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Barriers and facilitators to influenza-like illness absenteeism among healthcare workers in a tertiary-care healthcare system, 2017–2018 influenza season

Published online by Cambridge University Press:  02 March 2021

Diep Hoang Johnson ,
Fauzia Osman ,
Jero Bean ,
Linda Stevens ,
Daniel Shirley ,
Julie A. Keating ,
Shabvon Johnson  and
Nasia Safdar
Diep Hoang Johnson
Affiliation:
University of Wisconsin Health, University of Wisconsin-Madison, Madison, Wisconsin
Fauzia Osman
Affiliation:
Division of Infection Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Jero Bean
Affiliation:
University of Wisconsin Health, University of Wisconsin-Madison, Madison, Wisconsin
Linda Stevens
Affiliation:
University of Wisconsin Health, University of Wisconsin-Madison, Madison, Wisconsin
Daniel Shirley
Affiliation:
Division of Infection Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Julie A. Keating
Affiliation:
William S. Middleton Memorial Veterans Hospital, University of Wisconsin-Madison, Madison, Wisconsin
Shabvon Johnson
Affiliation:
University of Wisconsin Health, University of Wisconsin-Madison, Madison, Wisconsin
Nasia Safdar*
Affiliation:
Division of Infection Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin William S. Middleton Memorial Veterans Hospital, University of Wisconsin-Madison, Madison, Wisconsin
*
Author for correspondence: Nasia Safdar, E-mail: [email protected]
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Abstract

Objective:

Influenza can be introduced and propagated in healthcare settings by healthcare workers (HCWs) working while ill with influenza. However, reasons driving this behavior are unclear. In this study, we examined barriers to and facilitators of absenteeism during the influenza season.

Design:

Cross-sectional mixed methods study.

Setting:

Ambulatory and inpatient settings in a large, tertiary-care healthcare system.

Methods:

An anonymous electronic survey was sent to HCWs between June 11 and July 13, 2018, asking participants to self-report influenza-like illness (ie, ILI symptoms of fever, chills, cough, or sore throat) during the 2017–2018 influenza season. We conducted a logistical regression analysis to identify factors associated with absenteeism.

Results:

Of 14,250 HCWs, 17% responded to the survey. Although 1,180 respondents (51%) reported symptoms of ILI, 575 (43%) did not stay home while ill. The most commonly perceived barriers to ILI absenteeism included being understaffed (odds ratio [OR], 1.78; P = .04), unable to find a replacement for work (OR, 2.26; P = .03), desiring not to use time off (OR, 2.25; P = .003), and paid by the hour or unable to afford being absent (OR, 2.05; P = .02). Common perceived facilitators of absenteeism included support from coworkers and management, clearer policy, better sick days availability, and lower perceived threat of disciplinary action.

Conclusions:

Reporting to work with ILI symptoms is common among HCWs. Most barriers and facilitators are related to systems. Addressing system factors, such as policies regarding sick days and sick leave and ensuring adequate backup staffing, is likely to facilitate absenteeism among ill HCWs.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 10 , October 2021 , pp. 1198 - 1205
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Copyright
© The Author(s), 2021 Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

a

Authors of equal contribution.

