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Week 4 Critical Appraisal/Integrative Literature Review

Week 4 Critical Appraisal/Integrative Literature Review

QUESTION
Write a literature review of your change project topic using peer-reviewed articles and books, as well as non-research literature such as evidence-based guidelines, toolkits, and standardized procedures. Identify and cite all sources of data according to APA guidelines. The goal is to review and critique the most current research to support your change project; this research will help drive the focus of your research. Summarize the key findings and provide a transition to the methods, intervention, or clinical protocol section of your final paper. Describe any gaps in knowledge that you found and the effects this may have on nursing practice as it relates to your change project topic. The literature review should be a synthesis of how each article relates to your change project. Also, when writing your literature review, remember to include subtopics to your main topic and gather data on these areas as well. For example, if you are doing a project on cancer, then subtopics for cancer treatments should be included.

Your integrative literature review should be at least 6 pages in length, not including the cover or reference pages, and must contain a minimum of 10 scholarly articles, published within the past 5 years.

I have added the project I am working off of based on Importance for COVID-19 Vaccine in employee health
Week 4 Critical Appraisal/Integrative Literature Review

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Week 4 Critical Appraisal/Integrative Literature Review

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Week 4 Critical Appraisal/Integrative Literature Review
Vaccine hesitancy among healthcare workers is not an uncommon phenomenon. Still, with the prevalence of the COVID-19 pandemic and its effects on the general population, vaccine hesitancy becomes an issue that needs immediate attention. Research has found that, among other positive outcomes, vaccinated healthcare workers and those who have a more positive attitude towards vaccines are more likely to recommend vaccination to their patients, translating to a higher number of patient vaccinations. Several sources have documented diverse reasons for hesitancy among healthcare workers, and addressing the reasons for resisting uptake of vaccines translates to a higher intake. Of vital interest were the roles of preceptors in informing healthcare workers and the application of a clinical teaching partnership. For these reasons, this section seeks to find out what other sources suggest about ways of combatting vaccine hesitancy among healthcare workers, primarily through preceptorship and Clinical Teaching Practice.
The theoretical framework of this research is to further existing knowledge on vaccine hesitancy among healthcare workers and ways of combating it. Chen & Cole identify vaccine hesitancy as a problem for the general population and healthcare workers. They suggest that combatting vaccine hesitancy by answering the causes of the hesitancy would be a great place to start. Heyerdahl et al. (2022) also recognize vaccine hesitancy as a problem that influences the uptake of vaccines in the general population because patients take healthcare workers as the most trusted sources of information regarding health and vaccines, thus influencing vaccine uptake. They also identify several risks associated with vaccine hesitancy among healthcare workers. Healthcare workers do not voice their concerns to their colleagues because of institutional pressure to partake in what promotes public health and safety. The themes identified in most research articles are the causes of vaccine hesitancy, its impact on the general population, and ways of combating vaccine hesitancy among healthcare workers.
Vaccine hesitancy and the causes
The WHO describes vaccine hesitancy as any delay in accepting or refusing to accept vaccines despite existing vaccination services (World Health Organization, 2020). It recognizes that it is broad, diverse, and content-specific and differs with the type of vaccine, hesitant individuals, and the country in which they are hesitant. Similarly, Chen & Cole (2021) also identify healthcare workers as hesitant individuals and find that nurses have the most considerable rates of hesitancy among healthcare workers, especially those who work in indirect patient care like administrative services (Chen & Cole, 2021). Chen & Cole identify lack of sufficient knowledge or misinformation regarding vaccines, lack of support to prove vaccine safety and efficacy, and perceived risks of vaccination as the route cause for vaccine hesitancy. Similarly, Nossier identified factors as the causes of vaccine hesitancy (Nossier, 2021). The combination of factors includes but is not limited to perceived risks associated with vaccines, lack of confidence in vaccines, individual values, and socioeconomic contexts that drive individual perceptions. The perceptions associated with healthcare workers were the issues with vaccine safety and efficacy, the short time associated with making the vaccine, and the novelty of the method used.
