Strategies to Increase Influenza Vaccination Rates Among Health Care Personnel

1
Strategies to Increase Influenza Vaccination
RatesAmong Health Care Personnel

• Sarah Partain, MSN, MBA, RN, CIC
• IHS Open Door Forum
• October 23, 2008

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Southcentral Foundation

• Alaska Native-owned healthcare organization
  serving Alaska Native and American Indian people
  living in Anchorage, the Mat-Su Valley, and 60
  rural villages in the Anchorage Service Unit.
• Vision A Native community that enjoys physical,
  mental, emotional and spiritual wellness.
• Mission Working together with the Native
  community to achieve wellness through health and
  related services.

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Employee Health Challenges

• Access database used
• Information incomplete and/or inaccurate
• Employee Health was covered by Safety Officer
• Initial TB skin tests and TB exposure follow up
  only
• Nov 2004 Database changed to OHM for Windows
• Info from old database manually transferred over
  corrections not made at time of transfer
• May 2005 Employee Health/Infection Coordinator
  hired
• No EH or IC experience

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EH/IC Coordinator

• Staffed with 1 RN (me!)
• Responsible for bi-weekly New Hire Orientation
• 2-step TB skin testing
• Updating immunizations as needed
• Checking antibody titers
• Annual EH requirements
• TB skin tests
• Influenza vaccinations
• Respirator fit testing

• Exposure follow up for
• Bloodborne Pathogens
• TB
• Infection Prevention Control education

5
Influenza Vaccination Challenges

• No one had solid numbers of how many employees
  received influenza vaccinations.
• Info was entered into RPMS only not easy to
  retrieve for employees only.
• Not all employees are beneficiaries
• Safety Officer said he usually ordered 200 doses.
• Employees took vaccine from Pharmacy.
• Pharmacy had factored in for patients only.

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Initial Steps

• 2005 EH ordered 200 doses vaccine in June (very
  late!) from State Vaccine Depository
• Recd 100 doses because of expected shortages
• Begged for more vaccine from Pharmacy
• Minimal EH outreach
• Relied on word of mouth campaign to let
  employees know about vaccine availability
• Gave 280 doses total

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2006

• Ordered 750 doses from IHS Service Supply Center
  (Ada, OK) in January
• Recd order in small amounts between Oct 15 and
  Dec 1
• Scheduled 3 all day Flu Shot Clinics
• Borrowed 200 doses from Pharmacy for first Flu
  Shot Clinic
• Scheduled visits to individual departments at
  managers request
• 650 doses given (52 workforce vaccinated)
• Lost 100 doses due to refrigeration failure

8
2007

• Ordered 1000 doses from same vendor
• Asked that entire order be shipped in September
• New Joint Commission standard (IC.4.15) in effect
  1/1/07 that organization must offer influenza
  vaccine to employees and volunteers with close
  patient contact
• Initiated declination form to collect total
  numbers of employees contacted (modified from
  Immunization Action Coalition
  http//www.immunize.org .
• Continued EH visits to off-campus departments.
• Designated EH representatives in some clinical
  departments to administer vaccine

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2007 Total Numbers

• 875 employees vaccinated (68 workforce)
• 178 declinations received (8 workforce)
• 10 of declinations were pregnant women who
  wanted preservative-free vaccine
• 50 non-employees vaccinated
• Students
• Employee Day Care employees
• CIRI Headquarters

10
2008

• Ordered 1100 doses through Pharmacy Services
• Including 100 doses preservative-free vaccine in
  response to previous years feedback on
  declination forms
• Initiated Employee Health Tuesdays in Primary
  Care Center
• Continue EH outreach to individual departments,
  esp. to off-campus locations
• EH reps continue to administer vaccine in
  selected clinics

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2008 Goal

• 100 response to flu vaccine campaign
• Vaccinations Declinations
• Progress to be charted for employees on
  thermometer goal graph

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Incentives!?

• Jeans Day if individual has completed all EH
  requirements
• Pizza Party or Ice Cream Social for first
  department to reach 100 response (vaccinations
  declinations)
• Funded by Employee Health

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Declination of Influenza Vaccination Form
(example)