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Assignment: Project Selection and Approval
You will identify a specific evidence-based practice proposal topic for the project. Consider the clinical environment in which you are currently working or have recently worked. The project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting.
Write a 500-750 word description of your proposed project topic. Make sure to include the following:

The      problem, issue, suggestion, initiative, or educational need that will be      the focus of the project
The      setting or context in which the problem, issue, suggestion, initiative, or      educational need can be observed.
A      description providing a high level of detail regarding the problem, issue,      suggestion, initiative, or educational need.
Impact      of the problem, issue, suggestion, initiative, or educational need on the      work environment, the quality of care provided by staff, and patient      outcomes.
Significance      of the problem, issue, suggestion, initiative, or educational need and its      implications to nursing.
A      proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles.  Please note that all project written assignments in this class will be about the topic that you choose this week.
Answers by topic
Problem: Many patients refuses to receive the flu vaccine when influenza vaccination related to substantial reductions in the risk of hospitalization for pneumonia or influenza. 
Issue. The infection diseases have a higher incidence in Homestead, Florida. Influenza increase a risk to developing pneumonia in general population during flu season.
Initiative: In my study I will make a survey in 30 patient where they tell me if they getting the getting a flu vaccine, in case that they say NO, I make the survey about their knowledge in advantage the patient in get the vaccine that lead change their opinion in this preventive action, and then make educative program and I will expose in the community.
Context: Community Setting conducted in homestead, Fl population 69, 907, with 60 % of Hispanic mainly agricultural community. Reviewed zip code 33033. https://www.census.gov/quickfacts/fact/table/homesteadcityflorida,US/PST045217
Propose solution: 
Solution: Based in patient uncertain and doubt relate to lack of knowledge referent to advantages to get flu vaccine, I will made educative program oriented to eliminate the lack of knowledge regarding the preventive action of the flu vaccine like method to avoid spread infection diseases.
Impact of problem
Center for Diseases Control and Prevention (2018) “recommends a yearly flu vaccine as the first and most important step in protecting against influenza and its potentially serious complications”
· Annual seasonal flu vaccine is the best way to help protect against flu.
· Flu vaccination reduce severity of illness in people who get vaccinated but still get sick.
· Getting vaccinated yourself protect people around you, including the vulnerable population, like babies and young children, older people, pregnant women and people with certain chronic health conditions.
Alberta Health. (2015). Vaccine uptake following a measles outbreak in Alberta, Health System  Accountability and Performance, Surveillance and Assessment Branch. Retrieved from 
Atkinson, P. (1984). Training for certainty. Social Science & Medicine, 19(9), 949–956. doi:10.1016/0277-9536(84)90324-1.
Center of Diseases Control and Prevention (2013). Understanding How Vaccines Work.
Manca, T. (2016). Health professionals and vaccine narrative: “the power of the personal story’ and the management of medical uncertain”. Department of Sociology, University of Alberta, Edmonton, Canada.
On the bias of estimates of influenza vaccine effectiveness from test-negative studies.
Ainslie KEC, Shi M, Haber M, Orenstein WA.
Vaccine. 2017 Dec 19;35(52):7297-7301. doi: 10.1016/j.vaccine.2017.10.107. Epub 2017 Nov 13.
N Engl J Med. 2007 Oct 4;357(14):1373-81.
Effectiveness of influenza vaccine in the community-dwelling elderly.
Nichol KL1, Nordin JD, Nelson DB, Mullooly JP, Hak E.
United States Census bureaus
Center for Diseases Control and Prevention (2018). Preventive Steps. Seasonal Influenza (FLU). Retrieved by www.cdc.gov
Center for Diseases Control and Prevention (2018). Preventing the Flu: Good Health Habits Can Help the Stop Germs. Seasonal Influenza (FLU). Retrieved by www.cdc.gov

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