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Push to Vaccinate Health Workers Is On

New federal regulations require vaccination counts for health care employees

New federal regulations now require hospitals to count vaccination rates for anyone who works in a health care facility between October 1 and March 31, according to an article in the July/August issue of HealthLeaders magazine. That includes everyone from volunteers and clerical workers to physicians and executives. Organizations then report their rates to the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network for public reporting, which began late last year for 2013–2014, on Hospital Compare.

At Lourdes Health System’s two hospitals in New Jersey, ensuring that 2,700 workers get their seasonal flu shots — to stay healthy and to avoid infecting patients — is such a high priority that workers who refuse must find work elsewhere.

“We made it mandatory in the fall of 2012,” long before many other hospitals in the nation, said Jennifer Moughan, chief human resources officer for Our Lady of Lourdes Medical Center in Camden and Lourdes Medical Center of Burlington County in Willingboro.

That’s one reason Lourdes dramatically bucks a troublesome trend in New Jersey, where hospitals’ average rates of influenza immunization have tracked the lowest in the nation. For the 2013–2014 season that ended March 31, 2014, only 59% of health care workers in New Jersey hospitals who should get their shots did so. Across the country, health care worker compliance rates averaged 79%.

With a goal of getting most workers immunized by December 15, when holiday festivities and travel enable viral spread, Moughan’s teams “go floor to floor. We have stationary clinics and carts that roll around at night and on weekends, and there’s no way you don’t have a vaccine offered to you sometime in this period.”

A prevailing controversy deals with the lack of rock-solid evidence of causal links between health care worker immunization and reduced hospital-acquired influenza illness or mortality in patients, said Megan Lindley, an expert on health care worker vaccination at the CDC. That’s because many illnesses look like influenza but are something else, and because it’s difficult to restrict patients’ exposure to visitors.

In a CDC internet survey of health care workers who said they would not be vaccinated in November 2014, 21% said the vaccine didn’t work; 17% said they didn't need it; 13% said they might get sick from it; and 7% thought the ingredients were “not good for you.”

According to the CDC’s Influenza Division, last season’s vaccine was a tough one for influencing a national vaccination policy; it was only 19% effective against the prevailing virus, which meant that health workers lost confidence in the vaccine’s effectiveness.

Palomar Health, a two-hospital system in San Diego County, converted to a mandatory mask requirement for any employees among its 2,754 workers who refused to get vaccinated last flu season. The result: immunization rates soared, from 73% and 74%, respectively, during the 2013–2014 flu season year, to 91% and 94%, said Russell Riehl, director of employee, corporate, and retail health.

Immunized workers are distinguished from those who must wear a mask by an annual flu-shot sticker placed on their badges. The policy starts about 4 weeks after vaccine distribution begins in the hospital, and when mask dispensers are set up at every doorway for arriving workers.

Health care worker immunization rates now are reported to the CDC and to the Centers for Medicare & Medicaid Services as part of the inpatient quality reporting program, for which hospitals receive a 2% Medicare payment increase. But the measure is not yet part of hospital value-based purchasing or the hospital-acquired condition penalty, although it could be at some point.

Source: HealthLeaders Media; August 13, 2015.

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