Correlates of Improved Influenza Vaccination of Healthcare Personnel: A Survey of Hospitals in Louisiana

2013 ◽  
Vol 34 (7) ◽  
pp. 723-729 ◽  
Author(s):  
Kayla L. Fricke ◽  
Mariella M. Gastañaduy ◽  
Renee Klos ◽  
Rodolfo E. Bégué

Objective.To describe practices for influenza vaccination of healthcare personnel (HCP) with emphasis on correlates of increased vaccination rates.Design.Survey.Participants.Volunteer sample of hospitals in Louisiana.Methods.All hospitals in Louisiana were invited to participate. A 17-item questionnaire inquired about the hospital type, patients served, characteristics of the vaccination campaign, and the resulting vaccination rate.Results.Of 254 hospitals, 153 (60%) participated and were included in the 124 responses that were received. Most programs (64%) required that HCP either receive the vaccine or sign a declination form, and the rest were exclusively voluntary (36%); no program made vaccination a condition of employment. The median vaccination rate was 67%, and the vaccination rate was higher among hospitals that were accredited by the Joint Commission; provided acute care; served children, pregnant women, oncology patients, or intensive care unit patients; required a signed declination form; or imposed consequences for unvaccinated HCP (the most common of which was to require that a mask be worn on patient contact). Hospitals that provided free vaccine, made vaccine widely available, advertised the program extensively, required a declination form, and imposed consequences had the highest vaccination rates (median, 86%; range, 81%–91%).Conclusions.The rate of influenza vaccination of HCP remains low among the hospitals surveyed. Recommended practices may not be enough to reach 90% vaccination rates unless a signed declination requirement and consequences are implemented. Wearing a mask is a strong consequence. Demanding influenza vaccination as a condition of employment was not reported as a practice by the participating hospitals.

2006 ◽  
Vol 27 (6) ◽  
pp. 612-617 ◽  
Author(s):  
Joon Young Song ◽  
Cheong Won Park ◽  
Hye Won Jeong ◽  
Hee Jin Cheong ◽  
Woo Joo Kim ◽  
...  

Objective.To identify the factors that inhibit or motivate influenza vaccination among healthcare workers (HCWs).Methods.In March 2000, we prepared 34-item questionnaire for both vaccine recipients and nonrecipients regarding demographic characteristics, factors motivating and inhibiting vaccination, and knowledge and attitudes about influenza vaccination. On the basis of the results of our survey, an aggressive hospital vaccination campaign was undertaken. In April 2004, after the 4-year campaign, the same questionnaire was again administered to HCWs.Results.In both 2000 and 2004, the main motives for undergoing influenza vaccination were “hospital campaign” and “recommendation by colleagues”; the percentage of respondents who were motivated by the hospital campaign had remarkably increased from 27% in 2000 to 52% in 2004 (P<.001), whereas the percentage who were motivated by recommendation by colleagues had not changed significantly (21% vs 14%). Qverall, the 4 reasons most frequently cited by HCWs for noncompliance with vaccination were insufficient available time, confidence in their health, doubt about vaccine efficacy, and fear of injection. In 2000, vaccination rates were below 30%, irrespective of occupation. After an aggressive vaccination campaign, the increase in the vaccination rate was highest among the nursing staff, increasing from 21% in 2000 to 92% in 2004, whereas the vaccination rate among the physicians was still below 60%.Conclusion.We conclude that a hospital campaign can markedly improve influenza vaccination rates among HCWs. Both a mobile cart system and free vaccine supply contributed to improving the vaccination rates in our study. In addition, a specifically tailored intervention strategy was required.


2015 ◽  
Vol 36 (6) ◽  
pp. 717-724 ◽  
Author(s):  
Marci Drees ◽  
Kathleen Wroten ◽  
Mary Smedley ◽  
Tabe Mase ◽  
J. Sanford Schwartz

