Increasing Immunization Rates in Adults Aged 65 and Older in Rural Primary Care

Abstract

Vaccine hesitancy is a prevalent barrier to vaccination and is responsible for suboptimal immunization rates. This quality improvement project sought to decrease vaccine hesitancy and increase immunization rates in adult patients 65 and older in a rural internal medicine clinic in Montana, specifically focusing on pneumococcal, influenza, and COVID-19 vaccines. This project follows the Institute for Healthcare Improvement Model for Improvement framework. A microsystem assessment revealed a gap in patient education regarding these vaccines. A literature review was conducted, and motivational interviewing was found to be an evidence-based tool healthcare staff can use to decrease vaccine hesitancy. An aim was created: Staff will utilize motivational interviewing techniques to decrease vaccine hesitancy and increase immunization rates of pneumococcal, influenza, and COVID-19 by 20%. Interventions were chosen to educate staff about the three specific vaccines and motivational interviewing techniques and to have staff utilize motivational interviewing techniques during each rooming process. The project implementation was broken down into seven steps and addressed the most significant potential barrier: staff resistance to change. This quality improvement project supports nursing education and practice change in primary care. This nursing practice change can increase immunization rates and reduce illness, hospitalizations, and death in older adult patients in rural primary care.