Improve Competency With Evidence-Based Immunization Practice Education

Thursday, 27 July 2017: 3:50 PM

Pamela K. Strohfus, DNP, MA
School of Nursing, Boise State University, Boise, ID, USA

Aim: To improve competency of health care personnel and increase vaccine effectiveness and medical office immunization rates, an evidence-based immunization educational program was implemented and analyzed. The goals of the program were to develop fiscal responsibility of resources, improve internal processes, enhance learning and education, and increase patient safety through effective vaccination.


Vaccines may be compromised partly due to educational deficits of inter professional healthcare personnel in vaccine administration and storage (Nikula, Nohynek, Puukka, & Leino-Kilpi, 2011; Yeung, Goodman, & Fedorak, 2012). These knowledge deficits could further compromise vaccine efficacy decreasing immunization rates among populations (McCollister & Valbona, 2011). Disease outbreaks could occur when herd immunity is not achieved (Centers for Disease Control and Prevention (CDC) 2016).

Evidence based resources are available to ensure quality immunization practices through the use of standing orders, documentation into immunization registries, utilization of data and thermoregulation guidelines (Darden, et al., 2011; LeClaire-Smith, 2016). Yet several studies reveal errors in administration and storage of vaccines which affect the vaccine efficacy (Lang, et al., 2014; Merhekar, et al., 2013).

Methods: Twenty-seven medical offices participated in an educational program in a rural/urban area in the United States. Knowledge-based testing of immunization practices was conducted pre-education, post-education, and 12-months post-education of medical assistants, licensed practical nurses, registered nurses, nurse practitioners, and physicians. Immunization rates were assessed before-education and 18-months post-education.

Results: There were several significant findings when education was provided including: 1. Immunization rates increased by 10.3%, 2. Knowledge overall increased by 7.8%, 3. Under-educated personnel did not pass the test before or after education, 4. Registered nurses and pediatric medical offices passed the test before and after education, 5. Use of standing orders increased by 84%, and 6. Knowledge did not improve overall in ‘storage’ category.

Conclusion: Managing immunization practices is very complex. Registered nurses are well suited to manage, administer, and handle vaccines. Unlicensed personnel are less able to appropriately manage, administer, and handle vaccines without formal and continuous education and administrative support. Storage and handling education must be reviewed intermittently to assure compliance. Education saves resources, decreases errors, & increases immunization rates.