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Abstract
The influenza virus is one of the deadliest respiratory diseases that has killed several in the United States and other parts of the world. Between 2018 and 2019, the Center for Disease Control and Prevention reported that influenza killed over 35,000 people in the US alone. The disease affects the elderly, especially those aged 65 years and above. The main issue, however, is that most cases remain unreported. Worse still, most people tend to keep it to themselves. While influenza virus can be immunized, most people do not seek to be vaccinated for fear of some of the rumors that have originated from some medical practitioners. According to the CDC data, only about 49% of adults and 59% of children go for influenza virus immunization. The current projects seek to build awareness of vaccination to increase the rate by 10% within three months through virtual education. The success of this project implies that the government and the medical leadership can find other strategies to educate the people about the virus and the burden of the disease to the US economy. This may change the perception of people and turn them towards seeking it to be immunized.
Introduction
The influenza virus is one of the most common infections that affects a great majority of people in different parts of the world. It is characterized by swollen lymph nodes, breathing difficulty, chest pains, fever, fatigue, nausea, among other symptoms (Nyamusore et al., 2018). According to Hartman et al. (2018), underdiagnoses of influenza are a common occurrence in different hospitals across the globe. The Center for Disease Control and Prevention, CDC (2019), estimated that there were more than 35.5 million cases of influenza infections in the United States between 2018 and 2019. Out of that number of cases, there were 16.5 million hospital visits where 49,600 were hospitalized (Campos-Outcalt, 2018), and 34, 200 people died from the disease. CDC further revealed that 136 children died between 2018 and 2019 as a result of the infection.
The organization further revealed that many deaths that result from influenza attack do not become part of the statistics, partly because not all children’s deaths resulting from the virus attack were tested in the laboratories. CDC’s estimation of rates of hospitalization and deaths associated with the influenza virus season over the past few five years suggests how severe the infection is and how worse it can get (CDC, 2019). Data from the organization reveal that there were over 46,000 cases of hospitalizations among children. There were 8100 deaths among young adults aged between 18 and 64 years. However, the data revealed that 57% of the reported influenza cases occurred among older adults over 65 years old. Furthermore, the CDC showed that older adults’ death resulted in 75% of all cases. Thus, the data is significant in that it demonstrates that older people are more prone to the virus and can easily succumb when infected.
The main issue that increases influenza-related deaths results from the laxity of individuals to get vaccinated against the virus. According to the CDC (2016), only 59.3% are vaccinated among children, and 43.6% among adults. However, the number should exceed that due to the severe threats that disease poses to the country. The primary cause for insufficient vaccination is that the lack of information and attitudes towards influenza virus infection (Boey et al., 2018). The issue of not taking vaccination affects both ordinary people and medical practitioners. According to Pless et al. (2017), the main reasons why nursing object against influenza vaccination include the idea that influenza virus weakens the body and makes it unhealthy, the need to maintain their decisional autonomy and distrust on the surrounding environment. Unfortunately, most of these ideas are within the public, who question the need for the vaccine if those who should administer have doubts about it use.
The current project seeks to improve influenza vaccination among patients aged between 18 and 75 years old. The project expects to achieve this goal by providing virtual education awareness among outpatients and increase the rate of vaccination by 10% in three months. Since the issue affects clinician as well, the best platform to approach these issues is to incorporate nurses who recognize the need for vaccination. The current wave of coronavirus 2 (SARS-CoV-2) can provide an excellent way to reach the people on the need for taking in flu vaccines (Lee et al., 2020). The world is open to knowledge through mobile phone devices and the internet; thus, using a virtual platform to provide the needed education is essential to approach taken in this project. The outcome of this project should make nurse leaders act to improve public knowledge and attitudes towards influenza vaccination within the US.
Educating the public on the importance of influenza vaccination has worked in other parts of the world. A structured influenza vaccination campaign resulted in improved the number of vaccinations among Registered Nurses (RN) in the first quarter of the year of the campaign (Spoltore, 2016). The study found out that 91% of people vaccinated had received education against 76.1% who were uneducated on the vaccination of the flu. Also, the survey revealed that the non-educated individuals who took the vaccine accounted for 23.9% while the educated one who did not take the vaccine was 8.9% of the group. The outcome revealed a correlation between education and taking the vaccine with statistical values as x2=7.210, p=0.007 (Spoltore, 2016). Therefore, education plays a critical role in the influencing the public knowledge and attitudes concerning influenza vaccination.
