Minimum healthcare worker influenza immunization rates required to decrease influenza transmission in two acute-care hospitals

2020 ◽  
Vol 42 (1) ◽  
pp. 109-110
Author(s):  
Victoria R. Williams ◽  
Maja McGuire ◽  
Kevin Katz ◽  
Jerome A. Leis
Keyword(s):  
Healthcare Worker ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Influenza Immunization ◽  
Immunization Rates ◽  
Influenza Transmission

scholarly journals Minimum Healthcare Worker Influenza Immunization Rates Required to Decrease Influenza Transmission in Acute-Care Inpatients

2020 ◽  
Vol 41 (S1) ◽  
pp. s317-s318
Author(s):  
Victoria Williams ◽  
Wendy Morgan ◽  
Maja McGuire ◽  
Kevin Katz ◽  
Jerome Leis
Keyword(s):  
Acute Care ◽  
Influenza A ◽  
Influenza Season ◽  
Acute Care Hospitals ◽  
Home Setting ◽  
Immunization Rate ◽  
Influenza Immunization ◽  
Immunization Rates ◽  
Care Facilities ◽  
Acute Care Facilities

Background: Annual influenza immunization of healthcare workers (HCWs) is widely recommended to reduce the risk of healthcare-associated influenza (HAI). Although there is a clear association between higher HCW immunization and reduced incidence of HAI, data in acute care are lacking compared to the nursing home setting. Objective: Our goal was to assess the association between HCW influenza immunization and the incidence of HAI across 2 acute-care facilities. Methods: A multicenter prospective cohort study was undertaken at 2 acute-care hospitals including 1 university and 1 community-based academic hospital. Any patient prospectively identified with HAI was included between 2013–2014 and 2018–2019, whereas 2017–2018 was excluded due to vaccine mismatch. The HCW influenza immunization rate was defined as the proportion of HCWs (nurses and other allied and support staff but excluding physicians) immunized prior to December 15. A case of HAI was defined as laboratory-confirmed influenza A or B with symptom onset >72 hours after admission. The association between inpatient ward HCW influenza immunization rate and the incidence of HAI was compared using a Poisson regression analysis adjusting for hospital and influenza season. Results: Over 5 influenza seasons, the incidences of HAI at either facility were 0.24 and 0.22 per 1,000 patient days, whereas the median HCW influenza immunization rates were 57.3% (IQR, 42.5%–66.4%) and 66.6% (IQR, 50.6%–76.8%), respectively. When adjusting for hospital and influenza season in the multivariate analysis, HCW influenza immunization rates of 65% and 70% were not associated with HAI incidence. In contrast, HCW influenza immunization rates ≥75% was associated with a trend toward reduced HAI (IRR, 0.65; 95% CI, 0.39–1.08; P = .096) whereas inpatient wards above 80% immunization had significantly lower risk of HAI (IRR, 0.28; 95% CI, 0.089–0.89; P = .03). Conclusions: The risk of HAI across 2 acute-care hospitals was significantly lower among inpatient wards achieving HCW influenza immunization rates >80%. Acute-care facilities should aim for this minimum HCW immunization rate to protect patients from the complications of HAI.Funding: NoneDisclosures: None

Measuring influenza immunization coverage among health care workers in acute care hospitals and continuing care organizations in Canada

2013 ◽  
Vol 41 (4) ◽  
pp. 340-344 ◽  
Author(s):  
Susan Quach ◽  
Jennifer A. Pereira ◽  
Jemila S. Hamid ◽  
Lois Crowe ◽  
Christine L. Heidebrecht ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Health Care Workers ◽  
Immunization Coverage ◽  
Acute Care Hospitals ◽  
Continuing Care ◽  
Influenza Immunization ◽  
Care Workers

Physical restraint to patients with dementia in acute physical care settings: effect of the financial incentive to acute care hospitals

2017 ◽  
Vol 30 (7) ◽  
pp. 991-1000 ◽  
Author(s):  
Miharu Nakanishi ◽  
Yasuyuki Okumura ◽  
Asao Ogawa
Keyword(s):  
Acute Care ◽  
Financial Incentive ◽  
Physical Restraint ◽  
Acute Care Hospitals ◽  
Dementia Care ◽  
Lower Percentage ◽  
Public Healthcare ◽  
Cross Sectional ◽  
Insurance Program ◽  
Healthcare Insurance

