الفهرس 
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Abstract
Dissertation Title : External Validity of a Clinical Nursing Protocol for Management of Vaccination Process. Implementation of the clinical nursing protocol for vaccination process management would provide a referenced educational tool for improving the vaccinator nurses’ knowledge and raising their vaccination practice. The RE-AIM model is an external validity tool to provide a comprehensive approach for evaluating the potential public health impact of an intervention. The aim of the present study is to test external validity of a clinical nursing protocol for management of vaccination process. The study was conducted at (28) primary health care facilities of Mansoura district at Dakahlia governorate. The sample size was 160 vaccinator nurses, as well as, 384 caregivers chosen by using convenient sampling technique. Tools of the study were used to collect the data comprised of: vaccinator nurses’ demographic and occupational data; knowledge and practice of in relation to vaccination process management; vaccinator nurses’ feedback related the orientation sessions and the applied protocol. As well as caregivers’ satisfaction regarding the delivered vaccination services. Study results revealed that the protocol was externally valid; Reach into the studied vaccinator nurses (R=30.61%) was acceptable, effectiveness (E= 55.32%), Adoption (A= 53.36%), Implementation (I= 98.4%), and maintenance (M =74.35 %) of CNP were high by the included facilities. The overall measure of the CNP impact calculated to be 62.4%. The main conclusion drawn from the present study is that the clinical nursing protocol for vaccination process management is externally valid. The implementation of the clinical nursing protocol in different facilities by different vaccinator nurses resulted in improvement in nurses’ knowledge and practice regarding vaccination process management, as well as raising caregivers’ satisfaction regarding the delivered vaccination services with long-term maintenance. The study recommended dissemination of the clinical nursing protocol for vaccination process management among vaccinator nurses for future, at different PHC facilities and on regular basis.