Assignment Prompt & Instructions
– ## 611week4assignment.docx
– ## 611week3asignment.docx
**## 611week4assignment.docx**
**_Introduction & PICOT Question Assignment_**
For this assignment, you will write an introduction. Refer to
[Module 3: Lecture Materials & Resources](https://stu.instructure.com/courses/46198/pages/module-3-lecture-materials-and-resources) to help you complete this assignment.
**Your Introduction must include:**
· Your PICOT question.
· Purpose of or rationale for the scholarly project:
· Provide an evidence-based explanation of why it is necessary to complete your scholarly project and what benefit will be gained (health promotion, fiscal, and efficiency).
· Background on the problem or population of interest:
· Using primary sources, provide data on your topic.
· Providing the background will demonstrate the focused need for your project.
· Significance of the problem to nursing and health care:
· State how your problem or population of interest aligns with the larger interest of health care in the community.
· Create a context to why your topic is important.
· Benefit of the project to nursing practice:
· State what will be gained from your project.
· Describe the expected outcomes of your project to practice within your population and setting.
· Relate the outcomes to evidence-based guidelines and outcomes.
· Describe how your project may influence other populations or settings.
**Submission Instructions:**
· The introduction is original work and logically organized.
· The paper is 2-3 pages in length and follows current APA format including citation of references.
· Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
· Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
· Your submission will be reviewed for plagiarism with Turnitin.
**Grading Rubric**
Your assignment will be graded according to the grading rubric.
**Essay/Paper Rubric**
| | | |
| — | — | — |
| Essay/Paper Rubric |
| **Criteria** | **Ratings** | **Points** |
| **Identification of Main Issues/Problems** | **Distinguished**<br>Identify and demonstrate a sophisticated understanding of the issues/problems.<br>**4 pts**<br>**Excellent**<br>Identifies and demonstrate an accomplished understanding of most of issues/problems.<br>**3 pts**<br>**Fair**<br>Identifies and demonstrate an an acceptable understanding of most of issues/problems.<br>**2 pts**<br>**Poor**<br>Identifies and demonstrate an unacceptable understanding of most of issues/problems.<br>**1 pts** | /4 pts |
| **Analysis and Evaluation of Issues/Probelms** | **Distinguished**<br>Presents an insightful, thorough analysis and evaluation of issues/problems.<br>**4 pts**<br>**Excellent**<br>Presents a thorough analysis and evaluation of most of the issues/problems.<br>**3 pts**<br>**Fair**<br>Presents a superficial or incomplete analysis and evaluation of issues/problems.<br>**2 pts**<br>**Poor**<br>Presents unacceptable analysis and evaluation of issues/problems.<br>**1 pts** | /4 pts |
| **Demonstrates a Conceptual Understanding** | **Distinguished**<br>Provides a thorough, competent and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.<br>**4 pts**<br>**Excellent**<br>Provides a competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.<br>**3 pts**<br>**Fair**<br>Provides a competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.<br>**2 pts**<br>**Poor**<br>Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.<br>**1 pts** | /4 pts |
| **Use of Citations to Course Readings and Additional Research/Literature** | **Distinguished**<br>Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.<br>**4 pts**<br>**Excellent**<br>Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.<br>**3 pts**<br>**Fair**<br>Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.<br>**2 pts**<br>**Poor**<br>Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing.<br>**1 pts** | /4 pts |
| **Writing Mechanics and APA Formatting Guidelines** | **Full Marks**<br>Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.<br>**4 pts**<br>**Excellent**<br>Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.<br>**3 pts**<br>**Fair**<br>Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.<br>**2 pts**<br>**Poor**<br>Demonstrates issues in writing and communicating clearly. APA style and writing mechanics need serious attention.<br>**1 pts** | /4 pts |
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## image2.png
**## 611week3asignment.docx**
3
**Literature Review and Evidence Matrix**
Krystal Nieto
St. Thomas University
NURS 611
Dr. Patton
July 20, 2025
**Literature Review and Evidence Matrix**
**Literature Review**
Influenza infection is one of the leading respiratory infectious diseases that poses a major health risk for older adults, leading to higher mortality and mobility rates among this population. According to research, among reported millions of flu-related illnesses, hospitalizations, medical visits, and deaths, "people 65 years and older accounted for 45% of hospitalizations and 58.7% of deaths, (Du et al., 2024, p.1). Influenza vaccination has played a major role in improving global health, particularly among vulnerable populations, such as the elderly, who are at a higher risk of developing severe flu complications. However, despite the clear benefits and availability of vaccine services, the acceptance and coverage of influenza vaccination remains a major issue among older adults dwelling in the community. In addressing this gap, nursing interventions play a significant role in promoting vaccine acceptance and uptake through education, reminders, telehealth, and tailored communication. The research aims to explore barriers to influenza vaccination uptake in older adults aged 60 years and above, and to identify evidence-based nursing interventions that can help improve the rate of influenza vaccination in community settings. Therefore, this section of the research will review peer-reviewed literature on nursing interventions to address the problem, drawing on research conducted over the last five years, and provide a summary and analysis of the studies. These findings will not only provide the background for the research problem but also contribute to a further understanding of evidence-based nursing interventions, which are the solutions.
