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Nurses are good at giving flu vaccines, bad at getting them

Alexandra Wilson Pecci, for HealthLeaders Media, November 27, 2012

Nurses are leading the way in reducing readmissions, improving infection control, and greening hospitals. Now add improving vaccination rates to that list.

A new study in the Annals of Family Medicine finds that more elderly and at-risk adults get flu and pneumonia vaccinations when the shots are administered by nurses instead of doctors.

Researchers at the University of Alberta in Edmonton, Canada, analyzed 77 studies about methods for improving vaccination rates, from patient financial incentives to patient outreach.

They found that "interventions involving team change were effective, especially where nurses had been assigned responsibilities for administering vaccine."

Of all the methods they studied, the researchers found that giving vaccination responsibility to nurses was among the most successful ways to improve vaccination rates.

"The evidence, we think, clearly shows that shifting the responsibility and the ability to vaccinate to non-physician personnel... works," Jeffrey Johnson, one of the researchers, told Reuters Health.

That nurses can help improve vaccination rates is no surprise, but I can't help but notice an ironic side to this: Nurses might be good at giving the vaccine and making sure their patients get it, but they and other healthcare workers are notoriously bad at getting flu vaccines for themselves.

As surely as autumn brings falling leaves and longer nights, every flu season brings with it the annual controversy surrounding vaccines for healthcare workers. Each year, the Centers for Disease Control and Prevention encourages people to get flu vaccines to protect themselves from the virus. And yet each year, new stats show that healthcare workers are among the worst offenders for not complying with those recommendations. Earlier this fall, 2011–2012 flu season stats from the CDC showed that in physician offices, one in three (32.3%) workers were not immunized. In long-term care facilities, nearly half (47.6%) of workers failed to get their flu shots.

According to other CDC data, voluntary measures for ensuring employee vaccination don't seem to work as well as mandatory ones. "During the 2010–2011 influenza season, coverage for influenza vaccination among healthcare workers was estimated at 63.5%," the CDC reports. However, "coverage was 98.1% among healthcare workers who had an employer requirement for vaccination."

Although vaccination mandates are growing more widespread, many organizations remain hesitant to make vaccinations a condition of employment, rendering the mandates effectively toothless.

So what's a hospital to do? I saw one solution during a recent visit to a rehab center. A handful of employees were wearing surgical masks as they went about their work day. These employees weren't sick or necessarily caring for people who were sick. They were wearing masks because they hadn't gotten a flu shot.

They were part of a new policy requiring employees who'd opted not to get a flu vaccine to wear a mask while at work, even when they were feeling healthy. Those who had received the vaccine were identified by a dot on their employee badge. Notices about this new policy were posted around the hospital.

As the mother of a young patient, I want healthcare workers to get flu shots. But I wondered whether the masks were more of a public shaming technique—the vaccine version of a scarlet letter—than a real protection mechanism.

On my next visit, I didn't see any employees wearing the masks. Either the new policy had quickly fizzled out, or the vaccine holdouts had buckled and decided that getting a flu shot was better than the hassle of spending the next five months wearing a mask. Are there better solutions to the problem of non-vaccinated healthcare workers? Please share your thoughts with me and your fellow readers.

Source: HealthLeaders Media