Hilary M. Babcock
In a small survey conducted at a St. Louis hospital, many health care personnel could not describe the correct transmission-based precautions for patients with influenza, and some even said they had reservations about the safety and effectiveness of the influenza vaccine.
Hilary M. Babcock, MD,
MPH, associate professor of medicine in the division of infectious diseases at Washington University School of Medicine, and colleagues surveyed 170 full- and part-time health care personnel (HCP) at a long-term care (LTC) facility with a mandatory influenza vaccination policy.
Just 73 people responded to the survey. Among those, 42 reported closer contact with patients — including many nurses — and 21 said they had less patient contact working in jobs such as food service worker and administrator.
“As expected,” Babcock and colleagues wrote in Infection Control & Hospital Epidemiology, “respondents who had closer contact with patients had better knowledge of infection prevention practices, as well as better understanding of facility transmission-based precautions procedures. However, because all HCP at this facility are likely to have at least occasional patient contact and contact with other HCP, it is important that all staff receive training on infection prevention policies and practices.”
Among 61 HCP who completed a section of the survey about infection prevention precautions, just 47.5% knew that the appropriate precautions for a patient with influenza are standard and droplet precautions, Babcock and colleagues reported. “Correctly answering infection prevention knowledge questions did not vary by years of experience but did vary” — 59% vs. 35.3% — “for HCP with more direct patient contact vs. less patient contact,” they wrote.
In other results the researchers described as concerning, 41.5% of respondents reported working while sick, and just 46.5% said work policies made it easy for them to stay home when they are ill. Almost a quarter — 24% — said they did not receive enough training to recognize respiratory infections in patients, and just 29% said the facility has a good system for identifying patients on transmission-based precautions, Babcock and colleagues reported.
Many respondents did not agree that respiratory infections are a serious problem in LTC facilities (20%) or that performing hand hygiene protects patients from them (23%), although almost all respondents reported cleaning their hands upon entering and exiting a patient’s room.
According to Babcock and colleagues, answers to questions about the influenza vaccine indicated that many HCP were skeptical about its benefits. Around 22% expressed concerns about the safety of the vaccine and more than 27% did not agree that it was effective. Moreover, more than 28% said they would not get the vaccine if it was not mandatory.
Although the response rate to the survey was low and data were self-reported by anonymous participants, Babcock and colleagues said their findings “identified several gaps in infection prevention knowledge and training, barriers to infection prevention practices, and misperceptions concerning the safety and effectiveness of the influenza vaccine and the risk posed by influenza for both patients and HCP.”
“The issues identified by this survey may serve as targets for future staff education and vaccine promotion efforts,” they concluded. “Addressing barriers to vaccination among HCP may help to improve vaccination rates in settings where mandatory vaccination is not in effect and can also help to improve staff buy-in at facilities with mandatory vaccination policies. Larger HCP surveys of staff from LTC facilities across the United States would help to define future interventions.” – by Gerard Gallagher
Disclosures: The authors report no relevant financial disclosures.