An article by Antonelli Incalzi et al. (2024) provides an in-depth narrative review of influenza vaccination, emphasizing the role of healthcare providers, especially nurses, in addressing vaccination hesitancy among the older population. According to the article, influenza leads to a health burden, especially in older adults, and vaccination has been proven to be the most effective method for controlling and preventing flu-related illnesses or complications. However, despite these benefits, the vaccination rate among older adults living in the community remains low. The review points out the need for all healthcare professionals and specialists to participate in increasing the vaccination rate by highlighting that there is a gap in standardized nursing protocols and a need for tailored vaccination interventions at the community level.
Du et al. (2024) conducted a systematic review of 22 randomized controlled trials, reviewing the effectiveness of various intervention strategies that can help increase vaccination rates. Based on the study, health education, which included face-to-face or telephone communication focusing on the elderly's knowledge of influenza and its vaccination, was found to be an effective intervention. These findings suggest that nurses can utilize health education and different learning or communication methods, such as promotional posters, publicity videos, and other community-based educational interactive activities, to improve the understanding of influenza and its vaccination, eventually resulting in acceptance and a high rate of vaccination. Du et al.'s (2024) study also identifies centralized reminders and onsite vaccination as effective interventions, where nurses remind the elderly through mail, phone, or face-to-face to get the flu vaccine and inform them on the significance. Combining healthcare education, centralized reminder, and onsite vaccination was found to be an effective strategy for addressing the problem. This indicates that nurses should combine or integrate various strategies from education, to personalized communication, or reminders to increase vaccination coverage or rate in older adults.
Jiang et al. (2022) randomized controlled trial in western China presents video-led educational intervention as an effective strategy to improve vaccination rate in elderly populations. The study indicated that although the influenza vaccination is widely available in the community, there is a lack of knowledge related to the severity of the infections in the vulnerable population, like the elderly, and suspicion about the safety of the vaccines, which were the main barriers to influenza vaccination in the older population. Based on the results, the use of video-led educational intervention positively influenced old people's willingness to take the influenza vaccine, as it resulted in improved knowledge on the vaccine and actual uptake. This supports Du et al.'s (2024) results, where health education was found to be an effective nursing intervention, making it an evidence-based strategy.
Supporting Du et al. (2024), centralized remainder as an effective nursing intervention, Sääksvuori et al. (2022) conducted a large-scale cluster randomized clinical trial in Finland, which concluded that information nudges as a behavioral intervention can increase the influenza vaccination rate. Based on these findings, well-tailored informational nudges such as reminders and personalized communication can help address common barriers to vaccination in older adults. However, the effectiveness of reminders regarding vaccination benefits may depend on the prior vaccination history of the older adults, suggesting that it is important for nurses to design reminders that address the psychological barriers, which may prevent this population from getting influenza vaccination.
Overall, the literature suggests that influenza vaccination is crucial in preventing flu-related complications in older people who are at higher risk. To address the acceptance of the vaccine and vaccination rate among this population, the studies suggest evidence-based nursing interventions that involve employing health education tools such as videos, behavioral information nudges, onsite vaccination that combines education and informed consent, as well as personalized or centralized communication. However, the gaps remain in ways to effectively integrate these nursing interventions into routine nursing practice and ways to identify effective practices that are adaptable across diverse cultural and healthcare settings.
**Evidence Matrix**
Name:
\_\_\_____________
Date:
\_\_\______________
| | | | | | | | |
| — | — | — | — | — | — | — | — |
| **Author(s)** | **Journal** | **Year of Publication** | **Research Design** | **Sample Size** | **Outcome variable Measured** | **Quality (A, B, C)** | **Results/Author’s suggested Conclusion** |
| Antonelli Incalzi et al., | Internal and Emergency Medicine | 2024 | Narrative Review and Expert Opinion | N/A | Barriers and strategies for Vaccination | B | -Vaccination can help reduce severe elderly illnesses or complications associated with influenza.<br>-Emphasized on nurses utilizing personalized communication to increase vaccine confidence and adherence among the older population. |
| Du et al., | Age and ageing | 2024 | Systematic Review and Network Meta-Analysis of 22 Randomized Controlled Trials | 385,182 older adult participants. | Intervention strategies for increasing coverage of influenza and pneumonia vaccination | A | -Among the evaluated interventions, a combination of healthcare education, centralized reminder, and onsite vaccination improved the elderly vaccination rate.<br>-The authors recommend considering the costs. |
| Jiang et al., | BMC Public Health | 2022 | Community-based Randomized Controlled Trial | 350 (older adults aged 60 years and above) | Video-led education intervention impact. | A | -Video-led education was an effective intervention for improving elderly willingness to be vaccinated. <br>-The authors recommend that policymakers research the cost-effectiveness of applying this intervention to a broader population and regions. |
| Sääksvuori et al., | PLoS Medicine | 2022 | Cluster Randomized Controlled Trial | A large population of the elderly in Finland | Effect of remainder on the vaccination rate | A | -Sending reminders was an effective nurse intervention to increase the vaccination rate among the elderly. |
**References**
Antonelli Incalzi, R., Consoli, A., Lopalco, P., Maggi, S., Sesti, G., Veronese, N., & Volpe, M. (2024). Influenza vaccination for elderly, vulnerable, and high-risk subjects: a narrative review and expert opinion.
_Internal and Emergency Medicine_,
_19_(3), 619-640.
