1. Health Promotion Shingles Immunization Tonya Anderson, RN, BSN PCNP Student Auburn University

2.  Health promotion is one of the most important roles of the nurse practitioner.  The goal for each patient is that they achieve and maintain optimal health.  “Optimal Health is created by a balance of all of the components of health: physical, psychological, and spiritual.”  Examples: immunization, smoking cessation, health screenings, disease prevention classes, and weight loss and diet education. Health Promotion (Dunphy, 2011 )

3.  Increase Awareness  Improve Health  Prevent Disease  Motivate Patients to take control of their health  Decrease Complications Health Promotion Goals

4. Shingles Prevention Health Promotion Project

5.  Site: Thomasville Nutrition Center  Attendees: 24 Senior citizens age 60 and older. Implementation

6.  The project focused on individuals age 60 years and older.  Goal: Educate the group about shingles, its complications, and prevention through vaccination.  A brochure was developed and provided for each that attended. Design

7.  A 15 minute presentation  Question and Answer session  Survey Delivery

8.  A painful skin rash that is made up of blisters which develop on one side of the body. Fever, chills, headache, upset stomach Symptoms last 2-4 weeks.  It is not contagious but those who have not had the chickenpox or the chickenpox vaccine can get chickenpox. This is rare.  Shingles is caused by the same virus that causes chickenpox (varicella-zoster). Shingles (Herpes Zoster) (CDC, 2011)

9.  If you have had the chickenpox then the shingles virus is dormant in the cells of the nervous system and may manifest at any time in your life.  One in three people age 60 or older will have shingles.  People who are age 85 or older have a 50% risk of having shingles. Risks (CDC, 2011 )

10.  One in five will have Post Herpetic Neuralgia  Skin infections and scarring  Hearing loss  Visual impairment Complications

11.  Licensed in 2006  CDC (2011) recommends Zostavax for age 60 and older  Reduces risk of shingles by 51%  Reduced risk of post herpetic neuralgia by 67%  Cash cost is $220  Covered by Medicare D plans Zostavax

12.  Redness, soreness, swelling, or itching at injection site. (1 in 3)  Headache (1 in 70) Common Side Effects

13.  Those with weakened immune systems due to HIV, chemotherapy, leukemia, lymphoma, or long-term steroid use  Pregnant  Those allergic to gelatin or neomycin Who should not take Zostavax?

14.  20% had shingles in the past  46% did not know that shingles could have long term effects  1 of 24 did not know about the Zostavax  21% had taken the vaccine  Of the 79% that had not 57% plan to take the vaccine  100% of the group believed that the information was helpful Evaluation

15. References  Centers for Disease Control (2011, January). Shingles Vaccination: What you need to Know. Retrieved on November 9, 2012, form http://www.cdc,gov/vaccines/vpd-vac/shingles/vacc- need-know.htm  Dunphy, L. M., Winland-Brown, J. E., Porter, B. O. & Thomas, D. J. (2011). Primary care: The art and science of advanced practice nursing (3 rd ed.). Philadelphia, PA: F. A. Davis Company.  Rutechi, G. W. (2013, October). Herpes zoster on the rise. Consultant: Peer-Reviewed Consultations in Primary Care 53(10), 751.

16. Questions