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Evidence based practice is vital in finding nursing solutions. It is based on empirical studies and use of available published resources to give answers to existing clinical questions. In this project, the model used is the Stetler Model. Here, the evidence based practice in the field of nursing is based on five major steps which include; the preparation stage, validation stage, comparative evaluation or decision making stage, the translation or application stage and the evaluation stage (Keele, 2011).
The preparation stage entails identifying the problem and validating the same with the available evidence. In this case, the issue at hand is the morbidity and mortality due to influenza especially among the vulnerable group. Those under observation are the elderly people above 65 years. The project is aimed at finding out whether the influenza vaccine helps in the reduction of morbidity and mortality due to the influenza infections among the vulnerable groups particularly the elderly. Research has shown that the use of the influenza vaccine is quite significant in the reduction and elimination of flu infections and mortality among the vulnerable groups (Mazurek, 2010).
The second stage is the validation stage. The stage involves the critiquing and synthesis of the empirical and non-empirical evidence using the evidence table. The evidence of low quality is left out at this stage and incase there is no evidence, the whole process stalls at this stage. Evidence has shown that there is a close link between the issuance of the influenza vaccination and reduction in morbidity and mortality due to flu. The journal entitled ‘Clinical Infectious Diseases’ shows that vaccination against influenza plays a significant role in the reduction of influenza especially among the vulnerable groups. Those who were not vaccinated against flu were prone to numerous infections and reduced performance at the workplace during the influence seasons. Those who were vaccinated were however less prone to these conditions as they were more resistant to the infection. This project is aimed at proving this hypothesis hence advocate for increased vaccination among the vulnerable groups if the hypothesis is proved right (Young, 2003).
The third stage entails comparative evaluation and decision making. At this stage, the findings are synthesized cumulatively and decisions made concerning the evidence to be used and that which should not. In case the available evidence is invalid, one can decide to carry out individual research. In this case, the evidence found indicates that vaccinating people has much benefit as it helps in the prevention and control of morbidity and mortality due to influenza infection. The evidence shows that those who were vaccinated were much resistant to the infection as fewer cases of influenza related infections were reported in comparison to those who were not vaccinated. This shows the significance of vaccination in controlling influenza. Very few of the vaccinated needed to go for clinical check-ups or used influenza medication (Houser, 2010).
The fourth stage entails translation and application. Here, the decision is made concerning the level of application whether individual, group or if it is to be done at the organizational level. Here, the proposal is done and the implementation strategy is laid. A pilot project might be done at this stage. In this case, the evidence will be applied at group level where the participants are divided into two groups, those that are vaccinated and those that are not. They are then monitored to determine whether the vaccine is effective in the control of influenza. The final stage is the evaluation stage. The evaluation that is done at this stage is either the formative or summative. In the given case, the evaluation is aimed at proving that vaccination is critical in the control or prevention of influenza (Hammersley, 2007).
Implementation plan
This study takes place in a hospital setting. The subjects under study are the elderly patients above 65 years at mission hospital based in California. They are put into two groups, those who are vaccinated against influenza and those who are not. The two groups are then observed over some time to determine the difference between the vaccinated and non-vaccinated in relation to the influenza related illnesses. The project is supposed to take a span of two months. It is supposed to take place between the month of November and December 2012. This period is has been chosen as it is the time when flu is quite rampant among the population (Prohaska, 2012).
The first two weeks will involve getting the subjects’ names and grouping them accordingly. They are put into two groups. The third and fourth week will involve vaccination of the members of one group while the other is not vaccinated. The fifth and sixth week is for observation, recording as well at testing the participants for the influenza virus. It also entails comparing the findings with the hypothesis. The last two weeks will involve the evaluation of the findings, conclusion and the issuance of the appropriate recommendations (Louise, 2008).
For this project to be effected, there are a number of resources that are needed. For instance, two qualified nurses who would help in the training and administering of the appropriate vaccine in the right way and in the right dosage. There also needs to be the typically intramuscular influenza vaccine (flu shot), syringes, record books and pens. Two computers are needed for effective storage and analysis of the collected data. The patients under study are divided into two groups where one is vaccinated and the other left out. The two groups are then observed over time for flu related morbidity and mortality. The same is recorded and analyzed. In this case, the independent variable is the vaccination from flu while the dependent variable includes influenza related symptoms and mortality due to the infection. Influenza tests are also carried out and results recorded for evaluation and analysis. Tables and chats are drawn so as to compare the morbidity and mortality among the two groups (Overholt, 2011).