[https://link.springer.com/article/10.1007/s11739-023-03456-9](https://link.springer.com/article/10.1007/s11739-023-03456-9)
Du, P., Jin, S., Lu, S., Wang, L., Ma, X., Wang, J., & Feng, X. (2024). Strategies to increase the coverage of influenza and pneumonia vaccination in older adults: a systematic review and network meta-analysis.
_Age and ageing_,
_53_(3), afae035.
[https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920](https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920)
Jiang, M., Yao, X., Li, P., Fang, Y., Feng, L., Hayat, K., & Atif, N. (2022). Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial.
_BMC Public Health_,
_22_(1), 1128.
[https://link.springer.com/article/10.1186/s12889-022-13536-8](https://link.springer.com/article/10.1186/s12889-022-13536-8)
Sääksvuori, L., Betsch, C., Nohynek, H., Salo, H., Sivelä, J., & Böhm, R. (2022). Information nudges for influenza vaccination: Evidence from a large-scale cluster-randomized controlled trial in Finland.
_PLoS Medicine_,
_19_(2), e1003919.
[https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919](https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919)
**## 611week3asignment.docx**
3
**Literature Review and Evidence Matrix**
Krystal Nieto
St. Thomas University
NURS 611
Dr. Patton
July 20, 2025
**Literature Review and Evidence Matrix**
**Literature Review**
Influenza infection is one of the leading respiratory infectious diseases that poses a major health risk for older adults, leading to higher mortality and mobility rates among this population. According to research, among reported millions of flu-related illnesses, hospitalizations, medical visits, and deaths, "people 65 years and older accounted for 45% of hospitalizations and 58.7% of deaths, (Du et al., 2024, p.1). Influenza vaccination has played a major role in improving global health, particularly among vulnerable populations, such as the elderly, who are at a higher risk of developing severe flu complications. However, despite the clear benefits and availability of vaccine services, the acceptance and coverage of influenza vaccination remains a major issue among older adults dwelling in the community. In addressing this gap, nursing interventions play a significant role in promoting vaccine acceptance and uptake through education, reminders, telehealth, and tailored communication. The research aims to explore barriers to influenza vaccination uptake in older adults aged 60 years and above, and to identify evidence-based nursing interventions that can help improve the rate of influenza vaccination in community settings. Therefore, this section of the research will review peer-reviewed literature on nursing interventions to address the problem, drawing on research conducted over the last five years, and provide a summary and analysis of the studies. These findings will not only provide the background for the research problem but also contribute to a further understanding of evidence-based nursing interventions, which are the solutions.
An article by Antonelli Incalzi et al. (2024) provides an in-depth narrative review of influenza vaccination, emphasizing the role of healthcare providers, especially nurses, in addressing vaccination hesitancy among the older population. According to the article, influenza leads to a health burden, especially in older adults, and vaccination has been proven to be the most effective method for controlling and preventing flu-related illnesses or complications. However, despite these benefits, the vaccination rate among older adults living in the community remains low. The review points out the need for all healthcare professionals and specialists to participate in increasing the vaccination rate by highlighting that there is a gap in standardized nursing protocols and a need for tailored vaccination interventions at the community level.
Du et al. (2024) conducted a systematic review of 22 randomized controlled trials, reviewing the effectiveness of various intervention strategies that can help increase vaccination rates. Based on the study, health education, which included face-to-face or telephone communication focusing on the elderly's knowledge of influenza and its vaccination, was found to be an effective intervention. These findings suggest that nurses can utilize health education and different learning or communication methods, such as promotional posters, publicity videos, and other community-based educational interactive activities, to improve the understanding of influenza and its vaccination, eventually resulting in acceptance and a high rate of vaccination. Du et al.'s (2024) study also identifies centralized reminders and onsite vaccination as effective interventions, where nurses remind the elderly through mail, phone, or face-to-face to get the flu vaccine and inform them on the significance. Combining healthcare education, centralized reminder, and onsite vaccination was found to be an effective strategy for addressing the problem. This indicates that nurses should combine or integrate various strategies from education, to personalized communication, or reminders to increase vaccination coverage or rate in older adults.
Jiang et al. (2022) randomized controlled trial in western China presents video-led educational intervention as an effective strategy to improve vaccination rate in elderly populations. The study indicated that although the influenza vaccination is widely available in the community, there is a lack of knowledge related to the severity of the infections in the vulnerable population, like the elderly, and suspicion about the safety of the vaccines, which were the main barriers to influenza vaccination in the older population. Based on the results, the use of video-led educational intervention positively influenced old people's willingness to take the influenza vaccine, as it resulted in improved knowledge on the vaccine and actual uptake. This supports Du et al.'s (2024) results, where health education was found to be an effective nursing intervention, making it an evidence-based strategy.
Supporting Du et al. (2024), centralized remainder as an effective nursing intervention, Sääksvuori et al. (2022) conducted a large-scale cluster randomized clinical trial in Finland, which concluded that information nudges as a behavioral intervention can increase the influenza vaccination rate. Based on these findings, well-tailored informational nudges such as reminders and personalized communication can help address common barriers to vaccination in older adults. However, the effectiveness of reminders regarding vaccination benefits may depend on the prior vaccination history of the older adults, suggesting that it is important for nurses to design reminders that address the psychological barriers, which may prevent this population from getting influenza vaccination.
