Leveraging Clinical Externs to Support High-Volume Employee Immunization Campaigns: A Proof-of-Concept Study

Area of Science:

• Healthcare workforce development
• Infectious disease prevention
• Nursing education

Background:

• Annual influenza and COVID-19 vaccination campaigns require significant nursing resources.
• Integrating unregulated care providers can potentially alleviate workforce pressures.
• Existing literature lacks detailed models for delegating vaccine administration to nursing students.

Purpose of the Study:

• To describe the implementation of a program integrating nursing Clinical Externs (CEs) into an annual vaccination campaign.
• To outline the education and competency validation strategies used for CEs administering injections.
• To evaluate the impact of the program on CE confidence, comfort, preparedness, and vaccination capacity.

Main Methods:

• A case study design was employed to implement and evaluate the CE vaccination program.
• Education was structured using adult learning principles and Benner's Novice to Expert Theory.
• Pre- and post-intervention surveys assessed CE confidence, comfort, and preparedness for intramuscular injections.

Main Results:

• CEs reported significant increases: 71% in extreme confidence, 71% in high comfort, and 56.6% in being very prepared post-intervention.
• CEs administered 1,575 vaccinations across multiple hospital sites, supporting high-volume clinic workflows.
• The program enabled Occupational Health Services (OHS) nurses to focus on clinical oversight and complex assessments.

Conclusions:

• Integrating CEs into immunization delivery effectively built learner competence and expanded vaccination capacity.
• The program offers a scalable and cost-effective workforce solution for hospital-based immunization campaigns.
• This model demonstrates the potential for delegation of specific clinical tasks to supervised nursing students.