A high percentage of trainees and program leaders — 54% and 26%, respectively — reported that they showed up to work with influenza-like illness despite knowing the risk to others, according to a study.
“This study was prompted by the high-severity influenza 2017-2018 season which affected the entire country as well as our institution. At the height of the season, our medicine teaching services staffed inpatient units in which up to a third of patients had confirmed or suspected influenza,” Kelsie Cowman, MPH, program analyst for the antimicrobial stewardship program at Montefiore Medical Center in New York, told Infectious Disease News.
“Training programs experience workforce strain due to influenza, and program directors are challenged with providing adequate clinical coverage at times when the hospital is at maximum capacity. Collaborators from Montefiore’s antimicrobial stewardship program, infection prevention, and internal medicine program leadership conducted the study to gain insight into how many trainees came to work while sick with influenza-like illness (ILI) presenteeism and their reasons for doing so, as well as the program leadership perceptions of ILI presenteeism among trainees and their own ILI presenteeism practices.”
Through a survey conducted at Montefiore, researchers assessed the knowledge, attitudes and practices regarding ILI presenteeism of trainees and program leaders between April 23 and June 15, 2018.
In total, 197 of 400 (49%) house staff and 23 of 39 (59%) program leaders participated in the survey. Results showed that 107 trainees (54%) and six program leaders (26%) self-reported ILI presenteeism in the past 12 months, but also that more than 90% of participants know ILI presenteeism places others at risk.
According to the study, both program leaders and trainees cited “not wanting to burden colleagues” as the top reason for ILI presenteeism. Additionally, Cowman and colleagues found that a majority of participants said they would care for patients while experiencing upper respiratory symptoms without fever.
“ILI presenteeism places patients and health care workers at risk for respiratory viral transmission from symptomatic health care workers. To reduce ILI presenteeism, cultural changes should augment safety and prevention practices in training programs,” Cowman said. “Given the inevitability of seasonal influenza and its burden on the health care system, hospital leaders, program directors, and educators must collaborate on innovative strategies to protect both patients and frontline providers.” – by Caitlyn Stulpin
Disclosures: The authors report no relevant financial disclosures.