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6/25/2004

Experts Offer Strategies to Increase Influenza Vaccination of Health Care Workers

Kate Traynor

To improve influenza immunization rates among hospital employees, vaccination must be treated as a patient health and safety issue rather than a personal choice of health care workers, according to the National Foundation for Infectious Diseases (NFID).

The organization released a report (PDF) this week describing strategies for increasing influenza vaccination coverage among health care workers.

The report states that health care workers "are frequently implicated as the source of influenza in health care settings." But according to the Centers for Disease Control and Prevention (CDC), only 36 percent of health care workers typically receive an annual influenza vaccination.

Safety Groups Endorse Influenza
Vaccination of Health Care Workers

Vaccination of health care workers against influenza is item 26 on the National Quality Forum (NQF) list of 30 safe practices for better health care (PDF). The organization released the list of safe practices last year and called for universal adoption of all 30 items by health care organizations.

Item 5 on the list calls for the active participation of pharmacists in the medication-use process in hospitals.

The Leapfrog Group, a coalition that promotes quality and patient-safety practices in hospitals, this year endorsed (PDF) NQF's safe practices and now uses them to rate hospital performance.

In addition to protecting patients, NFID stated that vaccinating the hospital staff reduces employee absenteeism due to illness and medical visits and cuts antimicrobial use. Several studies described in the report determined that hospitals save money overall when their staff is vaccinated against influenza.

According to the report, making influenza vaccination convenient for health care workers is one of the most effective ways to improve vaccination rates. NFID recommended that health care organizations set up "rolling carts" to bring the vaccine to employees instead of forcing them to seek vaccination.

Suggested sites for staff vaccination events include cafeterias during lunch and break times, parking garages during shift changes, and medical records areas where physicians and residents go to sign charts. NFID also recommended vaccinating the medical staff during rounds and conferences.

If employees must come to a clinic to receive an influenza vaccination, the report notes that setting up individual appointments can be more effective than holding walk-in sessions.

Also key to improving vaccine coverage is removing cost barriers, according to the report. Because vaccination of health care workers protects patients from infection, NFID advised health care facilities to view influenza vaccination as "an infection control and patient safety measure that is the ultimate fiscal responsibility of the institution."

In addition to paying for vaccine or providing it at minimal cost to employees, the report recommends that health care facilities get a commitment from top management to promote vaccination. Department managers, the report states, "should roll up their sleeves first" during vaccination campaigns.

The report also stresses the importance of educating the hospital staff each year about "myths and misconceptions about the influenza virus" and the vaccine. Educational programs may need to be multilingual to reach all employees who should be vaccinated, according to the report.

The report describes health care workers as "any employee in a health care setting who comes into contact with patients."

NFID prepared its report after holding a roundtable discussion last November with ASHP and 26 other health care stakeholder groups.