Former studies conducted by other researchers revealed that motivating education improved the rate of vaccination. Burke et al. (2019) showed an evidence-based education intervention and showed that it is crucial to overcome various critical barriers that may affect the success of an education program. The authors indicated that it was essential to establish the reasons why caregivers are against influenza vaccination. The study demonstrated that most parents do not get sufficient knowledge about influenza vaccine because they have to move from one doctor to the other when seeking treatments for their children. However, they can be instrumental in passing knowledge to their families (Scott et al., 2019). Thus, educating nurses and caregivers at the start of their practice is essential to giving knowledge to the public (Burke et al., 2019). Still, it is critical to have a united voice among healthcare experts to provide a unanimous call for vaccination of influenza flu as doing this can save the lives of several people.
Non-compliance among healthcare practitioners is one of the leading causes of harm to the public. Most people are afraid to take the vaccine for fear of the consequences related to the unethical conduct of some doctors, which the public allude to the influenza vaccines (Ezeokoye, 2018). Taking guidelines from CDC can help prevent cases associated with the wrong administration of the drugs by either untrained medical personal of using generic drugs. Following the standard procedures set forth by the organization can result in better health outcomes. In particular, education on adherence to vaccination guidelines is essential. According to Krawczyk et al. (2015) and Lai et al. (2017), educating IHN RNs, Chinese sample, and Quebec daughters improved their adherence to vaccination by 48%.
Purpose Statement
The purpose of the current project is to improve influenza vaccination in patients aged 18 to 75 years old using virtual education awareness in an outpatient clinic by 10 percent within a period of 3 months. To evaluate the success of this I project I will ask the following question:
Will the exposure to influenza vaccination program increase the number of those vaccinated against the flue?
To help answer the research question, I will test the following hypotheses:
- H1: There is no statistical difference between the rate of vaccination among people who have been educated on the vaccine and those who have been educated.
- H0: There is a significant statistical difference between those who are educated and those who do not receive education on the influence vaccination.
Data
Population
This project will draw its participants from a population of adults aged from 18 to 75 years old who met the criteria of receiving the influenza vaccine and attend the Victorian Care Group (VGC) outpatient medical clinic for medical care. There 200 adults who are registered to received upkeep from the facility. Of the 200 adults, 100 (50%) have been screened for the virus in the current flu season.
Sample
This project used a sample of 30 participants selected from the 100 who were screened for influenza vaccine. Of the 100 participants, 20 were excluded from the study following the exclusion criteria used as defined by the CDC screening guidelines. According to the policy, asks the health status of the person, possible allergic reactions to the components of the vaccine. The screening tool also asks whether the person has had a severe reaction to the vaccine before or Guillain-Barré syndrome (Grohskopf, 2020). Participants who indicated they had had the issues in the checklist were excluded from the study. The 80 people who passed the inclusion criteria were asked whether they would like to participate in the study. Thirty-five of them (43.75%) agreed to be part of the survey. However, based on the pre-planned need to use 30 participants, a subsample corresponding to 37.5% was selected to take the survey.
The sample selected varied in terms of age, gender, education level, and, ethnicity. The project ran the descriptive statistics on all the demographic variables. Half the sample (50%) was assigned to the treatment group to be educated on the influenza vaccine. The other half (50%) was assigned to the control group, whereby the members in this section would not receive the treatment. Each of the participants was given a consent form to ensure they were duly informed regarding the research. The demographics included males 11 (36.87%) and females 19 (63.3%) of all ethnicities, from age 18 to 75. The average age was 32 (12). More than two thirds, 24 (80%) were African Americans. The table 1 below describes the characteristics of the sample.
Table 1. The demographics of the sample used.
Data collection
First, the rate of vaccinations was determined over the past decade to create a model that could help in understanding how the people know about influenza virus vaccine and their attitudes towards the immunization. The phone numbers of the participants were taken; they were informed that it would be used to contact them. The phone numbers were used to add the participants to virtual space (WhatsApp group). In the group, the selected 15 members of the treatment group received media information about different aspects of influenza and the vaccination needs. The members of the group were required to acknowledge that they read the information sent to them, and if they had questions, they were free to ask. This process happened for four weeks before influenza season.
