Translation science can be defined as a branch of science which aims to develop various interventions and programs that can help improve the health of human beings using the “bench to bedside” approach (Wagner and Kroetz, 2016). The translation science project which will be discussed in this paper is mainly focused on the effect of the implementation of a vaccination screening program on the vaccination rates of elderly Hispanic population aged between 65 and 90 years old in a Community Health setting in Miami-Dade area. Currently, there are numerous evidences that can support the need for various interventions and programs to help increase the vaccination rates among the elderly population. Some of these evidences and studies clearly identify the effectivity and efficiency of selected interventions and programs when it comes to the improvement of vaccination rates.
According to the study of Phillips, Kumar, Patel, and Arya (2014), vaccinations could contribute to the prevention of the contraction of influenza and its various complications. Based on the report of Centers for Disease Control and Prevention in 2013, a total of 5-20% of the population in the United States acquire influenza every year. The Hispanics are considered to the population of interest because they are considered to be one of the growing populations in the United Stated and studies have also revealed that they are currently experiencing increased disparity especially when it comes to experiencing healthcare services (Pearson, Zhao, and Ford, 2010).
Description of selected advanced nursing practice translation of evidence into practice (both integrative and systematic review of evidence)
The presence of health disparity among the ethnic groups can be supported by different studies which focus on the said issue. A study by Ojha, Stallings-Smith, Flynn, Adderson, Offutt-Powell, and Gaur (2015) explored the impact of vaccine concerns when it comes to the racial or ethnic disparities in terms of the uptake of influenza vaccine among healthcare workers. Based on the results of the study, the population of non-Hispanic Blacks experienced a lower influenza vaccine uptake as compared to the population of the non-Hispanic Whites. Additionally, it was also revealed that a modestly lower uptake of the influenza vaccines were found among the Hispanic and Asian health workers population. Similar results were obtained by the study of Haviland, Elliott, Hambarsoomian, and Lurie (2011) wherein Spanish and English speaking Hispanics experienced lower immunization rates for pneumococcal and influenza vaccines as compared to Spanish and English speaking non-Hispanic whites.
Another study by Pearson, Zhao, and Ford (2010) also stressed that the population of elderly Hispanics in the United States who prefer to communicate in Spanish have lesser chance of receiving influenza vaccinations as compared to elderly Hispanics who communicate in English. As observed in the last two studies, the reason for the disparity among the populations were due to their relative language preference. A study by Lu, O’Halloran, Williams, Lindley, Farrall, and Bridges (2015) also studied the issue of health disparity among populations. Based on the results of the study, the population of non-Hispanic blacks, Hispanics, and non-Hispanic Asians obtained a significantly lower coverage for vaccination as compared to the vaccination coverage of non-Hispanic whites. The relatively lower coverage of vaccination among the population have been associated with age, sex, education, health insurance, usual place of care, and the number of physician visits in the last 12 months. The recommendation of health authorities to encourage the provision of influenza vaccinations among the elder population aged 60 years old and above is necessary because of the variations in the uptake of vaccinations according to different countries, socio-economic status, and health-risk status. A study conducted by Thomas and Lorenzetti (2014) revealed that there is a considerable increase in the demand of the community when it comes to vaccinations. In fact, the study also reported that some of the effective interventions include a letter with a leaflet/postcard, nurses/pharmacists who are working on educating patients, a phone call from a respected senior or boss, and a telephone vaccination. Aside from these interventions, the study also revealed that vaccination access can be enhance through home visits of health professionals who discuss and offer free vaccines to patients. The involvement of the healthcare providers can also help in the improvement of the provision provided by the healthcare providers and healthcare professionals.
In addition, a study by Ruttimann, Bonvehi, Vilar-Compte, Isturiz, Labarca, and Vidal (2013) revealed that there is a current high burden of influenza in the Americas. As a matter of fact, it has been estimated that it contributes to 90% of the seasonal deaths recorded in the region. According to the findings of the study, age-specific risk has been considered as a significant factor when dealing with the risk of severity, complications, hospitalizations, and deaths associated with influenza. Furthermore, the report also stated that other authors revealed that the immune response of the elderly population to the influenza vaccine were significantly lower than the young adults. This finding raised numerous questions from the scientific community. However, the claim that there is a more rapidly decline in the influenza vaccine-induced antibody titers among the elderly than the young adults have already been rejected by a recently published systematic review. Moreover, the same report was able to provide various recommendation to address the issues on influenza among the elderly population. Some of the established recommendations include better surveillance of the elderly population among the Latin American countries, improved accessibility of laboratory tests and examinations for the elderly especially for the early detection and treatment of influenza, provision of more support and evidences that can prove the effectivity of antiviral agents in terms of treating influenza among the elderly population, development of indirect strategies that can help reduce the burden of influenza among the elderly, and the provision of control measures related to the traditional infection of diseases.
The vaccination rates of different populations can be affected by various factors such as social and intermediate determinants. Some of the social determinants that affect immunization rates of the elderly population include gender, age, marital status, educational attainment, ethnicity or race, socio-economic status, as well as social and cultural values. On the other hand, intermediate determinants can also be considered as factors such as housing or place of residence, behavioral beliefs, social influences, vaccination status, information sources, and perceived health status. Factors related to the health care system can also be linked to the relatively low coverage of immunization rates. Some of the health care system related factors are accessibility, affordability, knowledge and attitudes about vaccination, and medical advice of health professionals (Nagata, Hernandez-Ramos, Kurup, Albrecht, Vivas-Torrealba, and Franco-Paredes, 2011).
Presentation of selected advanced practice translation of evidence analysis with proposed management (structure-process-outcomes) for information systems change
One of the ways to deal with the dynamics of the health sector and the unpredictable changes in the field is through health informatics. Health informatics can be used to help identify possible problems through the application of technology. An example is the use of electronic records in assessing the status of patients. Technology also allows uploading of vital signs, laboratory test results, and medical procedures conducted in a patient in a database which hastens the process of interpretation and interprofessional collaboration.
As a DNP nurse, being competent in the field of nursing informatics can improve and strengthen our skills when it comes to decision making and analysis of patient records. Additionally, health informatics can also develop the leadership skills of nurses especially when it comes to the provision of the important information needed in the patient records and the development of a standardized nursing language to ensure that the terms and results seen in the records are universal. Additionally, since DNP nurses have been trained and prepared to handle evidence-based projects and various leadership roles, they are expected to be stakeholders when it comes to the implementation, evaluation, and sustainment of the various development strategies and programs in the field of nursing informatics (Lee, 2014).
Conclusion
The provision of various evidences and studies focused on the low coverage of immunization among the elderly population led to the development and implementation of various strategies that can alleviate the problem and burden associated with influenza infection. However, these researches and studies will not be useful unless they are put into practice especially in the health care sector. The translation of these evidences into practice can be attained through change management and health informatics. The development of nursing informatics or electronic health records can greatly benefit the patients and the health professionals because it promotes interprofessional collaboration and efficiency in the workplace. Since health informatics allow easy access to patient records and pertinent information of the hospital, early detection of possible changes and problems would be easier, thus allowing early assessment and improvement of the projects and programs as a whole.
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