Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-12-02T21:16:24.426Z Has data issue: false hasContentIssue false
  • English
  • Français

A Survey of Policies at Children's Hospitals Regarding Immunity of Healthcare Workers: Are Physicians Protected?

Published online by Cambridge University Press:  02 January 2015

Natalie E. Lane ,
Ronald I. Paul ,
Denise F. Bratcher  and
Beth H. Stover
Natalie E. Lane
Affiliation:
Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Louisville, Division of Infectious Diseases, Kosair Children's Hospital, Louisville, Kentucky
Ronald I. Paul
Affiliation:
Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Louisville, Division of Infectious Diseases, Kosair Children's Hospital, Louisville, Kentucky
Denise F. Bratcher
Affiliation:
Department of Pediatrics, Division of Infectious Diseases, School of Medicine, Division of Infectious Diseases, Kosair Children's Hospital, Louisville, Kentucky
Beth H. Stover
Affiliation:
Department of Pediatrics, Division of Infectious Diseases, Kosair Children's Hospital, Louisville, Kentucky
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine policies at children's hospitals regarding immunizations, annual tuberculosis (TB) screening, and blood or body fluid exposure follow-up, particularly as they apply to physicians.

Design and Participants:

A three-page survey was sent to infection control practitioners (ICPs) in April 1994 at hospitals affiliated with the National Association of Children's Hospitals and Related Institutions. One follow-up mailing was sent to nonresponding ICPs.

Results:

Responses were received from 62 (67%) of 93 ICPs. Thirty-five (66%) of 53 children's hospitals had an immunity policy that applied to medical students, 42 (79%) of 53 to resident physicians, 32 (52%) of 62 to hospital-based physicians, and 18 (29%) of 62 to private or community physicians (who admit patients to one hospital). Physicians were required to show evidence of an annual TB screen at 36 hospitals (58%). Immunity policies or TB screening were provided for the following physician groups: medical students, 13 (21%); resident physicians, 43 (69%); hospital-based physicians, 50 (81%); and private or community physicians, 23 (37%). Infection control practitioners reported that the following diseases had been identified within the past 5 years at their hospitals: measles, 82%; mumps, 40%; rubella, 31%; TB, 94%; hepatitis B, 94%; pertussis, 90%; varicella, 98%; and influenza, 94%. Physicians in these institutions were reported to have contracted the following diseases from patient exposure: measles, hepatitis B, TB, pertussis, varicella, and influenza.

Conclusion:

Children's hospitals vary widely in their policies regarding healthcare-worker immunity, and, in many cases, physicians may not be protected from nosocomial transmission of community infections.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 6 , June 1997 , pp. 400 - 404
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Chan, JC, Tabak, JI. Risk of tuberculous infection among house staff in an urban teaching hospital. South Med J 1985;78:1061–1064.Google Scholar
2. Sokolove, PE, Mackey, D, Wiles, J. Exposure of emergency department personnel to tuberculosis: PPD testing during an epidemic in the community. Ann Emerg Med 1994;24:418–421.CrossRefGoogle ScholarPubMed
3. Nichol, KL, Olson, R. Medical students' exposure and immunity to vaccine-preventable diseases. Arch Intern Med 1993;153:1913–1916.CrossRefGoogle ScholarPubMed
4. Polk, BF, White, JA, DeGirolami, PC. An outbreak of rubella among hospital personnel. N Engl J Med 1980;303:541–545.CrossRefGoogle ScholarPubMed
5. Poland, GA, Nichol, KL. Medical students as sources of rubella and measles outbreaks. Arch Intern Med 1990;150:44–46.CrossRefGoogle ScholarPubMed
6. Kurt, TL, Yeager, AS, Guenette, S. Spread of pertussis by hospital staff. JAMA 1972;221:264–267.Google Scholar
7. Centers for Disease Control. Update on adult immunization—recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1991;40(RR-12):1–94.Google Scholar
8. American Hospital Association Technical Panel on Infections Within Hospitals. Management advisory—health care delivery: immunization. Am J Infect Control 1994;22:42–46.Google Scholar
9. Valenti, WM, ed. Employee health guidelines from the American Occupational Medical Association. Infect Control 1984;5:303–306.Google Scholar
10. Centers for Disease Control. Immunization Recommendations for Health-Care Workers. Atlanta, GA: US Department of Health and Human Services, Public Health Service; 1989.Google Scholar
11. National Coalition for Adult Immunization. Standards for adult immunization practice—special communication. Am J Infect Control 1993;21:331–332.Google Scholar
12. Bratcher, DF, Stover, BH, Lane, NE. Compliance with national recommendations for TB screening/immunization of healthcare workers: part 2, report from a children's hospital. Infect Control Hosp Epidemiol 1995;16:35; Am J Infect Control 1995;23:112-113.Google Scholar
13. Rabalais, G, Adams, G, Stover, B. PPD skin test conversion in health-care workers after exposure to Mycobacterium tuberculosis . Lancet 1991;338:826.Google Scholar
14. Atkinson, WL, Markowitz, LE, Adams, NC. Transmission of measles in medical settings—United States, 1985-1989. Am J Med 1991;91(suppl 3B):320S–324S.CrossRefGoogle ScholarPubMed
15. Wright, LJ, Carlquist, JF. Measles immunity in employees of a multihospital healthcare provider. Infect Control Hosp Epidemiol 1994;15:8–11.Google Scholar
16. Poland, GA, Nichol, KL. United States and Canadian medical schools immunization policies: a survey. Clin Res 1988;36:726A. Abstract.Google Scholar
17. Ewert, DP, Garcia, D, George, J. A comparison of hospital policies for measles, mumps, and rubella infection control in Los Angeles County, 1989 and 1992. Am J Infect Control 1995;23:369–372.Google Scholar
18. Poland, GA, Nichol, KL. Rubella and measles outbreaks, medical students and medical school immunization policies. Clin Res 1988;36:914A. Abstract.Google Scholar
19. Lane, NE, Stover, BH, Bratcher, DF, Paul, RI. Pediatric emergency medicine physicians (PEMP) and communicable diseases: can we be trusted to take care of ourselves? Arch Pediatr Adolesc Med 1995;149:93.Google Scholar
20. Centers for Disease Control. Nosocomial transmission of multidrug-resistant tuberculosis to health-care workers and HIV-infected patients in an urban hospital—Florida. MMWR 1990;89:718–722.Google Scholar
21. Cocchiarrella, I, Cohen, R, Muzaffar, S. PPD conversion among housestaff in a public hospital. Am Rev Respir Dis 1992; 145(suppl):A102.Google Scholar
22. George, RH, Bully, PR, Gill, ON. An outbreak of tuberculosis in a children's hospital. J Hosp Infect 1986;8:129–142.Google Scholar
23. Linnemann, CC, Ramundo, N, Perlstein, PH. Use of pertussis vaccine in an epidemic involving hospital staff. Lancet 1975;2:540–544.Google Scholar
24. Christie, CD, Glover, AM, Willke, MJ. Containment of pertussis in the regional pediatric hospital during the greater Cincinnati epidemic of 1993. Infect Control Hosp Epidemiol 1993;16:556–563.Google Scholar
25. Gustafson, TL, Lavely, GB, Brawner, ER. An outbreak of airborne nosocomial varicella. Pediatrics 1982;70:550–556.CrossRefGoogle ScholarPubMed
26. Stover, BH, Cost, KM, Hamm, C. Varicella exposure in a neonatal intensive care unit: case report and control measures. Am J Infect Control 1988;16:167–172.Google Scholar