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

K. Sue Hoyt, PhD, FNP-BC, ENP-C, FAEN, FAANP, FAAN

Abstract

Herpes Zoster Vaccine to the Homebound Elderly: Prevention, Protection, and Access to Care

Purpose: To increase the administration rate of the Herpes Zoster (Hz) vaccine Zostavax by 10% for persons 65 years and older in a home-based primary care practice, utilizing Medicare part D.

Background: Persons in the United States (US) age 40 years and older show a 99% positive serology for Varicella, which causes Hz decades later. Zostavax has been shown to decease Hz by 51% and post-herpetic neuralgia by 67%.

Brief Description: The goal of Healthy People 2020 is to increase the vaccination rates of persons 65 years and older by 10%; the current rate is 15.8%. Eligible patients receiving home-based primary care will be identified and the Hz vaccine will be ordered through a delivering pharmacy. It will be stored in the freezer at the patient’s home until administered at the next visit.

Outcomes: An increase in administration of the Hz vaccine in the older adult population, providing protection against Hz outbreaks.

Implications: Outbreaks in the US for persons 50 years and older cost $5 billion in 2013. Vaccinations should reduce Hz outbreaks, and decrease associated complications. The Hz vaccine is delivered to the residence and covered under the Medicare part D program, saving up to $268 per person. The practice could be reimbursed up to $27.55 for the injection.

Included in

Nursing Commons

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