Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)




BACKGROUND: Evidence shows that vaccinations lessen disease and death yet many people remain hesitant to receive the COVID-19 vaccination.

PROBLEM: By some estimates, COVID-19 has resulted in $16 trillion in lost wages, healthcare costs, disruptions in the healthcare system, and the economic infrastructure of the country.

METHOD: An exhaustive literature search was conducted resulting in 13 full-text articles. A quality improvement (QI) intervention was developed using the Health Belief Model as a framework and the Johns Hopkins Nursing Evidence-Based Practice for Nurses and Healthcare Professionals Model to translate evidence into practice.

INTERVENTION: Patients from two medical-surgical units of a small community hospital were screened to identify unvaccinated patients. An evidence-based, personalized, motivational interviewing intervention was initiated to determine if a statistically significant decrease in vaccine hesitancy would result. The project leader used a pretest-posttest numerical rating scale (NRS) to measure vaccine hesitancy before and after the intervention.

RESULTS: Results of the QI project showed intention to be vaccinated against COVID-19 was statistically significantly greater after the use of a motivational interviewing intervention than before motivational interviewing with a medium effect size (z = -2.69) indicating clinical significance, p = .007, r = 0.37.

CONCLUSION: Despite the statistical and clinical significance found in this QI project of a decrease in vaccine-hesitancy, it was determined that there is a limited benefit for the use of motivational interviewing in this inpatient setting due to 97.6%, (n = 41) of those scoring less than 4 on the 1-10 scale showing no change in intention to be vaccinated. Those who scored less than 4 on the NRS were termed “vaccine-resistant.”