Variable
This project used independent and dependent variables to measure the impact of education the rate of vaccination. Thus the independent variables included age, gender, race, and educational level. These elements measured how each factor individually led to the knowledge and attitudes towards influenza virus vaccination. The dependent variable measured the role of education on the rate of immunization. This helped to answer how education had an impact on the rate of vaccination.
Research Design
This research uses a convince control group pretest-posttest design. In this design, the participants are assigned to treatment and control groups. The two groups have the same conditions except that the treatment group are educated on the vaccine. After the initial measurements have been taken, the participants are post-tested on the dependent variable. The difference in the compared post-test measurement is used to determine if there is a statistically significant difference between the two groups based on the pretest outcomes held as a covariate analysis output.
Results
Analysis
The data will be analyzed using SPSS to produce descriptive statistics. Table 2 below indicates the number of the treatment group and the control group who attended the clinic for vaccination. The original number of participants in each group was 15. The analysis of the data produces different statistical quantities. These comprise mean, median, the standard deviation of the data, and variance as shown in table 2 below.
Table 2. The data for those who attended the clinic after the experiment.
Table 3. Descriptive statistics output.
The statistical procedure to tests the null hypothesis is a Paired Samples t-test procedure. In this case, the pretest will be compared to the posttest to determine if statistically significant gains have been made in Knowledge/Awareness. These t-tests will be executed for each group – the Treatment and the Comparison group. The pretest scores will serve as the covariate. The dependent variable (Posttest) will be compared to determine if differences between the two groups exist in Knowledge/Awareness for vaccination. The probability level for rejecting the null hypothesis is p<.05.
Table 4. T-test analysis for two sample for means.
The Paired Comparison t-test demonstrated that the treatment group had a statistically significant gain from pre to post-testing. The pretest mean was 14.30 (SD=7.11) which rose to 20.22 (SD=7.11) and was significant at the p <.05 level (t=12.88, df = 1, 14, p=.04). On the other hand, the Comparison group began with a pretest score of 14.27 (SD=7.12) and was not significantly different at post-testing with a mean of 14.27 and Standard Deviation of 7.12 (t=1.88, df =1, 14, p=22). This mean increase in the post-testing treatment group of 5.92 supports the project of utilizing influenza vaccine education awareness/knowledge based on the Center for Disease Control Vaccine Information Statement to improve knowledge about the influenza vaccine. It can also help to increase vaccine uptake by 5.92 points in adult patients 18 to 75 years in an outpatient clinic within 30 days. There will be remarkable clinical significance with an increase in knowledge and subsequent vaccine uptake of 5.92. The benefits of getting vaccinated can never be overemphasized. By this study, we may notice many clinical and cost benefits.
If the CDC influenza vaccination educational program can increase influenza vaccination uptake, we may see a corresponding decrease in influenza infections (Babcock, Jernigan, & Relman, 2014). We may see a reduction in hospitalizations, medical visits, and substantial averted illnesses. We may also witness considerable cost savings from morbidity and mortality across all age groups. We may also notice a reduction from work hours missed and loss of productivity (Petrie et al., 2015).
Discussion
Conclusion
The current project indicates that education plays a crucial role in increasing the rate of influenza vaccinations. By educating people about the disease and the importance of taking the vaccine before the flu season, they get ready by getting to the hospital to be vaccinated. Most people do not want to be vaccinated due to the fear of propaganda, some of which comes from medical professionals. However, it takes the same medical practitioners to change the perception of the people and to unite their voices to create a positive influence among the people.
Limitations
The current study is not without a flaw. Firstly, the sample used is relatively small to make the study to be adopted and used to formulate a statewide policy. As the sample increases, the more accurate the findings become. Secondly, there was bias in the selection of participants. Other methods could have resulted in a more random sample. There are a few limitations to this study.
Significance and implications
The current project has established that people shy away from taking the influenza vaccine due to the fear instilled in them. As such, most people suffer from that fear, yet, if they are aware of the truth, they can act otherwise. A significant finding from other studies showed that healthcare workers also contribute to the build-up in fear among different people. Thus, people question where they should take the vaccine when those they trust with their lives fear to take the same injections they are ready to give others (Jamison et al., 2019). Consequently, this research provides an understanding in which the doctors and other clinicians should be put under oath to protect the lives of the public, or where possible should have their licenses revoked when they are found guilty of spreading false information to the public. While this is a matter of debate, the deaths that result from the diseases cannot be excused when the source of wrong information can be closed.
