Meeting Patients Where They Are: A Nurse-Driven Quality Improvement Project to Provide Influenza Vaccinations in the Emergency Department

Published:March 30, 2023DOI:



      Influenza is highly contagious, vaccine-preventable, and may result in significant morbidity and mortality. While vaccination is the primary protection against influenza, vaccination rates remain low. Traditionally, primary care clinics, retail pharmacies, and public health departments offer influenza vaccines. However, offering influenza vaccines in new settings may increase their availability to the public and increase community uptake. This project aimed to add emergency departments as a new influenza vaccine location to increase the number of vaccines distributed during the 2020 to 2021 influenza season.


      Adult patients discharged from 24 emergency departments were included in this pre- post-intervention project. A nurse-driven order set was established to enhance efficiency. Education materials (scripting, fliers, etc.) were developed to help nurses feel comfortable with vaccine information.


      Nurses indicated that education helped increase their belief that influenza vaccination was important. After completing the educational material, a higher number of nurses agreed that it was necessary to encourage others to be vaccinated (P < 0.05). Moreover, emergency department influenza vaccinations increased significantly throughout the 2020 to 2021 influenza season. Nurses across all 24 hospitals administered 2002 vaccines during this season compared to 9 during the previous year’s season.


      The project demonstrated that delivering influenza vaccinations in emergency departments is challenging yet achievable. Educational offerings were valuable resources to increase nurses’ knowledge and positive attitudes about providing influenza vaccines to patients. Further studies regarding how vaccinations could be provided in more emergency departments and alternative care sites, such as urgent care and clinics other than primary care providers, are needed.

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      Stacie Hunsaker, Member, Sigma Theta Tau International Chapter Iota Iota, is an Associate Teaching Professor, Brigham Young University College of Nursing; is an IQSIP Chair, Utah State Emergency Nurses Association; and is an Emergency Nurse, Intermountain Healthcare, Provo, Utah. Twitter: @HunsakerStacie. ORCID identifier:


      Larry Garrett is an Assistant Clinical Professor, University of Utah College of Nursing, Salt Lake City, UT. ORCID identifier:


      Katreena Merrill, Member, Sigma Theta Tau International Chapter Iota Iota, is a Professor, Brigham Young University College of Nursing, Provo, UT. Twitter: @MerrillKatreena. ORCID identifier:


      Rachelle Rhodes is a Clinical Operations Specialty Based Care Executive Director, Emergency Department-Trauma Lane, Intermountain Healthcare, Salt Lake City, UT.