Which step is NOT part of the four steps set by NVAS for Adult Immunization Practice?

The four steps set forth by the National Vaccine Advisory Committee (NVAC) for Adult Immunization Practice are Assess, Recommend, Administer, and Document. The steps are designed to provide a systematic approach to improving immunization practices for adults.

Assess involves evaluating the individual's vaccination history and identifying which vaccines are necessary based on age, health status, and other relevant factors. Recommend is crucial as it entails suggesting appropriate vaccines based on the assessment, thereby ensuring that patients understand the importance of immunization. Administer is when the healthcare provider delivers the vaccine, while Document emphasizes the importance of recording vaccinations provided to maintain accurate health records for the individual.

"Discuss" is not recognized as one of the core steps in this model. While discussing is an important part of patient interaction, it is not one of the specified steps in the NVAC framework. Therefore, the absence of "Discuss" as an explicit step aligns with the established guidelines for adult immunization practices.