com/news/2013/06/13/ut-yale-flu-vaccines-aimed-at-younger-populations-could
-break-annual-transmission-cycle/
Bay Health. Keep Your Baby Save Through Immunizations. Retrieved from
http://www.bayhealth.org/BayhealthContentPage.aspx?nd=1149&news=625
McElligott, J. T., Roberts, J. R., OBrien, E. S., Freeland, K. D., Kolasa, M. S., Stevenson, J., &
Darden, P. M. (2011). Improving immunizations rates at 18 months of age: Implications for
individual practices. Public Health Reports, 126, 33-38. Retrieved from
http://www.jstor.org/stable/41639283

Reference Page Continued

Phillips, C., Cota-Robles, S., Knight, M., Francis, J., Phillips, E., & Mazerbo, L. (2011). Child
immunization status among a sample of adolescent mothers: Comparing the validity of
measurement strategies, Journal of Famliy Social Work, 14, 326-328.
DOI:10.1080/10522158.2011.584303
San Mateo County Health System. (2012). Immunization Programs. Retrieved from
http://www.smchealth.org/immunizations
Staullbaumer, Tonya. (March 2012). Nurse practitioners role in providing evidence-based
research on childhood vaccines. The Kansas Nurse, 87. Retrieved April 16, 2014.
Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011). Fundamentals of Nursing: The Art and
Science of Nursing Care. (7th ed., pg. 369). Philadelphia, PA: Lippincott Williams & Wilkins.
Thorpe, Elizabeth. (February 1, 2012). Homeschooling parents practices and beliefs about
childhood immunizations. Vaccine, 30,6 pg 1149-1153.
http://dx.doi.org/10.1016/j.vaccine.2011.12.019

Reference Page Continued

Vaccines . (2013, November 18). ProConorg Headlines. Retrieved April 21, 2014, from
http://vaccines.procon.org/
Vaccine Safety. (2011, February 8). Centers for Disease Control and Prevention. Retrieved April
21, 2014, from http://www.cdc.gov/vaccinesafety/Vaccines/Common_questions.html6+