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A Successful Mandatory Influenza Vaccination Campaign Using an Innovative Electronic Tracking System

Published online by Cambridge University Press:  02 January 2015

Tara N. Palmore ,
J. Patrick Vandersluis ,
Joan Morris ,
Angela Michelin ,
Lisa M. Ruprecht ,
James M. Schmitt  and
David K. Henderson
Tara N. Palmore
Affiliation:
Clinical Center, Bethesda, Maryland
J. Patrick Vandersluis
Affiliation:
National Institutes of Health, Bethesda, Maryland; HealthRx, Fairfax, Virginia
Joan Morris
Affiliation:
Occupational Medical Service, Division of Occupational Health and Safety, Bethesda, Maryland
Angela Michelin
Affiliation:
Clinical Center, Bethesda, Maryland
Lisa M. Ruprecht
Affiliation:
Clinical Center, Bethesda, Maryland
James M. Schmitt
Affiliation:
Occupational Medical Service, Division of Occupational Health and Safety, Bethesda, Maryland
David K. Henderson*
Affiliation:
Clinical Center, Bethesda, Maryland
*
National Institutes of Health, 10 Center Drive, MSC 1504, Bethesda, MD 20892-1888 ([email protected])
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Abstract

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 12 , December 2009 , pp. 1137 - 1142
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1.Centers for Disease Control and Prevention. Flu symptoms and severity. Atlanta, GA: Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/flu/about/disease/symptoms.htm. Accessed May 20, 2009.Google Scholar
2.Nichols, WG, Guthrie, KA, Corey, L, Boeckh, M. Influenza infections after hematopoietic stem cell transplantation: risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis 2004;39:1300–1306.CrossRefGoogle ScholarPubMed
3.Voirin, N, Barret, B, Metzger, MH, Vanhems, P. Hospital-acquired influenza: a synthesis using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement. J Hosp Infea 2009;71:1–14.CrossRefGoogle ScholarPubMed
4.Gooskens, J, Jonges, M, Claas, ECJ, Meijer, A, van den Broek, PJ, Kroes, ACM. Morbidity and mortality associated with nosocomial transmission of oseltamivir-resistant influenza A(H1N1) virus. JAMA 2009;301:1042–1046.Google Scholar
5.Pearson, ML, Bridges, CB, Harper, SA. Influenza vaccination of healthcare personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;55:1–16.Google Scholar
6.Cunney, RJ, Bialachowski, A, Thornley, D, Smaili, FM, Pennie, RA. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000;21:449–454.Google Scholar
7.Saito, R, Suzuki, H, Oshitani, H, Sakai, T, Seki, N, Tanabe, N. The effectiveness of influenza vaccine against influenza A (H3N2) virus infections in nursing homes in Niigata, Japan, during the 1998-1999 and 19992000 seasons. Infea Control Hosp Epidemiol 2002;23:82–86.CrossRefGoogle ScholarPubMed
8.Potter, J, Stott, DJ, Roberts, MA, et al.Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infea Dis 1997;175:1–6.CrossRefGoogle ScholarPubMed
9.Carman, WF, Elder, AG, Wallace, LA, et al.Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000;355:93–97.CrossRefGoogle ScholarPubMed
10.Hayward, AC, Harling, R, Wetten, S, et al.Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ 2006;333:1241.CrossRefGoogle ScholarPubMed
11.Thomas, RE, Jefferson, TO, Demicheli, V, Rivetti, D. Influenza vaccination for health-care workers who work with elderly people in institutions: a systematic review. Lancet Infect Dis 2006;6:273–279.CrossRefGoogle ScholarPubMed
12.National Foundation for Infectious Diseases. Influenza Immunization Among Health Care Personnel: Call to Action. Bethesda, MD: National Foundation for Infectious Diseases, 2008. Available at: http://www.nfid .org/publications/. Accessed May 20, 2009.Google Scholar
13.Fiore, AE, Shay, DK, Broder, K, et al.Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008. MMWR Recomm Rep 2008;57:1–60.Google Scholar
