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医护人员流感疫苗接种:评估南意大利某医院现场接种策略以提高医护人员疫苗接种率。

Influenza vaccination in health-care workers: an evaluation of an on-site vaccination strategy to increase vaccination uptake in HCWs of a South Italy Hospital.

机构信息

Interdisciplinary Department of Medicine, Section of Occupational Medicine, Aldo Moro University of Bari, Bari, Italy.

Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy.

出版信息

Hum Vaccin Immunother. 2019;15(12):2927-2932. doi: 10.1080/21645515.2019.1625645. Epub 2019 Jul 25.

Abstract

Despite the international recommendation and specific programs, and although the vaccination of health-care workers (HCWs) is considered the main measure to prevent nosocomial influenza, vaccination coverage (VC) among HCWs remains low. One of the most important barriers to vaccination uptake is the time required to attend a vaccination clinic. Centers for Disease Control and Prevention (CDC) recommends on-site influenza vaccination as a proven and cost-effective strategy that increases productivity, reduces overall absenteeism and prevents direct health-care costs. In order to increase vaccine compliance in the HCWs, the Hygiene and the Occupational Medicine departments of Bari Policlinico General University-Hospital, in the 2017/18 influenza season, promoted an on-site vaccination program in eight Operative Units (OUs). We investigated the influenza VC among HCWs of Bari Policlinico (n = 3,397), comparing VC after implementation of the on-site strategy by the Hygiene department during the 2017/18 influenza season to VC in 2016/17 season. For 2017/18 season, we also compared VC in OUs target of on-site strategy with data from in eight "control" Units (choose by simple random sampling) not included in the on-site offer. In the 2016/17 influenza season, 295/3,397 HCWs were vaccinated (VC: 8.7%) while in the 2017/18 season 482 HCWs (VC: 14.2%) received the vaccination. In OUs target of on-site vaccination, 71 HCWs (VC: 10.0%) were vaccinated in the 2016/17 season and 126 (18.0%) in the 2017/18 season, of which 101/126 (80.2%) were vaccinated in an on-site clinic. VC in OUs target of on-site vaccination increased between 2016/17 and 2017/18 seasons of 16.8 ± 10.4% (range: 5.5-37.1), while the coverage in OUs of the control group increased of 1.6 ± 2.2% (range: -1.7-4.5), with a significant difference ( < .05). Our study suggests that the offer of on-site vaccination during the 2017/18 season led to an increase of VC in HCWs compared to the classical vaccination clinic approach. The determinants of adhesion and not-adhesion must be analyzed in dept, to experiment, in the future, new good clinical practices to increase the vaccination coverage in HCWs.

摘要

尽管有国际建议和具体方案,而且尽管医护人员(HCWs)接种疫苗被认为是预防医院内流感的主要措施,但 HCWs 的疫苗接种覆盖率(VC)仍然很低。接种疫苗的最重要障碍之一是参加疫苗接种诊所所需的时间。疾病控制与预防中心(CDC)建议在现场接种流感疫苗,这是一种经过验证且具有成本效益的策略,可提高生产力,减少总体缺勤率并预防直接医疗费用。为了提高 HCWs 的疫苗接种合格率,巴里综合大学医院的卫生和职业医学系在 2017/18 流感季节,在 8 个手术单元(OU)中推广了现场接种计划。我们调查了巴里综合医院(n = 3397)的 HCWs 中的流感 VC,比较了卫生部门在 2017/18 流感季节实施现场策略后的 VC,与 2016/17 流感季节的 VC。对于 2017/18 赛季,我们还将现场策略目标 OU 中的 VC 与未包含在现场服务中的 8 个“对照”OU(通过简单随机抽样选择)中的数据进行了比较。在 2016/17 流感季节,有 295/3397 名 HCWs 接种了疫苗(VC:8.7%),而在 2017/18 赛季,有 482 名 HCWs(VC:14.2%)接种了疫苗。在现场接种疫苗的 OU 中,2016/17 赛季有 71 名 HCWs(VC:10.0%)接种了疫苗,2017/18 赛季有 126 名(18.0%),其中 101 名(80.2%)在现场诊所接种了疫苗。2016/17 赛季和 2017/18 赛季现场接种 OU 的 VC 分别增加了 16.8 ± 10.4%(范围:5.5-37.1),而对照组 OU 的覆盖率增加了 1.6 ± 2.2%(范围:-1.7-4.5),差异有统计学意义(<0.05)。我们的研究表明,与传统的疫苗接种门诊方法相比,2017/18 季节现场接种疫苗的提供导致 HCWs 的 VC 增加。必须深入分析粘附和不粘附的决定因素,以便在未来尝试新的良好临床实践来提高 HCWs 的疫苗接种覆盖率。

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