Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Home
  • Home
Article
  • Cited by 162

  • Get access
    Add to cart USD35.00
    Check if you have access via personal or institutional login
    Log in Register

Preventing Nosocomial Influenza by Improving the Vaccine Acceptance Rate of Clinicians

  • Cassandra D. Salgado (a1), Eve T. Giannetta (a2), Frederick G. Hayden (a2) and Barry M. Farr (a2)

Abstract

Objectives:

To assess the effects of interventions to prevent transmission of influenza and to increase employee compliance with influenza vaccination.

Design:

The change in the proportion of hospitalized patients with laboratory-confirmed nosocomial influenza was observed over time and assessed using chi-square for trend analysis. The association between nosocomial influenza in patients and healthcare worker (HCW) compliance with vaccine was assessed by logistic regression.

Setting:

A 600-bed, tertiary-care academic hospital.

Methods:

After an outbreak of influenza A at this hospital in 1988, a mobile cart program was instituted with increased efforts to motivate employees to be vaccinated and furloughed when ill as well as new measures to prevent nosocomial spread.

Results:

HCW vaccination rates increased from 4% in 1987–1988 to 67% in 1999–2000 (P < .0001). Proportions of nosocomially acquired influenza cases among employees or patients both declined significantly (P < .0001). Logistic regression analysis revealed a significant inverse association between HCW compliance with vaccination and the rate of nosocomial influenza among patients (P < .001).

Conclusion:

A mobile cart vaccination program and an increased emphasis on HCWs to receive the vaccine were associated with a significant increase in vaccine acceptance and a significant decrease in the rate of nosocomial influenza among patients.

Copyright

COPYRIGHT: © The Society for Healthcare Epidemiology of America 2004

Corresponding author

Hospital Epidemiologist, Medical University of South Carolina, 100 Doughty Street, Suite 210 BA/IOP, Charleston, SC 29425

References

Hide All
1. Cunney, R, Bialachowski, A, Thornley, D, Smaill, F, Pennie, R. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2000;21:449–454.
2. Adal, K, Flowers, R, Anglim, A, et al. Prevention of nosocomial influenza. Infect Control Hosp Epidemiol 1996;17:641–648.
3. Everts, R, Hanger, H, Jennings, L, Hawkins, A, Sainsbury, R. Outbreaks of influenza A among elderly hospital inpatients. N Z Med J 1996;109:272–274.
4. Pachucki, C, Pappas, S, Fuller, G, Krause, S, Lentino, J, Schaaff, D. Influenza A among hospital personnel and patients: implications for recognition, prevention, and control. Arch Intern Med 1989;149:77–80.
5. Rivera, M, Gonzalez, N. An influenza outbreak in a hospital. Am J Nurs 1982;82:1836–1838.
6. Hall, C. Nosocomial viral respiratory infections: perennial weeds on pediatric wards. Am J Med 2001;70:670–676.
7. Munoz, F, Campbell, J, Atmar, R, et al. Influenza A virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J 1999;18:811–815.
8. Evans, M, Hall, K, Berry, S. Influenza control in acute care hospitals. Am J Infect Control 1997;25:357–362.
9. Serwint, J, Miller, R. Why diagnose influenza infections in hospitalized pediatric patients? Pediatr Infect Dis J 1993;12:200–204.
10. Saxen, H, Virtanen, M. Randomized, placebo-controlled double blind study on the efficacy of influenza immunization on absenteeism of health care workers. Pediatr Infect Dis J 1999;18:779–783.
11. Wilde, J, McMillan, J, Serwint, J, Butta, J, O'Riordan, M, Steinhoff, M. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA 1999;281:908–913.
12. Hammond, G, Cheang, M. Absenteeism among hospital staff during an influenza epidemic: implications for immunoprophylaxis. Canadian Medical Association Journal 1984;131:449–452.
13. Nichol, K, Lind, A. Margolis, K, et al. The effectiveness of vaccination against influenza in healthy working adults. N Engl J Med 1995;333:889–893.
14. Nichol, K. Cost-benefit analysis of a strategy to vaccinate healthy working adults against influenza. Arch Intern Med 2001;161:749–759.
15. Bridges, C, Thompson, W, Meltzer, M, et al. Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomized controlled trial JAMA 2000;284:1655–1663.
16. Campbell, D, Rumley, M. Cost-effectiveness of the influenza vaccine in a healthy, working-age population. J Occup Environ Med 1997;39:408–414.
17. Kumpulainen, V, Makela, M. Influenza vaccination among healthy employees: a cost benefit analysis. Scand J Infect Dis 1997;29:181–185.
18. Wenzel, R, Osterman, C, Hunting, K, Gwaltney, J. Hospital-acquired infections: I. Surveillance in a university hospital. Am J Epidemiol 1976;103:251–260.
19. Directigen FLU-A [package insert]. Sparks, MD: Becton Dickinson; 2000.
20. Rosner, B. Fundamentals of Biostatistics. Belmont, CA: Duxbury Press; 2000:397.
21. Mehta, CR, Patel, NR. Exact logistic regression: theory and examples. Stat Med 1995;14:2143–2160.
22. Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2001;50:1–44.
23. Centers for Disease Control and Prevention. Recommendations for prevention and control of influenza: recommendations of the Immunization Practices Advisory Committee. Ann Intern Med 1986;105:399–404.
24. Garner, J, The Hospital Infection Control Practices Advisory Committee (HICPAC). Guidelines for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996;17:53–80.
25. Williams, W, Hickson, M, Kane, M, Kendal, A, Spika, J, Hinman, A. Immunization policies and vaccine coverage among adults: the risk for missed opportunities. Ann Intern Med 1988;108:616–625.
26. Reese, S, Owen, P, Bender, B, et al. Influenza and pneumococcal vaccination levels among persons aged s= 65 years: United States, 1999. MMWR 2001;50:532–537.
27. Yassi, A, Murdzak, C, Cheang, Tran N, Aoki, F. Influenza immunization: knowledge, attitude and behaviour of health care workers. Canadian Journal of Infection Control 1994;9:103–108.
28. Christian, M. Influenza and hepatitis B vaccine acceptance: a survey of health care workers. Am J Infect Control 1991;19:177–184.
29. Russell, D, Cameron, D, Lockey, R, Behnke, R, Sinnott, J, Ganguly, R. Influenza vaccination acceptance among health care professionals. Vaccine 1991;9:691–692.
30. Heimberger, T, Chang, H, Shaikh, Crotty L, Morse, D, Birkhead, G. Knowledge and attitudes of healthcare workers about influenza: why are they not getting vaccinated? Infect Control Hosp Epidemiol 1995;16:412–415.
31. Carman, W, Elder, A, Wallace, L, et al. Effects of influenza vaccination of healthcare workers on mortality of elderly people in long-term care: a randomized controlled trial. Lancet 2000;355:93–97.
32. Walker, F, Singleton, J, Strikas, R, National Immunization Program, CAG. Are U.S. health care workers receiving annual influenza vaccinations? Presented at the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 26-29, 1999; San Francisco, CA. Abstract 752.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed