 |
|
Johns Hopkins flu expert calls for mandatory vaccination of health care workers
November 10, 2005Johns Hopkins' senior hospital epidemiologist and flu expert is calling for mandatory vaccination of all health care workers as the best means of protecting patients and hospital staff from widespread outbreaks of the viral illness. Studies by other United States researchers show that voluntary vaccination programs don't do the job and that each year, nearly 40,000 Americans die from influenza, many of them elderly or ill, with weakened immune systems that cannot readily fend off the disease.
In an editorial to be published in the journal Infection Control and Hospital Epidemiology online Nov. 9, Trish Perl, M.D., M.Sc., concludes that mass vaccination policies are required to prevent patients from accidentally contracting the virus directly from an infected medical staff worker or indirectly from other patients or visitors via medical staff.
Previous research from Hopkins showed that annual flu shots have been almost 88 percent effective at reducing the risk of flu infection and that they reduced by one-half the number of deaths among hospital patients from the disease.
Perl's view, which is likely to inform further debate on the subject of voluntary versus mandatory worker vaccination programs, is based on research showing that despite free and ready access to the vaccine, only 40 percent of all health care workers actually get a flu shot.
"We have gone as far as possible with vaccination programs emphasizing education and health promotion," says Perl, an associate professor of medicine and pathology at The Johns Hopkins University School of Medicine. "It's now time to go the extra step, requiring active declination or even making vaccination a mandatory part of the job, linked to patient safety, along with such tasks as keeping hands clean and getting mandatory TB tests."
Neither state nor federal law requires workers to provide medical details when they call in sick so it is difficult to precisely link seasonal hospital absenteeism and high rates of non-vaccination, she notes.
"We need to close the very serious gap between knowledge and behavior that exists among health care workers," Perl argues, and it can be done, she says. In 2003, her team, along with occupational health services, at Hopkins vaccinated more than 70 percent of 10,000 hospital staff. "But we can do better and, ideally, at Hopkins and other hospitals, our objective would be to consistently have more than 90 percent of staff vaccinated each year."
According to Perl, numerous staff surveys from other hospitals have shown that the most common reason cited for not getting a vaccination is a lack of time (47 percent). Surprisingly, a remarkably high number of staff, more than 30 percent, believed they could catch influenza from the vaccine itself, which is false.
Perl also notes from surveys that relying on people's self-awareness is not sufficient to prevent the flu from spreading. "One-half of infected health care workers have no idea when they are infected with influenza, often having few if any signs and symptoms and making it impossible to ask all staff to stay home when they are feeling ill to prevent other people from catching their infection," she says.
Still other studies have found that education campaigns can be effective at increasing vaccination rates among health care workers by as much as 60 percent. And to the surprise of those conducting these surveys, the reason most likely to motivate health care workers to get the shot is that it benefits patients, not themselves.
However, in the editorial, Perl concludes that, "'Shifting the message from self-interest to altruism in protecting patients may improve vaccination rates, but it won't fix the problem. From a hospital policy standpoint, this is a real patient safety issue and vaccination can be viewed as a means of protecting patients from influenza exposure and the related mortality seen among vulnerable populations. Vaccination should be presented as such to both health care workers and every hospital's leadership."
Perl notes that even without mandatory vaccination policies, other potential barriers to widespread vaccination can be helpful and should be implemented nationwide. Among her recommendations are free shots for all staff, easy access to flu shot clinics on site, flexible vaccination hours, emphasis on patient safety aspects of the program, education to counter beliefs that the shots can make you sick and encouragement from hospital leaders to get the vaccine.
The next step, Perl says, is for health care professional associations, such as the Infectious Disease Society of America and the U.S. Joint Commission of Accreditation on Healthcare Organizations, to endorse mandatory flu shots. One group, the Society for Health Care Epidemiology, last month endorsed just such a plan. However, she acknowledges that current federal workers' rights prevent employers from making vaccinations a requirement.
Perl says her proposal is open to discussion at Hopkins. "Ultimately, we want to make vaccination as mandatory for workers as the law allows in order to effectively accomplish what we cannot enforce," she says.
