Ofstead Cori L, Amelang Miriam R, Wetzler Harry P, Tan Litjen
Ofstead & Associates, Inc., 400 Selby Avenue, Suite V, Blair Arcade West, Saint Paul, MN 55102, USA.
Ofstead & Associates, Inc., 400 Selby Avenue, Suite V, Blair Arcade West, Saint Paul, MN 55102, USA.
Vaccine. 2017 Apr 25;35(18):2390-2395. doi: 10.1016/j.vaccine.2017.03.041. Epub 2017 Mar 25.
Influenza vaccination rates among healthcare providers (HCPs) in long-term care facilities (LTCFs) are commonly below the Healthy People 2020 goal of 90%. This study was conducted to develop and evaluate an intervention program designed to increase influenza uptake among HCPs in LTCFs.
This study was conducted in four Midwestern LTCFs. Baseline interviews, surveys, and administrative data analysis were performed following the 2013-2014 influenza season. Interventions implemented during the 2014-2015 season were based on the health belief and ecological models and included goal-setting worksheets, policy development, educational programs, kick-off events, incentives, a vaccination tracking roster, and facility-wide communication about vaccine uptake among HCPs. Outcomes were evaluated in 2015.
At baseline, 50% of 726 nursing staff employed during the 2013-2014 influenza season had documented receipt of influenza vaccine (Site A: 34%; Site B: 5%; Site C: 75%; Site D: 62%), and 31% of 347 survey respondents reported absenteeism due to respiratory illness. At follow-up, 85% of HCPs had documented receipt of influenza vaccine (p<0.01) and 19% of 323 survey respondents reported absenteeism due to respiratory illness (p<0.01). Vaccination rates among respondents' family members increased from 31% at baseline to 44% post-intervention (p<0.01). Reasons for declining vaccination did not change following exposure to educational programs, but HCPs were more likely to recommend vaccination to others after program implementation.
Vaccination rates among long-term care HCPs and their family members increased significantly and HCP absenteeism decreased after the implementation of multifaceted interventions based on an ecological model. The findings suggest that major increases in HCP vaccination can be achieved in LTCFs. More research is needed to evaluate the impact of increased HCP vaccination on the health and productivity of LTCF employees, their family members, and residents.
长期护理机构（LTCF）中医疗保健人员（HCP）的流感疫苗接种率通常低于《健康人民2020》设定的90%的目标。本研究旨在制定并评估一项干预计划，以提高长期护理机构中医疗保健人员的流感疫苗接种率。
本研究在中西部的四个长期护理机构中进行。在2013 - 2014年流感季节之后进行了基线访谈、调查和行政数据分析。2014 - 2015年季节实施的干预措施基于健康信念和生态模型，包括目标设定工作表、政策制定、教育项目、启动活动、激励措施、疫苗接种跟踪名册以及针对医疗保健人员疫苗接种情况在机构范围内进行沟通。2015年对结果进行了评估。
在基线时，2013 - 2014年流感季节受雇的726名护理人员中有50%记录接种了流感疫苗（A机构：34%；B机构：5%；C机构：75%；D机构：62%），347名调查受访者中有31%报告因呼吸道疾病缺勤。随访时，85%的医疗保健人员记录接种了流感疫苗（p<0.01），323名调查受访者中有19%报告因呼吸道疾病缺勤（p<0.01）。受访者家庭成员的疫苗接种率从基线时的31%升至干预后的44%（p<0.01）。接触教育项目后，疫苗接种率下降的原因没有改变，但医疗保健人员在项目实施后更有可能向他人推荐接种疫苗。
基于生态模型实施多方面干预措施后，长期护理机构医疗保健人员及其家庭成员的疫苗接种率显著提高，医疗保健人员的缺勤率降低。研究结果表明，长期护理机构中医疗保健人员的疫苗接种率可大幅提高。需要更多研究来评估医疗保健人员疫苗接种率提高对长期护理机构员工、其家庭成员和居民的健康及生产力的影响。