References

Centers for Disease Control and Prevention (CDC). Update: influenza activity in the United States during the 2018–19 season and composition of the 2019–20 influenza vaccine. Morb Mortal Wkly Rep 2019;68:544–551.CrossRefGoogle Scholar
Summary of the 2017–2018 influenza season. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm. Accessed January 4, 2020.Google Scholar
Estimated influenza illnesses, medical visits, hospitalizations, and deaths in the United States—2017–2018 influenza season. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/about/burden/2017-2018.htm. Accessed January 4, 2020.Google Scholar
2017–2018 estimated influenza illnesses, medical visits, hospitalizations, and deaths and estimated influenza illnesses, medical visits, hospitalizations, and deaths averted by vaccination in the United States. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/about/burden-averted/2017-2018.htm. Accessed January 4, 2020.Google Scholar
Centers for Disease Control and Prevention. Health-related workplace absenteeism among full-time workers—United States, 2017–2018 influenza season. Morb Mortal Wkly Rep 2019;68:577–582.CrossRefGoogle Scholar
Wilson, K, Wood, S, Schaecher, K, et al. Nosocomial outbreak of influenza A H3N2 in an inpatient oncology unit related to healthcare workers presenting to work while ill. Am J Infect Control 2019;47:683–687.CrossRefGoogle Scholar
Balicer, R, Huerta, M, Levy, Y, et al. Influenza outbreak control in confined settings. Emerg Infect Dis 2005;11:579–583.CrossRefGoogle ScholarPubMed
Naudion, P, Lepiller, Q, Bouiller, K. Risk factors and clinical characteristics of patients with nosocomial influenza A infection. J Med Virol 2020;92:1047–1052.CrossRefGoogle ScholarPubMed
Bischoff, W, Petraglia, M, McLouth, C, et al. Intermittent occurrence of healthcare-onset influenza cases in a tertiary care facility during the 2017–2018 flu season. Am J Infect Control 2020;48:112–115.CrossRefGoogle Scholar
Prevention strategies for seasonal influenza in healthcare settings. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm. Accessed January 4, 2020.Google Scholar
Influenza vaccination information for healthcare workers. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/professionals/healthcareworkers.htm. Accessed January 4, 2020.Google Scholar
Centers for Disease Control and Prevention. Influenza vaccination coverage among healthcare personnel—United States, 2017–2018 influenza season. Morb Mortal Wkly Rep 2018;67:1050–1054.CrossRefGoogle Scholar
Centers for Disease Control and Prevention. Influenza vaccination of healthcare personnel. Morb Mortal Wkly Rep 2006;55:1–16.Google Scholar
Peasah, S, Azziz-Baumgartner, E, Breese, J, et al. Influenza cost and cost-effectiveness studies globally—a review. Vaccine 2013;31:5339–5348.CrossRefGoogle Scholar
Anikeeva, O, Braunack-Mayer, A, Rogers, W. Requiring influenza vaccination for healthcare workers. Am J Public Health 2019;99:24–29.CrossRefGoogle Scholar
Rakita, R, Hagar, B, Crome, P, et al. Mandatory influenza vaccination of healthcare workers: a 5-year study. Infect Control Hosp Epidemiol 2010;31:881–888.CrossRefGoogle ScholarPubMed
Yue, X, Black, C, Ball, S, et al. Workplace interventions associated with influenza vaccination coverage among healthcare personnel in ambulatory care settings during the 2013–2014 and 2014–2015 influenza seasons. Am J Infect Control 2017;45:1243–1248.CrossRefGoogle Scholar
Murti, M, Otterstatter, M, Orth, A, Balshaw, R, et al. Measuring the impact of influenza vaccination on healthcare worker absenteeism in the context of a province-wide mandatory vaccinate-or-mask policy. Vaccine 2019;37:4001–4007.CrossRefGoogle ScholarPubMed
Naleway, AL, Henkle, EM, Ball, S, et al. Barriers and facilitators to influenza vaccination and vaccine coverage in a cohort of healthcare personnel. Am J Infect Control 2014;42:371–375.CrossRefGoogle Scholar
Chiu, S, Black, C, Yue, X, et al. Working with influenza-like illness: presenteeism among US healthcare personnel during the 2014–2015 influenza season. Am J Infect Control 2017;45:1254–1258.CrossRefGoogle Scholar
Putri, W, Muscatello, D, Stockwell, M, et al. Economic burden of seasonal influenza in the United States. Vaccine 2018;36:3960–3966.CrossRefGoogle ScholarPubMed
Burns, K, Kho, M. How to assess a survey report: a guide to readers and peer reviewers. CMAJ 2015;187:E198–E204.CrossRefGoogle ScholarPubMed
Flanigan, T, McFarlane, E, Cook, S. Conducting survey research among physicians and other medical professionals—a review of current literature. Section on Survey Research Methods 2008. AAPOR website. http://www.asasrms.org/Proceedings/y2008/Files/flanigan.pdf 4136–4147. Published 2008. Accessed December 30, 2020.Google Scholar
Kelley, K, Clark, B, Brown, V, et al. Good practice in the conduct and the reporting of survey research. Int J Qual Health Care 2003;15:226–266.CrossRefGoogle ScholarPubMed
Zhai, Y, Santibanez, TA, Kahn, KE, et al. Paid sick leave benefits, influenza vaccination, and taking sick days due to influenza-like illness among US workers. Vaccine 2018;36:7316–7323.CrossRefGoogle Scholar
Webster, R, Liu, R, Karimullina, K, et al. A systematic review of infectious illness presenteeism: prevalence, reasons and risk factors. BMC Pub Health 2019;19:799–812.CrossRefGoogle ScholarPubMed
Szymczak, J, Smathers, S, Hoegg, C, et al. Reasons why physicians and advanced practice clinicians works while sick: a mixed-methods analysis. JAMA Pediatr 2015;169:815–821.CrossRefGoogle ScholarPubMed
Jiang, L, McGeer, A, McNeil, S, et al. Canadian Healthcare Worker Study Group. Which healthcare workers work with acute respiratory illness? Evidence from Canadian acute-care hospitals during four influenza seasons: 2010–2011 to 2013–2014. Infect Control Hosp Epidemiol 2019;40:889–896.CrossRefGoogle Scholar
Kumar, S, Grefenstette, J, Galloway, D, et al. Policies to reduce influenza in the workplace: impact assessments using an agent-based model. Am J Pub Health 2013;103:1406–1411.CrossRefGoogle ScholarPubMed
Gianino, M, Politano, G, Scarmozzino, A, et al. Estimation of sickness absenteeism among Italian healthcare workers during seasonal influenza epidemics. PloS One 2017;12:1–12 e0182510.CrossRefGoogle Scholar
Meredith, N. Improving flu campaigns: protecting healthcare workers and patients. Brit J Nurs 2018;27:22–23.CrossRefGoogle ScholarPubMed
Converse, PD, Wolfe, EW, Oswald, FL. Response rates for mixed-mode surveys using mail and e-mail/web. Am J Eval 2008;29:99–107.CrossRefGoogle Scholar
Draugalis, JR, Coons, SJ, Plaza, CM. Best practices for survey research reports: a synopsis for authors and reviewers. Am J Pharm Educ 2008;72:1–6.CrossRefGoogle ScholarPubMed
What is a good survey response rate? Survey Gizmo website. https://www.surveygizmo.com/resources/blog/survey-response-rates/. Accessed January 14, 2020.Google Scholar
Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health. World Health Organization website. https://www.who.int/docs/default-source/coronaviruse/who-rights-roles-respon-hw-covid-19.pdf?sfvrsn=bcabd401_0. Accessed October 26, 2020.Google Scholar
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