First Advisor

Ernst, Diane

Thesis Committee Member(s)

Cullen, Patricia L.


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

88 pages


Executive Summary An Evidence-Based Intervention to Improve Vaccination Rates for Seasonal Influenza Among Registered Nurses Problem Seasonal influenza continues to cause the hospitalizations and deaths of tens of thousands every year in the U.S. (National Foundation for Infectious Diseases, 2008). Vaccination of healthcare workers for influenza has been recommended for more than 30 years (Willis & Wortley, 2007) and reports of transmission of influenza by registered nurses (RNs) to patients are well documented. In spite of these facts, RN vaccination rates remain below the recommended target of 90% (U.S. Department of Health and Human Services, 2012). The evidence suggests that RNs who refuse influenza vaccination are less knowledgeable about influenza, the risks of the vaccine, side effects, and vaccine efficacy, than those who are vaccinated (Clark et al., 2009). Mandatory vaccination policies are becoming more common as efforts to improve rates voluntarily have failed. Purpose This project's purpose was to evaluate if an educational intervention on influenza and its risks, while dispelling common myths and misconceptions of influenza vaccines, would improve the rate of RN vaccination. The Health Belief Model's (Champion, 1984; Champion & Skinner, 2008; Glanz, Rimer, & Lewis, 2002) conceptual framework informed and guided the project. Goal The goal for this project was to improve RN vaccination rates for seasonal influenza, leading ultimately to decreased hospitalizations and mortality from influenza. Objective This project's primary objective was to develop and implement an evidence based educational intervention providing information to RNs on influenza's risks, vaccine efficacy and safety, while attempting to dispel myths and misconceptions commonly held by RNs who refuse seasonal influenza vaccination. Plan Over a two-week period in November 2013, presentations on influenza, its risks, and the safety and efficacy of vaccines, were provided at a large, urban medical center, reporting RN vaccination rates of 40%. A convenience sample of 57 RNs attended the presentations. Each participant's pre-intervention vaccination status was then compared to his or her vaccination status following the intervention. Non-parametric and correlational tests were utilized to determine if vaccination rates improved following the intervention and if any relationships that might affect vaccination status could be identified. Outcomes and Results Vaccination rates increased only slightly following intervention, and the change was not significant. There were some associations noted with age and race/ethnicity and vaccination status that were identified. Results suggest that education alone is not sufficient to effect a positive change in vaccination. Further study is recommended in order to determine what, if any, combination of interventions might improve RN voluntary acceptance of vaccination, as mandatory healthcare worker vaccination policies are increasingly implemented across the country.

Date of Award

Fall 2013

Location (Creation)

Denver, Colorado

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