Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2020


Doctor of Nursing Practice (DNP)

Primary Advisor

Christine Pintz Ph.D., RN, FNP-BC, FAANP; Lynn Miller DNP NP FRE


Background: Provision of vaccinations is one of the most basic interventions aimed at health promotion and disease prevention in the primary care setting. Despite increased public awareness and improved access to vaccinations through minute-clinic settings, health fairs, and employer-offered vaccination clinics, adults in the United States continue to fall short of national goals. Literature demonstrates vaccination rates among adults vary widely and may be affected by a multitude of factors, however vaccination rates may be greatly improved with increased provider engagement.

Objectives: The purpose of this project was to develop, implement, and evaluate a program to improve immunization rates in an ambulatory family practice setting. The primary aim of this study was to implement and assess the efficacy of a multi-pronged provider and staff engagement intervention targeted at increasing influenza vaccination of adults ≥18 years of age in the outpatient setting. The primary outcome measured was practice vaccination rates for the influenza vaccine among adult patients seen between October 1, 2019-November 30, 2019.

Methods: This project followed a pre-post-test design, tracking practice influenza vaccination rates among adult patients, following a comprehensive practice intervention to improve provider engagement, tracking of influenza vaccinations, and patient understanding of vaccinations through increased patient education efforts.

Results: During the two-month intervention period, 171 adult patients were evaluated. Data analysis revealed a 12.3% increase in vaccination rates (from 15.2% to 27.5%). A statistically significant improvement in vaccination rates among adult patients was noted following the intervention (t (170) = 3.470, p = 0.001). Pre- and post-test surveys were completed by staff members and analyzed before and after staff training. Analysis of staff surveys revealed no statistically significant changes among any of the survey items. Additionally, a total of 25 patient surveys were completed to assess reasons for vaccine refusal, revealing the primary reason for vaccine refusal was dislike of needles.

Conclusions: Current data demonstrates an overall increase of 12.3% in vaccination rates among patients seen during the intervention period. Additionally, improved vaccination rates were noted in each of the specific demographic categories.

Open Access


Included in

Nursing Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.