Application of middle range nursing theory to practice.
What types of things should Ms. Chang ask about to assess the reasons for the decline in immunization rates,
In assessing the reasons for the decline in immunization rate, the nurse should ask what has changed to match the decline in immunization rates. In asking this question, the nurse will assume that the reported decline is resultant of a specific cause(s) that would be noted as a changing variable to match the decline. The changing variable is likely to be attributed to the major stakeholders (such as medical personnel, patients and healthcare administrators who present policy) thus creating a need to identify the stakeholders who can affect the immunization rates, and how changes attributed to them cased the decline (Marquis & Huston, 2017). Application of middle range nursing theory to practice.
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Chang developed and distributed a survey to each unit manager. After analyzing her results, she identified three major reasons that many in the staff declined the flu vaccine:
A large number (over 40%) believed that the vaccine might give them the flu.
This is an activity related effect. These patients have a subjective negative feeling that a stimulus property of the vaccination is the development of flu. Also, it is an interpersonal influence since modeling (vicarious learning from observing others who have been vaccinated), and social support (testimonials from others) all indicate that the patient is likely to become since from flu if vaccinated (Cherry & Jacob, 2016). Application of middle range nursing theory to practice.
25% vaccinated
This is a competing demand since the vaccination is offered at a day and time that is not convenient for the patient. In this case, the patients indicate that within the scope of behavioral outcome, they are committed to being vaccinated as a plan of action, showing intention and identifying a planned strategy to get vaccinated having identified a location in terms of time and day. However, time and day are environmental contingencies over which the patients have little to not control, making it difficult to be vaccinated in the indicated time (Cherry & Jacob, 2016). Application of middle range nursing theory to practice.
10% – Something unnatural into the body.
This is an interpersonal influence that concerns belief. The patients rely on modeling, social support and norms (expectations) to determine that the vaccine is harmful. As such, the best way to maintain good health is not to intentionally seek ill health by getting vaccinated (Cherry & Jacob, 2016).
Motivational factors
These are personal factors that can take the form of socio-cultural, psychological and biological influences. They are predictive factors of vaccination behavior that shape the nature of the patients’ response and are influenced by interaction with the environment (Cherry & Jacob, 2016). Application of middle range nursing theory to practice.
Use all concepts from Pender’s model to state actions Ms. Chang can take to improve the immunization rates.
Pender’s model seeks to achieve health promotion to improve the individual level of well-being. In this case, there are three actions that the nurse can undertake to improve immunization rates. The first action is to improve the patients’ knowledge levels concerning vaccination so that they are presented with factual information and myths are debunked. This would prevent them from making erroneous assumptions, such as claiming that the vaccine is harmful. The second action is to schedule vaccination at times that are convenient to the patient, considering both the time and date when the patient can access the vaccination services. The final action is to seek community support, such as getting the church and important personalities to actively advocate for immunization (Marquis & Huston, 2017). Application of middle range nursing theory to practice.
