Mossad Sherif B, Deshpande Abhishek, Schramm Sarah, Liu Xiaobo, Rothberg Michael B
1Department of Infectious Disease,Cleveland Clinic,Cleveland,Ohio.
3Center for Value-Based Care Research,Medicine Institute,Cleveland Clinic,Cleveland,Ohio.
Infect Control Hosp Epidemiol. 2017 Aug;38(8):966-969. doi: 10.1017/ice.2017.91. Epub 2017 May 18.
OBJECTIVE To compare the rates of and reasons for presenteeism associated with influenza-like illness (ILI) among healthcare professionals (HCPs) caring for hospitalized inpatient transplant recipients and internal medicine patients. DESIGN We designed a 10-question anonymous survey in which ILI was defined as fever (>37.8°C) and cough and/or sore throat and ILI B was defined as fever (>37.8°C) or cough or sore throat; both definitions were considered in the absence of another known cause. SETTING Tertiary-care center. PARTICIPANTS Physicians, advanced practice providers (APPs) and nurses. INTERVENTION Survey deployed at peak of influenza activity in 2016. MEASUREMENTS Rates of ILI, presenteeism, wearing masks, and time away due to ILI. RESULTS Of 707 HCPs surveyed, 286 (40%) responded; 15 (5.2%) reported having ILI, and 73 (25.5%) reported having ILI B in the preceding 2 weeks. Presenteeism rates were 92% in both groups of HCPs and were higher among women (adjusted odds ratio [AOR], 2.64; 95% CI, 1.23-5.71; P=.01) and those ≤40 years old (AOR, 1.92; 95% CI, 1.03-3.68; P=.04). Healthcare professionals who cared for transplant recipients and female HCPs were more likely to wear masks (AOR, 2.13; 95% CI, 1.05-3.40; P=.04 for transplant recipients and AOR, 3.96; 95% CI, 1.35-11.63; P=.01 for female HCPs). Nurses were more likely than physicians and APPs to take time off (AOR, 3.33; 95% CI, 1.10-10.09; P=.03.) CONCLUSIONS Presenteeism among HCPs with ILI is common, including among those caring for transplant recipients. Nonpunitive systems should encourage HCPs not to work with ILI and to wear masks to prevent spread of infections. Infect Control Hosp Epidemiol 2017;38:966-969.
目的 比较照顾住院移植受者的医护人员(HCP)和内科患者中与流感样疾病(ILI)相关的带病出勤率及原因。设计 我们设计了一项包含10个问题的匿名调查,其中ILI被定义为发热(>37.8°C)且伴有咳嗽和/或咽痛,ILI B被定义为发热(>37.8°C)或咳嗽或咽痛;在无其他已知病因的情况下考虑这两种定义。地点 三级医疗中心。参与者 医生、高级执业提供者(APP)和护士。干预措施 在2016年流感活动高峰期开展调查。测量指标 ILI发病率、带病出勤率、戴口罩情况以及因ILI缺勤的时间。结果 在接受调查的707名HCP中,286名(40%)做出回应;15名(5.2%)报告在前两周患有ILI,73名(25.5%)报告患有ILI B。两组HCP的带病出勤率均为92%,且女性(调整优势比[AOR],2.64;95%置信区间[CI],1.23 - 5.71;P = 0.01)和年龄≤40岁者(AOR,1.92;95% CI,1.03 - 3.68;P = 0.04)的带病出勤率更高。照顾移植受者的医护人员和女性HCP更有可能戴口罩(移植受者:AOR,2.13;95% CI,1.05 - 3.40;P = 0.04;女性HCP:AOR,3.96;95% CI,1.35 - 11.63;P = 0.01)。护士比医生和APP更有可能请假(AOR,3.33;95% CI,1.10 - 10.09;P = 0.03)。结论 患有ILI的HCP中带病出勤很常见,包括照顾移植受者的人员。非惩罚性制度应鼓励HCP在患有ILI时不工作并佩戴口罩以防止感染传播。《感染控制与医院流行病学》2017年;38:966 - 969。