Most of the issue that happens to be people as a result of taking the vaccine have resulted from failure to follow the guidelines provided by the CDC. For instance, people who suffer from Guillain Barre Syndrome should not be allowed to take the vaccine as it can react with the body, causing harm rather than help. Thus, this project underscores the need to follow the stipulated guidelines to help restore the public confidence in medical practices.
References
Hartman, L., Zhu, Y., Edwards, K. M., Griffin, M. R., & Talbot, H. K. (2018). Underdiagnosis of influenza virus infection in hospitalized older adults. Journal of the American Geriatrics Society, 66(3), 467-472. Web.
Boey, L., Bral, C., Roelants, M., De Schryver, A., Godderis, L., Hoppenbrouwers, K., & Vandermeulen, C. (2018). Attitudes, believes, determinants and organisational barriers behind the low seasonal influenza vaccination uptake in healthcare workers–a cross-sectional survey. Vaccine, 36(23), 3351-3358. Web.
Pless, A., McLennan, S. R., Nicca, D., Shaw, D. M., & Elger, B. S. (2017). Reasons why nurses decline influenza vaccination: a qualitative study. BMC nursing, 16(1), 20. Web.
Burke, K., Schwartz, S., & Breda, K. (2019). Don’t hesitate, vaccinate! An influenza vaccine education program.Nursing Forum, 54(4), 553-556. Web.
Ezeokoye, C. (2018). Improving Influenza Vaccination Uptake in the United States Based on Influenza Vaccine Knowledge and Awareness from the Centers for Disease Control and Prevention (Doctoral dissertation, Brandman University).
Scott, V. P., Opel, D. J., Reifler, J., Rikin, S., Pethe, K., Barrett, A., & Stockwell, M. S. (2019). Office-based educational handout for influenza vaccination: a randomized controlled trial. Pediatrics, 144(2). Web.
Krawczyk, A., Knäuper, B., Gilca, V., Dubé, E., Perez, S., Joyal-Desmarais, K., & Rosberger, Z. (2015). Parents’ decision-making about the human papillomavirus vaccine for their daughters: I. Quantitative results. Human Vaccines & Immunotherapeutics, 11(2), 322-329. Web.
Lai, A., Fong, D., Lam, J., & Ip, M. (2017). Long-term efficacy of an education programme in improving adherence with continuous positive airway pressure treatment for obstructive sleep apnoea.Hong Kong Med J, 23(3 Supplement 2). Vaccine Information Statement. Web.
Grohskopf, L. A., Jatlaoui, T. C., & Fiebelkorn, A. P. (2020). 2020-2021 influenza vaccination recommendations and clinical guidance during the COVID-19 pandemic.
Spoletore,T. L. (2016). An Evidence-Based Strategy to Improve Influenza Vaccination Rates among Registered Nurses in Hospitals.
Liang, G., Fu, W., & Wang, K. (2019). Analysis of t-test misuses and SPSS operations in medical research papers.Burn Trauma, 7(31). Web.
Nyamusore, J., Rukelibuga, J., Mutagoma, M., Muhire, A., Kabanda, A., Williams, T., Mutoni, A., Kamwesiga, J., Nyatanyi, T., Omolo, J. and Kabeja, A. (2018). The national burden of influenza‐associated severe acute respiratory illness hospitalization in Rwanda, 2012‐2014. Influenza And Other Respiratory Viruses, 12(1), 38-45. Web.
Campos-Outcalt, D. (2018). CDC recommendations for the 2018-2019 influenza season: Vaccines will contain a new A (H3N2) component and B antigen. The live attenuated influenza vaccine returns as an option for those 2–to 49-years of age. Journal of Family Practice, 67(9), 550-554.
Lee, J. S., Park, S., Jeong, H. W., Ahn, J. Y., Choi, S. J., Lee, H.,… & Jeong, S. J. (2020). Immunophenotyping of COVID-19 and influenza highlights the role of type I interferons in development of severe COVID-19. Science Immunology, 5(49). Web.
Jamison, A. M., Quinn, S. C., & Freimuth, V. S. (2019). “You don’t trust a government vaccine”: Narratives of institutional trust and influenza vaccination among African American and white adults. Social Science & Medicine, 221, 87-94. Web.
Tables
Table 1. The demographics of the sample used.
Table 2. The data for those who attended the clinic after the experiment.
Table 3. Descriptive statistics output.
Table 4. T-test analysis for two sample for means.
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