Other Titles
Promoting health through immunizations
Abstract
Background: A top priority of the US Veterans Health Administration (VHA) Public Health Office, Goals for 2014-15 VHA Influenza Vaccination Program was to; "promote seasonal influenza vaccination to all Veteran patients" per Center of Disease Control (CDC) recommendation that, "all persons aged 6 months and older are recommended for annual vaccination". Latest VHA Influenza Surveillance Data Report (2014) cites heightened influenza cases in both inpatient and outpatient settings, with "nearly one-third" of veterans being tested for influenza were found to be positive. Thus, to enhance influenza vaccination amongst Spinal Cord Injury Veterans considered as vulnerable population due to the chronicity and co-morbidity of their health trauma, an inter-professional team was assembled and application for a clinical grant was submitted to the VHA Office of Public Health (OPH) and Office of Health Equity (OHE) Program (2015), entitled: "Promotion of Influenza Vaccination amongst Veterans in the Spinal Cord Injury (SCI) Out-Patient Clinic"; which was selected and subsequently awarded ($1.5 K).
Design: Exploratory, prospective and purposive convenience sampling of patients presenting to the SCI Clinic for annual screening in a large VA hospital in the US southwest region. Upon official allocation of the grant to the facility, influenza vaccination commenced in September 2015 to January 2016. With the grant's tri-fold objectives, namely; 1) actual administration of influenza vaccination to SCI outpatients during annual screening; 2) Pre-and post-vaccination counseling through collaboration and partnership with inter-and intra-professional staff the local facility and the federal Office of Public Health (OPH) and Office of Health Equity (OHE); and 3) Provision of incentives, in the form of personal item (bag of socks) and gift certificates.
Methods: During FY 2015-2016 (September-January), there were 240 patients who presented to the SCI Clinic. There were two nurses assigned to the SCI Clinic, one Registered Nurse and one Licensed Vocational Nurse. There were three ways any patient might have presented to the Clinic; 1) annual screening, 2) medical/health appointments (i.e., skin condition), and 3) "walk-in" patients who would ask the Clinic clerk for influenza immunization. Either nursing staff would then offer and/or administer the influenza vaccination for the patient who would accept it. For those who accepted the influenza vaccination, the staff provided gift vouchers and bag of socks. Likewise, the staff offered both incentives to those who declined.
Results: There were 240 patients who presented to the SCI Clinic from September 2015 to January 2016. The percentage of patients who accepted and received the influenza vaccine was 68%; those who declined the influenza vaccination was 15%; and 17% was recorded as "unknown". Ages of veterans ranged from 18-90. The majority of patients who received influenza vaccinations were 61-70 years old (42%). Other age ranges were as follows: a) 51-60 (21%); b) 71-80 (15%); c) 41-50 (13%); d) 31-40 (6%); e) 81-90 (2%) and 18-30 (1%). For gender, overwhelming majority was male (96%); female (4%). Results for the level of spinal cord injury were as follows: a) paraplegia (38%); b) tetraplegia (24%); and c) unknown (not recorded) 38%.There were 11 verbatim declinations recorded by the clinic staff. Reasons verbalized, included; 1) "made me sick" (n-7); 2) "never takes shot" (n-2); 3) "does not get sick" (n-1); 4) "don't want it" (n-1). However, there were other health factors documented that influenced non-acceptance of influenza vaccination for 53 patients; which were: 1)Refusal (outright) (N- 18); 2) Fear (of vaccination) (N-5), with two subcategories namely, side-effects (n-3) and needles (n-2); 3) Contraindications (influenza vaccination) (N-3); 4) Health reasons /Allergy) (N-1); 5) Delay (N-1); 6) Not effective (N-1); 7) "Never gets" vaccination (N-1); and 8) Non-VA vaccination (N-23).
Conclusion: SCI patients are considered amongst vulnerable populations due to the chronicity and co-morbidity of their health trauma sustained from combat. Thus, influenza vaccination rates of veterans are closely monitored in the federal performance measurement system. Incentives provided to encourage patient participation in influenza vaccination were received favorably by those who received the immunizations. One patient initially declined vaccination, but was persuaded with incentive offer. Majority of patients who declined were not influenced by the incentives and may be worthwhile to explore qualitatively the personal reasons for declination.
