Lehmann Birthe A, Chapman Gretchen B, Franssen Frits M E, Kok Gerjo, Ruiter Robert A C
Center for Infectious Disease Control, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), PO Box 1, Bilthoven, BA 3720, The Netherlands.
Department of Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA.
Vaccine. 2016 Mar 8;34(11):1389-92. doi: 10.1016/j.vaccine.2016.01.046. Epub 2016 Feb 3.
The prevention of health care acquired infections is an important objective for patient safety and infection control in all health care settings. Influenza vaccination uptake among health care workers (HCWs) is the most effective method to prevent transmission to patients, but vaccination coverage rates are low among HCWs. Several educational campaigns have been developed to increase the influenza vaccination coverage rates of HCWs, but showed only small effects. The aim of this study was to test an opt-out strategy in promoting uptake among HCWs in a tertiary care center for patients with complex chronic organ failure.
HCWs were randomly assigned to one of two conditions. In the opt-out condition (N=61), participants received an e-mail with a pre-scheduled appointment for influenza vaccination, which could be changed or canceled. In the opt-in condition (N=61), participants received an e-mail explaining that they had to schedule an appointment if they wanted to get vaccinated.
The findings show no statistically detectable effect of condition on being vaccinated against influenza. However, HCWs in the opt-out condition were more likely to have an appointment for influenza vaccination, which in turn increased the probability of getting vaccinated.
To change the default to promote influenza vaccination among HCWs might be an easy and cost-effective alternative to the complex vaccination campaigns that have been proposed in recent years.
预防医疗保健相关感染是所有医疗保健机构中保障患者安全和控制感染的重要目标。医护人员接种流感疫苗是预防向患者传播流感的最有效方法,但医护人员的疫苗接种覆盖率较低。已经开展了多项教育活动来提高医护人员的流感疫苗接种覆盖率,但效果甚微。本研究的目的是在一家为患有复杂慢性器官衰竭患者服务的三级医疗中心,测试一种“默认同意”策略对促进医护人员接种疫苗的效果。
医护人员被随机分配到两种情况之一。在“默认同意”情况下(N = 61),参与者收到一封电子邮件,其中包含预先安排好的流感疫苗接种预约,可更改或取消。在“主动选择”情况下(N = 61),参与者收到一封电子邮件,解释说如果他们想接种疫苗,必须自行安排预约。
研究结果显示,两种情况对流感疫苗接种率没有统计学上可检测到的影响。然而,“默认同意”情况下的医护人员更有可能预约流感疫苗接种,这反过来又增加了接种疫苗的可能性。
改变默认设置以促进医护人员接种流感疫苗,可能是一种比近年来提出的复杂疫苗接种活动更简单且具有成本效益的替代方法。