Hospital Employee Immunization 1

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Information about Hospital Employee Immunization 1
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Published on January 17, 2008

Author: Ulisse

Source: authorstream.com

Maximizing Healthcare Employee Immunization :  Maximizing Healthcare Employee Immunization Patrick O’Reilly, PhD Masspro November 2007 Immunization Rates for Healthcare Workers :  Immunization Rates for Healthcare Workers  CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2005;54(No.RR-81). WKing,Swoolhandler, ABrown, LJiang, KKevorkian, DHimmelstein, D Bor,JGen Intern Med. 2006 February; 21(2): 181–184. National Rates Overall immunization rate: 35%-40% (2000 National Health Interview Survey) Lowest rates: <50, African-Americans, Health Aides Massachusetts Hospital Employees (2005) 48% (Masspro survey) Nursing Home Staff (2005) 34%   (MassHealth survey) Joint Commission Infection Control Standard:  Joint Commission Infection Control Standard Establish an annual influenza vaccination program that includes at least staff and licensed independent practitioners Provide access to influenza vaccinations on-site Educate staff and licensed independent practitioners about flu vaccination, include non-vaccine control measures and diagnosis, transmission and potential impact of influenza Annually evaluate vaccination rates and reasons for non-participation in the organization’s immunization program Implement enhancements to the program to increase participation. What is the impact of low employee immunization rates?:  What is the impact of low employee immunization rates? Increased risk to patients. Facilities may be required to put a hold on all new admissions until the outbreak is lessened. Patients may have to be diverted due to overcrowding in emergency rooms. Such diversions can have serious medical consequences for patients. Increased staff absenteeism that may require overtime pay or hiring temporary staff. Maximizing Healthcare Employee Immunization :  Maximizing Healthcare Employee Immunization Patrick O’Reilly, PhD Masspro November 2007 “Immunization of health care workers is a serious patient safety issue, given the clear and compelling data regarding the frequency and severity of influenza infection.”:  “Immunization of health care workers is a serious patient safety issue, given the clear and compelling data regarding the frequency and severity of influenza infection.” From: Requiring influenza vaccination for health care workers: seven truths we must accept - 2005 Gregory Poland, Pritish Tosh, Robert Jacobson What are the seven truths?:  What are the seven truths? Poland’s 7 Truths:  Poland’s 7 Truths Influenza infection is a serious illness causing significant morbidity and mortality adversely affection the public health on an annual basis. Poland’s 7 Truths:  Poland’s 7 Truths Influenza infection is a serious illness causing significant morbidity and mortality adversely affection the public health on an annual basis. Influenza-infected HCP can transmit this deadly virus to their vulnerable patients. Roll of HCP in Disease Transmission:  Roll of HCP in Disease Transmission ■ Health care workers are frequently implicated as the source of influenza transmission in health care settings: Employees continue to work while sick with influenza Unvaccinated workers who are infected but not sick can still spread the virus Up to ¼ of HCP contract influenza during the winter Source: APIC Member Initiative Protect your patients. Protect yourself. 2004 Influenza Epidemiology:  Influenza Epidemiology Individuals are contagious for 1-4 days before the onset of symptoms and approximately 5 days after the onset of first symptoms. Approximately 50% of infected people are asymptomatic. Source: APIC Member Initiative Protect your patients. Protect yourself. 2004 Impact on Healthcare Facilities:  Impact on Healthcare Facilities Influenza is highly contagious. Can spread rapidly through a healthcare facility Influenza is transmitted to patients by other patients, visitors, and healthcare personnel. Patients in healthcare facilities are at high risk of complications from influenza due to their age and chronic medical conditions. Source: APIC Member Initiative Protect your patients. Protect yourself. 