Introduction

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Introduction Vaccinating children is crucial because it prevents the spread of potentially deadly illnesses like measles and mumps. Although measles was thought to have been eliminated in 2000, 704 new cases were discovered in 2019. With outbreaks of illnesses that may be prevented by vaccination, the rise in youngsters falling behind on their immunizations or not receiving them at all is becoming a healthcare emergency and, in some places, a catastrophe. Healthcare clinicians at the primary care level are responsible for correcting any misinformation or myths their patients may have heard about immunizations ( Patel et al., 2019) . Primary care practitioners should respect patients' values and norms and deliver information openly, honestly, and nonjudgmentally. The NCQA includes immunization rates for children in the HEDIS database, which measures the efficiency of healthcare. The Centers for Disease Control and Prevention has shown that mumps epidemics may be mitigated with vaccination, with the benefits lasting for a shorter period and affecting fewer people. Infants younger than two months old are at a higher risk of contracting pertussis because they are too young to receive the Diphtheria Tetanus and Pertussis (Tdap) vaccine. Given that the United States (US) has one of the highest mortality rates in the world among wealthy countries, it is recommended that mothers receive Tdap during pregnancy for infant protection ( Patel et al., 2019) . Primary care NPs are responsible for educating their patients and caregivers about the value of vaccines in reducing the risk of vaccine- preventable disease transmission and sickness. This paper aims to investigate potential strategies that might save expenses, boost patient happiness, and enhance health outcomes. Patient Intervention Standardized screening tool In order to determine whether or not a patient should be given the flu vaccine, pharmacists can use a screening tool that includes questions about the patient's medical history and other factors to determine whether or not the patient should be given the vaccine. When a patient checks in at the primary care clinic for an appointment, the frontline medical assistant or nurse can use the electronic medical record (EMR) with a pre-made template to ask questions from the screening tool. This may be used to assess the efficiency of the screening method and give a chance for vaccination to be provided and a "strong recommendation" to be made during the appointment with the NP. Pharmacies in California and Michigan have used the screening tool to screen patients successfully. Consistent with CDC screening recommendations, there has been an increase in the number of people getting flu shots and pneumococcal vaccinations, and the availability of Tdap for pregnant women has increased, decreasing the risk of pertussis infection and even saving lives. It is a great way for people of all ages to get the vaccines they missed ( T. Bach & A. Goad, 2019) . Here is a chance to use and develop a practice-wide resource that can help ensure all scheduled immunizations are administered and those that may have been forgotten. Vaccination clinic visits may be reduced with the screening tool and the electronic medical record's ability to track efficacy. Text messages One strategy for ensuring that patients are up-to-date on life-saving vaccinations is to send them, or their parents or caregivers, a text message three days before an appointment at the clinic reminding them that they are due or overdue for certain immunizations and adding that it is available to be given at

the time of appointment. Patients' willingness to get a flu vaccine was raised by as much as 11% when they were reminded by text message ahead of primary care appointments that a dose had been allocated for them ( Milkman et al., 2021) . Penn Medicine and Geisinger Health tested the effectiveness of using text messages to encourage people to get flu shots. When confirming a patient's preferred mode of notification and phone number in the registration process, it is possible to inquire about their interest in using the EMR to monitor the efficacy of text messages ( Milkman et al., 2021) . Electronic medical records allow for retrieving this data, allowing the administration to compare the outcomes of vaccinated versus unvaccinated patients. Education of staff and patients with posters and handouts Patient education is essential to successful vaccination campaigns and is also necessary for vaccine uptake. Involved staff members' education is also crucial since they can only confidently advise patients on proper information and how to resolve incorrect information if they are up-to-date on vaccinations. Staff should be prepared to answer questions from patients and caregivers about vaccines, and educational materials like handouts, posters, and phone calls may help encourage them to do so. Moreover, the staff should enquire as to the potential consequences on their offspring as well. In the case of flu vaccinations, patients may not know how many individuals die from or have problems due to the flu and congestive heart failure. The staff should be aware of the dangers associated with not getting certain vaccines, such as pertussis vaccination during pregnancy to protect the unborn child from a potentially fatal infection; from 2012-2017, 67% of pertussis deaths reported to the CDC were in infants younger than two months old ( Kroenke et al., 2019) . Staff education should focus on the CDC's recommended vaccination schedule for high-risk patients and any potential risks associated with administering the vaccine. The EMR's efficacy may be gauged by first auditing the number of patients needing vaccinations who are overdue or have no records of receiving them and following up with mailers and phone calls. A follow-up audit of the clinic's electronic medical records (EMR) of patients is being conducted to track the increase in the number of patients who have received immunizations following the rollout of education to staff and patients. Improved Patient Outcomes Patients benefit from better protection against vaccine-preventable illnesses due to increased vaccination coverage after introducing a new screening tool to assess for required or missed vaccines. Patients are immunized against vaccine-preventable diseases, the risk of potential outbreaks in the community is decreased, and patients have the option of traveling without the risk of contracting or spreading vaccine-preventable diseases like measles, which was eradicated in the past but has recently been on the rise due to vaccination hesitancy ( T. Bach & A. Goad, 2019). Vaccine uptake can be boosted by educating both patients and healthcare providers so that the former can better respond to patients' questions and concerns, and the latter can counteract the harmful effects of misinformation campaigns by providing accurate data on the benefits and drawbacks of vaccination ( D'Errico et al., 2021) . Cost Saving The Centers for Disease Control and Prevention estimates that immunizations save nearly $2.2 trillion in healthcare costs and prevent 472 million illnesses and 1,052,000 deaths in vaccinated children born in the United States between 1994 and 2021. The practice may save money that would otherwise be spent