Overall, the literature suggests that influenza vaccination is crucial in preventing flu-related complications in older people who are at higher risk. To address the acceptance of the vaccine and vaccination rate among this population, the studies suggest evidence-based nursing interventions that involve employing health education tools such as videos, behavioral information nudges, onsite vaccination that combines education and informed consent, as well as personalized or centralized communication. However, the gaps remain in ways to effectively integrate these nursing interventions into routine nursing practice and ways to identify effective practices that are adaptable across diverse cultural and healthcare settings.
**Evidence Matrix**
Name:
\_\_\_____________
Date:
\_\_\______________
| | | | | | | | |
| — | — | — | — | — | — | — | — |
| **Author(s)** | **Journal** | **Year of Publication** | **Research Design** | **Sample Size** | **Outcome variable Measured** | **Quality (A, B, C)** | **Results/Author’s suggested Conclusion** |
| Antonelli Incalzi et al., | Internal and Emergency Medicine | 2024 | Narrative Review and Expert Opinion | N/A | Barriers and strategies for Vaccination | B | -Vaccination can help reduce severe elderly illnesses or complications associated with influenza.<br>-Emphasized on nurses utilizing personalized communication to increase vaccine confidence and adherence among the older population. |
| Du et al., | Age and ageing | 2024 | Systematic Review and Network Meta-Analysis of 22 Randomized Controlled Trials | 385,182 older adult participants. | Intervention strategies for increasing coverage of influenza and pneumonia vaccination | A | -Among the evaluated interventions, a combination of healthcare education, centralized reminder, and onsite vaccination improved the elderly vaccination rate.<br>-The authors recommend considering the costs. |
| Jiang et al., | BMC Public Health | 2022 | Community-based Randomized Controlled Trial | 350 (older adults aged 60 years and above) | Video-led education intervention impact. | A | -Video-led education was an effective intervention for improving elderly willingness to be vaccinated. <br>-The authors recommend that policymakers research the cost-effectiveness of applying this intervention to a broader population and regions. |
| Sääksvuori et al., | PLoS Medicine | 2022 | Cluster Randomized Controlled Trial | A large population of the elderly in Finland | Effect of remainder on the vaccination rate | A | -Sending reminders was an effective nurse intervention to increase the vaccination rate among the elderly. |
**References**
Antonelli Incalzi, R., Consoli, A., Lopalco, P., Maggi, S., Sesti, G., Veronese, N., & Volpe, M. (2024). Influenza vaccination for elderly, vulnerable, and high-risk subjects: a narrative review and expert opinion.
_Internal and Emergency Medicine_,
_19_(3), 619-640.
[https://link.springer.com/article/10.1007/s11739-023-03456-9](https://link.springer.com/article/10.1007/s11739-023-03456-9)
Du, P., Jin, S., Lu, S., Wang, L., Ma, X., Wang, J., & Feng, X. (2024). Strategies to increase the coverage of influenza and pneumonia vaccination in older adults: a systematic review and network meta-analysis.
_Age and ageing_,
_53_(3), afae035.
[https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920](https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920)
Jiang, M., Yao, X., Li, P., Fang, Y., Feng, L., Hayat, K., & Atif, N. (2022). Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial.
_BMC Public Health_,
_22_(1), 1128.
[https://link.springer.com/article/10.1186/s12889-022-13536-8](https://link.springer.com/article/10.1186/s12889-022-13536-8)
Sääksvuori, L., Betsch, C., Nohynek, H., Salo, H., Sivelä, J., & Böhm, R. (2022). Information nudges for influenza vaccination: Evidence from a large-scale cluster-randomized controlled trial in Finland.
_PLoS Medicine_,
_19_(2), e1003919.
[https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919](https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919)
**## 611week4assignment.docx**
**_Introduction & PICOT Question Assignment_**
For this assignment, you will write an introduction. Refer to
[Module 3: Lecture Materials & Resources](https://stu.instructure.com/courses/46198/pages/module-3-lecture-materials-and-resources) to help you complete this assignment.
**Your Introduction must include:**
· Your PICOT question.
· Purpose of or rationale for the scholarly project:
· Provide an evidence-based explanation of why it is necessary to complete your scholarly project and what benefit will be gained (health promotion, fiscal, and efficiency).
· Background on the problem or population of interest:
· Using primary sources, provide data on your topic.
· Providing the background will demonstrate the focused need for your project.
· Significance of the problem to nursing and health care:
· State how your problem or population of interest aligns with the larger interest of health care in the community.
· Create a context to why your topic is important.
· Benefit of the project to nursing practice:
· State what will be gained from your project.
· Describe the expected outcomes of your project to practice within your population and setting.
· Relate the outcomes to evidence-based guidelines and outcomes.
· Describe how your project may influence other populations or settings.
**Submission Instructions:**
· The introduction is original work and logically organized.
· The paper is 2-3 pages in length and follows current APA format including citation of references.
· Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
· Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
· Your submission will be reviewed for plagiarism with Turnitin.
**Grading Rubric**
Your assignment will be graded according to the grading rubric.
