Introduction and Rationale
A performance improvement project was undertaken to increase health care worker (HCW)
influenza vaccination acceptance rates in the long-term care setting by using a novel
15-minute education intervention called the “Flu in 15.” As a core principle, we taught
that more Americans die from complications of influenza than hepatitis B, yet there
remains individual reluctance and barriers to achieve high acceptance rates of influenza
vaccination among HCWs.
Methods
During chance encounters we offered the Flu in 15 in-service to all HCWs at the Johns
Hopkins Bayview Care Center including certified nursing assistants (also called geriatric
nursing assistants), registered nurses, registered dieticians, environment staff,
physical therapists, occupational therapists, speech therapists, respiratory therapists,
social workers, and administrators. Of the 106 of 347 HCWs who participated in the
Flu in 15 in-service, 58 were by chance encounters selected to be surveyed based on
convenience. We surveyed 68 of 241 HCWs who did not attend the Flu in 15 in-service
as a comparison.
Results
Of the 58 participants who were asked if the in-service helped them understand why
a flu vaccine is needed yearly, we found that 15% responded “tremendously,” 48% “a
lot,” 26% “some,” 7% “a little,” and 2% “no.” We had 24% report that the program was
effective in changing their behavior to accept the flu vaccination for the first time.
We found that 49% responded that the in-service was effective in either changing their
behavior to accept the flu vaccination for the first time or reaccept it if recently
declined in previous years. With respect to motivation, 42% of the certified nursing
assistants stated that the in-service made them think more about returning to school
to get a license in some area of health care. Although not cause and effect, we observed
an increase in the HCW acceptance rate of the influenza vaccine from 65% in 2006–2007
to 73% in 2007–2008. We noticed a decreased trend in patient deaths attributed to
complications of influenza with 4 deaths in 2006–2007 and no deaths in 2007–2008.
Conclusions
The Flu in 15 in-service promoted a better understanding of the importance of the
influenza vaccine and demonstrated an associated increase in HCW acceptance of the
flu vaccine. Although we cannot claim cause and effect, we noted a decrease in resident
mortality in the intervention year compared with the prior year. Now that some medical
centers require yearly influenza vaccines among HCWs, the education component remains
relevant to provide reason behind the mandate.
Keywords
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Article info
Footnotes
M.J.B.’s Geriatric fellowship was supported by the Donald W. Reynolds Foundation while a fellow at Johns Hopkins School of Medicine. None of the authors have financial or personal conflicts of interest.
Identification
Copyright
© 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
