Date of Award

Spring 5-25-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Dr. Razel Milo PhD, DNP, FNP-C

Second Advisor

Kevin Maxwell, DNP, FNP-BC

Abstract

Title: Shingles Vaccine: Identifying high risk groups in the IBD clinic setting

Background: The Inflammatory Bowel Disease (IBD) population is an immunocompromised patient population who is at risk for Herpes Zoster (HZ) due to their medication regimen, which further compromises their immune system. It can be difficult for patients to receive appropriate preventative health maintenance measures due to patients’ fears, primary care providers’ lack of knowledge, and gastroenterologists not addressing what may be considered primary care topics. Furthermore, evidence demonstrates that IBD patients have low vaccination rates despite insurance coverage.

Purpose of Project: (a) To increase awareness of the importance of Shingrix in the Inflammatory Bowel Disease population (over 50 years old); (b) To increase Shingrix vaccination orders by 5% in a two-month period.

EBP Model/Frameworks: The ACE Star model was used to guide this project.

Evidenced-Based Interventions: A PowerPoint presentation will be utilized to educate IBD healthcare providers on the newest evidence regarding high risk groups for shingles and Shingrix. In addition, posters will be located in every patient room for patient education on Shingrix.

Evaluation/Results: No significant difference was found in vaccination rates between pre-and post-project implementation of patient posters and staff educational PowerPoint. Limitations included small patient sample size in post implementation.

Implication for Practice: Most insurance plans now cover Shingrix for patients aged 50 years and older. Spreading awareness of the importance of this vaccination will aid in increasing low numbers of vaccination rates in the IBD population.

Conclusion: The new Shingrix vaccine is not a live vaccine, therefore can be administered to immunocompromised patients, including those patients who have received the previous shingles vaccine, Zostavax. It is essential to assess health maintenance, including vaccines needed, at patients’ initial visit.

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