© 2011 Pennsylvania Patient Safety Authority

© 2011 Pennsylvania Patient Safety Authority

© 2011 Pennsylvania Patient Safety Authority

Selected slides used with permission

© 2011 Pennsylvania Patient Safety Authority

© 2011 Pennsylvania Patient Safety Authority

© 2011 Pennsylvania Patient Safety Authority

© 2011 Pennsylvania Patient Safety Authority

© 2011 Pennsylvania Patient Safety Authority

© 2011 Pennsylvania Patient Safety Authority

Employee Vaccination and Patient Safety Training

James Davis, BSN RN CCRN CIC

© 2011 Pennsylvania Patient Safety Authority

• Health care worker (HCW) Influenza vaccination is sub-optimal.

– Less than 65% of HCWs get vaccinated annually.1

• HCWs who are clinically or sub-clinically infected can transmit Influenza virus to other persons.2

• Low rates of HCW vaccination have been linked to hospital Influenza outbreaks.2

SituationSituation

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Influenza-associated death cause

< 19 years 19 – 64 years ≥ 65 years Total

Pneumonia 97 666 5546 6309

Respiratory & circulatory 124 2385 21098 23607

BackgroundBackground

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Distribution of Mortality

< 19 years 19 – 64 years ≥ 65 years

Pneumonia 1.5% 10.6% 87.9%

Respiratory & circulatory 0.5% 10.1% 89.4%

CDC Annual Estimates of Influenza-associated Deaths & Mortality 1976-20073

© 2011 Pennsylvania Patient Safety Authority

BackgroundBackground

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© 2011 Pennsylvania Patient Safety Authority

• The highest percentage of people utilizing healthcare services are 65-84 years old.

• That is; the highest percentage of people coming in contact with HCWs, are 65-84 years old.

– HCWs are at risk for contracting Influenza from, and spreading Influenza to this vulnerable population.

• The highest distribution of mortality from Influenza-associated illness is in people ≥ 65 years old.

– Un-vaccinated HCWs can spread Influenza to patients and contribute to increased mortality.

AssessmentAssessment

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© 2011 Pennsylvania Patient Safety Authority

• High levels of HCW vaccination could have an impact on cost savings related to reduction of Medicare spending on respiratory conditions.

AssessmentAssessment

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Of the 221 Pa. nursing homes (NH) that responded to the survey:

•18 Pa. NHs have mandatory annual HCW vaccination programs in place.

Does a high level of HCW vaccination make a tangible difference in the reduction of respiratory tract infection and Influenza related illness (RTI/ILI) in Pa. nursing homes?

PA-PSRS 2010 Annual Survey Data5PA-PSRS 2010 Annual Survey Data5

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PA-PSRS 2010 Annual Survey DataPA-PSRS 2010 Annual Survey Data

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LTC Program RTI / ILI Rate5

95% LCL 95% UCL

Voluntary (n=203) 0.64 0.61 0.66

Mandatory (n=18) 0.50 0.44 0.57

• There is a statistically significant decrease in combined seasonal RTI/ILI rates in Pa. NHs that mandate HCW vaccination.5

• A review of the NH Influenza data derived from the PA-PSRS annual survey will be available in an upcoming issue of The Pennsylvania Patient Safety Advisory.

© 2011 Pennsylvania Patient Safety Authority

• Mandatory HCW vaccination programs in Pa. NHs have shown a 21.1% decrease in combined seasonal RTI/ILI infection rates.5

• Crude patient mortality rates were 42% lower in facilities with higher staff vaccination rates.2

• Reducing transmission of Influenza from HCW to patients may reduce Influenza related patient deaths.2

• Protection of patients and HCWs through vaccination for Influenza may decrease Medicare spending on respiratory illness.

Should healthcare workers be vaccinated?Should healthcare workers be vaccinated?

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1. Center for Disease Control and Prevention (CDC). Influenza vaccination coverage estimates and selected related results from a national internet panel survey of health care personnel, United States, November 2010 [cited 2011 May 13]. Available from Internet: http://www.cdc.gov/flu/pdf/vaccination/BlackNovemberHCPsurveyResults.pdf

2. Pearson ML, Bridges CB, Harper SA. MMWR. Influenza vaccination of health-care personnel. Recommendations of the healthcare infection control advisory committee (HICPAC) and the advisory committee on immunization practices (ACIP). 2006 Feb. 24 [cited 2011 May 13]. Available from Internet: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5502a1.htm

3. Center for Disease Control and Prevention (CDC). Estimates of deaths associated with seasonal influenza-United States 1976-2007. MMWR 2010;59:1057-1062.

4. Agency for Healthcare Research and Quality (AHRQ). The national inpatient sample (NIS). 2008 [cited 2011 May 13]. Available from Internet: http://www.hcup-us.ahrq.gov/reports/factsandfigures/2008/TOC_2008.jsp

5. The Pennsylvania Patient Safety Authority. PA-PSRS 2010 annual survey. 2010. [unpublished results].

ReferencesReferences

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