**Essay/Paper Rubric**
| | | |
| — | — | — |
| Essay/Paper Rubric |
| **Criteria** | **Ratings** | **Points** |
| **Identification of Main Issues/Problems** | **Distinguished**<br>Identify and demonstrate a sophisticated understanding of the issues/problems.<br>**4 pts**<br>**Excellent**<br>Identifies and demonstrate an accomplished understanding of most of issues/problems.<br>**3 pts**<br>**Fair**<br>Identifies and demonstrate an an acceptable understanding of most of issues/problems.<br>**2 pts**<br>**Poor**<br>Identifies and demonstrate an unacceptable understanding of most of issues/problems.<br>**1 pts** | /4 pts |
| **Analysis and Evaluation of Issues/Probelms** | **Distinguished**<br>Presents an insightful, thorough analysis and evaluation of issues/problems.<br>**4 pts**<br>**Excellent**<br>Presents a thorough analysis and evaluation of most of the issues/problems.<br>**3 pts**<br>**Fair**<br>Presents a superficial or incomplete analysis and evaluation of issues/problems.<br>**2 pts**<br>**Poor**<br>Presents unacceptable analysis and evaluation of issues/problems.<br>**1 pts** | /4 pts |
| **Demonstrates a Conceptual Understanding** | **Distinguished**<br>Provides a thorough, competent and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.<br>**4 pts**<br>**Excellent**<br>Provides a competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.<br>**3 pts**<br>**Fair**<br>Provides a competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.<br>**2 pts**<br>**Poor**<br>Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.<br>**1 pts** | /4 pts |
| **Use of Citations to Course Readings and Additional Research/Literature** | **Distinguished**<br>Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.<br>**4 pts**<br>**Excellent**<br>Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.<br>**3 pts**<br>**Fair**<br>Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.<br>**2 pts**<br>**Poor**<br>Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing.<br>**1 pts** | /4 pts |
| **Writing Mechanics and APA Formatting Guidelines** | **Full Marks**<br>Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.<br>**4 pts**<br>**Excellent**<br>Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.<br>**3 pts**<br>**Fair**<br>Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.<br>**2 pts**<br>**Poor**<br>Demonstrates issues in writing and communicating clearly. APA style and writing mechanics need serious attention.<br>**1 pts** | /4 pts |
## image1.png
## image2.png
**## 611week3asignment.docx**
3
**Literature Review and Evidence Matrix**
Krystal Nieto
St. Thomas University
NURS 611
Dr. Patton
July 20, 2025
**Literature Review and Evidence Matrix**
**Literature Review**
Influenza infection is one of the leading respiratory infectious diseases that poses a major health risk for older adults, leading to higher mortality and mobility rates among this population. According to research, among reported millions of flu-related illnesses, hospitalizations, medical visits, and deaths, "people 65 years and older accounted for 45% of hospitalizations and 58.7% of deaths, (Du et al., 2024, p.1). Influenza vaccination has played a major role in improving global health, particularly among vulnerable populations, such as the elderly, who are at a higher risk of developing severe flu complications. However, despite the clear benefits and availability of vaccine services, the acceptance and coverage of influenza vaccination remains a major issue among older adults dwelling in the community. In addressing this gap, nursing interventions play a significant role in promoting vaccine acceptance and uptake through education, reminders, telehealth, and tailored communication. The research aims to explore barriers to influenza vaccination uptake in older adults aged 60 years and above, and to identify evidence-based nursing interventions that can help improve the rate of influenza vaccination in community settings. Therefore, this section of the research will review peer-reviewed literature on nursing interventions to address the problem, drawing on research conducted over the last five years, and provide a summary and analysis of the studies. These findings will not only provide the background for the research problem but also contribute to a further understanding of evidence-based nursing interventions, which are the solutions.
An article by Antonelli Incalzi et al. (2024) provides an in-depth narrative review of influenza vaccination, emphasizing the role of healthcare providers, especially nurses, in addressing vaccination hesitancy among the older population. According to the article, influenza leads to a health burden, especially in older adults, and vaccination has been proven to be the most effective method for controlling and preventing flu-related illnesses or complications. However, despite these benefits, the vaccination rate among older adults living in the community remains low. The review points out the need for all healthcare professionals and specialists to participate in increasing the vaccination rate by highlighting that there is a gap in standardized nursing protocols and a need for tailored vaccination interventions at the community level.
Du et al. (2024) conducted a systematic review of 22 randomized controlled trials, reviewing the effectiveness of various intervention strategies that can help increase vaccination rates. Based on the study, health education, which included face-to-face or telephone communication focusing on the elderly's knowledge of influenza and its vaccination, was found to be an effective intervention. These findings suggest that nurses can utilize health education and different learning or communication methods, such as promotional posters, publicity videos, and other community-based educational interactive activities, to improve the understanding of influenza and its vaccination, eventually resulting in acceptance and a high rate of vaccination. Du et al.'s (2024) study also identifies centralized reminders and onsite vaccination as effective interventions, where nurses remind the elderly through mail, phone, or face-to-face to get the flu vaccine and inform them on the significance. Combining healthcare education, centralized reminder, and onsite vaccination was found to be an effective strategy for addressing the problem. This indicates that nurses should combine or integrate various strategies from education, to personalized communication, or reminders to increase vaccination coverage or rate in older adults.
Jiang et al. (2022) randomized controlled trial in western China presents video-led educational intervention as an effective strategy to improve vaccination rate in elderly populations. The study indicated that although the influenza vaccination is widely available in the community, there is a lack of knowledge related to the severity of the infections in the vulnerable population, like the elderly, and suspicion about the safety of the vaccines, which were the main barriers to influenza vaccination in the older population. Based on the results, the use of video-led educational intervention positively influenced old people's willingness to take the influenza vaccine, as it resulted in improved knowledge on the vaccine and actual uptake. This supports Du et al.'s (2024) results, where health education was found to be an effective nursing intervention, making it an evidence-based strategy.
