Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T21:01:46.907Z Has data issue: false hasContentIssue false
  • English
  • Français

Preventing Respiratory Viral Transmission in Long-Term Care: Knowledge, Attitudes, and Practices of Healthcare Personnel

Published online by Cambridge University Press:  27 November 2017

Caroline A. O’Neil ,
Lindsay Kim ,
Mila M. Prill ,
Nimalie D. Stone ,
Shikha Garg ,
H. Keipp Talbot  and
Hilary M. Babcock
Caroline A. O’Neil*
Affiliation:
Infectious Diseases Division, Washington University School of Medicine, St Louis, Missouri
Lindsay Kim
Affiliation:
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Mila M. Prill
Affiliation:
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Nimalie D. Stone
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Shikha Garg
Affiliation:
Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
H. Keipp Talbot
Affiliation:
Vanderbilt University School of Medicine, Nashville, Tennessee
Hilary M. Babcock
Affiliation:
Infectious Diseases Division, Washington University School of Medicine, St Louis, Missouri
*
Address correspondence to Caroline O’Neil, Infectious Diseases Division, Washington University School of Medicine, 4523 Clayton Ave, Box 8051, St Louis, MO 63110 (o’[email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

To examine knowledge and attitudes about influenza vaccination and infection prevention practices among healthcare personnel (HCP) in a long-term-care (LTC) setting.

DESIGN

Knowledge, attitudes, and practices (KAP) survey.

SETTING

An LTC facility in St Louis, Missouri.

PARTICIPANTS

All HCP working at the LTC facility were eligible to participate, regardless of department or position. Of 170 full- and part-time HCP working at the facility, 73 completed the survey, a 42.9% response rate.

RESULTS

Most HCP agreed that respiratory viral infections were serious and that hand hygiene and face mask use were protective. However, only 46% could describe the correct transmission-based precautions for an influenza patient. Correctly answering infection prevention knowledge questions did not vary by years of experience but did vary for HCP with more direct patient contact versus less patient contact. Furthermore, 42% of respondents reported working while sick, and 56% reported that their coworkers did. In addition, 54% reported that facility policies made staying home while ill difficult. Some respondents expressed concerns about the safety (22%) and effectiveness (27%) of the influenza vaccine, and 28% of respondents stated that they would not get the influenza vaccine if it was not required.

CONCLUSIONS

This survey of staff in an LTC facility identified several areas for policy improvement, particularly sick leave, as well as potential targets for interventions to improve infection prevention knowledge and to address HCP concerns about influenza vaccination to improve HCP vaccination rates in LTCs.

