Friday, July 13, 2007
This presentation is part of : Innovations in Health Promotion
Impact of an Educational Intervention on the Adoption of Proactive Immunization Practices among Nurses
Larue Caroline, PhD1, Letellier Monique, MD, MEd2, Petit Geneviève, MD, Fellow, in, public, health3, Gauvin Lise, PhD4, Guimond Catherine, BacScInf5, Valiquette Louise, MD, MSc, fellow5, and Nicole Boulianne, Inf, MSc6. (1) Faculté des sciencces infirmières, Université de Montréal, Montreal, QC, Canada, (2) Vaccination, Direction de la santé publique, Montréal, QC, Canada, (3) Santé publique, Université de Sherbrooke, Montréal, QC, Canada, (4) Département de médecine sociale et préventive, Université de Montréal, Montreal, QC, Canada, (5) Vigie et protection, Santé publique, Montreal, QC, Canada, (6) Santé publique de Québec, Québec, QC, Canada
Learning Objective #1: Describe the impact of an intervention aimed at the adoption of pro-active immunization practices among nurses working in community health centers
Learning Objective #2: Discuss the role of reflexive thinking in fostering the adoption of pro-active immunization practices among nurses

Introduction : Although nurses perform about 50% of immunizations among children aged 0 to 5 years old in Quebec, a recent study (Petit et al., 2006) showed that adoption of proactive immunization practices is suboptimal. The poor uptake of immunization practices among nurses is likely associated with less favourable beliefs about the value of vaccination among nurses in comparison to physicians (Dionne et al, 1999, 2001). An educational intervention was thus developed to improve immunization practices among nurses which involved creating a place for critical reflection on professional practice and a commitment to motivational interviewing.

Goal : This study examined the impact of the intervention on immunization practices among nurses who immunized children aged 0 to 5 years old in community health centers.

Methods : We conducted a cluster-randomized trial wherein community health centers were randomized to experimental and control conditions. Only nurses working in experimental centers participated in the intervention. Prior to and 3 months following the intervention time frame, all nurses completed a validate questionnaire (Petit et al., 2006) dealing with the frequency of use of immunization practices, a retrospective diary of four consecutive vaccination episodes (Larue et al., 2006), and their responses to a simulated clinical vaccination situation.

Results : Overall 82 nurses working in 15 experimental health centers and 61 nurses working in 18 control health centers participated in the study. Preliminary analyses showed that immunization practices pertaining to informing parents about the benefits of immunization, correcting false information and myths, and unequivocally recommending immunization were adopted more frequently following the intervention by nurses randomized to the experimental condition.


Conclusion : An intervention creating a place for reflection on professional practices for immunization is a good catalyst for reducing discrepancies between current and ideal vaccination practices among nurses.