OBJECTIVEAchieving high healthcare personnel (HCP) influenza vaccination rates has typically required mandating vaccination, which is often challenging to implement. Our objective was to achieve >90% employee influenza vaccination without a mandate.DESIGNProspective quality improvement initiativeSETTING AND PARTICIPANTSAll employees of a 2-hospital, 1,100-bed, community-based academic healthcare system.METHODSThe multimodal HCP vaccination campaign consisted of a mandatory declination policy, mask-wearing for non-vaccinated HCP, highly visible “I’m vaccinated” hanging badges, improved vaccination tracking, weekly compliance reports to managers and vice presidents, disciplinary measures for noncompliant HCP, vaccination stations at facility entrances, and inclusion of a target employee vaccination rate (>75%) metric in the annual employee bonus program. The campaign was implemented in the 2011–2012 influenza season and continued throughout the 2012–2013 through 2014–2015 influenza seasons. Employee compliance, vaccination, exemption and declination rates were calculated and compared with those of the seasons prior to the intervention.RESULTSCompared with vaccination rates of 57%–72% in the 3 years preceding the intervention, employee influenza vaccination increased to 92% in year 1 and 93% in years 2–4 (P<.001). The proportion of employees declaring medical/religious exemptions or declining vaccination decreased during the 4 years of the program (respectively, 1.2% to 0.5%,P<.001; 4.4% to 3.8%,P=.001).CONCLUSIONSAn integrated multimodal approach incorporating peer pressure, accountability, and financial incentives was associated with increased employee vaccination rate from ≤72% to ≥92%, which has been sustained for 4 influenza seasons. Such programs may provide a model for behavioral change within healthcare organizations.Infect Control Hosp Epidemiol2015;00(0): 1–8


2009 ◽  
Vol 30 (12) ◽  
pp. 1137-1142 ◽  
Author(s):  
Tara N. Palmore ◽  
J. Patrick Vandersluis ◽  
Joan Morris ◽  
Angela Michelin ◽  
Lisa M. Ruprecht ◽  
...  

Background.Although influenza vaccination of healthcare workers reduces influenza-like illness and overall mortality among patients, national rates of vaccination for healthcare providers are unacceptably low. We report the implementation of a new mandatory vaccination policy by means of a streamlined electronic enrollment and vaccination tracking system at the National Institutes of Health (NIH) Clinical Center.Objective.To evaluate the outcome of a new mandatory staff influenza vaccination program.Methods.A new hospital policy endorsed by all the component NIH institutes and the Clinical Center departments mandated that employees who have patient contact either be vaccinated annually against influenza or sign a declination specifying the reason(s) for refusal. Those who fail to comply would be required to appear before the Medical Executive Committee to explain their rationale. We collected in a database the names of all physician and nonphysician staff who had patient contact. When a staff member either was vaccinated or declined vaccination, a simple system of badge scanning and bar-coded data entry captured essential data. The database was continuously updated, and it provided a list of noncompliant employees with whom to follow up.Results.By February 12, 2009, all 2,754 identified patient-care employees either were vaccinated or formally declined vaccination. Among those, 2,424 (88%) were vaccinated either at the NIH or elsewhere, 36 (1.3%) reported medical contraindications, and 294 (10.7%) declined vaccination for other reasons. Among the 294 employees without medical contraindications who declined, the most frequent reason given for declination was concern about side effects.Conclusions.Implementation of a novel vaccination tracking process and a hospital policy requiring influenza vaccination or declination yielded dramatic improvement in healthcare worker vaccination rates and likely will result in increased patient safety in our hospital.


Author(s):  
Michael Currat ◽  
Catherine Lazor-Blanchet ◽  
Giorgio Zanetti

Abstract Background Vaccination is the most effective prevention of seasonal influenza. Despite its recommendation and active promotion, vaccination coverage remains low among healthcare staff. The goal of the study was to test if a pre-employment health check is a good opportunity to promote future vaccination against influenza among healthcare workers newly hired by a university hospital. Methods All new hospital employees active at the bedside who underwent a pre-employment health check between the end of 2016’s influenza epidemic and the start of the next influenza vaccination campaign were randomly allocated to a control group or an intervention group. The intervention consisted of a semi-structured dialog and the release of an information leaflet about influenza and influenza vaccination during the check-up, and the shipment of a postcard reminder 2 weeks before the next vaccination campaign. Vaccination rates during the campaign were compared among the two groups. Results Three hundred fifty-seven employees were included. Vaccination rates were similar in both groups: 79/172 (46%) in the control and 92/185 (50%) in the intervention group. A significantly higher rate of vaccination was noted among physicians (70/117, 60%) than among other employees (101/240, 42%, p = 0.001). In a pre-defined exploratory analysis among physicians, the vaccination rate was higher in the intervention group (36/51, 71%) than in the control group (34/65, 52%, p = 0.046). Conclusions Promotion of the influenza vaccine during pre-employment health check did not improve the vaccination rate of newly hired hospital healthcare workers overall during the next influenza vaccination campaign. Results suggest a favourable impact on the vaccination rate of physicians. Thus, there may be an interest in using communication strategies tailored to the different categories of healthcare workers to promote the influenza vaccine during pre-employment health check. Trial registration ClinicalTrials, NCT02758145. Registered 26 April 2016.


2012 ◽  
Vol 33 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Kathleen Quan ◽  
David M. Tehrani ◽  
Linda Dickey ◽  
Eugene Spiritus ◽  
Denise Hizon ◽  
...  

