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Nurses Owning Their Practice One Shot At A Time
Handout (302.1 kB)
To demonstrate through a nurse-led immunization clinic utilizing standing orders that nurses have the skills and abilities to accurately identify and administer immunizations at the same rate as the provider.
Significance:
The Future of Nursing Report (IOM, 2011) highlights the need for efficient care delivery models which match the work with the individual's skill level and allows nurses to work to the fullest extent of their education and licensure. A nurse-led immunization clinic demonstrates this concept.
Strategy and Implementation:
The Immunization Action Coalition (IAC) developed standing orders for immunizations that are available on their website. We developed one policy covering all immunizations rather than a separate policy for each immunization. Teen clinic agreed to pilot this new process. In October 2011, patients needing immunizations only were scheduled with a nurse rather than a provider. Nurses had an electronic schedule with twelve available appointment slots throughout the day that could be used. An audit tool was developed to analyze what immunizations were given versus what the patient was eligible for. The patient's personal immunization record was compared to the most current immunization schedule published by the Center for Disease Control. Over a one year period nurses demonstrated an 86% accuracy rate at identifying all immunizations needed while providers had a 54% accuracy rate.
Evaluation:
Standing orders for immunizations in an effective way to utilize nurses education and licensure without compromising care. Nurses were able to identify gaps in immunization status at a higher rate than providers. This should be routine practice anywhere immunizations are given.
Implications for Practice:
Changes in health care provide an opportunity for nurses to play an integral part in maximizing their skills and abilities. This project demonstrates how nurses functioning at the fullest extent of their education and licensure can have a positive impact on outcomes.