Sigma Membership
Beta Beta (Houston)
Type
Presentation
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Clinical Grant Award, Influenza Vaccination, Spinal Cord Injury Veterans
Recommended Citation
Cozart, Huberta-Corazon (Bette) Thiam, "Deployment of clinical grant to enhance influenza vaccination among spinal-cord injury outpatient veterans" (2017). INRC (Congress). 165.
https://www.sigmarepository.org/inrc/2017/presentations_2017/165
Conference Name
28th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Dublin, Ireland
Conference Year
2017
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Acquisition
Proxy-submission
Deployment of clinical grant to enhance influenza vaccination among spinal-cord injury outpatient veterans
Dublin, Ireland
Background: A top priority of the US Veterans Health Administration (VHA) Public Health Office, Goals for 2014-15 VHA Influenza Vaccination Program was to; "promote seasonal influenza vaccination to all Veteran patients" per Center of Disease Control (CDC) recommendation that, "all persons aged 6 months and older are recommended for annual vaccination". Latest VHA Influenza Surveillance Data Report (2014) cites heightened influenza cases in both inpatient and outpatient settings, with "nearly one-third" of veterans being tested for influenza were found to be positive. Thus, to enhance influenza vaccination amongst Spinal Cord Injury Veterans considered as vulnerable population due to the chronicity and co-morbidity of their health trauma, an inter-professional team was assembled and application for a clinical grant was submitted to the VHA Office of Public Health (OPH) and Office of Health Equity (OHE) Program (2015), entitled: "Promotion of Influenza Vaccination amongst Veterans in the Spinal Cord Injury (SCI) Out-Patient Clinic"; which was selected and subsequently awarded ($1.5 K).
Design: Exploratory, prospective and purposive convenience sampling of patients presenting to the SCI Clinic for annual screening in a large VA hospital in the US southwest region. Upon official allocation of the grant to the facility, influenza vaccination commenced in September 2015 to January 2016. With the grant's tri-fold objectives, namely; 1) actual administration of influenza vaccination to SCI outpatients during annual screening; 2) Pre-and post-vaccination counseling through collaboration and partnership with inter-and intra-professional staff the local facility and the federal Office of Public Health (OPH) and Office of Health Equity (OHE); and 3) Provision of incentives, in the form of personal item (bag of socks) and gift certificates.
Methods: During FY 2015-2016 (September-January), there were 240 patients who presented to the SCI Clinic. There were two nurses assigned to the SCI Clinic, one Registered Nurse and one Licensed Vocational Nurse. There were three ways any patient might have presented to the Clinic; 1) annual screening, 2) medical/health appointments (i.e., skin condition), and 3) "walk-in" patients who would ask the Clinic clerk for influenza immunization. Either nursing staff would then offer and/or administer the influenza vaccination for the patient who would accept it. For those who accepted the influenza vaccination, the staff provided gift vouchers and bag of socks. Likewise, the staff offered both incentives to those who declined.
Results: There were 240 patients who presented to the SCI Clinic from September 2015 to January 2016. The percentage of patients who accepted and received the influenza vaccine was 68%; those who declined the influenza vaccination was 15%; and 17% was recorded as "unknown". Ages of veterans ranged from 18-90. The majority of patients who received influenza vaccinations were 61-70 years old (42%). Other age ranges were as follows: a) 51-60 (21%); b) 71-80 (15%); c) 41-50 (13%); d) 31-40 (6%); e) 81-90 (2%) and 18-30 (1%). For gender, overwhelming majority was male (96%); female (4%). Results for the level of spinal cord injury were as follows: a) paraplegia (38%); b) tetraplegia (24%); and c) unknown (not recorded) 38%.There were 11 verbatim declinations recorded by the clinic staff. Reasons verbalized, included; 1) "made me sick" (n-7); 2) "never takes shot" (n-2); 3) "does not get sick" (n-1); 4) "don't want it" (n-1). However, there were other health factors documented that influenced non-acceptance of influenza vaccination for 53 patients; which were: 1)Refusal (outright) (N- 18); 2) Fear (of vaccination) (N-5), with two subcategories namely, side-effects (n-3) and needles (n-2); 3) Contraindications (influenza vaccination) (N-3); 4) Health reasons /Allergy) (N-1); 5) Delay (N-1); 6) Not effective (N-1); 7) "Never gets" vaccination (N-1); and 8) Non-VA vaccination (N-23).
Conclusion: SCI patients are considered amongst vulnerable populations due to the chronicity and co-morbidity of their health trauma sustained from combat. Thus, influenza vaccination rates of veterans are closely monitored in the federal performance measurement system. Incentives provided to encourage patient participation in influenza vaccination were received favorably by those who received the immunizations. One patient initially declined vaccination, but was persuaded with incentive offer. Majority of patients who declined were not influenced by the incentives and may be worthwhile to explore qualitatively the personal reasons for declination.
Description
Support provided by: Public Health Clinical Grant Award from the Veterans Health Administration OPH and OHE.