Infect Control Hosp Epidemiol 2017;38:1449–1456

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 12 , December 2017 , pp. 1449 - 1456
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Menec, VH, MacWilliam, L, Aoki, FY. Hospitalizations and deaths due to respiratory illnesses during influenza seasons: a comparison of community residents, senior housing residents, and nursing home residents. J Gerontol 2002;57:M629–M635.CrossRefGoogle ScholarPubMed
2. Smith, PW, Bennett, G, Bradley, S, et al. SHEA/APIC Guideline: infection prevention and control in the long-term care facility. Am J Infect Control 2008;36:504–535.CrossRefGoogle ScholarPubMed
3. Bush, KA, McAnulty, J, McPhie, K, et al. Antiviral prophylaxis in the management of an influenza outbreak in an aged care facility. Commun Dis Intel Q Rep 2004;28:396–400.Google Scholar
4. Coles, FB, Balzano, GJ, Morse, DL. An outbreak of influenza A (H3N2) in a well immunized nursing home population. J Am Geriatr Soc 1992;40:589–592.CrossRefGoogle Scholar
5. Dharan, NJ, Patton, M, Siston, AM, et al. Outbreak of antiviral drug-resistant influenza a in long-term care facility, Illinois, USA, 2008. Emerg Infect Dis 2009;15:1973–1976.CrossRefGoogle ScholarPubMed
6. Jordan, JG, Pritchard, S, Nicholson, G, et al. Pneumonia Associated with an Influenza A H3 Outbreak at a Skilled Nursing Facility—Florida, 2014. Morb Mort Wkly Rep 2015;64:985–986.CrossRefGoogle Scholar
7. Gupta, RK, Zhao, H, Cooke, M, et al. Public health responses to influenza in care homes: a questionnaire-based study of local health protection units. J Public Health 2007;29:88–90.Google Scholar
8. Kuster, SP, Shah, PS, Coleman, BL, et al. Incidence of influenza in healthy adults and healthcare workers: a systematic review and meta-analysis. PloS One 2011;6:e26239.Google Scholar
9. Voirin, N, Payet, C, Barrat, A, et al. Combining high-resolution contact data with virological data to investigate influenza transmission in a tertiary care hospital. Infect Control Hosp Epidemiol 2015;36:254–260.Google Scholar
10. Eibach, D, Casalegno, JS, Bouscambert, M, et al. Routes of transmission during a nosocomial influenza A(H3N2) outbreak among geriatric patients and healthcare workers. J Hosp Infect 2014;86:188–193.CrossRefGoogle ScholarPubMed
11. Hayward, AC, Harling, R, Wetten, S, et al. Effectiveness of an influenza vaccine programme for care home staff to prevent death, morbidity, and health service use among residents: cluster randomised controlled trial. BMJ 2006;333:1241.CrossRefGoogle ScholarPubMed
12. Carman, WF, Elder, AG, Wallace, LA, et al. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000;355:93–97.Google Scholar
13. Potter, J, Stott, DJ, Roberts, MA, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997;175:1–6.CrossRefGoogle ScholarPubMed
14. Lemaitre, M, Meret, T, Rothan-Tondeur, M, et al. Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial. J Am Geriatr Soc 2009;57:1580–1586.Google Scholar
15. Ahmed, F, Lindley, MC, Allred, N, Weinbaum, CM, Grohskopf, L. Effect of influenza vaccination of healthcare personnel on morbidity and mortality among patients: systematic review and grading of evidence. Clin Infect Dis 2014;58:50–57.Google Scholar
16. Dolan, GP, Harris, RC, Clarkson, M, et al. Vaccination of healthcare workers to protect patients at increased risk of acute respiratory disease: summary of a systematic review. Influenza Other Respir Virus 2013;7(Suppl 2):93–96.CrossRefGoogle ScholarPubMed
17. Ng, AN, Lai, CK. Effectiveness of seasonal influenza vaccination in healthcare workers: a systematic review. J Hosp Infect 2011;79:279–286.Google Scholar
18. Thomas, RE, Jefferson, T, Lasserson, TJ. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. Cochrane Database Syst Rev 2013:Cd005187.Google Scholar
19. Shugarman, LR, Hales, C, Setodji, CM, Bardenheier, B, Lynn, J. The influence of staff and resident immunization rates on influenza-like illness outbreaks in nursing homes. J Am Med Dir Assoc 2006;7:562–567.CrossRefGoogle ScholarPubMed
20. Wendelboe, AM, Avery, C, Andrade, B, Baumbach, J, Landen, MG. Importance of employee vaccination against influenza in preventing cases in long-term care facilities. Infect Control Hosp Epidemiol 2011;32:990–997.CrossRefGoogle ScholarPubMed
21. Prevention Strategies for Seasonal Influenza in Healthcare Settings. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm. Published 2013. Accessed May 3, 2017.Google Scholar
22. Vaccines against influenza. WHO position paper—November 2012. Wkly Epidemiol Rec 2012;87:461–476.Google Scholar
23. Black, CL, Yue, X, Ball, SW, et al. Influenza vaccination coverage among health care personnel-United States, 2015–16 influenza season. Morb Mort Wkly Rep 2016;65:1026–1031.Google Scholar
24. Healthy people 2020 topics and objectives: immunization and infectious diseases. Office of Disease Prevention and Health Promotion website. https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives. Published 2010. Accessed November 14, 2016.Google Scholar
25. Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377–381.CrossRefGoogle ScholarPubMed
26. Daugherty, JD, Blake, SC, Grosholz, JM, Omer, SB, Polivka-West, L, Howard, DH. Influenza vaccination rates and beliefs about vaccination among nursing home employees. Am J Infect Control 2015;43:100–106.CrossRefGoogle ScholarPubMed
27. Manuel, DG, Henry, B, Hockin, J, Naus, M. Health behavior associated with influenza vaccination among healthcare workers in long-term-care facilities. Infect Control Hosp Epidemiol 2002;23:609–614.Google Scholar
28. Looijmans-van den Akker, I, van Delden, JJ, Verheij, TJ, et al. Which determinants should be targeted to increase influenza vaccination uptake among health care workers in nursing homes? Vaccine 2009;27:4724–4730.Google Scholar
29. Nace, DA, Hoffman, EL, Resnick, NM, Handler, SM. Achieving and sustaining high rates of influenza immunization among long-term care staff. J Am Med Dir Assoc 2007;8:128–133.CrossRefGoogle ScholarPubMed
30. Kimura, AC, Nguyen, CN, Higa, JI, Hurwitz, EL, Vugia, DJ. The effectiveness of vaccine day and educational interventions on influenza vaccine coverage among health care workers at long-term care facilities. Am J Public Health 2007;97:684–690.Google Scholar
31. Lam, PP, Chambers, LW, MacDougall, DM, McCarthy, AE. Seasonal influenza vaccination campaigns for health care personnel: systematic review. CMAJ 2010;182:E542–E548.Google Scholar