A New Approach to Improving Healthcare Personnel Influenza Immunization Programs: A Randomized Controlled Trial

Abstract

BackgroundHealthcare personnel influenza immunization rates remain sub-optimal. Following multiple studies and expert consultations, the “Successful Influenza Immunization Programs for Healthcare Personnel: A Guide for Program Planners” was produced. This trial assessed the impact of the Guide with facilitation in improving healthcare personnel influenza immunization rates in Canadian healthcare organizations.MethodsA sample of 26 healthcare organizations across six Canadian provinces (ON, MB, NS, BC, SK, NL) was randomized to Intervention (n=13) or Control groups (n=13). Baseline influenza immunization rates were obtained for 2008–2009; the study groups were followed over two subsequent influenza seasons. The Intervention group received the Guide, facilitation support through workshops for managers and ongoing support. The Control groups conducted programs as usual. The Groups were compared using their reported influenza healthcare personnel influenza immunization rates and scores from a program assessment questionnaire.FindingsTwenty-six organizations agreed to participate. 35% (9/26) of sites were acute care hospitals, 19% (5/26) continuing care, long-term care organizations or nursing homes, and 46% (12/26) were mixed acute care hospitals and long-term care or regional health authorities. The median rate of influenza immunization among healthcare personnel for the Intervention group was 43%, 44%, and 51% at three points in time respectively, and in the Control group: 62%, 57%, and 55% respectively. No significant differences were observed between the groups at the three points in time. However, there was a 7% increase in the median rates between the Baseline Year and Year Two in the Intervention group, and a 6% decrease in the Control group over the same time period, which was statistically significant (0.071 versus -0.058, p < 0.001).InterpretationThis pragmatic randomized trial of the Guide with facilitation of its implementation improved healthcare personnel immunization rates, but these rates continued to be sub-optimal and below rates achievable in programs requiring personnel to be immunized.Trial RegistrationClinicalTrials.gov NCT01207518

Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review

“…Tables S1 and S2 report the synthesis of the included studies. Seven were randomized controlled trials [50][51][52][53][54][55][56], six were pre-post surveys [57][58][59][60][61][62], one assessed the vaccination rate trend in accordance with the types of interventions [63], 11 were cross sectional studies [64][65][66][67][68][69][70][71][72][73][74], and two were interrupted time series studies [75,76]. The majority (52%) of the selected studies were performed in the USA, which was followed by Europe (33%), Canada (11%), and Australia (4%).…”

“…With the EPHPP quality assessment tool [49], seven out of the 27 studies included in the current review were assessed as works of 'strong' quality [50][51][52][53][54][55][56], five papers of 'moderate' quality [58,63,72,74,75], and the remaining 15 works as 'weak' quality [56,[59][60][61][62][64][65][66][67][68][69][70][71]73,76]. Results of the application of the EPHPP quality assessment tool are reported in Tables S1 and S2.…”

“…Eighteen studies examined policy/leadership interventions that lead to vaccination. Five "have a policy on immunization" (3a) [53,60,67,69,72], five have a "mandatory vaccination policy" (3b) [57,63,64,71,74], three have "facilities recommending influenza immunization for staff" (3c) [51,67,70], three "require completion of declination forms" (3d) [61,66,75], five "identify lead personnel to arrange for vaccination sessions and vaccination promotion" (3e) [51,53,58,59,74], one "facilitates support by experts" (3f) [50], five "document vaccination status of staff and share feedback and goals" (3g) [59,60,67,71,76], one arranges "patient restriction for sick employees" (3h) [64], two consider the "vaccination rate as a target for quality improvement" (3j) [61,76], and three refer to "leadership involvement" (3k) [59,61,76].…”

Determinants of nurses’ willingness to receive vaccines: Application of the health belief model

“…The use of vaccines has been promoted to protect people of all ages against several diseases by emphasising the importance of vaccinations in adults, no longer making vaccinations a proprietary right reserved for children (World Health Organization (WHO) ). In medical fields, the most crucial issue is maintaining the immunity of healthcare personnel (HCP) to effectively reduce the risk of pathogen transmission by HCP to patients (Centers for Disease Control & Prevention, ; Chambers et al, ). Moreover, vaccinating HCP reduces personnel and labour costs during an epidemic (Ozisik, Tanriover, Altınel, & Unal, )…”

“…In particular, HCP who worked in obstetrics and gynaecology, paediatrics, and emergency departments, infectious disease division, and postpartum nursing care centres had first priority (Taiwan Centers for Disease Control, ). Most existing studies on HCP immunisations mainly focused on influenza and Hep B vaccines and reported that HCP exhibited different behavioural patterns towards different vaccine types (Adekanle, Ndububa, Olowookere, Ijarotimi, & Ijadunola, ; Chambers et al, ; Karaivazoglou et al, ). However, HCPs’ behavioural patterns towards MMR, varicella and DTaP vaccines are unclear.…”