14.Talbot, TR, Bradley, SF, Cosgrove, SE, Ruef, C, Siegel, JD, Weber, DJ. Influenza vaccination of healthcare workers and vaccine allocation for healthcare workers during vaccine shortages. Infect Control Hosp Epidemiol 2005;26:882–890.Google Scholar
15.Infectious Diseases Society of America. Flu Experts Call for Mandatory Shots for Health Care Workers. Arlington, VA: Infectious Diseases Society of America, 2007. Available at: http://www.idsociety.org/Content.aspx?id=3708. Accessed May 20, 2009.Google Scholar
16.American College of Physicians. ACP Policy on Influenza Vaccination of Health Care Workers. Philadelphia, PA: American College of Physicians, 2007. Available at: http://www.acponline.org/clinical_information/resources/adult_immunization/. Accessed May 28, 2009.Google Scholar
17.National Foundation for Infectious Diseases. Improving Influenza Vaccination Rates in Healthcare Workers: Strategies to Increase Protection for Workers and Patients. Bethesda, MD: National Foundation for Infectious Diseases, 2004. Available at: http://www.nfid.org/publications/. Accessed May 28, 2009.Google Scholar
18.Dash, GP, Fauerbach, L, Pfeiffer, J, et al.APIC position paper: improving health care worker influenza immunization rates. Am J Infect Control 2004;32:123–125.Google ScholarPubMed
19.American Nurses Association. Report to the Board of Directors on Seasonal Influenza Vaccination for Registered Nurses. Silver Spring, MD: American Nurses Association, 2006. Available at http://www.prevent influenza.org/ANAonHCW.pdf. Accessed May 28, 2009.Google Scholar
20.Lindley, MC, Horlick, GA, Shefer, AM, Shaw, FE, Gorji, M. Assessing state immunization requirements for healthcare workers and patients. Am J Prev Med 2007;32:459–465.Google Scholar
21. Centers for Disease Control and Prevention. State Immunization Laws for Healthcare Workers and Patients. Atlanta, GA: Centers for Disease Control and Prevention. Updated May 28,2009. Available at http://www2axdc.gov/nip/stateVaccApp/StateVaccsApp/default.asp. Accessed May 28, 2009.Google Scholar
22.Talbot, TR. Improving rates of influenza vaccination among healthcare workers: educate; motivate; mandate? Infect Control Hosp Epidemiol 2008;29:107–110.Google Scholar
23.Polgreen, PM, Septimus, EJ, Parry, MF, et al.Relationship of influenza vaccination declination statements and influenza vaccination rates for healthcare workers in 22 US hospitals. Infea Control Hosp Epidemiol 2008;29:675–677.Google Scholar
24.Borlaug, G, Newman, A, Pfìster, J, Davis, JP. Factors that influenced rates of influenza vaccination among employees of Wisconsin acute care hospitals and nursing homes during the 2005-2006 influenza season. Infect Control Hosp Epidemiol 2007;28:1398–1400.Google Scholar
25.Bertin, M, Scarpelli, M, Proctor, AW, et al.Novel use of the intranet to document health care personnel participation in a mandatory influenza vaccination reporting program. Am J Infect Control 2007;35:33–37.Google Scholar
26.Hagar, B. Mandatory influenza vaccination: the Virginia Mason story. In: 42nd National Immunization Conference. Atlanta, GA; 2008. Available at: http://cdc.confex.com/recording/cdc/nic2008/ppt/free/4db77adf5df9 fff0d3caf5cafe28f496/paperl5824_5.ppt. Accessed May 20, 2009.Google Scholar
27.Babcock, HM, Gemeinhart, N, Jones, M, Dunagan, WC, Woeltje, KF. Mandatory influenza vaccination: translating policy to practice. In: 19th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America. San Diego, CA; 2009. Abstract 517.Google Scholar
28.Tucker, SJ, Poland, GA, Jacobson, RM. Health and safety: requiring influenza vaccination for health care workers. Am J Nurs 2008;108:32–34.Google Scholar
29.Ofstead, CL, Tucker, SJ, Beebe, TJ, Poland, GA. Influenza vaccination among registered nurses: information receipt, knowledge, and decisionmaking at an institution with a multifaceted educational program. Infect Control Hosp Epidemiol 2008;29:99–106.CrossRefGoogle ScholarPubMed