2004 Influenza Transmission in Health Care Facilities:  Influenza Transmission in Health Care Facilities In 1957, an influenza outbreak infected 39% of patients and incapacitated all but one physician on the neurology ward of a VA hospital. In the 1990s, a nursing home outbreak led to infection in 19% of residents. Thirty-four pneumonia cases: 19 residents hospitalized, two deaths Only 10% of health care workers were immunized In 2000, an outbreak in a NICU affected 19 infants, killing one; HCP were the suspected cause of illness because none of the mothers were infected. Source: APIC Member Initiative Protect your patients. Protect yourself. 2004 Poland’s 7 Truths:  Poland’s 7 Truths Influenza infection is a serious illness causing significant morbidity and mortality adversely affection the public health on an annual basis. Influenza-infected HCP can transmit this deadly virus to their vulnerable patients. Influenza vaccination of HCP saves money for employees and employers and prevents workplace disruption. Economic Impact of Influenza:  Economic Impact of Influenza Yearly influenza vaccination provides a cost savings for workers: Immunized employees save approximately $47 in medical costs annually. Healthy workers who receive an annual influenza vaccination have about 44% fewer doctor visits. Source: APIC Member Initiative Protect your patients. Protect yourself. 2004 Economic Impact of Influenza:  Economic Impact of Influenza Studies show that immunizing HCP against influenza is cost-effective for health care facilities: Workers who receive influenza vaccine take approximately 50% fewer sick days. Replacement workers can result in increased expenses caused by decreased productivity, increased medical errors, and disrupted work environments. Staff shortages can result in or be exacerbated by influenza outbreaks. Double shifts increase the probability of medical errors. Source: APIC Member Initiative Protect your patients. Protect yourself. 2004 Poland’s 7 Truths:  Poland’s 7 Truths Influenza infection is a serious illness causing significant morbidity and mortality adversely affection the public health on an annual basis. Influenza-infected HCP can transmit this deadly virus to their vulnerable patients. Influenza vaccination of HCP saves money for employees and employers and prevents workplace disruption. Influenza vaccination of HCP is already recommended by the CDC and is the standard of care. What is propelling this issue?:  What is propelling this issue? Advisory Committee for Immunization Practices (ACIP) Healthcare Infection Control Practices Advisory Committee (HICPP) National Foundation for Infectious Diseases Center for Disease Control and Prevention American Academy of Family Physicians Joint Commission (New Standard, 2007) Massachusetts Department of Public Health (New Regulation, 2007) Poland’s 7 Truths:  Poland’s 7 Truths Influenza infection is a serious illness causing significant morbidity and mortality adversely affection the public health on an annual basis. Influenza-infected HCP can transmit this deadly virus to their vulnerable patients. Influenza vaccination of HCP saves money for employees and employers and prevents workplace disruption. Influenza vaccination of HCP is already recommended by the CDC and is the standard of care. Immunization requirements are effective and work in increasing vaccination rates. Poland’s 7 Truths:  Poland’s 7 Truths Influenza infection is a serious illness causing significant morbidity and mortality adversely affection the public health on an annual basis. Influenza-infected HCP can transmit this deadly virus to their vulnerable patients. Influenza vaccination of HCP saves money for employees and employers and prevents workplace disruption. Influenza vaccination of HCP is already recommended by the CDC and is the standard of care. Immunization requirements are effective and work in increasing vaccination rates. HCP and health care systems have an ethical and moral duty to protect vulnerable patients from transmissible diseases. FIRST DO NO HARM! Summary of CDC's HICPAC/ACIP Recommendations:  FIRST DO NO HARM! Summary of CDC's HICPAC/ACIP Recommendations Educate HCP regarding the benefits of influenza vaccination Offer influenza vaccine annually to all eligible HCP   Provide influenza vaccination to HCP at the work site and at no cost   Obtain a signed declination from HCP who