Johns Hopkins Medical Institutions
Perl's view, which is likely to inform further debate on the subject of voluntary versus mandatory worker vaccination programs, is based on research showing that despite free and ready access to the vaccine, only 40 percent of all health care workers actually get a flu shot.
"We have gone as far as possible with vaccination programs emphasizing education and health promotion," says Perl, an associate professor of medicine and pathology at The Johns Hopkins University School of Medicine. "It's now time to go the extra step, requiring active declination or even making vaccination a mandatory part of the job, linked to patient safety, along with such tasks as keeping hands clean and getting mandatory TB tests."
Neither state nor federal law requires workers to provide medical details when they call in sick so it is difficult to precisely link seasonal hospital absenteeism and high rates of non-vaccination, she notes.
"We need to close the very serious gap between knowledge and behavior that exists among health care workers," Perl argues, and it can be done, she says. In 2003, her team, along with occupational health services, at Hopkins vaccinated more than 70 percent of 10,000 hospital staff. "But we can do better and, ideally, at Hopkins and other hospitals, our objective would be to consistently have more than 90 percent of staff vaccinated each year."
According to Perl, numerous staff surveys from other hospitals have shown that the most common reason cited for not getting a vaccination is a lack of time (47 percent). Surprisingly, a remarkably high number of staff, more than 30 percent, believed they could catch influenza from the vaccine itself, which is false.
Perl also notes from surveys that relying on people's self-awareness is not sufficient to prevent the flu from spreading. "One-half of infected health care workers have no idea when they are infected with influenza, often having few if any signs and symptoms and making it impossible to ask all staff to stay home when they are feeling ill to prevent other people from catching their infection," she says.
Still other studies have found that education campaigns can be effective at increasing vaccination rates among health care workers by as much as 60 percent. And to the surprise of those conducting these surveys, the reason most likely to motivate health care workers to get the shot is that it benefits patients, not themselves.
However, in the editorial, Perl concludes that, "'Shifting the message from self-interest to altruism in protecting patients may improve vaccination rates, but it won't fix the problem. From a hospital policy standpoint, this is a real patient safety issue and vaccination can be viewed as a means of protecting patients from influenza exposure and the related mortality seen among vulnerable populations. Vaccination should be presented as such to both health care workers and every hospital's leadership."
Perl notes that even without mandatory vaccination policies, other potential barriers to widespread vaccination can be helpful and should be implemented nationwide. Among her recommendations are free shots for all staff, easy access to flu shot clinics on site, flexible vaccination hours, emphasis on patient safety aspects of the program, education to counter beliefs that the shots can make you sick and encouragement from hospital leaders to get the vaccine.
The next step, Perl says, is for health care professional associations, such as the Infectious Disease Society of America and the U.S. Joint Commission of Accreditation on Healthcare Organizations, to endorse mandatory flu shots. One group, the Society for Health Care Epidemiology, last month endorsed just such a plan. However, she acknowledges that current federal workers' rights prevent employers from making vaccinations a requirement.
Perl says her proposal is open to discussion at Hopkins. "Ultimately, we want to make vaccination as mandatory for workers as the law allows in order to effectively accomplish what we cannot enforce," she says.
Johns Hopkins Medical Institutions
American College of Physicians recommends flu vaccination for health-care workers
The American College of Physicians (ACP) recommends that an annual influenza vaccine should be required for every health care worker with direct patient care activities.
Prediction markets accurately forecast influenza activity
Influenza experts have borrowed a page from economists, creating a futures market for influenza activity that predicted outbreaks two to four weeks in advance. The influenza prediction market is presented in the Jan. 15 issue of Clinical Infectious Diseases.
Implantable chips bear promise, but privacy standards needed
Radio frequency identification (RFID) chips implanted into human beings hold the promise of improving patient care, particularly in emergency settings, but only after privacy questions are addressed, according to a Beth Israel Deaconess Medical Center (BIDMC) physician who has a chip implanted in his arm.