Supporting Du et al. (2024), centralized remainder as an effective nursing intervention, Sääksvuori et al. (2022) conducted a large-scale cluster randomized clinical trial in Finland, which concluded that information nudges as a behavioral intervention can increase the influenza vaccination rate. Based on these findings, well-tailored informational nudges such as reminders and personalized communication can help address common barriers to vaccination in older adults. However, the effectiveness of reminders regarding vaccination benefits may depend on the prior vaccination history of the older adults, suggesting that it is important for nurses to design reminders that address the psychological barriers, which may prevent this population from getting influenza vaccination.
Overall, the literature suggests that influenza vaccination is crucial in preventing flu-related complications in older people who are at higher risk. To address the acceptance of the vaccine and vaccination rate among this population, the studies suggest evidence-based nursing interventions that involve employing health education tools such as videos, behavioral information nudges, onsite vaccination that combines education and informed consent, as well as personalized or centralized communication. However, the gaps remain in ways to effectively integrate these nursing interventions into routine nursing practice and ways to identify effective practices that are adaptable across diverse cultural and healthcare settings.
**Evidence Matrix**
Name:
\_\_\_____________
Date:
\_\_\______________
| | | | | | | | |
| — | — | — | — | — | — | — | — |
| **Author(s)** | **Journal** | **Year of Publication** | **Research Design** | **Sample Size** | **Outcome variable Measured** | **Quality (A, B, C)** | **Results/Author’s suggested Conclusion** |
| Antonelli Incalzi et al., | Internal and Emergency Medicine | 2024 | Narrative Review and Expert Opinion | N/A | Barriers and strategies for Vaccination | B | -Vaccination can help reduce severe elderly illnesses or complications associated with influenza.<br>-Emphasized on nurses utilizing personalized communication to increase vaccine confidence and adherence among the older population. |
| Du et al., | Age and ageing | 2024 | Systematic Review and Network Meta-Analysis of 22 Randomized Controlled Trials | 385,182 older adult participants. | Intervention strategies for increasing coverage of influenza and pneumonia vaccination | A | -Among the evaluated interventions, a combination of healthcare education, centralized reminder, and onsite vaccination improved the elderly vaccination rate.<br>-The authors recommend considering the costs. |
| Jiang et al., | BMC Public Health | 2022 | Community-based Randomized Controlled Trial | 350 (older adults aged 60 years and above) | Video-led education intervention impact. | A | -Video-led education was an effective intervention for improving elderly willingness to be vaccinated. <br>-The authors recommend that policymakers research the cost-effectiveness of applying this intervention to a broader population and regions. |
| Sääksvuori et al., | PLoS Medicine | 2022 | Cluster Randomized Controlled Trial | A large population of the elderly in Finland | Effect of remainder on the vaccination rate | A | -Sending reminders was an effective nurse intervention to increase the vaccination rate among the elderly. |
**References**
Antonelli Incalzi, R., Consoli, A., Lopalco, P., Maggi, S., Sesti, G., Veronese, N., & Volpe, M. (2024). Influenza vaccination for elderly, vulnerable, and high-risk subjects: a narrative review and expert opinion.
_Internal and Emergency Medicine_,
_19_(3), 619-640.
[https://link.springer.com/article/10.1007/s11739-023-03456-9](https://link.springer.com/article/10.1007/s11739-023-03456-9)
Du, P., Jin, S., Lu, S., Wang, L., Ma, X., Wang, J., & Feng, X. (2024). Strategies to increase the coverage of influenza and pneumonia vaccination in older adults: a systematic review and network meta-analysis.
_Age and ageing_,
_53_(3), afae035.
[https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920](https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920)
Jiang, M., Yao, X., Li, P., Fang, Y., Feng, L., Hayat, K., & Atif, N. (2022). Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial.
_BMC Public Health_,
_22_(1), 1128.
[https://link.springer.com/article/10.1186/s12889-022-13536-8](https://link.springer.com/article/10.1186/s12889-022-13536-8)
Sääksvuori, L., Betsch, C., Nohynek, H., Salo, H., Sivelä, J., & Böhm, R. (2022). Information nudges for influenza vaccination: Evidence from a large-scale cluster-randomized controlled trial in Finland.
_PLoS Medicine_,
_19_(2), e1003919.
[https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919](https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919)
**## 611week4assignment.docx**
**_Introduction & PICOT Question Assignment_**
For this assignment, you will write an introduction. Refer to
[Module 3: Lecture Materials & Resources](https://stu.instructure.com/courses/46198/pages/module-3-lecture-materials-and-resources) to help you complete this assignment.
**Your Introduction must include:**
· Your PICOT question.
· Purpose of or rationale for the scholarly project:
· Provide an evidence-based explanation of why it is necessary to complete your scholarly project and what benefit will be gained (health promotion, fiscal, and efficiency).
· Background on the problem or population of interest:
· Using primary sources, provide data on your topic.
· Providing the background will demonstrate the focused need for your project.
· Significance of the problem to nursing and health care:
· State how your problem or population of interest aligns with the larger interest of health care in the community.
· Create a context to why your topic is important.
· Benefit of the project to nursing practice:
· State what will be gained from your project.
· Describe the expected outcomes of your project to practice within your population and setting.
