Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
St. Luke's Physician Group-Infectious Disease Associates, St. Luke's University Health Network, Bethlehem, PA.
Am J Infect Control. 2019 Aug;47(8):895-901. doi: 10.1016/j.ajic.2019.02.004. Epub 2019 Mar 19.
Working with influenza-like illness (ILI) is pervasive throughout health care. We assessed knowledge, attitudes, and practices regarding ILI presenteeism of both postgraduate trainees and program leaders.
This survey study was conducted at the Montefiore Medical Center, Albert Einstein College of Medicine, a large academic center in the Bronx, New York. Internal medicine and subspecialty house staff and program directors completed an anonymous electronic survey between April 23 and June 15, 2018.
A total of 197 of 400 (49%) house staff and 23 of 39 (59%) program leaders participated; 107 (54%) trainees and 6 (26%) program leaders self-reported ILI presenteeism in the past 12 months. More than 90% of trainees and program leaders reported that ILI presenteeism places others at risk. Only 9% of program leaders accurately estimated trainee ILI presenteeism prevalence. Both cited "not wanting to burden colleagues" as the top reason for ILI presenteeism. Twenty-six (24%) trainees practiced ILI presenteeism on critical care units. The majority reported that they would provide patient care with upper respiratory symptoms without fever. Most trainees incorrectly answered influenza knowledge questions.
ILI presenteeism prevalence is high within training programs at our medical center. Program leaders can model best practices, enforce nonpunitive sick-leave policies, and ensure infection prevention competencies are met annually.
流感样疾病（ILI）的防治在整个医疗保健领域都很普遍。我们评估了研究生受训者和项目负责人对 ILI 出勤的知识、态度和实践。
这项调查研究是在纽约布朗克斯的阿尔伯特·爱因斯坦医学院的蒙蒂菲奥里医疗中心进行的。内科和亚专业住院医师和项目主任在 2018 年 4 月 23 日至 6 月 15 日期间完成了匿名电子调查。
共有 400 名住院医师中的 197 名（49%）和 39 名项目主任中的 23 名（59%）参与了调查；107 名（54%）受训者和 6 名（26%）项目主任报告在过去 12 个月中出现了 ILI 出勤。超过 90%的住院医师和项目主任报告说，ILI 出勤会使他人面临风险。只有 9%的项目负责人准确估计了受训者 ILI 出勤的流行率。双方都将“不想给同事带来负担”作为 ILI 出勤的首要原因。26%的住院医师在重症监护病房实行 ILI 出勤。大多数人报告说，他们在上呼吸道症状没有发热的情况下会提供患者护理。大多数住院医师错误地回答了流感知识问题。
我们医疗中心的培训计划中 ILI 出勤的发生率很高。项目负责人可以树立最佳实践的榜样，执行非惩罚性的病假政策，并确保每年都满足感染预防能力要求。