on sick visits and disease treatment if certain conditions were not prevented by boosting immunization rates ( Seither et al., 2019) . Patient Ratings By taking an interest in their health, keeping them informed, and using the tool to check for vaccination gaps, providers may provide patient-centered treatment. While also listening to patients' concerns, nurse practitioners may provide all the facts they need to make educated vaccine choices. In addition, we provide them with the information they need to make decisions without fear of reprisal by giving them pamphlets and going over them with them during our meetings. According to the Consumer Assessment of Healthcare Providers and Systems (CHAPS), nurse practitioners have higher patient satisfaction ratings than their MD colleagues, which rates those enrolled in Medicaid and they received 7.9 out of 10 for overall satisfaction ( Kippenbrock et al., 2019) . This nurse practitioner involvement demonstrates that the patient is important. As a result of the assistance provided by nurse practitioners, patients are more likely to be satisfied with their vaccination selections. Conclusion Generally, vaccinating children protects them against deadly and contagious illnesses. An ideal moment to bring patients up to date on vaccinations is during routine checkups, when a standardized screening method may be used to provide any immunizations that were skipped during the last visit. Three days before an appointment is a good time to send a patient or parent a text message reminding them of the appointment and assuring them that the necessary vaccination will be available. Handouts, posters, and phone calls to patients and staff may help dispel vaccine myths and encourage well-informed vaccination choices. In addition to improving patient outcomes, increasing vaccination rates may reduce the cost to the clinic caused by sick visits that might have been avoided if the patients had been vaccinated against the disease in the first place. Patients are happy with their treatment because they are educated and empowered to choose with the nurse practitioner. References D'Errico, M. P., Tung, W. C., Lu, M., & D'Errico, R. (2021). Knowledge, attitudes, and practices related to human papillomavirus vaccination among college students in a state university: Implications for nurse practitioners. Journal of the American Association of Nurse Practitioners , 33 (9), 709-718. DOI: 10.1097/JXX.0000000000000431 Kippenbrock, T., Emory, J., Lee, P., Odell, E., Buron, B., & Morrison, B. (2019). A national survey of nurse practitioners’ patient satisfaction outcomes. Nursing outlook , 67 (6), 707-712. https://doi.org/10.1016/j.outlook.2019.04.010 Kroenke, K., Alford, D. P., Argoff, C., Canlas, B., Covington, E., Frank, J. W., ... & Sullivan, M. (2019). Challenges with implementing the centers for disease control and prevention opioid guideline: a consensus panel report. Pain Medicine , 20 (4), 724-735. https://doi.org/10.1093/pm/pny307 Milkman, K. L., Patel, M. S., Gandhi, L., Graci, H. N., Gromet, D. M., Ho, H., ... & Duckworth, A. L. (2021). A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s

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appointment. Proceedings of the National Academy of Sciences , 118 (20), e2101165118. https://doi.org/10.1073/pnas.2101165118 Patel, M., Lee, A. D., Redd, S. B., Clemmons, N. S., McNall, R. J., Cohn, A. C., & Gastañaduy, P. A. (2019). Increase in measles cases—United States, January 1–April 26, 2019. Morbidity and Mortality Weekly Report , 68 (17), 402-404. https://www.jstor.org/stable/26644196 Seither, R., McGill, M. T., Kriss, J. L., Mellerson, J. L., Loretan, C., Driver, K., ... & Black, C. L. (2021). Vaccination coverage with selected vaccines and exemption rates among children in kindergarten— United States, 2019–20 school year. Morbidity and Mortality Weekly Report , 70 (3), 75. https://doi.org/10.15585%2Fmmwr.mm7003a2 T. Bach, A., & A. Goad, J. (2019). Using Community Pharmacy Immunization Screening Forms to Identify Potential Immunization Opportunities. Pharmacy , 7 (4), 160. https://doi.org/10.3390/pharmacy7040160

Introduction

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