Background.Assessing the relative success of serial strategies for increasing healthcare personnel (HCP) influenza vaccination rates is important to guide hospital policies to increase vaccine uptake.Objective.To evaluate serial campaigns that include a mandatory HCP vaccination policy and to describe HCP attitudes toward vaccination and reasons for declination.Design.Retrospective cohort study.Methods.We assessed the impact of serial vaccination campaigns on the proportions of HCP who received influenza vaccination during die 2006–2011 influenza seasons. In addition, declination data over these 5 seasons and a 2007 survey of HCP attitudes toward vaccination were collected.Results.HCP influenza vaccination rates increased from 44.0% (2,863 of 6,510 HCP) to 62.9% (4,037 of 6,414 HCP) after institution of mobile carts, mandatory declination, and peer-to-peer vaccination efforts. Despite maximal attempts to improve accessibility and convenience, 27.2% (66 of 243) of die surveyed HCP were unwilling to wait more than 10 minutes for a free influenza vaccination, and 23.3% (55 of 236) would be indifferent if they were unable to be vaccinated. In this context, institution of a mandatory vaccination campaign requiring unvaccinated HCP to mask during the influenza season increased rates of compliance to over 90% and markedly reduced the proportion of HCP who declined vaccination as a result of preference.Conclusions.A mandatory influenza vaccination program for HCP was essential to achieving high vaccination rates, despite years of intensive vaccination campaigns focused on increasing accessibility and convenience. Mandatory vaccination policies appear to successfully capture a large portion of HCP who are not opposed to receipt of die vaccine but who have not made vaccination a priority.Infect Control Hosp Epidemiol 2012;33(1):63-70


2009 ◽  
Vol 30 (7) ◽  
pp. 691-697 ◽  
Author(s):  
Richard Kent Zimmerman ◽  
Mary Patricia Nowalk ◽  
Chyongchiou J. Lin ◽  
Mahlon Raymund ◽  
Dwight E. Fox ◽  
...  

Objective.As healthcare personnel (HCP) influenza vaccination becomes a quality indicator for healthcare facilities, effective inter¬ventions are needed. This study was designed to test a factorial design to improve HCP vaccination rates.Design.A before-after trial with education, publicity, and free and easily accessible influenza vaccines used a factorial design to determine the effect of mobile vaccination carts and incentives on vaccination rates of HCP, who were divided into groups on the basis of their level of patient contact (ie, business and/or administrative role, indirect patient contact, and direct patient contact).Setting.Eleven acute care facilities in a large health system.Participants.More than 26,000 nonphysician employees.Results.Influenza vaccination rates increased significantly in most facilities and increased system-wide from 32.4% to 39.6% (P < .001). In the baseline year, business unit employee vaccination rates were significantly higher than among HCP with patient contact; rates did not differ significantly across groups in the intervention year. In logistic regression that accounted for demographic characteristics, intervention year, and other factors, the use of incentives and/or mobile carts that provided access to vaccine at the work unit significantly increased the likelihood of vaccination among HCP with direct and indirect patient contact, compared with control sites.Conclusions.Interventions to improve vaccination rates are differentially effective among HCP with varying levels of patient contact. Mobile carts appear to remove access barriers, whereas incentives may motivate HCP to be vaccinated. Education and publicity may be sufficient for workers in business or administrative positions. Interventions tailored by worker type are likely to be most successful for improving HCP vaccination rates.


2010 ◽  
Vol 31 (3) ◽  
pp. 233-240 ◽  
Author(s):  
M. Cristina Ajenjo ◽  
Keith F. Woeltje ◽  
Hilary M. Babcock ◽  
Nancy Gemeinhart ◽  
Marilyn Jones ◽  
...  

Objective.To describe the results of different measures implemented to improve adherence to the healthcare worker (HCW) influenza immunization program at BJC HealthCare during the period from 1997 through 2007.Design.Descriptive retrospective study.Setting.BJC HealthCare, a 13-hospital nonprofit healthcare organization in the Midwest.Methods.We reviewed and analyzed HCW influenza vaccination data from all BJC HealthCare Occupational Health Services and hospitals during the period from 1997 through 2007. Occupational health staff, infection prevention personnel, and key influenza vaccination campaign leaders were also interviewed regarding implementation measures during the study years.Results.At the end of 2007, BJC HealthCare had approximately 26,000 employees. With the use of multiple progressive interventions, influenza vaccination rates among BJC employees increased from 45% in 1997 to 72% in 2007 (P<.001). The influenza vaccination rate in 2007 was significantly higher than in 2006: 72%, compared with 54% (P<.001). Five hospitals had influenza vaccination rates that exceeded the target goal of 80% in 2007. The most successful interventions were adding influenza vaccination rates to the quality scorecard incentive program and the use of declination statements, both of which were implemented in 2007. The most important barriers to success identified by interview respondents were HCWs' misconceptions about influenza vaccination and a perceived lack of leadership support.Conclusions.Influenza vaccination rates among HCWs significantly improved with multiple interventions over the years. However, the BJC HealthCare influenza vaccination target of 80% was not attained at all hospitals with these measures. More aggressive interventions, such as implementing mandatory influenza vaccination policies, are needed to achieve higher vaccination rates.