decline influenza vaccination for reasons other than medical contraindications. Monitor HCP influenza vaccination coverage and declination   Use the level of HCP influenza vaccination coverage as one measure of a patient-safety quality program. www.immunize.org/catg.d/p2014.pdf Poland’s 7 Truths:  Poland’s 7 Truths Influenza infection is a serious illness causing significant morbidity and mortality adversely affection the public health on an annual basis. Influenza-infected HCP can transmit this deadly virus to their vulnerable patients. Influenza vaccination of HCP saves money for employees and employers and prevents workplace disruption. Influenza vaccination of HCP is already recommended by the CDC and is the standard of care. Immunization requirements are effective and work in increasing vaccination rates. HCP and health care systems have an ethical and moral duty to protect vulnerable patients from transmissible diseases. The health care system will either lead or be lambasted. Factors Influencing HCP Decisions to Receive Vaccine:  Factors Influencing HCP Decisions to Receive Vaccine Nichol KL. ICHE 1997; 18: 189. Summary:  Summary Healthy healthcare personnel who receive influenza vaccine have: Fewer upper respiratory infections Fewer health care visits Fewer sick days Less use of medication Lower total health care costs (i.e., save money) Protect the Health and Safety of Patients Nichol KL, Lind A, Margolis KL, et al (1995). The effectiveness of vaccination against influenza in health working adults. New England Journal of Medicine, 333:889-893. Why are the Rates Low? Reasons For Not Getting a Flu Immunization:  Why are the Rates Low? Reasons For Not Getting a Flu Immunization Inconvenient/Too Busy Concerned About Adverse Events Perception of Low Risk Cost Vaccine Not Effective Fear of Needles Make it Convenient Education Education Buy the Vaccine Education Flu-Mist© The Top 10 Poor Excuses for NOT Getting the Flu Shot :  The Top 10 Poor Excuses for NOT Getting the Flu Shot Slide27:  10. You think aches, pains & fever are underrated 9. You’re desperate for a little sympathy 8. You’d like to catch up on the TV soaps 7. You want to keep your colleagues at bay 6. You like your voice a little raspy 5. You get thrills from having the chills 4. You’d like some time away from the office 3. Your stock portfolio includes Kleenex® 2. You consider coughing a full body workout AND THE #1 POOR EXCUSE FOR NOT GETTING THE FLU SHOT IS... 1. You don’t really care about your health or the health of those around you! Elements of a Systematic Employee Immunization Program:  Elements of a Systematic Employee Immunization Program Secure leadership endorsement and support Address vaccine cost issues Establish multi-disciplinary team Develop internal marketing and implementation plan Set vaccination goals Educate healthcare workers Provide easy access Provide incentives Monitor vaccination rate Slide29:  Employee Flu Immunization Campaign Kit Employee Immunization Kit:  Employee Immunization Kit Step 1: Initiate the Campaign:  Step 1: Initiate the Campaign The Five Ws: Who, What, Where, When, Why LAIV vs. TIV Annotated Web Links CDC MDPH Masspro National Foundation for Infectious Disease Step 2: Plan the Campaign:  Step 2: Plan the Campaign Building a Multi-disciplinary Team Assess Last Year’s Program Organizational Commitment Pre-Clinic Preparation Step 3: Promote the Campaign: Education:  Step 3: Promote the Campaign: Education Campaign Poster Campaign Flyers – 4 Languages Publicity Messages Planning a Kick-off Event Making the Campaign Fun Step 4: Operate Clinics & Track Progress:  Step 4: Operate Clinics & Track Progress Vaccine information Statement (VIS) Tips on Operating Clinics Sample Vaccine Administration Record (VAR Sample Vaccination Declination Form Celebrate Successes and Plan for Next Year Step 5: Celebrate Successes Plan for Next Year:  Step 5: Celebrate Successes Plan for Next Year Conduct Post-Campaign Assessment Post-Campaign Announcement Party, Party, Party Web-Sites:  Web-Sites Flu Clinic Locator Flu.masspro.org Campaign Kit www.massmed.org/flu_kit Maximizing Healthcare Employee Immunization :  Maximizing Healthcare Employee Immunization Patrick O’Reilly, PhD Masspro poreilly@maqio.sdps.org sknutsen@maqio.sdps.org November 2007

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