Infectious Disease Division, Washington University in St. Louis School of Medicine, St Louis, Missouri 63110, USA.
Infect Control Hosp Epidemiol. 2010 Mar;31(3):233-40. doi: 10.1086/650449.
To describe the results of different measures implemented to improve adherence to the healthcare worker (HCW) influenza immunization program at BJC HealthCare during the period from 1997 through 2007.
Descriptive retrospective study.
BJC HealthCare, a 13-hospital nonprofit healthcare organization in the Midwest.
We reviewed and analyzed HCW influenza vaccination data from all BJC HealthCare Occupational Health Services and hospitals during the period from 1997 through 2007. Occupational health staff, infection prevention personnel, and key influenza vaccination campaign leaders were also interviewed regarding implementation measures during the study years.
At the end of 2007, BJC HealthCare had approximately 26,000 employees. With the use of multiple progressive interventions, influenza vaccination rates among BJC employees increased from 45% in 1997 to 72% in 2007 (P < .001). The influenza vaccination rate in 2007 was significantly higher than in 2006: 72%, compared with 54% (P < .001). Five hospitals had influenza vaccination rates that exceeded the target goal of 80% in 2007. The most successful interventions were adding influenza vaccination rates to the quality scorecard incentive program and the use of declination statements, both of which were implemented in 2007. The most important barriers to success identified by interview respondents were HCWs' misconceptions about influenza vaccination and a perceived lack of leadership support.
Influenza vaccination rates among HCWs significantly improved with multiple interventions over the years. However, the BJC HealthCare influenza vaccination target of 80% was not attained at all hospitals with these measures. More aggressive interventions, such as implementing mandatory influenza vaccination policies, are needed to achieve higher vaccination rates.
描述在 1997 年至 2007 年间,为提高圣路易斯地区 BJC 医疗保健机构内医护人员(HCW)对流感免疫计划的依从性而实施的不同措施的结果。
描述性回顾性研究。
BJC 医疗保健,中西部的一家拥有 13 家医院的非营利性医疗机构。
我们对 1997 年至 2007 年间所有 BJC 医疗保健职业健康服务和医院的 HCW 流感疫苗接种数据进行了回顾和分析。在研究期间,我们还采访了职业健康人员、感染预防人员和关键流感疫苗接种活动负责人,以了解实施措施。
2007 年底,BJC 医疗保健拥有约 26000 名员工。通过使用多种渐进式干预措施,BJC 员工的流感疫苗接种率从 1997 年的 45%上升到 2007 年的 72%(P<.001)。2007 年的流感疫苗接种率明显高于 2006 年:72%,而 2006 年为 54%(P<.001)。五家医院在 2007 年达到了超过 80%的目标疫苗接种率。最成功的干预措施是将流感疫苗接种率纳入质量记分卡激励计划,并使用拒绝声明,这两项措施均于 2007 年实施。通过访谈受访者确定的最重要的成功障碍是 HCWs 对流感疫苗接种的误解和感知到的缺乏领导层支持。
通过多年的多项干预措施,HCW 的流感疫苗接种率显著提高。然而,通过这些措施,BJC 医疗保健机构的流感疫苗接种目标并未在所有医院实现。需要采取更积极的干预措施,如实施强制性流感疫苗接种政策,以提高疫苗接种率。