Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2025
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Dr. Mercedes Echevarria
Keywords
Influenza Vaccines; Health Education; Electronic Health Record
Abstract
Background: Healthcare authorities recommend that children under eight receive two doses of the flu vaccine, four weeks apart, during their first vaccination series. Evidence indicates that parent education, nursing education, cognitive reminders, and Electronic Health Record (EHR) reminders provide low-cost ways to enhance vaccination. Despite this, many children remain under-vaccinated from the flu yearly, indicating a need for more effective strategies.
Objectives: This project aimed to increase influenza two-dose series completion among patients aged 6 months to 2 years at a pediatric clinic through parent education, nursing education, cognitive reminders, and EHR reminders. Evaluated outcomes included (1) influenza series completion, (2) nurse knowledge/confidence, (3) guardian intent to vaccinate and perceived importance, (4) effectiveness of cognitive, and (5) EHR reminders.
Methods: A pre-/post-intervention design assessed nurse influenza knowledge and confidence. Parent/guardian understanding was evaluated post-intervention. Two-dose vaccine reminders via MyChart and cognitive prompts were implemented. The Plan-Do-Study-Act (PDSA) cycle guided the project. Completion rates were compared to prior flu seasons, and an EHR review measured overall series completion.
Results: The project included 237 patients and 18 nurses. Flu series completion was 10.1% (n=24), reflecting a 2.5% absolute improvement in this patient population compared to the previous flu season. Nurse knowledge significantly improved post-training (p=0.005). Among parents, 57.1% considered flu vaccination important, and 58.9% intended to complete their child’s series. 100% of clinic rooms had cognitive reminders in place throughout the project. 100% of eligible patients received monthly EHR reminders.
Conclusions: Implementing EHR reminders, cognitive reminders, nursing education, and guardian education modestly improved flu series completion. These low-cost, patient-centered strategies can support healthcare systems in enhancing population health, patient experience, and cost-effectiveness.
Copyright Notice
©2025 Madeline Robinson. All rights reserved.
Recommended Citation
Robinson, M. (2025). Two Influenza Doses by Two: A Quality Improvement Project. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/167
Open Access
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