A Novel Two-Tiered Approach to Increase Healthcare Worker Influenza Vaccination Rates

This study used hierarchical linear modeling to determine the relative contribution of hospital policies and state laws to healthcare worker (HCW) influenza vaccination rates. Hospital mandates with consequences for noncompliance and race were associated with 3%-12% increases in HCW vaccination; state laws were not significantly related to vaccination rates.

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The Impact of Healthcare Worker Influenza Vaccination on Nosocomial Influenza in a Tertiary Hospital: An Ecological Study

10.21203/rs.2.13528/v2 ◽

2020 ◽

Author(s):

Wycliffe Enli Wei ◽

Stephanie Fook-Chong ◽

Wen Kai Chen ◽

Maciej Piotr Chlebicki ◽

Wee Hoe Gan

Keyword(s):

Protective Effect ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Ecological Study ◽

Tertiary Hospital ◽

Vaccination Rate ◽

Incidence Rates ◽

Vaccination Rates ◽

The Impact

Abstract Background: To protect hospitalized patients who are more susceptible to complications of influenza, seasonal influenza vaccination of healthcare workers (HCW) has been recommended internationally. However, its effectiveness is still being debated. To assess the effectiveness of HCW influenza vaccination, we performed an ecological study to evaluate the association between healthcare worker influenza vaccination and the incidence of nosocomial influenza in a tertiary hospital within Singapore between 2013-2018. Methods: Nosocomial influenza was defined by influenza among inpatients diagnosed 7 days or more post-admission by laboratory testing, while healthcare worker influenza vaccination rate was defined as the proportion of healthcare workers that was vaccinated at the end of each annual seasonal vaccination exercise. A modified Poisson regression was performed to assess the association between the HCW vaccination rates and monthly nosocomial influenza incidence rates. Results: Nosocomial influenza incidence rates followed the trend of non-nosocomial influenza, showing a predominant mid-year peak. Across 2,480,010 patient-days, there were 256 nosocomial influenza cases (1.03 per 10,000 patient-days). Controlling for background influenza activity and the number of influenza tests performed, no statistically significant association was observed between vaccination coverage and nosocomial influenza incidence rate although a protective effect was suggested (IRR 0.89, 95%CI:0.69-1.15, p =0.37). Conclusion: No significant association was observed between influenza vaccination rates and nosocomial influenza incidence rates, although a protective effect was suggested. Aligning local HCW vaccine timing and formulation to that of the Southern Hemisphere may improve effectiveness. HCW vaccination remains important but demonstrating its effectiveness in preventing nosocomial influenza is challenging.

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The Impact of Healthcare Worker Influenza Vaccination on Nosocomial Influenza in a Tertiary Hospital: An Ecological Study

10.21203/rs.2.13528/v3 ◽

2020 ◽

Author(s):

Wycliffe Enli Wei ◽

Stephanie Fook-Chong ◽

Wen Kai Chen ◽

Maciej Piotr Chlebicki ◽

Wee Hoe Gan

Keyword(s):

Protective Effect ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Ecological Study ◽

Tertiary Hospital ◽

Vaccination Rate ◽

Incidence Rates ◽

Vaccination Rates ◽

The Impact

Abstract Background: To protect hospitalized patients who are more susceptible to complications of influenza, seasonal influenza vaccination of healthcare workers (HCW) has been recommended internationally. However, its effectiveness is still being debated. To assess the effectiveness of HCW influenza vaccination, we performed an ecological study to evaluate the association between healthcare worker influenza vaccination and the incidence of nosocomial influenza in a tertiary hospital within Singapore between 2013-2018. Methods: Nosocomial influenza was defined by influenza among inpatients diagnosed 7 days or more post-admission by laboratory testing, while healthcare worker influenza vaccination rate was defined as the proportion of healthcare workers that was vaccinated at the end of each annual seasonal vaccination exercise. A modified Poisson regression was performed to assess the association between the HCW vaccination rates and monthly nosocomial influenza incidence rates.Results: Nosocomial influenza incidence rates followed the trend of non-nosocomial influenza, showing a predominant mid-year peak. Across 2,480,010 patient-days, there were 256 nosocomial influenza cases (1.03 per 10,000 patient-days). Controlling for background influenza activity and the number of influenza tests performed, no statistically significant association was observed between vaccination coverage and nosocomial influenza incidence rate although a protective effect was suggested (IRR 0.89, 95%CI:0.69-1.15, p=0.37). Conclusion: No significant association was observed between influenza vaccination rates and nosocomial influenza incidence rates, although a protective effect was suggested. Aligning local HCW vaccine timing and formulation to that of the Southern Hemisphere may improve effectiveness. HCW vaccination remains important but demonstrating its effectiveness in preventing nosocomial influenza is challenging.

