Date of Award

Spring 5-7-2016

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Dr. Shelley Hawkins, PhD, FNP-BC, GNP, FAANP

Second Advisor

Dr. Ann Lowe, PhD, FNP


Purpose To establish an adult Pneumococcal (PCV13) vaccination protocol within a chain of retail healthcare clinics.

Background - Invasive Pneumococcal disease results in significant morbidity and mortality in patients ≥65 and those with immunocompromised status. Despite CDC recommendations, national PCV13 vaccination rates remain low in these populations. No adult PCV13 vaccination protocol existed in the project retail healthcare clinics.

Project Plan Process – An evidence-based PCV13 vaccination protocol based on the CDC guidelines using the Provus Discrepancy Evaluation Model as a framework was implemented. NPs were educated on indications for PCV13 vaccinations and a questionnaire to identify those patients who qualified. Qualified patients were either vaccinated or referred elsewhere for vaccination. The EMR system was reviewed to determine the number of patients who qualified for the PCV13 vaccination who were screened.

Results: Of the 3,202 patients, 4-6% qualified for the PCV13 vaccination, 27.7% were identified and offered the PCV13 vaccination and 11% were vaccinated or referred elsewhere for vaccination. Regarding age, 65.2% of patients who qualified for PCV13 were ≥65 in contrast to 34.8% who were 19-64 years old. As for those patients who were actually vaccinated, 76.5% were ≥65 while 23.5% were 19-64 years old.

Conclusions/Implications - Retail health care clinics can be an effective venue for providing essential vaccinations. Nurse practitioners are well prepared with the knowledge base and skill set to assume a leadership role in the development of vaccination programs within our communities.