Graduation Semester and Year
Summer 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Deborah Fern Behan
Abstract
Background: Vaccines recommended for patients over the age of 50 include those for influenza (Flu), COVID-19, respiratory syncytial virus (RSV), pneumococcal disease, shingles, hepatitis A, hepatitis B, and a booster dose of the Tetanus, diphtheria, and pertussis (Tdap) vaccine every 10 years (American Association of Retired Persons, 2025). Unfortunately, these vaccines are often not adequately discussed during patient visits or are mentioned only briefly, without a clear plan for administration (American Association of Retired Persons, 2025). A vaccination bundle, which included resources for all vaccines and the opportunity to receive vaccines such as flu, COVID-19, RSV, Pneumococcal, Tdap, shingles, and hepatitis A and B, was incorporated into the care protocol.
Methods: The PICOTS for the project focused on patients aged 50 and older who visited a clinic in North Texas. The intervention involved a vaccination bundle that included shared decision-making (SDM), resources for all recommended vaccinations, and the opportunity to receive vaccines available at the clinic, which included those for flu, COVID-19, RSV, pneumococcal disease, Tdap, shingles, hepatitis A, and hepatitis B. This was compared to standard care, which either mentioned recommended vaccinations or did not mention them at all. The desired outcomes included increased patient utilization of resources for vaccination recommendations and, ultimately, an increase in vaccination rates in the clinic over an eight-week period. The SDM-Q-9 and SDM-Q-DOC were used to evaluate the accuracy of Shared Decision Making (SDM).
Results: The results showed statistical significance with a p-value of less than .001 for the SDM and increased vaccination rates after the intervention was implemented (Table 1). The evidence indicates that the SDM intervention significantly improved vaccination rates in patients aged 50 years and older. The SDM-Q-9 and SDM-Q-DOC tools exhibited high total scores and demonstrated strong reliability, with Cronbach’s Alpha values of .976 and .941 from both patient and provider perspectives (Table 3).
Conclusion: By utilizing SDM, healthcare providers can significantly increase vaccination rates among patients aged 50 and older by discussing their vaccination status and allowing them to make informed decisions. Implementing these interventions for older patients at the North Texas clinic has enhanced the quality of patient care and reduced the risk of severe vaccine-preventable disease outcomes. Ultimately, this strategy helps prevent complications and lowers medical costs.
Keywords
Vaccination, Shared decision-making, Older adults
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Chen, Muxian, "Shared Decision-Making to Improve the Vaccination Rate Among Older Patients" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 8.
https://mavmatrix.uta.edu/nursing_dnpprojects2/8