Target Audience (click to view)
This activity is designed to meet the needs of physicians.
Learning Objectives(click to view)
Upon completion of the educational activity, participants should be able to:
- Discuss the findings of an opt-in internet panel survey of nearly 2,000 healthcare personnel (HCP), conducted by the CDC, to estimate adherence during the 2014-2015 influenza with the Advisory Committee on Immunization Practices recommendation that all HCP receive annual influenza vaccination.
Method of Participation(click to view)
Statements of credit will be awarded based on the participant reviewing monograph, correctly answer 2 out of 3 questions on the post test, completing and submitting an activity evaluation. A statement of credit will be available upon completion of an online evaluation/claimed credit form at http://akhcme.com/akhcme/lessons/36. You must participate in the entire activity to receive credit. If you have questions about this CME/CE activity, please contact AKH Inc. at firstname.lastname@example.org.
Credit Available(click to view)
CME Credit Provided by AKH Inc., Advancing Knowledge in Healthcare
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and Physician’s Weekly’s. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.
AKH Inc., Advancing Knowledge in Healthcare designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Commercial Support(click to view)
There is no commercial support for this activity.
Disclosures(click to view)
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Author Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other author for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.
Disclosure of Unlabeled Use & Investigational Product(click to view)
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer(click to view)
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant’s misunderstanding of the content.
Faculty & Credentials(click to view)
Discloses no financial relationships with pharmaceutical or medical product manufacturers.
Dorothy Caputo, MA, BSN, RN- CE Director of Accreditation
Discloses no financial relationships with pharmaceutical or medical product manufacturers.
AKH planners and reviewers have no relevant financial relationships to disclose.
Complete the Post Test(click to view)
Studies have shown that influenza among healthcare personnel (HCP) increases absenteeism and the potential to spread the infection to patients as well as family and friends. Additional research indicates that influenza vaccination of HCP reduces morbidity and mortality among nursing home patients, a population shown to be highly vulnerable to influenza. To reduce influenza-related morbidity, mortality, and absenteeism among HCP and their patients, the Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for all HCP. The CDC conducted an opt-in internet panel survey of nearly 2,000 HCP to estimate adherence with the ACIP recommendation for the 2014-2015 influenza season.
“We conducted an internet panel survey to obtain data on influenza coverage quickly following the end of an influenza season,” explains Carla L. Black, PhD, lead author of the study. “These data can then be used to enhance communication, messaging, and planning for the next influenza season.”
Dr. Black notes that HCP are a relatively rare segment of the population, and performing a population-based survey would be time-consuming and expensive. “The Internet panel survey estimates might be inexact measures of influenza vaccination coverage, but we’ve conducted the same survey for several years and are able to look at trends in coverage,” she says. “We were also interested in vaccination-related attitudes, practices, and knowledge among HCP, which are hard to obtain with current larger, population-based surveys.”
According to survey participant reports received for the 2014-2015 influenza season, overall HCP vaccination coverage was 77%, a rate that was similar to that of the 2013-2014 season but higher than what was seen during the 2010-2011 season (Figure). Coverage was highest among HCP who worked in a hospital (90%) and lowest among those working in long-term care (LTC) settings (64%).
By occupation, influenza coverage was highest among pharmacists (95%) and lowest among assistants and aides (64%). HCP who were required by their employer to be vaccinated reported the highest coverage rate (96%). The number of HCP required to be vaccinated against influenza nearly doubled since the 2011-2012 season, rising up to 40%. Among HCP without an employer requirement for vaccination, coverage rates were 74% and 84% for those working where vaccination was offered on-site at no cost for 1 day and multiple days, respectively. By comparison, those working where influenza vaccination was not required, promoted, or offered on-site had a coverage rate of just 44%. Overall, coverage increased between the 2013-2014 season and the 2014-2015 season for pharmacists, assistants and aides, and non-clinical personnel, whereas coverage among clinical personnel other than physicians, nurse practitioners, physician assistants, and nurses decreased during this period.
While coverage rates were lowest among assistants and aides, Dr. Black notes that occupation and work setting were closely related in this regard. “Most of the assistants and aides in our study who had the lowest coverage also worked at LTC facilities,” she says. “These facilities were least likely among all sites to promote influenza vaccination. About 30% of LTC employees reported that their employers did not have any promotions regarding vaccination. In contrast, less than 3% of HCP working in hospitals reported that their employers neither required, provided, nor promoted vaccination. Although not measured in this study, assistants and aides are also more likely to have factors that are associated with lower vaccination coverage among non-HCP, including lower incomes, less health insurance coverage, and a lower likelihood of having a regular physician. These factors could be mitigated by providing vaccination onsite at the workplace at no charge to the HCP.”
Room for Improvement
Although influenza vaccination coverage was high among physicians when compared with other HCP, Dr. Black says there is still room for improvement. “Physicians are in a position of authority in many healthcare settings,” she says. “They can set an example by getting vaccinated.” She adds that physicians can push for the promotion of vaccination among all HCP at their place of work.
The high rates of vaccination coverage and vaccination requirements and promotion in hospitals—when compared with other settings—may in part be a result of CMS requirements, which have been in place since January 2013. CMS requires hospitals to report HCP influenza vaccination levels as part of hospital quality reporting programs, according to the study authors. Vaccination coverage in non-hospital settings may improve in the future as more institutions are held accountable with quality reporting programs.
“Overall, influenza vaccination coverage among HCP is still suboptimal,” says Dr. Black. “However, there are several ways to improve coverage. Offering vaccination on site to employees at no cost in conveniently located places is associated with a large increase in coverage. On-site vaccination, along with other promotional activities like sending reminders to be vaccinated, educating HCP about the influenza vaccine, and identifying vaccinated or un-vaccinated personnel can increase coverage even further. Efforts to increase vaccination should also target assistants, aides, and non-clinical support staff.”
Readings & Resources (click to view)
Black C, Yue X, Ball S, et al. Influenza vaccination coverage among health care personnel—United States, 2014–15 influenza season. MMWR Morb Mortal Wkly Rep. 2015;64:993-999. Available at www.cdc.gov/mmwr/preview/mmwrhtml/mm6436a1.htm.
Hayward A, 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.
Black C, Yue X, Ball S, et al. Influenza vaccination coverage among health care personnel—United States, 2013–14 influenza season. MMWR Morb Mortal Wkly Rep. 2014;63:805-811.
Hollmeyer H, Hayden F, Mounts A, Buchholz U. Review: interventions to increase influenza vaccination among healthcare workers in hospitals. Influenza Other Respir Viruses. 2013;7:604-621.