Immunizations By: Lauren Kasperlik, Cory Tepatti, Megan
MacDermaid, Kaytlyn Jordan
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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.
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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.
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Introduction Based on evidence-based research, we promote
immunizations throughout lifespan development and create awareness
in nursing practice.
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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.
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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.
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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
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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.
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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
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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.
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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.
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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.
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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.
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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
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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
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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
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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.
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Impact on Safety and Quality
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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.
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Questions
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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.
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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
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http://www.cdc.gov/vaccines/programs/afix/index.html
http://www.cdc.gov/vaccines/programs/afix/index.html Ayesha Khan.
(June 13, 2013). Vaccines. Retrieved from http://bionews-
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McElligott, J. T., Roberts, J. R., OBrien, E. S., Freeland, K. D.,
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http://www.jstor.org/stable/41639283
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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
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
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Vaccine, 30,6 pg 1149-1153.
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http://dx.doi.org/10.1016/j.vaccine.2011.12.019
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Reference Page Continued Vaccines. (2013, November 18).
ProConorg Headlines. Retrieved April 21, 2014, from
http://vaccines.procon.org/ 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+http://www.cdc.gov/vaccinesafety/Vaccines/Common_questions.html6+