More Health Care Worker News Articles
 | An Introduction to Spanish for Health Care Workers: Communication and Culture (Second Edition) by Robert O. Chase, Clarisa B. Medina De Chase For health care providers who wish to learn Spanish to effectively communicate with patients, this book offers an excellent first course in the language. It is a classroom text that uses readings, exercises, and interactive activities to integrate the Spanish medical vocabulary, grammar, and colloquial terms that nurses, doctors, dentists and medical technicians most need. Rich cultural notes... |
 | Introduction to Health Occupation: Today's Health Care Worker (6th Edition) (Introduction to Health Occupations) by Shirley A. Badasch, Doreen S. Chesebro This book provides readers with basic information and skills needed to enter the health care field. It equips readers with the skills necessary to research many different occupations in the health care field and to become effective health care workers. Includes throughout four values indicators—dignity, a sense of justice, a spirit of service, and a desire to provide excellent ... |
 | Children With Cerebral Palsy: A Manual for Therapists, Parents and Community Workers (Children with Cerebral Palsy: A Manual for Therapists, Parents,) ... Palsy: A Manual for Therapists, Parents,) by Archie Hinchcliffe This book is a practical guide to the effective treatment of cerebral palsy in children. It provides a set of principles by which to observe and analyze individual patients' problems and then plan treatment. With the help of this book, non-specialists working with children with cerebral palsy can make decisions and choose the appropriate therapeutic activities for each child. It includes examples... |
| Introduction to Health Occupations Today's Health Care Worker - 6th Edition Book/ CD... | |
 | A Guide for Nursing Home Social Workers by Elise Beaulieu This book clearly distinguishes the function of beginning nursing home social workers and provides information and resources essential for them. Topics covered include: assessment; the intake and discharge processes; interventions; resource allocation; medication; diagnosis and treatment of depression; dementias; and legal issues, ethics, and confidentiality agreements. Making the volume still... |
 | Health and Health Care Policy: A Social Work Perspective by Cynthia Moniz, Stephen H. Gorin This text fills a void in social work literature by offering a comprehensive, in-depth overview of health and health policy. Health and Health Care Policy provides an overview of the development of health policy in the United States, with a particular focus on the failure to achieve universal coverage. It also discusses the role of private and public insurance and examines the uninsured... |
 | When Evening Comes: The Education of a Hospice Volunteer by Christine Andreae When Christine Andreae signed up for twenty-seven hours of patient-care training with the Blue Ridge Hospice in Virginia's Shenandoah Valley, her parents were still living and her grandparents' funerals hadn't involved a viewing. Her only direct experience with death had been when, at the age of six, she had gone with her father to the viewing for the family's parish priest.At a training session,... |
 | Bailliere's Nurses' Dictionary: for nurses and health care workers (Dictionary) by Barbara Weller Now in its 24th edition, Baillliere's Nurses' Dictionary is fully updated and revised to address the changing world of nursing and health services. This edition moves beyond the narrow medical focus of other pocket dictionaries and is firmly focused on the needs of today's nurses. Packed with useful information, it provides the essential pocket reference resource for everyone involved in nursing... |
 | Refraction 1 Introduction Library Edition: For Workers in Ophthalmology, Optometry, Optics, Opticianry, Allied Health, and Other Eye and Vision Care Industries and Practices by Daniel Farb Refraction 1 Introduction is useful for anyone who needs to learn about ophthalmology, optometry, vision care, or ophthalmic device and pharmaceutical sales, or individuals who want to understand concepts such as myopia, hyperopia, presbyopia, etc. Refractive principles are the foundation for eye exams and understanding the eye. This course introduces you to the basic concepts in an interactive,... |
 | I'm Here to Help: A Guide for Caregivers, Hospice Workers, and Volunteers by Catherine Ray This practical, caring, step-by-step guide is a standard text for the millions of professionals who are committed to taking care of those suffering from chronic or terminal illness and their families. I'm Here to Help imparts the skills and techniques necessary to facilitate communication in a succinct style and provides tips on how to initiate painful discussions, listen effectively, manage... |
| © 2008 BrightSurf.com |