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Improving Influenza Vaccination of Healthcare Workers by Means of Quality Improvement Tools

Infection Control and Hospital Epidemiology ◽

10.1086/660198 ◽

2011 ◽

Vol 32 (6) ◽

pp. 616-618 ◽

Cited By ~ 13

Author(s):

Jose Cadena ◽

Teresa Prigmore ◽

Jason Bowling ◽

Beth Ann Ayala ◽

Leni Kirkman ◽

...

Keyword(s):

Quality Improvement ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Seasonal Influenza ◽

Vaccination Rate ◽

Improvement Project ◽

Vaccination Rates ◽

Grand Rounds ◽

Voluntary Vaccination

For a healthcare worker seasonal influenza vaccination quality improvement project, interventions included support of leadership, distribution of vaccine kits, grand rounds, an influenza website, a Screensaver, e-mails, phone messages, and audit feedback. Vaccination rates increased from 58.8% to 76.6% (P < .01). Quality improvement increased the voluntary vaccination rate but did not achieve a rate more than 80%.

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The Impact of Healthcare Worker Influenza Vaccination on Nosocomial Influenza in a Tertiary Hospital: An Ecological Study

10.21203/rs.2.13528/v1 ◽

2019 ◽

Author(s):

Wycliffe Enli Wei ◽

Stephanie Fook-Chong ◽

Wen Kai Chen ◽

Maciej Piotr Chlebicki ◽

Wee Hoe Gan

Keyword(s):

Influenza Vaccination ◽

Healthcare Worker ◽

Healthcare Workers ◽

Ecological Study ◽

Statistical Significance ◽

Tertiary Hospital ◽

Vaccination Rate ◽

Incidence Rates ◽

Vaccination Rates ◽

The Impact

Abstract Background To protect hospitalized patients who are more susceptible to complications of influenza, seasonal influenza vaccination of healthcare workers (HCW) has been recommended internationally. However, its effectiveness is still being debated. To assess the effectiveness of HCW influenza vaccination, we performed an ecological study to evaluate the association between healthcare worker influenza vaccination and the incidence of nosocomial influenza in a tertiary hospital within Singapore between 2013-2018.Methods Nosocomial influenza was defined by influenza among inpatients diagnosed 7 days or more post-admission by laboratory testing, while healthcare worker influenza vaccination rate was defined as the proportion of healthcare workers that was vaccinated at the end of each annual seasonal vaccination exercise. A modified Poisson regression was performed to assess the association between the HCW vaccination rates and monthly nosocomial influenza incidence rates.Results Nosocomial influenza incidence rates followed the trend of non-nosocomial influenza, showing a predominant mid-year peak. Across 2,480,010 patient-days, there were 256 nosocomial influenza cases (1.03 per 10,000 patient-days). Controlling for background influenza activity and the number of influenza tests performed, 10% increase in vaccination coverage corresponded to 11% decrease in nosocomial influenza incidence rate (IRR 0.89, 95%CI:0.69-1.15, p =0.37).Conclusion We observed a negative association between influenza vaccination rates and nosocomial influenza incidence rates, although statistical significance was not reached. Aligning local HCW vaccine timing and formulation to that of the Southern Hemisphere may improve effectiveness. HCW vaccination remains important but demonstrating its effectiveness in preventing nosocomial influenza is challenging.

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Using behavior change frameworks to improve healthcare worker influenza vaccination rates: A systematic review

Vaccine ◽

10.1016/j.vaccine.2016.04.071 ◽

2016 ◽

Vol 34 (28) ◽

pp. 3235-3242 ◽

Cited By ~ 42

Author(s):

Kimberly M. Corace ◽

Jocelyn A. Srigley ◽

Daniel P. Hargadon ◽

Dorothy Yu ◽

Tara K. MacDonald ◽

...