Before carrying out this research, there needs to be training on the symptoms of influenza, the type of vaccine to be used and the normal response to the vaccine. The training will help in ensuring that the right dosage for the vaccine is administered using the right methodology. In this case, data are collected in the form of writing notes and tallying particularly via observation and clinical influenza tests. The influenza related infections are observed and tests done for the subjects in the two groups. The number of deaths due to influenza is also recorded. The findings are put in tables and charts and graphs are plotted for ease in analysis and comparison (Dixon, 2001).
The facilitators are trained to ensure the vaccine is administered in the right way and findings are recorded. The adverse effects need to be noted so as to avoid confusing them with the influenza symptoms. The whole research is supposed to cost about $2500. Two computers are supposed to be purchased at a cost of $250 each. The flu shot vaccines with the syringes would cost $500. Traveling and accommodation would cost about $750for the two months period. The stationary and other minor expenses are estimated at $ 250 while the two hired professional nurses are supposed to be given an allowance of $250 each. Most of the cost is however supposed to be covered by the institute. The research is therefore cost effective. After implementation, the research findings would be analyzed and if the findings tally with the hypothesis, then the same would be presented to medical associations and the concerned government ministries and institutions so as to ensure that vaccination among the vulnerable groups is advocated for and carried out so as to control influenza. Incase the findings prove otherwise, then the same would be stopped and appropriate research done so as to find the most effective ways of controlling influenza (Williams, 2007).
Evaluation process
In this case, secondary analysis is used. Existing evidence and research findings are analyzed to prove the hypothesis that influenza vaccine is important in the control of influenza. This method is used because it is less expensive and the researcher gets a deeper insight into complex issues. Comparison, summarizing and comparison are made easier. Data are also obtained via clinical trial or experiment. One group is vaccinated and the other left out and they are observed over time. The observation and recording method has also been used. The two groups are observed over two months and the findings recorded for analysis. This is important because the researcher gets firsthand information that is not subjected to biases (Soule, 2012).
The findings are supposed to help in determining whether vaccination is significant in the control of influenza. The morbidity and mortality due to influenza are observed and recorded. If the morbidity and mortality rate is higher in the non vaccinated group, then the study will have achieved its objective by proving that vaccination is important in the control of influenza. Observations are also made on the adverse effect and whether they have any effect on the intake of the vaccine.
The findings from the two groups are tabulated in relation to the occurrence of influenza related infections in the two groups. The number of those who die due to influenza related infections is recorded and tabulated. The participants are also tested for influenza at intervals to determine whether they have caught the influenza virus or are free from it. This makes the analysis credible and reliable. The findings are also compared to other researches that have been done before hence improving its validity. The findings would be crucial while advising medical practitioners, the relevant government ministries and individuals on the importance of vaccination on control of seasonal influenza especially among the most vulnerable groups (Reed, 2011).
If the results are not positive, then the appropriate step would be to do qualitative analysis of the effectiveness of vaccination in the prevention of influenza. Existing literature on the effect of vaccine on the prevention of influenza should be reviewed. A different study will to be done on a different group and using other variables so as to get the desired results. The findings of this practice would be vital for future research as they would form a basis for further research. This would act as secondary data for those who carry our research relating to this topic.
References
Dixon, M. (2001). Practical Guide to Primary Care Groups and Trusts. New York: Radcliffe Publishing.
Hammersley, M. (2007). Educational research and evidence-based practice. New York: SAGE.
Houser, J. (2010). Evidence-Based Practice. New York: Jones & Bartlett Publishers.
Keele, R. (2011). Nursing Research and Evidence-based Practice: Ten Steps to Success. Delhi: Jones & Bartlett Publishers.
Louise, M. (2008). Introduction to Public Health. Seydney: Elsevier.
Mazurek, B. (2010). Evidence-Based Practice in Nursing & Healthcare. London: Lippincott Williams & Wilkins.
Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare. London: Lippincott Williams & Wilkins.
Prohaska, T. (2012). Public Health for an Aging Society. Maryland : JHU Press.
Reed, P. (2011). Nursing Knowledge and Theory Innovation. New York: Springer Publishing Company.
Soule, B. (2012). Best Practices in Infection Prevention and Control. London: Joint Commission Resources.
Williams, M. (2007). Comprehensive Hospital Medicine: An Evidence-Based And Systems Approach. Seydney: Elsevier.
Young, D. (2003). Fundamentals of Nursing Research,. London: Jones & Bartlett.
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