Measuring Nursing Practitioners Performance: Childhood Immunization

Topic: Nursing
Words: 2059 Pages: 7


Healthcare quality measurements consider diverse factors to reveal the issues, and timely address them to improve cost savings, patient outcomes, and overall efficiency of services. In the United States, Healthcare Effectiveness Data and Information Set (HEDIS) established domains of care through which initiatives, interventions, technologies’ implementation, and nursing practitioners’ performance can be evaluated (National Committee for Quality Assurance [NCQA], n.d.). HEDIS includes more than 90 factors to assess the work of primary care facilities, and, based on them, interventions for quality improvement can be developed, implemented, and evaluated (NCQA, n.d.). Indeed, Childhood Immunization Status (CIS) is the effectiveness of care measurement, which displays how the population vaccinates the children and reveals any challenges in that healthcare domain. Primary care nursing practitioners aware of the issues related to CIS can impact the situation through interventions or evidence-based decision-making in communication with the patients. The strategies’ selection must address statistical data, healthcare systems’ effectiveness, and possible obstacles. This paper aims to develop three interventions to improve the CIS performance measure in primary care and evaluate their impact on patient outcomes, cost savings, and NPs ratings.

Childhood Immunization Status in Primary Care

CIS is the performance measurement that addresses how many children received the injections s for the preventative diseases, and therefore reveals the effectiveness of healthcare facility’s interventions to promote immunizations. This criterion is especially crucial in times of increased discussions about vaccination’s importance due to the COVID-19 pandemic’s elimination challenge. Indeed, NPs today need to be aware of the latest evidence-based strategies to promote immunizations for children and be capable of convincing parents to make the right decisions. NCQA (n.d.) states that “vaccination coverage must be maintained to prevent a resurgence of vaccine-preventable diseases.” Furthermore, underdelivering immunizations can lead to illnesses costly to the citizens, healthcare systems, and, in the worst cases, it will increase national mortality rates.

Performance measurement of CIS can become a valuable mark of effectiveness for the primary care facility and reveal the problems to address through NPs’ activities and interventions. Patient outcomes depend on the quality of operations, communications, and the procedures’ results (Frew & Lutz, 2017). Practitioners can impact each criterion to make evidence-based decisions, solve the short-term problems, and improve their own ratings in the long run. Interventions are divided on the type of activities or aspects of a challenge to address and can be environmental, behavioral, preventative, therapeutic, or legislative (Ozawa et al., 2018). Primary care organizations can improve the CIS measurement through multiple programs, operations, and treatment activities aimed to influence patient outcomes and their awareness of the vaccinations’ vitality. The interventions involving NPs to improve healthcare quality and practitioner’s rates are educational to influence behavior, preventive to increase the CIS, and environmental to help decrease the infections’ development risks.

Behavioral Intervention: Educational Program

The primary care NP’s are the leading communicators with patients, and educational and conversational approaches can impact multiple performance measurements. Behavioral interventions include different tools, such as programs, readings, recommendations, conductance, and handouts about specific healthcare challenges to address (Frew & Lutz, 2017). Consequently, NPs can advocate for vaccinations for children by providing sufficient knowledge and evidence-based practices that would influence clients’ decision-making. Furthermore, educational strategy can include conversations and questionnaires for patients to make practitioners understand if the additional explanations of immunizations’ work are necessary (Carter-Pokras et al., 2021). Although there is no specific nationwide legislation to make vaccinations obligatory, they are highly recommended by healthcare administrators and organizations (Harder et al., 2018). Avoiding immunizations during early childhood can lead to infectious diseases’ spread or cause severe conditions for an individual, and it is the parents’ responsibility to prevent such outcomes.

Behavioral intervention through education can also be performed by creating and distributing materials, handouts, and brochures about vaccination-preventable diseases. Performance measurement of CIS provides the latest percentage of immunizations from the most crucial infections, and NPs can create materials based on the latest data to address the emerging healthcare issues. For instance, posters and brochures about the importance of childhood vaccinations can be printed out and placed in examination rooms to catch the patients’ attention and trigger them to ask questions about vaccines. Educational materials can also describe the severity of avoiding immunizations for children to recall parental responsibility and take action (Carter-Pokras et al., 2021). NPs must achieve balance in the behavioral intervention and minimize the risk of pushing on the patients. The effectiveness of educational programs might significantly decrease if there is no self-motivation from the clients’ end. Parents encouraged to provide their children with timely vaccinations because of their responsibility and care would be more motivated to educate and take action.

Preventive Intervention: Vaccination

Vaccine delivery is a common practice in primary care facilities, and NPs can impact the performance measurement of CIS by providing timely immunization for children or decreasing the difficulties of receiving it. The injection can be performed after discussing with the parents and checking the calendar or after the patient is treated for persistent disease. Harder et al. (2018) claim that “medical record review indicated that quality improvement efforts led to increases in immunization coverage in pediatric primary care” (p. 440). Consequently, the preventive intervention would beneficially influence an organization and provide the clients with a broader scope of services. Primary care facilities can also establish special rooms or units to set events to vaccinate multiple groups of people. However, the initiative requires permission from leaders and physicians, and it would become a positive intervention for the facility’s quality improvement.

Increasing the availability of vaccines is also a part of preventive intervention. An NP must be aware of the current local CIS rates and encourage the primary care organization to take action in addressing the emerging challenges. Indeed, initiating the delivery of the vaccines to a facility and notifying the patients about it can increase the number of clients who would like to get immunizations for their children (Carter-Pokras et al., 2021). Patients with severe symptoms frequently visit primary care facilities, and if their conditions match the vaccine-preventive diseases’, they, or their parents, in the case of children, can be offered to receive a vaccine. The intervention requires to include measurements for analyzing its effectiveness, and the increasing numbers of immunization inquiries would perform as good identifications. Healthcare providers must encourage their organizations to improve their strategies of accelerating infections prevention, and vaccination is the most workable tool for efficient problem-solving.

