Immunizations challenge healthcare personnel and affects immunization rates

Strohfus, Pamela K.; Kim, Susan C.; Palma, Sara De; Duke, Russell A.; Remington, Richard; Roberts, Caleb

doi:10.1016/j.apnr.2016.11.005

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…The monitoring system in each Area Health is randomly carried out by the Division of Vaccine Preventable Disease, Department of Disease Control, on an annual basis. The participants thus acquired knowledge and experience from others and eventually developed a perception of their own competency[17, 18]. This corroborates a theory of Bandura[19], which offers a clear explanation of participant results, namely, that they had already been trained in immunization.…”

Section: Discussionsupporting

confidence: 81%

A study of the self-perceived competencies regarding the knowledge and skills of healthcare providers in the Expanded Program on Immunization in Thailand

Rutchanagul

Sangnimitchaikul

2019

JHR

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Purpose The Expanded Program on Immunization (EPI) has still been found to offer services that do not comply with standards. The purpose of this paper is to ascertain competency in terms of the knowledge and skills of the EPI staff. Design/methodology/approach The research design was a mixed-methods approach. The quantitative method employed a questionnaire survey on the perceived competency of 382 EPI staffs from six regions in Thailand. This was paired alongside of the qualitative method, where four staffs were in-depth interviewed, and the performance of the EPI staffs was observed. Findings The overall perceived competency in the work of immunization was at a high level. A comparative analysis between the quantitative and qualitative data showed findings in three categories. First, the perception of competency was high, and performance conformed to standards in the preparation of the setting and equipment for providing the service; second, the perception of competency was high, but in the performance of their work the participants did not comply completely with standards for scheduling the immunization appointments or for vaccine storage; and third, the perception of competency was either moderate or low, and the performance of work was inadequate for vaccine estimations, registering reports, and dealing with adverse events following immunization. Originality/value The findings showed a gap between perception of knowledge-and-skill competency and actual practice in EPI service. Effective cooperation among involved organizations in order to improve the standard of performance in expanding the quality of EPI service provision in Thailand is suggested.

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Section: Discussionsupporting

confidence: 81%

A study of the self-perceived competencies regarding the knowledge and skills of healthcare providers in the Expanded Program on Immunization in Thailand

Rutchanagul

Sangnimitchaikul

2019

JHR

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“…The level of education may be an important consideration in both inpatient and outpatient settings. [31] Even though respondents were 80% correct when giving the flu vaccine to a 450-pound patient into the deltoid with a 1.5-inch or greater needle, consider mass flu clinics using 1-inch needles as the default needle for influenza vaccine injections; these needles may not be adequate for IM injections in obese populations. For a male with BMI 25-30, a 1-inch needle may be sufficient for an IM injection at the deltoid but a female with BMI of 30 and above most likely will require a 1.5-inch long needle at the deltoid due to a thicker fat pad.…”

Section: Injection Depthmentioning

confidence: 99%

“…Other healthcare workers such as medical assistants (MAs) receive limited vocational or no formal training in IM injections; some are taught by providers who may or may not be updated in current evidence-based techniques. [31][32][33] Health care organizations may or may not provide continuing education for healthcare personnel after they have been hired, especially in injections. [30,34] These guidelines for large or obese patients currently recommend using 1-1.5-inch needles for patients 260+ pounds.…”

Section: Injection Depthmentioning

confidence: 99%

Evidence calls for practice change in intramuscular injection techniques

Strohfus

Paugh²,

Tindell³

et al. 2017

JNEP

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Background and Objective: Intramuscular (IM) injections are administered to patients in all health care settings. Even though this procedure is invasive and the evidence supporting the process of administration is extensive, techniques and procedures vary throughout the literature and in practice. The purpose of this descriptive correlational study was to 1) investigate the literature on current evidence-based IM injection procedures pertaining to gender, patient weight, injection site, needle length, and technique, 2) compare surveyed healthcare personnel self-reported IM injection practices, and 3) query respondents on informational resources they access, continuing education they receive, and their years of healthcare experience and higher education. Methods: The Intramuscular Injection Questionnaire (IIQ) was sent via email to various professional healthcare facilities and their respective social media sites. Two hundred and six (206) healthcare personnel of various healthcare backgrounds and educational levels accessed the IIQ via a link to Qualtrics software. SPSS Version 24 was used for data analysis. Results: Most respondents were registered nurses with 4 -15+ years of experience. Seventy-eight percent of respondents considered their IM injection knowledge at above average or expert levels. Gender was not considered an important factor when selecting an injection needle among 75% of participants. Of all respondents, 61% use z-track technique, 59% use the ventrogluteal site and 34% always bunch or stretch the skin during injection. IM injection education was not provided in 75% of healthcare facilities. Conclusions: IM injection practices vary among respondents and in the literature; some reported practices are contrary to current evidence-based practice. While the evidence provides some sound recommendations, some procedures are not well-documented or supported including in nursing texts. Nurses and other healthcare personnel must critically analyze the site, depth, needle, volume, medication, vaccine, and whether to bunch or stretch, according to evidence-based practice. Healthcare facilities should provide IM injection education routinely to ensure safe practices. Future studies (Level 1 and 2) are needed to further demonstrate the best evidence leading to safe and effective IM injections.

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“…In the case of an event, they must take immediate action for correcting improper storage and handling conditions. Strohfus et al proposed that after providing immunization education, with comparison pre-test and post-test results, the ability of medical staff to manage vaccine practice has increased by 7.8%, and the efficiency of immunization in the clinics has increased by 10.3% (Strohfus et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

New theoretical ISM-K2 Bayesian network model for evaluating vaccination effectiveness

Xie

Xiong

et al. 2022

J Ambient Intell Human Comput

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Aiming at the difficulty in obtaining a complete Bayesian network (BN) structure directly through search-scoring algorithms, authors attempted to incorporate expert judgment and historical data to construct an interpretive structural model with an ISM-K2 algorithm for evaluating vaccination effectiveness (VE). By analyzing the influenza vaccine data provided by Hunan Provincial Center for Disease Control and Prevention, risk factors influencing VE in each link in the process of “Transportation—Storage—Distribution—Inoculation” were systematically investigated. Subsequently, an evaluation index system of VE and an ISM-K2 BN model were developed. Findings include: (1) The comprehensive quality of the staff handling vaccines has a significant impact on VE; (2) Predictive inference and diagnostic reasoning through the ISM-K2 BN model are stable, effective, and highly interpretable, and consequently, the post-production supervision of vaccines is enhanced. The study provides a theoretical basis for evaluating VE and a scientific tool for tracking the responsibility of adverse events of ineffective vaccines, which has the value of promotion in improving VE and reducing the transmission rate of infectious diseases.

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Immunizations challenge healthcare personnel and affects immunization rates

Cited by 5 publications

References 23 publications

A study of the self-perceived competencies regarding the knowledge and skills of healthcare providers in the Expanded Program on Immunization in Thailand

A study of the self-perceived competencies regarding the knowledge and skills of healthcare providers in the Expanded Program on Immunization in Thailand

Evidence calls for practice change in intramuscular injection techniques

New theoretical ISM-K2 Bayesian network model for evaluating vaccination effectiveness

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