· Relate the outcomes to evidence-based guidelines and outcomes.
· Describe how your project may influence other populations or settings.
**Submission Instructions:**
· The introduction is original work and logically organized.
· The paper is 2-3 pages in length and follows current APA format including citation of references.
· Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
· Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual).
· Your submission will be reviewed for plagiarism with Turnitin.
**Grading Rubric**
Your assignment will be graded according to the grading rubric.
**Essay/Paper Rubric**
| | | |
| — | — | — |
| Essay/Paper Rubric |
| **Criteria** | **Ratings** | **Points** |
| **Identification of Main Issues/Problems** | **Distinguished**<br>Identify and demonstrate a sophisticated understanding of the issues/problems.<br>**4 pts**<br>**Excellent**<br>Identifies and demonstrate an accomplished understanding of most of issues/problems.<br>**3 pts**<br>**Fair**<br>Identifies and demonstrate an an acceptable understanding of most of issues/problems.<br>**2 pts**<br>**Poor**<br>Identifies and demonstrate an unacceptable understanding of most of issues/problems.<br>**1 pts** | /4 pts |
| **Analysis and Evaluation of Issues/Probelms** | **Distinguished**<br>Presents an insightful, thorough analysis and evaluation of issues/problems.<br>**4 pts**<br>**Excellent**<br>Presents a thorough analysis and evaluation of most of the issues/problems.<br>**3 pts**<br>**Fair**<br>Presents a superficial or incomplete analysis and evaluation of issues/problems.<br>**2 pts**<br>**Poor**<br>Presents unacceptable analysis and evaluation of issues/problems.<br>**1 pts** | /4 pts |
| **Demonstrates a Conceptual Understanding** | **Distinguished**<br>Provides a thorough, competent and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.<br>**4 pts**<br>**Excellent**<br>Provides a competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.<br>**3 pts**<br>**Fair**<br>Provides a competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.<br>**2 pts**<br>**Poor**<br>Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.<br>**1 pts** | /4 pts |
| **Use of Citations to Course Readings and Additional Research/Literature** | **Distinguished**<br>Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.<br>**4 pts**<br>**Excellent**<br>Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.<br>**3 pts**<br>**Fair**<br>Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.<br>**2 pts**<br>**Poor**<br>Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing.<br>**1 pts** | /4 pts |
| **Writing Mechanics and APA Formatting Guidelines** | **Full Marks**<br>Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.<br>**4 pts**<br>**Excellent**<br>Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.<br>**3 pts**<br>**Fair**<br>Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.<br>**2 pts**<br>**Poor**<br>Demonstrates issues in writing and communicating clearly. APA style and writing mechanics need serious attention.<br>**1 pts** | /4 pts |
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## image2.png
**## 611week3asignment.docx**
3
**Literature Review and Evidence Matrix**
Krystal Nieto
St. Thomas University
NURS 611
Dr. Patton
July 20, 2025
**Literature Review and Evidence Matrix**
**Literature Review**
Influenza infection is one of the leading respiratory infectious diseases that poses a major health risk for older adults, leading to higher mortality and mobility rates among this population. According to research, among reported millions of flu-related illnesses, hospitalizations, medical visits, and deaths, "people 65 years and older accounted for 45% of hospitalizations and 58.7% of deaths, (Du et al., 2024, p.1). Influenza vaccination has played a major role in improving global health, particularly among vulnerable populations, such as the elderly, who are at a higher risk of developing severe flu complications. However, despite the clear benefits and availability of vaccine services, the acceptance and coverage of influenza vaccination remains a major issue among older adults dwelling in the community. In addressing this gap, nursing interventions play a significant role in promoting vaccine acceptance and uptake through education, reminders, telehealth, and tailored communication. The research aims to explore barriers to influenza vaccination uptake in older adults aged 60 years and above, and to identify evidence-based nursing interventions that can help improve the rate of influenza vaccination in community settings. Therefore, this section of the research will review peer-reviewed literature on nursing interventions to address the problem, drawing on research conducted over the last five years, and provide a summary and analysis of the studies. These findings will not only provide the background for the research problem but also contribute to a further understanding of evidence-based nursing interventions, which are the solutions.
An article by Antonelli Incalzi et al. (2024) provides an in-depth narrative review of influenza vaccination, emphasizing the role of healthcare providers, especially nurses, in addressing vaccination hesitancy among the older population. According to the article, influenza leads to a health burden, especially in older adults, and vaccination has been proven to be the most effective method for controlling and preventing flu-related illnesses or complications. However, despite these benefits, the vaccination rate among older adults living in the community remains low. The review points out the need for all healthcare professionals and specialists to participate in increasing the vaccination rate by highlighting that there is a gap in standardized nursing protocols and a need for tailored vaccination interventions at the community level.
Du et al. (2024) conducted a systematic review of 22 randomized controlled trials, reviewing the effectiveness of various intervention strategies that can help increase vaccination rates. Based on the study, health education, which included face-to-face or telephone communication focusing on the elderly's knowledge of influenza and its vaccination, was found to be an effective intervention. These findings suggest that nurses can utilize health education and different learning or communication methods, such as promotional posters, publicity videos, and other community-based educational interactive activities, to improve the understanding of influenza and its vaccination, eventually resulting in acceptance and a high rate of vaccination. Du et al.'s (2024) study also identifies centralized reminders and onsite vaccination as effective interventions, where nurses remind the elderly through mail, phone, or face-to-face to get the flu vaccine and inform them on the significance. Combining healthcare education, centralized reminder, and onsite vaccination was found to be an effective strategy for addressing the problem. This indicates that nurses should combine or integrate various strategies from education, to personalized communication, or reminders to increase vaccination coverage or rate in older adults.
