Assessment of Tdap Administration in the Third Trimester of Pregnancy

Abstract

Introduction: In 2012, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention expanded their recommendation for the Tdap vaccination to include the antepartum period. Regardless of immunization history, the recommendation states that medical practitioners should administer the Tdap vaccination to every pregnant woman in each occurring pregnancy (Munoz, et al., 2014; Shakib, et al., 2013; Goldfarb, Little, Brown, Riley, 2014). Methods: To describe treatment practices and uptake of Tdap vaccine, a cross-sectional descriptive survey design was utilized. The purpose of survey is to gather information regarding prevalence, distribution, and interrelations of variables within a population (Polit & Beck). In this study, the survey questionnaire was conducted in an online format. Results: Of the six HBM questions included in the study, except for question four, the results of the chi-squared analysis suggest that any single measured dimension of the HBM cannot predict a health behavior, in this case receipt of the Tdap vaccination. The population is split regarding infants' perceived susceptibility to pertussis infection. Strong agreement to the benefit of vaccination was revealed. Question six regarded available information, although the majority were satisfied a significant percentage indicated a desire for more information. Discussion: This Doctorate of Nursing Practice project developed a survey based on the Health Belief Model with the intention of assessing perceived susceptibility, perceived severity, perceived benefits and perceived barriers to the health care preventative action of receiving the Tdap vaccination in the third trimester of pregnancy. Through in-depth literature review, consideration of the updated ACIP guidelines, and support of a developed theoretical framework, an eight-question survey was developed. The data examined in this project may serve to illustrate limitations in provider care that can be immediately improved upon, such as information sharing. The primary limitation of the study is in the sample size of 44 eligible survey responses and the uniform demographics of the population. Despite these limitations, the survey design may be extended to other populations of interest, with greater demographic variation for further study.