ABSTRACT
BACKGROUND: Vaccine-preventable diseases significantly influence the health and academic success of college students. Despite the known negative impact of these diseases, vaccination rates routinely fall short of national goals and recommendations. Although vaccination decisions are complex, a recommendation from a health care provider is one of the key motivators for individuals receiving a vaccine. Motivational interviewing (MI), a counseling approach primarily used to address substance abuse, can be applied to other health-related behaviors. LOCAL PROBLEM: Despite previous quality improvement efforts aimed at increasing vaccine rates for influenza, human papillomavirus (HPV), and meningitis B (MenB), vaccinations at large university health centers have been well below benchmarks set by Healthy People 2020. METHODS: This study was guided by the Theory of Planned Behavior and included MI training and regular reinforcement for health care providers to address vaccine hesitancy with college students. RESULTS: Influenza vaccination rates improved, but HPV vaccine rates remained stable and MenB vaccine rates decreased compared with the previous year. Clinicians demonstrated a significant increase in knowledge of MI techniques after a targeted educational intervention. Repeat measures indicate the potential for sustained improvement when ongoing reinforcement is provided. CONCLUSION: MI can be an effective part of a strategy to increase vaccination rates.
Subject(s)
Health Personnel/standards , Motivational Interviewing/standards , Students/psychology , Vaccination Refusal/psychology , Adolescent , Female , Health Knowledge, Attitudes, Practice , Health Personnel/statistics & numerical data , Humans , Influenza, Human/drug therapy , Influenza, Human/prevention & control , Influenza, Human/psychology , Male , Meningitis/drug therapy , Meningitis/prevention & control , Meningitis/psychology , Motivational Interviewing/methods , Motivational Interviewing/statistics & numerical data , Papillomavirus Infections/drug therapy , Papillomavirus Infections/prevention & control , Papillomavirus Infections/psychology , Quality Improvement , Southwestern United States , Students/statistics & numerical data , Universities/organization & administration , Universities/statistics & numerical data , Vaccination Refusal/statistics & numerical data , Young AdultABSTRACT
As Doctor of Nursing Practice (DNP) students and graduates begin to apply new knowledge in real-life situations, they are transforming their organizations. The impact of DNP projects is noted by measurable outcomes in diverse settings. This article presents 4 unique clinical/organizational examples of DNP projects. The authors have identified an application of complexity science and leadership theory in their practice changes. In addition, they share their thoughts and feelings as emerging leaders.
Subject(s)
Leadership , Nursing/methods , Education, Nursing, Graduate/methods , Humans , Nursing/organization & administrationABSTRACT
This article discusses role emergence from master's-prepared nurse practitioners to Doctor of Nursing Practice (DNP) innovative leaders who utilize Complexity science to impact health care organizations. DNP leaders are in position to disrupt linear traditional leadership and embark on new ideas for improvements in care delivery, organizational system processes, and policies within health care. Complexity science provides the necessary theoretical framework for nurse executives and stakeholders to interact with DNP leaders by engaging in collaborative efforts, cultivating communication from point of service providers to administrators, and coordinating interdisciplinary teams to approach gaps in practice, clinical issues, health care policy, and organizational sustainability. The DNP leader is aware that health care organizations are complex adaptive systems, continuously changing. These require skilled and knowledgeable leaders to support growth within an uncertain environment, and bring evidence to practice while promoting organizational wellness.
