Date of Conferral



Doctor of Nursing Practice (DNP)


Health Services


Dr. Deborah Lewis


Yearly influenza (flu) immunization rates for hospital healthcare workers (HCW) continue to be lower than those suggested by the Centers for Disease Control and the World Health Organization. Vaccination is considered a valuable step in the process to protect patients against influenza infection. The goal of Healthy People 2020, and most hospital administrators, is that 90% of HCWs are being immunized. The objectives for this systematic literature review were to identify best practice recommendations for improving the vaccine rate among HCWs. The Cochrane methodology framed this systematic review, and Fineout-Overholt's and Melnyk's levels of evidence were used to evaluate the reliability of information and effectiveness of their interventions. Twenty articles that met the inclusion criteria (HCWs with direct patient contact, published between 2009-2016, and written in English) were reviewed. Eight articles met Melnyk's criteria for evidence Levels 5 to 7, 8 articles met the criteria for Levels 3 to 4, 2 articles were Level 2, and 2 articles were systematic reviews of randomized controlled trials (Level 1). The major influences for accepting the flu vaccine was for self-protection; the leading deterrent for receiving the flu vaccine was unbelief and questions about effectiveness. Best practice strategies to increase vaccination rates among HCWs include understanding cultural beliefs, practices, and diversities. Involvement of leadership will direct changes through future policy development. The impact of a progressive flu vaccine campaign can effectively promote social change when health care workers' concerns are addressed and vaccination rates improve. Together, quality of care for patients may also improve.

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