ABSTRACTBackground:In April 2016, the Japanese government introduced an additional benefit for dementia care in acute care hospitals (dementia care benefit) into the universal benefit schedule of public healthcare insurance program. The benefit includes a financial disincentive to use physical restraint. The present study investigated the association between the dementia care benefit and the use of physical restraint among inpatients with dementia in general acute care settings.Methods:A national cross-sectional study design was used. Eight types of care units from acute care hospitals under the public healthcare insurance program were invited to participate in this study. A total of 23,539 inpatients with dementia from 2,355 care units in 937 hospitals were included for the analysis. Dementia diagnosis or symptoms included any signs of cognitive impairment. The primary outcome measure was “use of physical restraint.”Results:Among patients, the point prevalence of physical restraint was 44.5% (n= 10,480). Controlling for patient, unit, and hospital characteristics, patients in units with dementia care benefit had significantly lower percentage of physical restraint than those in any other units (42.0% vs. 47.1%; adjusted odds ratio, 0.76; 95% confident interval [0.63, 0.92]).Conclusions:The financial incentive may have reduced the risk of physical restraint among patients with dementia in acute care hospitals. However, use of physical restraint was still common among patients with dementia in units with the dementia care benefit. An educational package to guide dementia care approach including the avoidance of physical restraint by healthcare professionals in acute care hospitals is recommended.

scholarly journals Prevalence of SARS-CoV-2 antibodies in health care personnel of two acute care hospitals in Linz, Austria

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Margot Egger ◽  
Christian Bundschuh ◽  
Kurt Wiesinger ◽  
Elisabeth Bräutigam ◽  
Thomas Berger ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Health Care Personnel

scholarly journals Effectiveness of Ultraviolet-C Room Disinfection on Preventing Healthcare-Associated Clostridioides difficile Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s33-s33
Author(s):  
Michihiko Goto ◽  
Erin Balkenende ◽  
Gosia Clore ◽  
Rajeshwari Nair ◽  
Loretta Simbartl ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Incidence Rates ◽  
Positive Test ◽  
Negative Binomial Regression Model ◽  
Test Results ◽  
Clostridioides Difficile ◽  
Ultraviolet C ◽  
Healthcare Associated ◽  
Uv C

Background: Enhanced terminal room cleaning with ultraviolet C (UVC) disinfection has become more commonly used as a strategy to reduce the transmission of important nosocomial pathogens, including Clostridioides difficile, but the real-world effectiveness remains unclear. Objectives: We aimed to assess the association of UVC disinfection during terminal cleaning with the incidence of healthcare-associated C. difficile infection and positive test results for C. difficile within the nationwide Veterans Health Administration (VHA) System. Methods: Using a nationwide survey of VHA system acute-care hospitals, information on UV-C system utilization and date of implementation was obtained. Hospital-level incidence rates of clinically confirmed hospital-onset C. difficile infection (HO-CDI) and positive test results with recent healthcare exposures (both hospital-onset [HO-LabID] and community-onset healthcare-associated [CO-HA-LabID]) at acute-care units between January 2010 and December 2018 were obtained through routine surveillance with bed days of care (BDOC) as the denominator. We analyzed the association of UVC disinfection with incidence rates of HO-CDI, HO-Lab-ID, and CO-HA-LabID using a nonrandomized, stepped-wedge design, using negative binomial regression model with hospital-specific random intercept, the presence or absence of UVC disinfection use for each month, with baseline trend and seasonality as explanatory variables. Results: Among 143 VHA acute-care hospitals, 129 hospitals (90.2%) responded to the survey and were included in the analysis. UVC use was reported from 42 hospitals with various implementation start dates (range, June 2010 through June 2017). We identified 23,021 positive C. difficile test results (HO-Lab ID: 5,014) with 16,213 HO-CDI and 24,083,252 BDOC from the 129 hospitals during the study period. There were declining baseline trends nationwide (mean, −0.6% per month) for HO-CDI. The use of UV-C had no statistically significant association with incidence rates of HO-CDI (incidence rate ratio [IRR], 1.032; 95% CI, 0.963–1.106; P = .65) or incidence rates of healthcare-associated positive C. difficile test results (HO-Lab). Conclusions: In this large quasi-experimental analysis within the VHA System, the enhanced terminal room cleaning with UVC disinfection was not associated with the change in incidence rates of clinically confirmed hospital-onset CDI or positive test results with recent healthcare exposure. Further research is needed to understand reasons for lack of effectiveness, such as understanding barriers to utilization.Funding: NoneDisclosures: None

scholarly journals Pathogens Associated With Repeat Versus Single Central-Line–Associated Bloodstream Infections, Acute-Care Hospitals, NHSN