Jiang et al. (2022) randomized controlled trial in western China presents video-led educational intervention as an effective strategy to improve vaccination rate in elderly populations. The study indicated that although the influenza vaccination is widely available in the community, there is a lack of knowledge related to the severity of the infections in the vulnerable population, like the elderly, and suspicion about the safety of the vaccines, which were the main barriers to influenza vaccination in the older population. Based on the results, the use of video-led educational intervention positively influenced old people's willingness to take the influenza vaccine, as it resulted in improved knowledge on the vaccine and actual uptake. This supports Du et al.'s (2024) results, where health education was found to be an effective nursing intervention, making it an evidence-based strategy.
Supporting Du et al. (2024), centralized remainder as an effective nursing intervention, Sääksvuori et al. (2022) conducted a large-scale cluster randomized clinical trial in Finland, which concluded that information nudges as a behavioral intervention can increase the influenza vaccination rate. Based on these findings, well-tailored informational nudges such as reminders and personalized communication can help address common barriers to vaccination in older adults. However, the effectiveness of reminders regarding vaccination benefits may depend on the prior vaccination history of the older adults, suggesting that it is important for nurses to design reminders that address the psychological barriers, which may prevent this population from getting influenza vaccination.
Overall, the literature suggests that influenza vaccination is crucial in preventing flu-related complications in older people who are at higher risk. To address the acceptance of the vaccine and vaccination rate among this population, the studies suggest evidence-based nursing interventions that involve employing health education tools such as videos, behavioral information nudges, onsite vaccination that combines education and informed consent, as well as personalized or centralized communication. However, the gaps remain in ways to effectively integrate these nursing interventions into routine nursing practice and ways to identify effective practices that are adaptable across diverse cultural and healthcare settings.
**Evidence Matrix**
Name:
\_\_\_____________
Date:
\_\_\______________
| | | | | | | | |
| — | — | — | — | — | — | — | — |
| **Author(s)** | **Journal** | **Year of Publication** | **Research Design** | **Sample Size** | **Outcome variable Measured** | **Quality (A, B, C)** | **Results/Author’s suggested Conclusion** |
| Antonelli Incalzi et al., | Internal and Emergency Medicine | 2024 | Narrative Review and Expert Opinion | N/A | Barriers and strategies for Vaccination | B | -Vaccination can help reduce severe elderly illnesses or complications associated with influenza.<br>-Emphasized on nurses utilizing personalized communication to increase vaccine confidence and adherence among the older population. |
| Du et al., | Age and ageing | 2024 | Systematic Review and Network Meta-Analysis of 22 Randomized Controlled Trials | 385,182 older adult participants. | Intervention strategies for increasing coverage of influenza and pneumonia vaccination | A | -Among the evaluated interventions, a combination of healthcare education, centralized reminder, and onsite vaccination improved the elderly vaccination rate.<br>-The authors recommend considering the costs. |
| Jiang et al., | BMC Public Health | 2022 | Community-based Randomized Controlled Trial | 350 (older adults aged 60 years and above) | Video-led education intervention impact. | A | -Video-led education was an effective intervention for improving elderly willingness to be vaccinated. <br>-The authors recommend that policymakers research the cost-effectiveness of applying this intervention to a broader population and regions. |
| Sääksvuori et al., | PLoS Medicine | 2022 | Cluster Randomized Controlled Trial | A large population of the elderly in Finland | Effect of remainder on the vaccination rate | A | -Sending reminders was an effective nurse intervention to increase the vaccination rate among the elderly. |
**References**
Antonelli Incalzi, R., Consoli, A., Lopalco, P., Maggi, S., Sesti, G., Veronese, N., & Volpe, M. (2024). Influenza vaccination for elderly, vulnerable, and high-risk subjects: a narrative review and expert opinion.
_Internal and Emergency Medicine_,
_19_(3), 619-640.
[https://link.springer.com/article/10.1007/s11739-023-03456-9](https://link.springer.com/article/10.1007/s11739-023-03456-9)
Du, P., Jin, S., Lu, S., Wang, L., Ma, X., Wang, J., & Feng, X. (2024). Strategies to increase the coverage of influenza and pneumonia vaccination in older adults: a systematic review and network meta-analysis.
_Age and ageing_,
_53_(3), afae035.
[https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920](https://academic.oup.com/ageing/article-abstract/53/3/afae035/7626920)
Jiang, M., Yao, X., Li, P., Fang, Y., Feng, L., Hayat, K., & Atif, N. (2022). Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial.
_BMC Public Health_,
_22_(1), 1128.
[https://link.springer.com/article/10.1186/s12889-022-13536-8](https://link.springer.com/article/10.1186/s12889-022-13536-8)
Sääksvuori, L., Betsch, C., Nohynek, H., Salo, H., Sivelä, J., & Böhm, R. (2022). Information nudges for influenza vaccination: Evidence from a large-scale cluster-randomized controlled trial in Finland.
_PLoS Medicine_,
_19_(2), e1003919.
[https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919](https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003919)
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