5. Influenza Facts
• On average, 1 out of 5 Americans suffer from
influenza every year. In addition, influenza and its
related complications result in an estimated 226,000
hospitalizations and 36,000 deaths in the US each
year.
• The results for some will be lost work or school
days. But for those at highest risk, the results can be
more serious – ie…hospitalization and even death.
• Combined with pneumonia, influenza is the
nation's eighth leading cause of death.
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6. The Burden…
• Influenza is related to 1 out of 20 deaths in the US
among those older than 65.
• Experts estimate that the flu cost US workers as much
as $10 billion in lost wages during the 2006-2007 flu
season.
• The health care system is flooded with 24.7 million
cases of influenza each year. (Equates=31.4 million OP
visits and 3.1 million hospitalized days.
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8. What REALLY is the issue at hand?
• Is it personal freedom of choice?
• Do health care workers have a duty to be
vaccinated?
• Is it a professional responsibility for HCP?
• Is it an ethical responsibility for HCP?
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9. What have we done?
Mandatory 100%
consideration (consent or
declination)
Notification via mass email
and dept Flyers
NLC/Expanded
Management informed of
goals/expectations
Education, Education, Educa
tion
Glow Germ Pilot project on
nursing units
Roaming throughout
hospital/offsite clinics (All
shifts, varied hours)
Flyers, Brochures, table top
advertisement
Online Web Declination
Managerial awareness of
staff compliance
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11. Barriers
• Moral objection
• Fear
• Excuses
• Concerns about vaccine safety
• Concerns about side effects
• Organizational Safety Culture
• Organizational Physician Culture
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12. Best Practices and Regulatory Requirements
Standards
National Guidelines
Best Practice Guidelines
CDC
ANA
NIH
American Academy of Peds
ACIP
The Joint Commission
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13. Prevention and Control Measures
Strategies for the prevention and control of influenza in acute care facilities
include the following:
• Annual influenza vaccination of all eligible patients and health care
personnel
• Implementation of Standard and Droplet Precautions for infected
individuals
• Active surveillance and influenza testing for new illness cases
(This includes appropriate management of ill HCP).
• Restriction of ill visitors and personnel
(Appropriate absence/sick policies without fear of retribution)
• Rapid administration of influenza antiviral medications for treatment and
prevention during outbreaks
• Respiratory Hygiene/Cough Etiquette
• Hand Hygiene and stations throughout facility
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14. “Faces of Influenza is an
important initiative
designed to put a “face”
on influenza in the US
and to show Americans
firsthand the seriousness
of this potentially deadly
infectious disease.”
Faces of
Influenza
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Editor's Notes
Flu vaccination has been touted by many experts as the one most important preventative measures health care workers can do to not only decrease the chance of transmitting the disease to patients but also their friends and families.
An old cliché maintained that influenza was a wonderful disease as it killed no one but provided doctors with lots of patients. The 1918 pandemic turned this saying on its head. More Americans died from influenza than died in World War I. [National Library of Medicine]
1918 Influenza Kansas. Centers for Disease Control.
In an average year, adults in the US miss 70 million days of work due to influenza. The best way to prevent influenza is with an annual flu shot. The ability of a flu vaccine to protect a person depends on the age and health of the person receiving the vaccine. In addition, the similarity or "match" between the viruses in the vaccine and those in circulation can affect the vaccine’s ability to protect a person against the flu. Health care workers play an important role in protecting public health, we need you to be healthy and be able to cover your shift. Additionally, studies in long term care facilities show increased HCP influenza vaccination reduced patient mortality. Some have argued the findings in these studies don’t apply or cross over to acute care….http://www.facesofinfluenza.org/en/influenza-symptoms/CDC. Deaths: final data for 2006. National vital statistic reports. 2009. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf.
One assumption is that if this trend continues it will have devasting future affects on our “aging” healthcare providers and aging communities? What impact does this cost have on health care expenditures now and in the future? Voluntary measures have not produced significant increases in vaccination rates of health care workers, and efforts to increase the vaccination rate have been met with resistance. Within health care organizations strong administrative backing is imperative to provide the necessary support for execution of a successful influenza campaign.
(SHEA paper) - SHEA – Society for Healthcare Epidemiology of America in 2005 published a position paper largely discussing rationale for influenza vaccination in health care workers and strategies on how to improve vaccination rates. Since 2005, new evidenced is available so Oct 2010 they released a revised SHEA paper. THE MAIN ISSUE AT HAND IS: Core Patient and Healthcare Personnel safety practice. And the SHEA feels noncompliance should not be tolerated. We believe it is a patient safety and an employee safety issue.
With clear and striking evidence of the effectiveness of the flu vaccine in reducing hospitalizations and deaths and in producing direct cost savings, providers and patients alike should take steps to ensure that people at high risk receive the flu shot each year.Reduction of patient mortality, decreased nosocomial infections, reduced absenteeism, improved public health. FreeAccessible – Roamed to all offsite clinics to provide individual service so they wouldn’t have to come to “main campus”. Glow Germ - 2ab, NICU, ICU, L&D, 3B (most vulnerable populations)Plan: We are planning to do additional units and will also include non-patient care areas as well. For mandatory vaccination you must have 100% visible support from administration. You also must have a policy with “teeth” and consequences.
Schlieren images of two volunteers facing one another. The subject on the right is masked as a precaution. The volunteer on the left coughs in the direction of the other subject first without wearing a mask (a), then while wearing a standard surgical mask (b), and finally while wearing an N95 mask (c). This demonstrates the importance of wearing a mask in reducing the potential for airborne transmission of infection over this distance. Note that in (a) the jet of air produced by the cough plume is directed downwards at roughly a 30° angle, whereas in (b) the expelled air of the cough plume is split into upward and downward components as it exits from the top and bottom edges of the surgical mask. There is also leakage around the side edges of the mask out of the plane of the page, which is shown in the next figure. In (c), the tighter seal of the N95 mask against the face forces more of the expelled cough through the mask. A low-velocity expelled turbulent air mass can be seen just in front of the mask, which does not cross the distance to the other volunteerThere is a mannequin simulation of coughing. It coughs out a fine powder that glows with black lighting. They use it for teaching staff the importance of how far a cough will project and how it contributes to germs spreading by particles landing on the surrounding areas. The reason I stress the importance of masking is I feel there must be an option for healthcare workers who may have allergies, issues that preclude them from taking the flu vaccination. For these limited exempt workers, there must be an option. They should have a button that should relay “I wear it because I care”. I’m vaccinated because I care.
The answer: An organization must be clear on the purpose of flu vaccination and should give the employee options if they decline. Patient and staff safety should be first and foremost in every meeting taking place at the organization and definitely when policy changes are being considered.
Best Practice Guidelines and Standards prepared and disseminated by multi-faceted agencies to include (APIC, CDC, NCBI, WHO, JC, et al) The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) recommend annual influenza vaccinations for people at increased risk of severe influenza infection, their close contacts, and all healthcare workers.Butts and Rich (2008) - Best practice and due-care standards are adopted by regulatory agencies to minimize harm to patients.
http://www.cdc.gov/flu/professionals/infectioncontrol/healthcarefacilities.htmStandard PrecautionsDroplet Precautions – with aerosol generating procedures
There are several different community based campaigns - ONE: Faces of Influenza is an educational campaign from the American Lung Association, made possible through a collaboration with Sanofi Pasteur. The program is intended to help people see themselves, their loved ones, and others among the many “faces” of influenza – people 6 months of age and older who should be immunized against influenza annually. Vaccination is an important line of defense.
