Implementation of a Vaccines for Children Project for Underserved Children in Shawnee County, Kansas

Abstract

Introduction and Purpose: The project was conducted to improve access to immunizations and increase the number of recommended vaccines received by children residing in a rural Shawnee County, Kansas community. Framework: The Health Belief Model (Becker, 1974) and PDSA (IHI, 2021) QI method guided the project. Critical Appraisal and Synthesis of Literature: One Level I study and 18 Level II-V studies identified education and access as barriers to immunization in pediatric populations. Solutions included mobile health clinics, pharmacy-based clinics, and school-based clinics. Methods: (Plan) A first PDSA cycle involved formation of a focus group, and development of a parent survey to understand community barriers to pediatric immunization. (Do) A focus group of stakeholders was conducted that included Washburn University School of Nursing, county health department representatives, school officials, community librarian, and pharmacist. Surveys were distributed to two local schools and the local library. (Study) Focus group output was thematically analyzed, and survey data analyzed using SPSS to determine descriptive statistics. Results were shared with a second focus group and interventions were developed. (Act) Selected interventions to reduce vaccination barriers were implemented. Results: Sixty-four surveys were returned, representing 134 children, with a return rate of approximately 22%. A synthesis of focus group and survey findings identified barriers to be education and access. Completion of the first PDSA cycle resulted in distribution of an educational flyer and provision of a cost-effective school-based influenza clinic. Thirty influenza vaccines were administered to community members. Process Improvements: The infrastructure for subsequent PDSA cycles was established, and plans were made for expanding the impact of the project through continued stakeholder engagement and DNP leadership. Conclusions and Recommendations: One team member will continue future cycles to include provision of both required and recommended childhood vaccines, and potential expansion into surrounding communities.