Nova Scotia nurse practitioners improve vaccination rates through teamwork and innovation

For Nurse Practitioner Week, Nova Scotia Health is recognizing a team of nurse practitioners whose work to improve preventive care for older adults has recently been published in the Canadian Nurse Practitioner Journal.

In 2023, only about 35 per cent of Nova Scotians aged 65 and older had received the publicly funded pneumococcal vaccine, which helps protect against serious infections, including pneumonia. This was well below the national target of approximately 80 per cent, and nurse practitioners across the province saw the opportunity to improve preventive care.

The idea took shape through Nova Scotia Health's Primary Health Care Nurse Practitioner Community of Practice, a gathering of nurse practitioners from across health zones who come together to share knowledge and ideas. Through the Community of Practice, nurse practitioners identified opportunities to improve pneumococcal vaccination rates, which led to the development, testing and evaluation of changes in their clinics. Breanna Lloy, who was serving as Nova Scotia Health's nurse practitioner clinician scientist, helped support the project. The NP clinician scientist is a specialized role that supports nurse practitioners in leading research and using evidence to improve patient care.

"We started by looking at what we could do in terms of preventive healthcare," said Stacy Lillington, a nurse practitioner at Regency Park Family Practice in Halifax. "We talked about things like vaccinations and cervical cancer screening, but for the purpose of the project, we focused on the pneumonia vaccine."

One of the project's most successful strategies for increasing vaccination rates involved making better use of electronic medical records (EMRs). With support from Nova Scotia Health's Primary Health Care Practice Support team, nurse practitioners developed and introduced electronic reminders, or "pop-ups," that alert healthcare providers when a patient may be due for a vaccine, prompting them to discuss it during routine appointments.

"Because the days are so busy and the complexity of patients' needs has increased so much, it's easy to lose sight of some of these preventive pieces that are so important," said Lillington.

The team also created documentation tools and a step-by-step toolkit to help other clinics introduce similar changes, which could be adapted to other preventive health priorities, including shingles and RSV vaccinations, cervical cancer screening and diabetes care.

Martha Darling worked as practice facilitator supporting the work. “The nurse practitioners brought invaluable leadership and perspectives on how to improve clinical care, service delivery and patient experience,” she said. “My role was to make sure the EMR could support those improvements.”

From September 2023 to May 2025, the initiative expanded from three clinics to six, with encouraging results. Among patients aged 65 and older, pneumococcal vaccination rates increased from 22 to 75 per cent at one clinic and from 18 to 75 per cent at another. Three clinics reached or exceeded the 80 per cent target, with one achieving a vaccination rate of 95 per cent.

Nurse practitioner Tracy Kinch explained that electronic reminders were visible to registered nurses and medical office assistants, allowing them to help identify opportunities for vaccination.

"If the medical office assistant saw the reminder, they could offer to book the patient with me or with the registered nurse to discuss the vaccine," said Kinch. "It didn't have to come to me as the nurse practitioner to initiate those conversations."

It’s a perfect example of the team-based, preventive approach at the heart of Nova Scotia's health home model, where healthcare professionals work together to support patients' long-term health.

The team's work was published in the Canadian Nurse Practitioner Journal in 2026 under the title Enhancing Pneumococcal Vaccine Uptake Among Older Adults. In addition to Lloy, Kinch, Lillington and Darling, the article was co-authored by nurse practitioners’ Kim Seeley, Ellen Lukeman, Maggie Gillis and Sonya Marcott.

Lillington and Gillis also presented the team’s findings at a Nurse Practitioner Association of Canada conference.

“Nurse practitioners are educated to look beyond the individual visit to the system around it," said Kinch. "This project used that lens. We identified a gap in care across our clinics, redesigned how our teams and tools work together, and measured the results so other clinics can build on what worked.”

"It's about looking at the bigger picture and finding ways to provide better care, support overall wellness, and help our patients live healthier lives," said Lillington.

Read the published article: Enhancing Pneumococcal Vaccine Uptake Among Older Adults

Photo of Nurse practitioners’ Stacy Lillington (left) and Maggie Gillis (right) presenting their team's quality improvement project to increase pneumococcal vaccination rates among older adults at the Nurse Practitioner Association of Canada (NPAC) national conference in Halifax on April 11, 2026.