Bertin Mary, Scarpelli Michele, Proctor Andrew W, Sharp John, Robitson Ethel, Donnelly Todd, Young Claire, Gordon Steven M
Quality and Patient Safety Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Am J Infect Control. 2007 Feb;35(1):33-7. doi: 10.1016/j.ajic.2006.10.005.
The Advisory Committee on Immunization Practices and the Healthcare Infection Control Practices Advisory Committee recommend health care personnel (HCP) influenza vaccination to prevent transmission to patients. Recommendations include documenting declination and providing feedback of rates. We report the use of the intranet to achieve recommendations with mandatory participation of 20,170 HCP in an 1100-bed hospital.
Employees were required to log onto the intranet and select "vaccine received," "contraindicated," or "declined." Declining employees automatically received a screen with education about vaccination. A Microsoft Structured Query Language database was created and linked to a Human Resource database. Administrators were provided feedback on participation rates. Employees were notified of the program via letter. Reminders were provided through managers and newsletters.
Eighty-nine percent (17,998/20,170) accessed the intranet. Fifty-five percent (11,068) indicated "vaccine received" versus 38% in 2004-2005 (P < .000001), 31% (6300) "declined," and 3% (630) had "contraindications." Unit rates ranged from 24% to 91%.
The intranet provides a tool for measuring and reporting participation, declination, and vaccination rates. The intranet and a mandatory participation program were associated with an increase in rates. Low rates in HCP with access to, and education about, vaccine may impact consideration of a mandatory vaccination program.
免疫实践咨询委员会和医疗保健感染控制实践咨询委员会建议医护人员接种流感疫苗以防止病毒传播给患者。建议包括记录拒绝接种情况并提供接种率反馈。我们报告了在一家拥有1100张床位的医院中，通过内联网实现这些建议，20170名医护人员强制参与。
员工被要求登录内联网并选择“已接种疫苗”“禁忌接种”或“拒绝接种”。拒绝接种的员工会自动收到一个包含疫苗接种教育内容的页面。创建了一个微软结构化查询语言数据库，并将其与人力资源数据库链接。向管理人员提供了参与率反馈。通过信件通知员工该项目。通过管理人员和时事通讯提供提醒。
89%（17998/20170）的员工访问了内联网。55%（11068）的员工表示“已接种疫苗”，而2004 - 2005年为38%（P <.000,001），31%（6300）的员工“拒绝接种”，3%（630）的员工有“禁忌证”。各科室的接种率从24%到91%不等。
内联网为测量和报告参与率、拒绝接种率和接种率提供了一个工具。内联网和强制参与项目与接种率的提高相关。能够获取疫苗并接受相关教育的医护人员接种率较低，这可能会影响对强制接种项目的考虑。