Environmental Intervention: Risks’ Decrease

The environment of a certain region can be explored through the average rates of quality in healthcare organizations, socioeconomic statuses of the citizens, and accessibility of essential goods and services. NPs must know if there are any challenges in these segments which could influence CIS or infections risks and include preventative strategies into their practices. Furthermore, primary care patients can reveal if there is a threat of an outbreak before serious problems occur, and it is in a facility’s responsibility to note and report deviations to the government (Godard-Sebillotte et al., 2019). NP’s environmental intervention includes maintaining sterile conditions, educating patients and their parents about hygiene and infection prevention, and making evidence-based treatment decisions. Moreover, practitioners can influence CIS by researching how the procedure quality can be improved and what can convince the parents to let their children be vaccinated.

Interventions’ Impact on Patient Outcomes

The impact of behavioral intervention on patient outcomes depends on the efficiency of the educational strategies selected by NPs to include. The most appropriate result in the case of addressing the performance measurement of CIS is if the parents’ check their children’s immunizations via a calendar and ensure they received the necessary vaccinations. Furthermore, the increased number of questions and willingness to know more about diseases and the mechanisms of immune systems among patients is a profound outcome (Carter-Pokras et al., 2021). Lastly, if the children receive immunizations and the CIS measurements are within the standards, the number of primary care facilities visits with the symptoms of an infectious and vaccine-preventable disease will decrease.

Preventive intervention such as vaccination has the most direct patient outcome – the improvement of their health conditions. As the performance measurement is related to children, the change in their parents’ perception of immunizations is also a beneficial result of NP’s activities. Furthermore, improving CIS rates in a selected region can also be considered positive patient outcomes as more children become protected from developing severe diseases and infecting their peers (Ting et al., 2017). Lastly, if the disparities receive the preventive intervention with the same efficiency as other groups, they would likely suggest the primary care organization in their communities.

Environmental interventions contain improving the circumstances of facilities, vaccinations, and other treatment sterility and addressing the challenges of location-specific conditions. The related activities are considered beneficial patient outcomes if individuals of diverse cultural backgrounds receive equal high-quality treatment (Godard-Sebillotte et al., 2019). Moreover, NPs who create a culture of sustainably sterile conditions and well-performed procedures set up benchmarks for other local primary care facilities. Such environmental interventions are challenging to measure; however, they lead to positive patient outcomes.

Interventions’ Influence on Healthcare Cost Savings

The main influence of the successful educational intervention on healthcare cost savings is that vaccine delivery has a lower price for healthcare systems than treating children with infectious diseases. Besides, Medicare and Medicaid programs include immunizations, and treatment requires broader and unpredictable expenses (Ting et al., 2017). The behavioral intervention also impacts multiple people; they will educate each other on the important healthcare information they discovered. Consequently, overall healthcare costs savings would improve in a selected region.

Preventive interventions are the most cost-efficient because they ensure the local primary care facilities that their patients are vaccinated and less likely to reach out for treating infectious diseases. Moreover, immunizations delivered by NPs are less expensive and can be pre-calculated, while the insurance-based expenses on treatment, combined with preventative measures to eliminate infections outbreaks, would severely impact cost savings (Ting et al., 2017). Lastly, as CIS displays the facility’s effectiveness, reasonable rates can help attract additional investments and launch quality improvement projects. Environmental interventions might not effectively reduce the prices of a specific treatment or make healthcare more affordable for populations, yet they can holistically impact the quality of services and make them more cost-efficient (Ozawa et al., 2018). Furthermore, working on enhancing CIS rates at one facility can lead to the development of specific work practices to optimize financial operations.

NP’s Patient Ratings Growth

NP’s patient ratings reveal the clients’ satisfaction from the healthcare services, and in modern primary care facilities, employees’ fees and salaries depend on this measurement. As CIS is a part of effectiveness assessment, its improvement can lead to better practitioners’ outcomes (Kippenbrock et al., 2019). For instance, behavioral intervention through educating about vaccinations can lead to additional visits, and the parents who made crucial steps towards improving their children’s health would leave positive feedback about their NP.

Vaccination is a preventive intervention performed by NPs in primary care, and the increased number of children who timely received an immunization would profoundly impact patient ratings. Parents would be less worried about infections threat and would consider their practitioner a reliable specialist who truly cares about their children’s health and future. Environmental interventions can help grow NP’s patient ratings if they would actively address the challenges experienced locally and encourage the clients to participate in improving their communities’ well-being (Kippenbrock et al., 2019). CIS effectiveness measurements increase is an appropriate strategy to impact the healthcare quality, and practitioners’ personal involvement would be beneficial for their career.


Measuring NP performance through the evaluation of CIS ratings is a workable strategy that would also identify the overall situation in selected primary care facilities. Practitioners can impact childhood vaccination statistics through educational, preventive, and environmental interventions. Indeed, the first can be performed through programs, handouts, and related conversations, the second can be achieved through immunizations, and the third requires an NP to observe and influence local healthcare challenges. These interventions are beneficial for cost savings because they allow replacing pricey insurance-based treatment with vaccination and minimize the risks of infections diseases outbreaks which are expensive. NPs can significantly grow their patient ratings if they address the CIS measurement of effectiveness carefully and thoughtfully. Indeed, encouraging parents to immunize their children might be difficult, yet once they are convinced to take action, their opinion about a practitioner’s work would improve.


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