a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority , Halifax , NS , Canada.
b School of Nursing, St. Francis Xavier University , Antigonish , NS , Canada.
Hum Vaccin Immunother. 2018;14(8):1883-1889. doi: 10.1080/21645515.2018.1460296. Epub 2018 May 10.
In August 2012, British Columbia became the first Canadian province to implement a province-wide Influenza Prevention Policy requiring all healthcare workers (HCWs) in residential and acute care facilities to either be immunized against influenza, or wear masks in patient care areas during the influenza season. This qualitative case study sought to understand the key facilitators and barriers involved in developing and implementing British Columbia's Influenza Prevention Policy. An explanatory qualitative case study approach was selected for this project. Data were collected through the review of 110 documents (policy and planning documents, implementation tools, press releases, communication materials, etc.), and through 7 focus groups with policy implementation team members (n = 48). Focus group interview transcripts were analyzed using Framework Analysis methods, and Prior's approach guided document analysis. Four themes were identified: (1) Clashing paradigms, (2) Policy implementation gaps, (3) Pathways of power, and (4) Personal impacts. Issues embedded in macro-, meso-, and micro-level contexts, and planning across the province, were identified as critical to policy implementation. A province-wide approach with senior-level engagement and dedicated resources is critical in a province-wide influenza prevention policy for HCW. Recommendations to improve large-scale implementation of condition-of-service influenza policies include: engaging stakeholders early, considering the complexity of political contexts, allotting time to plan appropriately, developing 'enforcement' plans, and providing education and skills to frontline providers.
2012 年 8 月，不列颠哥伦比亚省成为加拿大第一个实施全省范围流感预防政策的省份，该政策要求所有住宅和急性护理设施中的医护人员（HCWs）接种流感疫苗，或在流感季节在患者护理区域佩戴口罩。本定性案例研究旨在了解制定和实施不列颠哥伦比亚省流感预防政策所涉及的主要促进因素和障碍。本项目选择了解释性定性案例研究方法。通过审查 110 份文件（政策和规划文件、实施工具、新闻稿、沟通材料等）和与政策实施团队成员（n = 48）进行的 7 次焦点小组收集数据。使用框架分析方法对焦点小组访谈记录进行分析，并通过 Prior 方法指导文件分析。确定了四个主题：（1）冲突的范式，（2）政策实施差距，（3）权力途径，（4）个人影响。确定嵌入宏观、中观和微观层面背景以及全省范围内规划的问题对政策实施至关重要。在全省范围内的流感预防政策中，需要高级别参与和专用资源的全省方法对 HCW 至关重要。改善条件服务流感政策大规模实施的建议包括：尽早让利益相关者参与，考虑政治背景的复杂性，适当分配时间进行规划，制定“执行”计划，并为一线提供者提供教育和技能。