Rittle conducted a literature review on several published articles regarding vaccine hesitancy for the COVID-19 vaccine. In France, fewer administrative healthcare staff like technicians and auxiliary nurses than other healthcare workers like doctors and physicians intended to get vaccinated (Rittle, 2022). Paris et al. also found that most healthcare workers that periodically accepted influenza vaccines accepted the COVID-19 vaccine compared to those that skipped out on the influenza vaccine (Paris et al., 2021). Rittle also found that in the United States, only a tiny fraction of doctors compared to a more significant percentage of nurses refused the novel vaccine. The majority of the reasons in these articles cited insufficient published information backing the long-term safety and efficacy of the vaccines, influence of media with negative or controversial information, concerns about the approval process, absence of enough availability of sufficient data supporting clinical trial and safety data, and multiple concerns for individual safety. Sometimes, some healthcare workers overlook the devastation some diseases would inflict on the general population when there are no interventions to stop them.
Effects
The effects of vaccine hesitance affect the individual and the entire healthcare sector. Vaccines are still the most significant evolution in the healthcare sector for healthcare workers to combat the spread of fatal infectious diseases. Healthcare workers that are hesitant risk exposure to the disease and are likely to fall ill after exposure. They would thus lose work days, spend more time away from work, and end up with poor work satisfaction because of persistent infection with certain strains that would have been prevented through vaccination. Additionally, they are less likely to suggest or promote vaccine uptake to their patients and would thus increase the continuity of hesitancy in the public. They are also less likely to provide accurate vaccine information to patients when they ask about the vaccines. Overall, vaccine hesitancy on healthcare workers would likely derail the effects of a campaign trial that would otherwise have been successful.
Interventions to reduce vaccine hesitancy among healthcare workers
Several authors recognize the need to combat vaccine hesitancy among healthcare workers using preceptors and clinical teaching practice. Preceptors are experienced and competent nurses who guide students’ professional journeys as they transition from lecture halls to practical setups. They provide resources and helpful knowledge to transition, facilitate the growth of nursing education translated into practical application and create an environment that is safe, peaceful, and healthy for mental, physical, and emotional well being.
Swann et al. recognize the need to educate healthcare workers on vaccines and what surrounds each vaccine. The researchers also acknowledge the need to elaborate on vaccine side effects and be diligent when reporting any adverse reaction (Swann et al., 2022). Additionally, Pennington (2021) adds that downplaying or hiding any information regarding vaccine safety, efficacy and tolerance would only create hype and strengthen any hesitancy from patients. The researchers also realize that using preceptors to educate students regarding vaccines should focus on informing the graduates of the long-term safety of the vaccines, emphasize the efficacy of the vaccines, and appeal to the ethics and sense of duty from the healthcare providers.
Additionally, preceptors have access to resources like medical agencies and bodies that contain credible information regarding vaccines and other medications (Swann et al., 2022). These bodies like the international regulators and the World Health Organization are mandated to provide credible information regarding vaccines like the clinical trial data that includes the efficacy, safety, and tolerance, all the identified variants of COVID-19, and all the information regarding the adverse effects associated with injection with the different vaccines, and updated advisory statements regarding vaccine boosters, safety in children, and pregnant women (International regulators and WHO, 2022). These international bodies monitor data on COVID-19 vaccines and offer advisory statements based on credible research and outcomes.
At the same time, Dara et al. (2021) also agree that the provision of sufficient information about all available vaccines, including accurate clinical trial data of all vaccines, the possible and reported side effects, and knowledge regarding the techniques the researchers used to make the vaccines, emphasize on the importance of vaccinations other than prevention of diseases and overall improvement in health and wellness of communities. Similarly, Fenele (2020) also identifies the role preceptors play in transitioning from student life to practice settings. Motivating preceptors to provide practical experiences with vaccinated and unvaccinated populations would improve vaccine uptake by healthcare workers. Additionally, Fenele advises all preceptors to listen to their charges’ concerns and ideas to understand better their background, motivation, and ideas to address each issue.
The Clinical Teaching Practice sessions also offer a robust platform for healthcare providers to share information regarding emerging issues with the teaching fraternity (Nguyen et al., 2020). A clinical teaching partnership is an arrangement where a clinical nursing specialist collaborates with a member from the university or accredited teaching institution to teach students on clinical matters. The faculty member and clinical specialist share information that each uses to shape knowledge dissemination direction. The academic partner schedules the expected experiences and shares information regarding areas the student might fall short. Essentially, the clinical teaching practice aims at integrating theory with practice. Chen & Cole encourage healthcare workers with vaccine hesitancy to evaluate the risks and benefits of vaccination to make a pragmatic decision. They also encourage healthcare workers to integrate evidence-based explanations.
