Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-22T22:41:01.420Z Has data issue: false hasContentIssue false
  • English
  • Français

Reliability and Validity of a Standardized Measure of Influenza Vaccination Coverage among Healthcare Personnel

Published online by Cambridge University Press:  02 January 2015

Tanya E. Libby ,
Megan C. Lindley ,
Suchita A. Lorick ,
Taranisia MacCannell ,
Soo-Jeong Lee ,
Carmela Smith ,
Anita Geevarughese ,
Monear Makvandi ,
David A. Nace  and
Faruque Ahmed
Tanya E. Libby*
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
Megan C. Lindley
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
Suchita A. Lorick
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
Taranisia MacCannell
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging, Zoonotic, and Infectious Diseases, CDC, Atlanta, Georgia
Soo-Jeong Lee
Affiliation:
University of California, San Francisco, School of Nursing, San Francisco, California
Carmela Smith
Affiliation:
CDC Contractor to New Mexico Department of Health, Santa Fe, New Mexico
Anita Geevarughese
Affiliation:
New York City Department of Health and Mental Hygiene, New York City, New York
Monear Makvandi
Affiliation:
Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico
David A. Nace
Affiliation:
University of Pittsburgh, Pittsburgh, Pennsylvania
Faruque Ahmed
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
*
California Emerging Infections Program, 360 22nd Street, Suite 750, Oakland, CA 94612 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To evaluate the reliability and validity of a standardized measure of healthcare personnel (HCP) influenza vaccination.

Setting.

Acute care hospitals, long-term care facilities, ambulatory surgery centers, physician practices, and dialysis centers from 3 US jurisdictions.

Participants.

Staff from 96 healthcare facilities randomly sampled from 234 facilities that completed pilot testing to assess the feasibility of the measure.

Methods.

Reliability was assessed by comparing agreement between facility staff and project staff on the classification of HCP numerator (vaccinated at facility, vaccinated elsewhere, contraindicated, declined) and denominator (employees, credentialed nonemployees, other nonemployees) categories. To assess validity, facility staff completed a series of case studies to evaluate how closely classification of HCP groups aligned with the measure's specifications. In a modified Delphi process, experts rated face validity of the proposed measure elements on a Likert-type scale.

Results.

Percent agreement was high for HCP vaccinated at the facility (99%) and elsewhere (95%) and was lower for HCP who declined vaccination (64%) or were medically contraindicated (64%). While agreement was high (more than 90%) for all denominator categories, many facilities' staff excluded nonemployees for whom numerator and denominator status was difficult to determine. Validity was lowest for credentialed and other nonemployees.

Conclusions.

The standardized measure of HCP influenza vaccination yields reproducible results for employees vaccinated at the facility and elsewhere. Adhering to true medical contraindications and tracking decimations should improve reliability. Difficulties in establishing denominators and determining vaccination status for credentialed and other nonemployees challenged the measure's validity and prompted revision to include a more limited group of nonemployees.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 4 , April 2013 , pp. 335 - 345
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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