Keyword(s):

Systematic Review ◽

Behavior Change ◽

Influenza Vaccination ◽

Healthcare Worker ◽

Vaccination Rates

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Needling Employees into Compliance: Improving Healthcare Worker Influenza Vaccination Rates Through the Use of Time Off Awards

American Journal of Infection Control ◽

10.1016/j.ajic.2009.04.270 ◽

2009 ◽

Vol 37 (5) ◽

pp. E193-E194

Keyword(s):

Influenza Vaccination ◽

Healthcare Worker ◽

Vaccination Rates ◽

Use Of Time

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Seasonal Influenza Vaccination of Healthcare Employees: Results of a 4-Year Campaign

Infection Control and Hospital Epidemiology ◽

10.1086/659764 ◽

2011 ◽

Vol 32 (5) ◽

pp. 444-448 ◽

Cited By ~ 10

Author(s):

Pamela Hirsch ◽

Michael Hodgson ◽

Victoria Davey

Keyword(s):

Influenza Vaccination ◽

Healthcare Worker ◽

Success Factors ◽

Health Department ◽

Web Based ◽

Vaccination Rates ◽

Telephone Interviews ◽

Improved Performance ◽

Facility Level ◽

Acceptance Rates

Objective.To document successful substantial increases in healthcare worker influenza vaccination rates and to identify reasons for success and failure.Design.(1) Four-year longitudinal characterization of facility vaccination rates, (2) Web-based facility-level questionnaire for influenza coordinators to identify success factors in year 3, and (3) semistructured telephone interviews of influenza coordinators at facilities with substantial increases or declines in year 4.Setting.National single-payer hospital (healthcare) system with 153 hospitals in 5 levels of complexity.Patients.Facility leadership staff.Methods.(1) Vaccination data collected from management sources (doses from pharmacies, denominator data from payrolls); (2) a Web-based survey aligned with a previously administered instrument (Wisconsin Health Department), piloted in-house, modified to reflect national strategies and improvements; and (3) semistructured telephone interviews with influenza coordinators at facilities that improved or worsened by more than 20% between the 2007–2008 and 2008–2009 influenza seasons.Results.Vaccination acceptance rates improved from 45% of healthcare workers in 2005–2006 to 66.5% in 2008–2009. Facilities with lower complexity had higher vaccination rates. No individual factors were associated with improved performance.Conclusions.Sustained management attention can lead to improvements in healthcare worker influenza vaccination rates. Wavering of attention, though, may lead to rapid loss of effectiveness. Declination statements in this system did not contribute to vaccine acceptance.

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Factors Associated with Increased Healthcare Worker Influenza Vaccination Rates: Results from a National Survey of University Hospitals and Medical Centers

Infection Control and Hospital Epidemiology ◽

10.1086/651666 ◽

2010 ◽

Vol 31 (05) ◽

pp. 456-462 ◽

Cited By ~ 32

Author(s):

Thomas R. Talbot ◽

Timothy H. Dellit ◽

Joan Hebden ◽

Danny Sama ◽

Joanne Cuny

Keyword(s):

Influenza Vaccination ◽

Healthcare Worker ◽

Vaccination Rate ◽

University Hospitals ◽

Vaccination Programs ◽

Train The Trainer ◽

Vaccination Rates ◽

Factors Associated ◽

Medical Centers ◽

Leadership Support

Objective. To ascertain which components of healthcare worker (HCW) influenza vaccination programs are associated with higher vaccination rates. Design. Survey. Setting. University-affiliated hospitals. Methods. Participating hospitals were surveyed with regard to their institutional HCW influenza vaccination program for the 2007-2008 influenza season. Topics assessed included vaccination adherence and availability, use of declination statements, education methods, accountability, and data reporting. Factors associated with higher vaccination rates were ascertained. Results. Fifty hospitals representing 368,696 HCWs participated in the project. The median vaccination rate was 55.0% (range, 25.6%-80.6%); however, the types of HCWs targeted by vaccination programs varied. Programs with the following components had significantly higher vaccination rates: weekend provision of vaccine (58.8% in those with this feature vs 43.9% in those without; P = .01), train-the-trainer programs (59.5% vs 46.5%; P = .005), report of vaccination rates to administrators (57.2% vs 48.1%; P = .04) or to the board of trustees (63.9% vs 53.4%; P = .01), a letter sent to employees emphasizing the importance of vaccination (59.3% vs 47%; P = .01), and any form of visible leadership support (57.9% vs 36.9%; P = .01). Vaccination rates were not significantly different between facilities that did and those that did not require a signed declination form for HCWs who refused vaccination (56.9% vs 55.1%; P = .68), although the precise content of such statements varied. Conclusions. Vaccination programs that emphasized accountability to the highest levels of the organization, provided weekend access to vaccination, and used train-the-trainer programs had higher vaccination coverage. Of concern, the types of HCWs targeted by vaccination programs differed, and uniform definitions will be essential in the event of public reporting of vaccination rates.

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