A Statewide System for Improving Influenza Vaccination Rates in Hospital Employees

Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
Infection Control and Hospital Epidemiology (Impact Factor: 3.94). 06/2009; 30(5):474-8. DOI: 10.1086/596780
Source: PubMed

ABSTRACT To describe and report the progress of a provider-initiated approach to increase influenza immunization rates for healthcare workers.
Observational study.
The State of Iowa.
Acute care hospitals in Iowa.
Hospitals reported rates of employee influenza vaccination to a provider-based collaborative during 2 influenza seasons (2006-2007 and 2007-2008). Hospital characteristics related to higher vaccination rates were examined.
One hundred (87.0%) of 115 Iowa hospitals and/or health systems participated in season 1; individual hospital vaccination rates ranged from 43.5% to 99.2% (mean, 72.4%; median, 73.1%). In season 2, 115 (100%) of 115 Iowa hospitals and/or health systems participated. Individual hospital vaccination rates ranged from 53.6% to 100% (mean, 79.5%; median, 82.0%). In both seasons, urban and large hospitals had vaccination rates that were 6.3% to 7.6% lower than those of hospitals in other locations. Hospitals that used declination statements had influenza vaccination rates 12.6% higher than hospitals that did not use declination statements in season 2.
The initial vaccination rates were high for healthcare workers in Iowa, especially in smaller rural hospitals, and rates increased during season 2. The successful voluntary approach for reporting influenza vaccination rates that we describe provides an efficient platform for collecting and disseminating other statewide measures of healthcare quality.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To develop an instrument to measure nurses' knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours and evaluate its construct validity and internal consistency reliability. Although instruments to assess predictors of nurses' vaccination behaviours have been developed, their validity and reliability have not been reported. Instrument development and initial validity and reliability testing. The instrument was developed drawing on a literature review and expert consultation and was refined through pilot work. A cross-sectional survey using a revised version of the instrument was conducted among a convenience sample of 520 registered nurses (response rate 77.4%). Cronbach's alpha coefficient was calculated to determine internal consistency of the sub-scale in the instrument. Principal components analysis with varimax rotation was carried out to evaluate the instrument's construct validity and examine its internal structure. Cronbach's alpha coefficients for the three newly developed scales ranged from 0.70-0.76. Principal components analysis produced a good fit and confirmed the internal design of the instrument. In the seasonal influenza knowledge sub-scale four factors explained 44.8% of the total variance; in the H1N1 knowledge sub-scale two factors explained 44.7% of the total variance. Three factors in the risk perception scale contributed 50.5% of the total variance and two factors in the vaccination behaviours scale contributed 62.1% of the total variance. An instrument has been developed to assess nurses' knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The instrument was valid and reliable for the setting where it was used. This instrument could be used to assess nurses' knowledge, risk perception, health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The three newly developed scales could also be used independently to measure variables influencing nurses' vaccination practices.
    Journal of Clinical Nursing 05/2012; 21(17-18):2636-46. DOI:10.1111/j.1365-2702.2011.03794.x · 1.23 Impact Factor
  • Source
    Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion 01/2009; 61(2):94-7. · 0.31 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Xisha carbonate platforms, which include the modern-day Xisha Atoll, occur upon the northern continental margin of the South China Sea (SCS). In this study, we identify the seismic characteristics about various sedimentary facies of the carbonate platform and different types of reef in this area, based on the 2-D seismic data, reefs show high-amplitue moundy continuous reflection at the top and weak chaotic reflections inside. Carbonate platforms show high-amplitude continuous reflection at the top and high reflection alternative with weak reflection. The above analysis provided information about the influence of fluctuations in relative sea level, tectonic movements, paleotopography and the development mechanism of the carbonate platform. Based on the seismic data and data from drillholes (Xichen-1, Xiyong-1), we propose a schematic sedimentary model of the Xisha carbonate platforms at the northern margin of the SCS and outline five stages of development for the carbonate platform. Its sedimentary evolution consists of Initial establishment stage, development stage, exposure stage, drowning stage and large atoll reefs development stage. We also propose that several phases tectonisms supply proper environment and structural position for carbonate platform development, they can also destroyed the exist platforms. Besides, eustasy change was also the main influential factor on the development of the platforms.
    Journal of Asian Earth Sciences 02/2011; 40(3):770-783. DOI:10.1016/j.jseaes.2010.11.003 · 2.83 Impact Factor


Available from