Student education would thus focus on the current practice environment, as healthcare providers would tailor the curriculum based on the demands that ensue. Students who train under the collaborative method have a grounded approach to practicing nursing, are pragmatic in decisions, use research to make choices, and provide adequate patient care. It thus goes without saying that including the importance and advantages of vaccination among healthcare workers would reduce vaccine hesitancy. Additionally, Heyerdahl et al. recognize the need to use new and diverse ways to address vaccine hesitancy. Having pragmatic conversations with the healthcare workers would identify the most effective response to vaccine hesitancy. Chen & Cole also suggests an approach where healthcare workers seek to understand their fellow workers to offer practical solutions.
The issues surrounding vaccine hesitancy today have existed since the inception of vaccines. The perceived effects of safety and efficacy, misinformation, insufficient knowledge, and loss of knowledge regarding the damage some diseases could do when left unchecked all stem from fears and myths perpetrated by individuals who had ulterior motives when at the time spreading lies. Healthcare workers work tirelessly to address hesitancy among their colleagues because most people in the general population look to them and trust their opinions regarding vaccines. Using preceptors to incorporate relevant vaccine information and provide healthcare workers with a platform to find information would reduce the rates of vaccine hesitancy. Additionally, using a collaboration of integrating classroom theories and concepts with practical setups ensures that nurses and other healthcare workers are prepared to face any issues that arise in the course of their profession. Ultimately, healthcare workers are humane, and society should allow them to express themselves. In contrast, healthcare providers should fulfill their moral obligation, adhere to what the law says, and work in the best interest of everyone involved in clinical teaching and practice.  
References
Chen, A. M., & Cole, J. W. (2021, October 26). Addressing vaccine hesitancy among health care workers. Pharmacy Times. https://www.pharmacytimes.com/view/addressing-vaccine-hesitancy-among-health-care-workers/
Dara, S., Sharma, S. K., Kumar, A., Goel, A., Jain, V., Sharma, M., Gupta, M., Saurabh, S., Bhardwaj, P., & Misra, S. (2021). Awareness, attitude, and acceptability of healthcare workers about COVID-19 vaccination in western India. Cureus. https://doi.org/10.7759/cureus.18400/
Fedele, R. (2020, May 3). What is a preceptor? ANMJ. https://anmj.org.au/what-is-a-preceptor/
Heyerdahl, L. W., Dielen, S., Nguyen, T., Van Riet, C., Kattumana, T., Simas, C., Vandaele, N., Vandamme, A., Vandermeulen, C., Giles-Vernick, T., Larson, H., Grietens, K. P., & Gryseels, C. (2022). Doubt at the core: Unspoken vaccine hesitancy among healthcare workers. The Lancet Regional Health – Europe, 12, 100289. https://doi.org/10.1016/j.lanepe.2021.100289/
International regulators and WHO. (2022, May 17). International regulators and WHO: Support healthcare professionals to enhance public confidence in COVID-19 vaccines. European Medicines Agency. https://www.ema.europa.eu/en/news/international-regulators-who-support-healthcare-professionals-enhance-public-confidence-covid-19/
Nguyen, V. N., Lawrence, K., & McGillion, A. (2020). The effectiveness of partnership models in clinical nursing education – A scoping review. Nurse Education Today, 90, 104438. https://doi.org/10.1016/j.nedt.2020.104438/
Nossier, S. A. (2021). Vaccine hesitancy: The greatest threat to COVID-19 vaccination programs. Journal of the Egyptian Public Health Association, 96(1). https://doi.org/10.1186/s42506-021-00081-2/
Paris, C., Bénézit, F., Geslin, M., Polard, E., Baldeyrou, M., Turmel, V., Tadié, É., Garlantezec, R., & Tattevin, P. (2021). COVID-19 vaccine hesitancy among healthcare workers. Infectious Diseases Now, 51(5), 484-487. https://doi.org/10.1016/j.idnow.2021.04.001/
Pennington, M. (2021, July 29). Vaccine hesitancy: A story as old as vaccines themselves. Charles River Laboratories. https://www.criver.com/eureka/vaccine-hesitancy-story-old-vaccines-themselves/
Rittle, C. (2022). COVID-19 vaccine hesitancy and how to address it. Workplace Health & Safety, 70(2), 56-62. https://doi.org/10.1177/21650799211073525/
Swann, M. C., Bendetson, J., Johnson, A., Jatta, M., Schleupner, C. J., & Baffoe-Bonnie, A. (2022). Examining drivers of COVID-19 vaccine hesitancy among healthcare workers. Infection Control Hospital Epidemiology, 1-40. https://doi.org/10.1017/ice.2022.34/
World Health Organization. (2020, October 15). Behavioural considerations for acceptance and uptake of COVID-19 vaccines: WHO technical advisory group on behavioural insights and sciences for health, meeting report. WHO | World Health Organization. https://www.who.int/publications/i/item/9789240016927/
Week 4 Critical Appraisal/Integrative Literature Review

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