A Statewide System for Improving Influenza Vaccination Rates in Hospital Employees

ArticleinInfection Control and Hospital Epidemiology 30(5):474-8 · June 2009with11 Reads
DOI: 10.1086/596780 · Source: PubMed
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.
    • "Several studies have suggested other predictors associated with nurses' vaccination including age, previous vaccination history, professional ethos, group identification and health motivation (Campos & Jalaludin 2003, Ofstead et al. 2008, Falomir-Pichastor et al. 2009, Norton et al. 2008, Shahrabani et al. 2009). Vaccination campaigns have attempted to improve vaccination rates among HCWs in some local settings but these campaigns have not always obtained the expected outcomes among nurses (Harbarth et al. 1998, Sartor et al. 2004, Ofstead et al. 2008) although others have reported increased vaccination coverage of HCWs (Bryant et al. 2004, Kuntz et al. 2008, Ribner et al. 2008, Polgreen et al. 2009). We hypothesise that this may be due to variables influencing nurses' vaccination behaviours that have not been clearly identified because the instruments used in the above studies were not systematically developed and tested. "
    [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.
    Full-text · Article · May 2012
    • "The program also did not include physicians. In a statewide program in which every hospital in Iowa ( ) voluntarily reported rates of HCW influenza vacn p 115 cination, the vaccination rates were 12.6% higher at those facilities that used declination statements, compared with those that did not [28]. This significant association was present even after adjustment for urban location and a composite variable indicating the total number of recommended practices identified to increase HCW vaccination rates (of a total of 15) implemented at each facility. "
    [Show abstract] [Hide abstract] ABSTRACT: In response to health care worker influenza vaccination rates that are below desired targets, strategies designed to stimulate vaccination have been proposed, including the use of declination statements for those refusing vaccination. The impact of these statements has not been thoroughly investigated and may be affected by their specific language and context. This review examines the available data on the use and impact of declination statements to increase health care worker vaccination rates and notes some potential pitfalls and issues that may arise with their use.
    Article · Oct 2009
  • Full-text · Article · Mar 2009
Show more