2011 ◽  
Vol 32 (4) ◽  
pp. 375-379 ◽  
Author(s):  
Lynne V. Karanfil ◽  
Jan Bahner ◽  
Joan Hovatter ◽  
William L. Thomas

Objective.To determine whether a mandatory seasonal influenza vaccination program will increase vaccination rates among healthcare personnel (HCP) and affiliated physicians.Setting.MedStar Health is a not-for-profit regional healthcare organization that includes 9 hospitals with approximately 25,000 HCP and approximately 4,000 affiliated physicians. HCP describes any person employed by MedStar Health.Methods.With previous vaccination rates parallel to reported national rates of 54% among HCP, MedStar Health introduced a mandatory seasonal influenza vaccination program promulgated during the 2009–2010 influenza season. HCP and affiliated physicians were given an opportunity to apply for medical or religious exemptions. Noncompliant HCP were terminated. Noncompliant physicians had their privileges administratively suspended for the influenza season.Results.HCP compliance (vaccinated and exempt) was 99.9%. The influenza vaccination rate among HCP was 98.5%. There were 338 approved medical exemptions and 18 approved religious exemptions. Only 0.01% of HCP (9 full-time, 2 part-time, and 17 per diem employees) were terminated. Overall, 93% of the affiliated physicians were vaccinated; 7 religious and 99 medical exemptions were granted. In total, 149 physicians (4%) had their admitting privileges suspended during the influenza season.Conclusion.A mandatory influenza vaccination program achieves high rates of vaccination among HCP and affiliated physicians.


2008 ◽  
Vol 29 (4) ◽  
pp. 309-313 ◽  
Author(s):  
Shetal I. Shah ◽  
Martha Caprio

Background.Trivalent inactivated influenza vaccine (TIV) is indicated for healthcare workers (HCWs); however, the vaccination rate in this population is estimated at 35%. We implemented a program for the administration of TIV, targeted at parents of neonatal intensive care unit (NICU) patients.Objective.To determine the effect of availability of TIV to parents in the NICU on HCW vaccination rates.Design.Questionnaire survey after an intervention-based study.Setting.Tertiary-care neonatal intensive care unit.Participants.Physicians, nurses, and other NICU-based staff.Methods.For the 2005-2006 influenza season, parents of NICU patients were screened and administered TIV, if informed consent was obtained. As a consequence, TIV was available 20 hours/day to all staff. Previous vaccination history and comorbidities in HCWs were also assessed.Results.Of 120 neonatal HCWs, 112 (93%) were screened during the 2005-2006 season; 80 (67%) were vaccinated, compared with 49 (41%) prior to the implementation of this program (P < .03, by Student's t test); 54 (45% of the study population, which includes senior neonatologists, fellow and resident physicians, nurses, respiratory therapists, X-ray technicians and clerical staff) received TIV in the NICU, compared with the 17 (14%) of 120 HCWs the previous year; and 20 (46%) of 43 HCWs of the nursing staff were vaccinated in the NICU, whereas only 3 (7%) of 43 HWCs were vaccinated outside the unit. Attending physicians had the lowest vaccination rate, and most cited efficacy and/or side effects in their deferral. Nurses most often refused influenza vaccination because they had a fear of injection.Conclusions.Administration of TIV in the NICU is an effective means of increasing the vaccination rate among neonatal HCWs. To increase compliance with vaccination, educational efforts for nurses should emphasize the possibility of viral transmission to neonates as motivation for vaccination. Physician-directed efforts should include tolerability of vaccine side effects. Live attenuated influenza vaccine, administered intranasally, should be considered to increase vaccination rates among NICU nurses.


Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Margaret A. Dudeck ◽  
Katherine Allen-Bridson ◽  
Raymund Dantes ◽  
Cindy Gross ◽  
...  

Abstract Using data from the National Healthcare Safety Network (NHSN), we assessed changes to intensive care unit (ICU) bed capacity during the early months of the COVID-19 pandemic. Changes in capacity varied by hospital type and size. ICU beds increased by 36%, highlighting the pressure placed on hospitals during the pandemic.


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