2020 ◽  
Vol 41 (S1) ◽  
pp. s343-s344
Author(s):  
Margaret A. Dudeck ◽  
Katherine Allen-Bridson ◽  
Jonathan R. Edwards
Keyword(s):  
Acute Care ◽  
National Level ◽  
Bloodstream Infections ◽  
Acute Care Hospitals ◽  
Central Line ◽  
Patient Specific ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
Repeat Infection ◽  
Single Versus

Background: The NHSN is the nation’s largest surveillance system for healthcare-associated infections. Since 2011, acute-care hospitals (ACHs) have been required to report intensive care unit (ICU) central-line–associated bloodstream infections (CLABSIs) to the NHSN pursuant to CMS requirements. In 2015, this requirement included general medical, surgical, and medical-surgical wards. Also in 2015, the NHSN implemented a repeat infection timeframe (RIT) that required repeat CLABSIs, in the same patient and admission, to be excluded if onset was within 14 days. This analysis is the first at the national level to describe repeat CLABSIs. Methods: Index CLABSIs reported in ACH ICUs and select wards during 2015–2108 were included, in addition to repeat CLABSIs occurring at any location during the same period. CLABSIs were stratified into 2 groups: single and repeat CLABSIs. The repeat CLABSI group included the index CLABSI and subsequent CLABSI(s) reported for the same patient. Up to 5 CLABSIs were included for a single patient. Pathogen analyses were limited to the first pathogen reported for each CLABSI, which is considered to be the most important cause of the event. Likelihood ratio χ2 tests were used to determine differences in proportions. Results: Of the 70,214 CLABSIs reported, 5,983 (8.5%) were repeat CLABSIs. Of 3,264 nonindex CLABSIs, 425 (13%) were identified in non-ICU or non-select ward locations. Staphylococcus aureus was the most common pathogen in both the single and repeat CLABSI groups (14.2% and 12%, respectively) (Fig. 1). Compared to all other pathogens, CLABSIs reported with Candida spp were less likely in a repeat CLABSI event than in a single CLABSI event (P < .0001). Insertion-related organisms were more likely to be associated with single CLABSIs than repeat CLABSIs (P < .0001) (Fig. 2). Alternatively, Enterococcus spp or Klebsiella pneumoniae and K. oxytoca were more likely to be associated with repeat CLABSIs than single CLABSIs (P < .0001). Conclusions: This analysis highlights differences in the aggregate pathogen distributions comparing single versus repeat CLABSIs. Assessing the pathogens associated with repeat CLABSIs may offer another way to assess the success of CLABSI prevention efforts (eg, clean insertion practices). Pathogens such as Enterococcus spp and Klebsiella spp demonstrate a greater association with repeat CLABSIs. Thus, instituting prevention efforts focused on these organisms may warrant greater attention and could impact the likelihood of repeat CLABSIs. Additional analysis of patient-specific pathogens identified in the repeat CLABSI group may yield further clarification.Funding: NoneDisclosures: None

scholarly journals Improving Influenza Immunization Rates

2021 ◽  
Vol 147 (2) ◽  
pp. AB123
Author(s):  
Jun Mendoza ◽  
James Quinn
Keyword(s):  
Influenza Immunization ◽  
Immunization Rates

scholarly journals Shooting from the ‘Scrip: Scope of Practice Laws and Access to Immunizations in the Pharmacy Setting

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 444
Author(s):  
Charles Stoecker
Keyword(s):  
Positive Impact ◽  
National Level ◽  
State Level ◽  
The United States ◽  
Scope Of Practice ◽  
Patient Specific ◽  
Behavioral Risk ◽  
Influenza Immunization ◽  
Immunization Rates ◽  
The Impact

In the past two decades, most states in the United States have added authorization for pharmacists to administer some vaccinations. Expansions of this authority have also come with prescription requirements or other regulatory burdens. The objective of this study was to evaluate the impact of these expansions on influenza immunization rates in adults age 65 and over. A panel data, differences-in-differences regression framework to control for state-level unobserved confounders and shocks at the national level was used on a combination of a dataset of state-level statute and regulatory changes and influenza immunization data from the Behavioral Risk Factor Surveillance System. Giving pharmacists permission to vaccinate had a positive impact on adult influenza immunization rates of 1.4 percentage points for adults age 65 and over. This effect was diminished by the presence of laws requiring pharmacists to obtain patient-specific prescriptions. There was no evidence that allowing pharmacists to administer vaccinations led patients to have fewer annual check-ups with physicians or not have a usual source of health care. Expanding pharmacists’ scope of practice laws to include administering the influenza vaccine had a positive impact on influenza shot uptake. This may have implications for relaxing restrictions on other forms of care that could be provided by pharmacists.

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