Abstract
Immunization is one of the most effective public health measures for preventing infectious diseases in children (Baidya et al., 2024). Immunization safety and effectiveness depends on proper injection site management (Rishovd, 2014; World Health Organization, 2018). Globally, Evidence-Based Practices (EBP) are recommended to enhance immunization effectiveness and minimize unwanted side effects (Cataldi et al., 2020). However, there is a dearth of empirical evidence on healthcare provider adherence to EBP in injection site management which presents a significant knowledge gap, especially in developing countries. This study assessed the experience and understanding of healthcare providers' adherence to EBP in administering childhood vaccines in three hospitals across Kumasi city, Ghana. The study used the convergent mixed-methods design. Quantitatively, a descriptive cross-sectional design was employed 28 childhood immunization health workers using a checklist to observe immunization practices and online questionnaire. Qualitatively, 12 participants were purposively sampled and interviewed. STATA 16 was used to analyze quantitative data(p ≤ 0.05). Braun and Clarke’s thematic analysis was applied to the qualitative data, which was audio recorded and transcribed verbatim.
Results show more females, with majority having diploma as the highest educational level. Knowledge was high (mean of 81.3), with 57.1%. Self-reported adherence was 96.4% (high) and observed adherence was 89.3% (High/Moderate) with minor facility variations. Significant association with knowledge score and adherence (p= 0.009). Five themes and eleven sub-themes emerged from the qualitative data. Facilitators were Professional roles in immunization, training, learning and knowledge translation, Adherence to EBP guidelines. Barriers were Systemic challenges and resource limitations; Cultural and client-related influences.
In conclusion, high level of knowledge and adherence to EBP in immunization is supported by strong professional norms, teamwork, and supervision. Investing in continuous professional education, effective supervision, and digital innovations for health care professionals can secure the long-term success (Shiri et al., 2023) of immunization. These will strengthen providers’ confidence and capabilities to ensure that knowledge is translated into EBP. Future studies should use longitudinal designs to assess the impact of EBP on immunization outcomes in children.
Notes
Reference list included in attached slide deck.
Sigma Membership
Upsilon Xi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Mixed/Multi Method Research
Keywords:
Implementation Science, Primary Care, Public and Community Health, Immunization of Children, Vaccination of Children, Evidenced-Based Practice, Evidenced-Based Nursing, Ghana
Recommended Citation
Owusu, Lydia Boampong, "Adherence to Evidence-Based Practice in Childhood Immunization: A Mixed-Methods Study" (2026). International Nursing Research Congress (INRC). 216.
https://www.sigmarepository.org/inrc/2026/presentations_2026/216
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-25
Adherence to Evidence-Based Practice in Childhood Immunization: A Mixed-Methods Study
Toronto, Ontario, Canada
Immunization is one of the most effective public health measures for preventing infectious diseases in children (Baidya et al., 2024). Immunization safety and effectiveness depends on proper injection site management (Rishovd, 2014; World Health Organization, 2018). Globally, Evidence-Based Practices (EBP) are recommended to enhance immunization effectiveness and minimize unwanted side effects (Cataldi et al., 2020). However, there is a dearth of empirical evidence on healthcare provider adherence to EBP in injection site management which presents a significant knowledge gap, especially in developing countries. This study assessed the experience and understanding of healthcare providers' adherence to EBP in administering childhood vaccines in three hospitals across Kumasi city, Ghana. The study used the convergent mixed-methods design. Quantitatively, a descriptive cross-sectional design was employed 28 childhood immunization health workers using a checklist to observe immunization practices and online questionnaire. Qualitatively, 12 participants were purposively sampled and interviewed. STATA 16 was used to analyze quantitative data(p ≤ 0.05). Braun and Clarke’s thematic analysis was applied to the qualitative data, which was audio recorded and transcribed verbatim.
Results show more females, with majority having diploma as the highest educational level. Knowledge was high (mean of 81.3), with 57.1%. Self-reported adherence was 96.4% (high) and observed adherence was 89.3% (High/Moderate) with minor facility variations. Significant association with knowledge score and adherence (p= 0.009). Five themes and eleven sub-themes emerged from the qualitative data. Facilitators were Professional roles in immunization, training, learning and knowledge translation, Adherence to EBP guidelines. Barriers were Systemic challenges and resource limitations; Cultural and client-related influences.
In conclusion, high level of knowledge and adherence to EBP in immunization is supported by strong professional norms, teamwork, and supervision. Investing in continuous professional education, effective supervision, and digital innovations for health care professionals can secure the long-term success (Shiri et al., 2023) of immunization. These will strengthen providers’ confidence and capabilities to ensure that knowledge is translated into EBP. Future studies should use longitudinal designs to assess the impact of EBP on immunization outcomes in children.
Description
This mixed-methods study examined healthcare providers’ knowledge and adherence to evidence-based injection site management during childhood immunizations. Findings revealed high knowledge and adherence, supported by professional norms and supervision. Continuous education and digital innovations are recommended to sustain safe immunization practices and improve child health outcomes globally.