1.Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention. Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60(RR-7):1–45.Google Scholar
2.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(9198):93–97.CrossRefGoogle ScholarPubMed
3.Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O'Riordan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA 1999;281(10):908–913.CrossRefGoogle ScholarPubMed
4.Salgado, CD, Giannetta, ET, Hayden, FG, Farr, BM. Preventing nosocomial influenza by improving the vaccine acceptance rate of clinicians. Infect Control Hosp Epidemiol 2004;25(11):923–928.CrossRefGoogle ScholarPubMed
5.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):1–6.CrossRefGoogle ScholarPubMed
6.Influenza vaccination coverage among healthcare personnel—United States, 2010–11 influenza season. MMWR Morb Mortal Wkly Rep 2011;60(32):1073–1077.Google Scholar
7.US Department of Health and Human Services. Healthy People 2020 Summary of Objectives: Immunization and Infectious Diseases. http://www.healthypeople.gov/2020/topicsobjectives2020/pdfs/Immunization.pdf. Accessed May 8, 2012.Google Scholar
8.Talbot, TR, Babcock, H, Caplan, AL, et al.Revised SHEA position paper: influenza vaccination of healthcare personnel. Infect Control Hosp Epidemiol 2010;31(10):987–995.CrossRefGoogle ScholarPubMed
9. National Foundation for Infectious Diseases. Call to Action: Influenza Immunization among Health Care Personnel, http://www.nfid.org/publications/cta/flu-hcp-cta08.pdf. Accessed August 20, 2012.Google Scholar
10. National action plan to prevent healthcare-associated infections: roadmap to elimination; influenza vaccination of healthcare personnel. US Department of Health and Human Services website. http://www.hhs.gov/ash/initiatives/hai/hcpflu.html. Accessed July 25, 2012.Google Scholar
11.Dash, GP, Fauerbach, L, Pfeiffer, J, et al.APIC position paper: improving health care worker influenza immunization rates. Am J Infect Control 2004;32(3):123–125.Google ScholarPubMed
12.Pearson, ML, Bridges, CB, Harper, SA; Healthcare Infection Control Practices Advisory Committee; Advisory Committee on Immunization Practices. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;55(RR-2):1–16.Google ScholarPubMed
13.New infection control requirement for offering influenza vaccination to staff and licensed independent practitioners. Jt Comm Perspect 2006;26(6):10–11.Google Scholar
14.Joint Commission revises influenza vaccination standard: applicability extending to all accreditation programs in 2012. ft Comm Perspect 2011;31(12):4–5.Google Scholar
15.Lindley, MC, Yonek, J, Ahmed, F, Perz, JF, Torres, GW. Measurement of influenza vaccination coverage among healthcare personnel in US hospitals. Infect Control Hosp Epidemiol 2009;30(12):1150–1157.CrossRefGoogle ScholarPubMed
16. Influenza vaccination coverage among healthcare personnel. NQF 0431. National Quality Forum website. http://www.qualityforum.org/MeasureDetails.aspx?actid=0&SubmissionId=511#k=0431. Accessed July 2, 2012.Google Scholar
17.MacCannell, T, Shugart, A, Schneider, A, et al.A qualitative assessment of a performance measure for reporting influenza vaccination rates among healthcare personnel. Infect Control Hosp Epidemiol 2012;33(9):945–948.CrossRefGoogle ScholarPubMed
18.Lindley, MC. Pilot-testing a standardized measure for reporting healthcare personnel influenza vaccination, 2010–2011. Paper presented at: National Influenza Vaccine Summit; May 9, 2011; San Diego.Google Scholar
19.Sim, J, Wright, CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 2005;85(3):257–268.CrossRefGoogle ScholarPubMed
20.Miller-Keane, , Miller, BF, O'Toole, M. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing and Allied Health. 7th ed. Philadelphia: Elsevier Health Sciences, 2003.Google Scholar
21.Fitch, K, Bernstein, S, Aguilar, N, et al.The RAND/UCLA Appropriateness Method User's Manual. Santa Monica, CA: Rand, 2001.Google Scholar
22.Fiore, AE, Uyeki, TM, Broder, K, et al.Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep 2010;59(RR-8):1–62.Google ScholarPubMed
23.Melia, M, O'Neill, S, Calderon, S, et al.Development of a flexible, computerized database to prioritize, record, and report influenza vaccination rates for healthcare personnel. Infect Control Hosp Epidemiol 2009;30(4):361–369.CrossRefGoogle ScholarPubMed
24.Russell, ML, Henderson, EA. The measurement of influenza vaccine coverage among health care workers. Am J Infect Control 2003;31(8):457–461.CrossRefGoogle ScholarPubMed
25.Miller, BL, Ahmed, F, Lindley, MC, Wortley, PM. Institutional requirements for influenza vaccination of healthcare personnel: results from a nationally representative survey of acute care hospitals—United States, 2011. Clin Infect Dis 2011;53(11):1051–1059.CrossRefGoogle Scholar
26.Talbot, TR. Do declination statements increase health care worker influenza vaccination rates? Clin Infect Dis 2009;49(5): 773–779.CrossRefGoogle ScholarPubMed
27.Polgreen, PM, Septimus, EJ, Parry, MF, et al.Relationship of influenza vaccination declination statements and influenza vaccination rates for healthcare workers in 22 US hospitals. Infect Control Hosp Epidemiol 2008;29(7):675–677.CrossRefGoogle ScholarPubMed
28.Polgreen, PM, Polgreen, LA, Evans, T, Helms, C. A statewide system for improving influenza vaccination rates in hospital employees. Infect Control Hosp Epidemiol 2009;30(5):474–478.CrossRefGoogle ScholarPubMed
29.Polgreen, PM, Chen, Y, Beekmann, S, et al.Elements of influenza vaccination programs that predict higher vaccination rates: results of an emerging infections network survey. Clin Infect Dis 2008;46(1):14–19.CrossRefGoogle ScholarPubMed
30.Ribner, BS, Hall, C, Steinberg, JP, et al.Use of a mandatory declination form in a program for influenza vaccination of healthcare workers. Infect Control Hosp Epidemiol 2008;29(4): 302–308.CrossRefGoogle Scholar
31.Babcock, HM, Gemeinhart, N, Jones, M, Dunagan, WC, Woeltje, KF. Mandatory influenza vaccination of health care workers: translating policy to practice. Clin Infect Dis 2010;50(4):459–464.CrossRefGoogle ScholarPubMed
32.Wu, SS, Yang, P, Li, HY, Ma, CN, Zhang, Y, Wang, QY. The coverage rate and obstructive factors of influenza vaccine inoculation among residents aged above 18 years in Beijing from 2007 to 2010. Zhonghua Yu Fang Yi Xue Za Zhi 2011;45(12):1077–1081.Google ScholarPubMed
33.National Voluntary Consensus Standards for Influenza and Pneumococcal Immunizations: A Consensus Report. Washington, DC: National Quality Forum, 2008.Google Scholar
34.Centers for Medicare and Medicaid Services. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and FY 2012 rates; hospitals' FTE resident caps for graduate medical education payment. Final rules. Fed Regist 2011;76(160):51476–51846.Google Scholar