Community Change

1
Community Change

• By Emily Alpers, Shirley Iler,
• Barbara Lentz, Sharon Lumbert

2
Review of Findings

• Problem statement Adults aged 65 and older in
  Kent County, Michigan are at risk of
  hospitalization and death related to failure to
  obtain yearly influenza (flu) shots as evidence
  by data showing that 32.9 of the elderly in Kent
  County have not received the flu shot
  (AccessKent).  
• After reviewing the evidence, we find that the
  difference in this population is that the
  majority of the elderly are uneducated on the
  benefits of the immunization. There are other
  differences like transportation issues and cost
  of the injection.  
• Our goal is to see 90 of seniors in Kent County
  are receiving the flu vaccine. Our proposed
  intervention is focused on education and the
  specifics will be discussed fully throughout this
  power point.

3
Interventions
4
The Who, What, When, Where, Why and How?  

• This flu season, we will be targeting those in
  the Kent County area who are 65-years-old and
  older. These individuals show a higher percentage
  of not receiving the flu vaccine when compared to
  the rest of counties in Michigan. Our primary
  goal and intervention will focus on education.

5
What will we do specifically?

• Create an educational flier.
• Contact local TV and radio stations for free air
  time and local newspapers for free adds.
• Recruit volunteers to post bulletins at buildings
  and businesses frequented by seniors.
• Send educational fliers by mail to homes of
  seniors.
• Contact local home health care agencies to have
  their nurses provide shots to clients and have
  volunteer nurses go to homes to provide shots.
• Enlist public transportation in Kent County to
  offer free rides to seniors on certain days to
  the locations available for flu vaccines.
• Schedule immunization clinics during daytime
  hours for convenience purposes for the elderly
• Set up a fast lane for elderly to reduce their
  wait time.

6
Best  Practices

• The nature of vaccinations makes this a
  primary prevention as the intervention is taking
  place before illness. Targeting the elderly
  population would be a branch off of this primary
  prevention. A secondary prevention will take
  place by targeting the family members, places of
  worship, and pharmacies of the elderly.

7
Has this intervention been done before?

• Educational information has been given out before
  and the Vaccine Information Sheet provides a lot
  of educational material. Local television
  advertisements have also been aired before for
  multiple things, including immunizations, breast
  cancer awareness and drug abuse. These ads are
  often part of local TV networks. These programs
  have been effective, but, could be more effective
  by targeting our population group in the county,
  adding increased incentives, and making it cost
  efficient.

8
Evidence-Based Practice

• The evidence-based practice that best fits this
  intervention is the decreased rate of vaccinated
  people over the age of 65 coupled with the
  hospitalization rate for the flu of that age
  group. This evidence makes the importance of
  education on the flu vaccine and availability
  highly important.

9
Adequate Local Resources

• Kent County has 6 available places through the
  health department where individuals can receive
  the flu shot. The flu vaccine can also be
  received through many pharmacies, including Rite
  Aide and Walgreens. There are also urgent cares
  and doctors offices that provide vaccines as
  well.

10
What else might be needed?

• Education is our primary focus. Providing
  education on the importance of the vaccine, where
  to receive the vaccine, and how to get to a place
  where one can receive the vaccine is part of our
  educational plan. We have also examined what
  insurances will cover the vaccine as many people
  over the age of 65 will likely have Medicare.
  According to the Medicare website, those with
  Part B coverage will have the flu vaccine covered
  100 (Medicare Part B).

11
Community Interests

• The statistics regarding the flu vaccination and
  hospital admissions for the flu for those over
  the age of 65 makes it clear that these
  interventions would fit well with community
  interests. It is estimated that 90 of seasonal
  flu related deaths and more than 60 of seasonal
  flu related hospitalizations in the United States
  each year are people 65 and over (CDC, 2010).

12
Permission

• Local television networks would need to be
  contacted to see if they would be willing to run
  advertisements for free regarding this education.
  Local free newspapers and coupon fliers would
  need to be contacted as well. Local
  transportation services would need to be
  contacted to determine if they are willing to
  provide free transportation to the elderly.

13
Evaluation
14
Desired Outcome

• The desired outcome would be to increase the
  percentage of people in Kent county, 65 years of
  age and older, who receive the influenza (flu)
  vaccine. This, in turn, would decrease the amount
  of hospitalizations and death due to contracting
  influenza.

15
Anticipated Time Frame

• According to the government website for Michigan,
  MIShots 2012 will evaluate the progress annually
  for vaccine coverage therefore, a change should
  be noted within a year. Review of influenza and
  pneumococcal vaccination will occur at least
  annually at long-term care facilities using
  results from other data sources (michigan.gov,
  2011). In order to see any real progress in the
  change we anticipate the evaluation in 2020 would
  give us a more accurate percentage.

16
Outcomes to be Tracked

• The short-term outcomes that we will track are
  reported cases of influenza among people gt65
  years of age, hospitalization due to
  complications from influenza, and follow up on
  the benefits of the educational materials that we
  instituted.
• At each of the immunization sites a
  flyer/questionnaire will be handed out with the
  immunization information which would include 
• How did you hear about this site?
• What public information did you find beneficial
  and educational?
• Were you assisted to your site by public
  transportation at low or no cost?
• Were you reached via telephone by the phone a
  friend for prevention program?
• Do you feel more educated regarding the
  importance and benefits of the influenza vaccine
  this year than you were last year? If so, how?

17
Tracking Changes

• There are available measures in place that would
  help track any changes in the elderly population
  gt65 who have adopted or disregarded the belief
  that there are benefits to getting the flu shot.
  The annual surveillance that the local health
  department observes provides us with previous
  years immunization records. The website for this
  information can be obtained at http//www.accesske
  nt.com/Health/HealthDepartment/Flu/.

18
The End

• Thank You!

19
Emily
20
Barbara
21
Sharon
22
Shirley
23
References

• Access Kent (n.d.) Flu Vaccine Information.
  Retrieved on November 6, 2011 from http/ /
  www.accesskent.com/ Health/HealthDepartment/Flu/.
   
• Center for Disease Control and Prevention,
  (2010). What You Should Know and Do this Flu
  Season If You Are 65 Years and Older Retrieved
  from http//www.cdc.gov/flu/about/disease/65over.
  htm
• Harkness, G. A., DeMarco, R. F., (2012).
  Community and Public Health Nursing Evidence
  for Practice. Philadephia Wolters
  Kluwer/Lippincott Williams Wilkins.
• Medicare.gov (n.d.) Medicare Part B Medical
  Insurance. Retrieved on November 15, 2011 from
  http//www.medicare.gov/navigation/medicare-basics
  /medicare- benefits/part-b.aspx.
• State of Michigan (2011). Population Vaccination
  Assessment. Retreived on November 4, 2011 from
  http//michigan.gov/mdch/0,4612,7-132-2940_2955_22
  779_ 40563_48357-202902 ,00.html.