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NUR 504 : Summary Of The Research Articles
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NUR 504 : Summary Of The Research Articles
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Course Code: NUR504
University: Grand Canyon University
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Country: United States
Question:
Article #2 : Interventions to increase influenza vaccination rates of theose 60 years and older Living in the community
Answer:
Problem Statement
Since the year 1964, the advisory committee on the Immunisation practices of the United States Public Health Service has recommended influenza vaccination of the high risk individuals, comprising of the older people. There are very poor evidences to support the influenza vaccination and still it is promoted by most of the health authorities (Dixon et al., 2017). The effectiveness of the interventions for increasing the rates of influenza vaccination in 60 years or older is still undetermined.
Statement of Purpose
Influenza vaccine is effective in decreasing the influenza-like illnesses, physician visits and working days lost (Petrie et al., 2015). In many nations, only the high-risk groups are subsidised a free vaccination service. The non-high-risk groups generally include the individuals of below the age of 65 years without any chronic disease, and those who are not working in healthcare sector. In countries like Europe and Australia, the influenza coverage rates for the non-high-risk adults ranges from 5.8 to 45.1 percent.
Research Question(s)
What is the efforts of the interventions for increasing the rates of influenza vaccination among the human beings aged 60 years or older than that?
Method
A total of 44 RCTs (Randomised controlled trials) were included in the study and all of them studied the seniors in the community and within the high-income nations. There were no RCTs belonging from the society-level interventions. With the same, the authors of this article searched the CENTRAL (Cochrane Central Register of Controlled Trials), comprising the Cochrane Acute Respiratory Infections Group’s Specialized Register, MEDLINE, EMBASE, AgeLine, ERIC and CINAHL.
Key Findings
The heterogeneity was marked up and meta-analysis was very limited. There were only five RCTs who were graded low and six of them were at the risk of the bias. They comprised of three of the thirteen personalised postcard interventions, and two among the four home visit interventions, three of the four reminder to the physicians interventions as well as three of the four facilitator interventions. However, it is also to mention that the other remaining 33 RCTs were all at higher risks of the biases and there were no recommendations for the practice that could be drawn. The interventions that were reviewed were categorised as those to increase the demand of the community, increase the access such as home visits, group visits and the provision of the free vaccination and the system or provide based interventions. The fourth category of the interventions are at society level. However, there are no randomised controlled trials that were found, this category would comprise of the mandated programs as well as government policies like paying healthcare workers for achieving the specific vaccination targets. All the RCTs were of the older people in the high income nations and other specific communities. The articles did not find any includable RCTs of the interventions for increasing the rates in the institutions. Elven out of forty four RCTs were at moderate or low risk of the biases. It is also to mention that there is a summary of the effects of the interventions for increasing the rates of influenza vaccinations in the article. They comprise of three of the thirteen personalised phone call or post card interventions, two out of four home visit interventions, three out of four facilitator interventions and three out of four reminders to the physicians interventions. The remaining thirty three RCTs were at the high risk of the biases as well as the limited outcomes of the RCTS at the moderate and the low risk of bias should also be viewed in this context.
Reference:
Dixon, B. E., Kasting, M. L., Wilson, S., Kulkarni, A., Zimet, G. D., & Downs, S. M. (2017). Health care providers’ perceptions of use and influence of clinical decision support reminders: qualitative study following a randomized trial to improve HPV vaccination rates. BMC medical informatics and decision making, 17(1), 119.
Petrie, J. G., Cheng, C., Malosh, R. E., VanWormer, J. J., Flannery, B., Zimmerman, R. K., … & Benoit, J. (2015). Illness severity and work productivity loss among working adults with medically attended acute respiratory illnesses: US influenza vaccine effectiveness network 2012–2013. Clinical Infectious Diseases, 62(4), 448-455.
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