The Behaviors of Nurses Who Immunize Children

Abstract

This study examined the behaviors of nurses who immunize children as a factor affecting immunization coverage for prevention of VPDs. Ajzen's (1985) theory of planned behavior was used to construct an instrument called the Nurses' Childhood Immunization Belief Questionnaire (NCIBQ). A mail survey approach was used to distribute the NCIBQ to 316 randomly selected nurses who immunize children in South Dakota following Dillman's (1978) total design method, yielding an 85% response rate.

Multiple regression analysis showed behavioral intention was a significant determinant of behavior (p = .000), perceived behavioral control was positively correlated with behavioral intention (p = .000) and a major predictor of immunizing behavior (p = .001). A positive correlation was found between respondents' immunizing behavior and age (p = .042), education (p <= .001), and professional certification (p < .015). Nurses in public settings were more able to follow accepted vaccine recommendations than those in private settings (p < .01). RNs were also more likely than LPNs to follow recommendations (p = .043), as were nurses with five facilitators to immunization present, including audits, standing orders, the AAP “Red Book”, the Standards for pediatric immunization practices, and WIC linkage (p < .05).</p>

Respondents identified a variety of interventions to relieve discomfort from vaccine injections. Missed opportunities to immunize were evident in responses to each of four case scenarios. Although nurses with more education were more successful at correctly identifying age-appropriate vaccines ( p < .05), inappropriate vaccine choices were common. Findings have several important implications for nursing practice, education, and research.