CME: A Strategy for Decreasing Influenza’s Impact

CME: A Strategy for Decreasing Influenza’s Impact

Research indicates that about 60% of influenza-related hospitalizations occur in adults aged 65 and older during most influenza seasons in the United States. Many of these patients are frail and at increased risk for functional decline. However, few studies have assessed the need for extended care admissions due to functional decline from influenza-associated hospitalizations among community-dwelling older adults. Additionally, whereas studies have shown that prompt treatment with influenza antiviral agents can reduce the duration of illness and prevent influenza-related complications, data are limited on the benefit of antiviral treatment in this patient population.   Examining the Issue For a study published in Clinical Infectious Diseases, Nancy M. Bennett, MD, MS, and colleagues analyzed predictors of extended care and the potential mitigating effect of antiviral treatment among community-dwelling patients aged 65 and older. Participants were hospitalized with laboratory-confirmed influenza during the 2010-2011, 2011-2012, and 2012-2013 influenza seasons. Extended care was defined as placement in a skilled nursing facility on hospital discharge. Treatment was categorized as early (4 days or less) or late (more than 4 days) in reference to the date of illness onset. “We also assessed a series of variables to determine which predicted loss of functional status and extended care placement,” says Dr. Bennett. The researchers found that among more than 6,500 participants, 18% were discharged from the hospital to extended care facilities. “These patients went from living independently to requiring significant care,” Dr. Bennett adds. A univariate analysis found the following to be predictors of discharge to extended care: Increasing age (10% among those aged 65 to 74, 16% for those aged 75 to 84, and 30%...
A Strategy for Decreasing Influenza’s Impact

A Strategy for Decreasing Influenza’s Impact

Research indicates that about 60% of influenza-related hospitalizations occur in adults aged 65 and older during most influenza seasons in the United States. Many of these patients are frail and at increased risk for functional decline. However, few studies have assessed the need for extended care admissions due to functional decline from influenza-associated hospitalizations among community-dwelling older adults. Additionally, whereas studies have shown that prompt treatment with influenza antiviral agents can reduce the duration of illness and prevent influenza-related complications, data are limited on the benefit of antiviral treatment in this patient population.   Examining the Issue For a study published in Clinical Infectious Diseases, Nancy M. Bennett, MD, MS, and colleagues analyzed predictors of extended care and the potential mitigating effect of antiviral treatment among community-dwelling patients aged 65 and older. Participants were hospitalized with laboratory-confirmed influenza during the 2010-2011, 2011-2012, and 2012-2013 influenza seasons. Extended care was defined as placement in a skilled nursing facility on hospital discharge. Treatment was categorized as early (4 days or less) or late (more than 4 days) in reference to the date of illness onset. “We also assessed a series of variables to determine which predicted loss of functional status and extended care placement,” says Dr. Bennett. The researchers found that among more than 6,500 participants, 18% were discharged from the hospital to extended care facilities. “These patients went from living independently to requiring significant care,” Dr. Bennett adds. A univariate analysis found the following to be predictors of discharge to extended care: Increasing age (10% among those aged 65 to 74, 16% for those aged 75 to 84, and 30%...
CME: Flu Vaccination Among Healthcare Professionals

CME: Flu Vaccination Among Healthcare Professionals

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.” Key Findings 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...
Flu Vaccination Among Healthcare Professionals

Flu Vaccination Among Healthcare Professionals

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.” Key Findings 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...

Leading the Fight Against Flu

In 2009, the H1N1 influenza virus significantly changed the way most healthcare workers in the United States think about the flu. Collectively, we learned once again that the influenza virus is an unpredictable and serious threat to our patients’ health and well-being. Every year, influenza sickens 5% to 20% of all Americans, sending about 200,000 people to the hospital. What’s worse is that thousands die from the flu each year. The best means to prevent influenza illness is vaccination. This flu season, the Department of Health and Human Services is recommending seasonal influenza vaccination for everyone 6 months of age and older. Moreover, the CDC and the Advisory Committee on Immunization Practices continue to recommend that immunization programs focus initially on providing protection for people at greater risk for influenza-related complications, including: Pregnant women. Children younger than 5, but especially children younger than 2. Adults aged 65 and older. People with chronic medical conditions (eg, asthma, diabetes, or heart disease) associated with greater risk for medical complications from influenza. People working in healthcare settings are also among those at high-risk of getting and spreading influenza. Lead By Example Healthcare workers can serve as role models for vaccination because they can provide vaccines and set an example by getting vaccinated themselves. Research continues to show that the flu can spread rapidly throughout healthcare settings if proper precautions aren’t taken. Vaccination of healthcare workers reduces influenza infection and absenteeism, prevents mortality in other patients, and results in financial savings to sponsoring health institutions. However, influenza vaccination coverage among healthcare workers in the U.S. remains low. Recent mid-season estimates suggest that approximately...
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