title: Personal choice or evidence-based nursing intervention: nurses' decision-making about influenza vaccination.
abstract: BACKGROUND
  Nursing interventions are actions taken by nurses to enhance patient outcomes. Little is known about nursing interventions such as influenza vaccination in which the nurse's decision to adopt a health behavior impacts patient outcomes. There is strong evidence that immunization of health care workers (HCWs) against influenza is effective in preventing the spread of this disease and lowers mortality among patients. Yet, worldwide influenza vaccination rates among HCWs are low, with nurse vaccination rates among the lowest.
  
  
  OBJECTIVE
  To understand the factors influencing nurses' decision-making about personally receiving immunization against influenza.
  
  
  METHODS
  A qualitative descriptive design in which data were collected using semistructured interviews was used. Participants were 14 RNs who indicated on a prior survey that they were uncertain about, or would not receive an influenza vaccine during the next vaccination season. Data were analyzed using content analysis.
  
  
  RESULTS
  The overarching theme is that influenza immunization is a low priority for nurses. Subthemes include a sense of good health, skepticism of the vaccine's value, fear of vaccine side effects, hand washing as prevention, and inconvenient immunization locations.
  
  
  CONCLUSIONS
  The nurse participants in this study viewed influenza vaccination as a personal health choice, not as an evidence-based nursing intervention. As a result, the decision to decline influenza vaccination was made in the context of personal health choice and/or risk of injury or illness to the nurse. Patient safety outcomes were not expressed as a factor in making the decision to decline influenza vaccination.
authors.affiliation: Department of Nursing, Mayo Clinic, Rochester, MN 55405, USA. rhudy.lori@mayo.edu
authors.forename: Lori M
authors.initials: LM
authors.lastname: Rhudy
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Tucker
authors.forename: Cori L
authors.initials: CL
authors.lastname: Ofstead
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Poland
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D003657:Decision Making; D055318:Evidence-Based Nursing; D005260:Female; D006801:Humans; D017053:Infection Control; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000451:nursing / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology*; D045808:Refusal to Participate / Q000523:psychology
chemical_list: D007252:Influenza Vaccines