Assessment of a Mandatory Tetanus, Diphtheria, and Pertussis Vaccination Requirement on Vaccine Uptake over Time

2012 ◽  
Vol 33 (1) ◽  
pp. 81-83 ◽  
Author(s):  
David J. Weber ◽  
Stephanie A. Consoli ◽  
Emily Sickbert-Bennett ◽  
William A. Rutala

Tetanus, diphtheria, and pertussis (Tdap) vaccine is recommended for all healthcare personnel who provide direct patient care unless medically contraindicated. Our university hospital made employment conditional upon receipt of Tdap vaccine. Implementation for newly hired employees quickly resulted in complete compliance, but achieving adherence among current workers required setting a termination date for noncompliance.Infect Control Hosp Epidemiol 2012;33(1):81-83

2015 ◽  
Vol 37 (2) ◽  
pp. 222-225 ◽  
Author(s):  
Samantha B. Dolan ◽  
Elizabeth J. Kalayil ◽  
Megan C. Lindley ◽  
Faruque Ahmed

One thousand hospitals were surveyed on a new measure of healthcare personnel influenza vaccination for the 2012–2013 influenza season. Facilities found it easier to collect data on employees than nonemployees; larger facilities reported more challenges than smaller facilities. Barriers may decrease over time as facilities become accustomed to the measure.Infect. Control Hosp. Epidemiol. 2016;37(2):222–225


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S102-S102
Author(s):  
Marci Drees ◽  
Tabe Mase ◽  
Jennifer Garvin ◽  
Kimberly Miller

Abstract Background While splashes to the eyes, nose and mouth can often be prevented through appropriate personal protective equipment (PPE) use, they continue to occur frequently when PPE is not used consistently. Due to the COVID-19 pandemic, we implemented universal masking and eye protection for all healthcare personnel (HCP) performing direct patient care and observed a subsequent decline in bloodborne pathogen (BBP) splash exposures. Methods Our healthcare system, employing >12,000 healthcare personnel (HCP), implemented universal masking in April 2020 and eye protection in June 2020. We required HCP to mask at all times, and use a face shield, safety glasses or goggles when providing direct patient care. Occupational Safety tracked all BBP exposures due to splashes to the eyes, nose, mouth and/or face, and compared exposures during 2020 to those in 2019. We estimated costs, including patient and HCP testing, related to splash exposures, as well as the additional cost of PPE incurred. Results In 2019, HCP reported 90 splashes, of which 57 (63%) were to the eyes. In 2020, splashes decreased by 54% to 47 (36 [77%] to eyes). In both years, nurses were the most commonly affected HCP type (62% and 72%, respectively, of all exposures). Physicians (including residents) had the greatest decrease in 2020 (10 vs. 1 splash exposures [90%]), while nurses had a 39% decrease (56 vs. 34 exposures). Nearly all of the most common scenarios leading to splash exposures declined in 2020 (Table). We estimated the cost of each BBP exposure as &2,940; this equates to a savings of &123,228. During 2020, we purchased 65,650 face shields, safety glasses and goggles (compared to 5303 similar items in 2019), for an additional cost of &238,440. Specific activities identified as leading to bloodborne pathogen splash exposures, 2019 vs. 2020. Conclusion We observed a significant decline in splash-related BBP exposures after implementing universal masking and eye protection for the COVID-19 pandemic. While cost savings were not observed, we were unable to incorporate the avoided pain and emotional trauma for the patient, exposed HCP, and coworkers. This unintended but positive consequence of the COVID-19 pandemic exemplifies the need for broader use of PPE, particularly masks and eyewear, for all patient care scenarios where splashes may occur. Disclosures All Authors: No reported disclosures


2020 ◽  
Vol 41 (5) ◽  
pp. 601-603
Author(s):  
Gita Nadimpalli ◽  
Lyndsay M. O’Hara ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
...  

AbstractThe transmission rate of methicillin-resistant Staphylococcus aureus (MRSA) to gloves or gowns of healthcare personnel (HCP) caring for MRSA patients in a non–intensive care unit setting was 5.4%. Contamination rates were higher among HCP performing direct patient care and when patients had detectable MRSA on their body. These findings may inform risk-based contact precautions.


2021 ◽  
pp. 107815522098557
Author(s):  
Matthew J Yacobucci ◽  
Christina L Lombardi ◽  
Laurie L Briceland

Introduction Student pharmacists contribute meaningfully to patient care during Advanced Practice Pharmacy Experiences (APPEs) in varied settings. We aimed to characterize and evaluate the impact of student participation in hematology-oncology (hem-onc) APPEs on the practice site, and on student professionalization. Methods For students completing hem-onc APPEs during 2016–2019, rotation activities and post-APPE self-reflections describing meaningful impact were reviewed; activities were categorized into direct and indirect patient care, and up to three reflection themes of professionalization impact were extracted from each self-reflection. Hem-onc preceptor cohort was surveyed to assess impact of student contributions on the practice site. Results 171 students completed hem-onc APPEs in ambulatory care (133) and/or inpatient (38) settings. Of 932 student-reported activities, the most common were: evaluating patient pharmacotherapy (209), providing education to medical staff (132), patient counseling [non-chemotherapy (99); chemotherapy (82)], and providing drug information (96); 89% involved direct patient care/education. Survey results from 16 of 33 preceptors identified the most impactful student activities as evaluating pharmacotherapy, medication education/adherence resources, and in-service presentations. Of 392 student self-reflections, themes of impact focused on professionalization/self-awareness (39.3%), counseling/communication skills (27.8%), practice skills development (20.4%) and collaborative teamwork (12.5%). Conclusion Pharmacy students make significant direct patient care contributions to hem-onc practice settings by evaluating pharmacotherapy and providing education to patients and healthcare personnel. Participation in hem-onc APPEs is highly influential to the professionalization of students, particularly in developing skills in oncology practice, patient interactions/communications, and developing self-awareness.


2009 ◽  
Vol 30 (4) ◽  
pp. 361-369 ◽  
Author(s):  
Michael Melia ◽  
Sarah O'Neill ◽  
Sherry Calderon ◽  
Sandra Hewitt ◽  
Kelly Orlando ◽  
...  

Objective.To describe the method used to develop a flexible, computerized database for recording and reporting rates of influenza vaccination among healthcare personnel who were classified by their individual levels (hereafter, “tiers”) of direct patient contact.Design.Three-year descriptive summary.Setting.Large, academic, tertiary care medical center in the United States.Participants.All of the medical center's healthcare personnel.Methods.The need to develop a computer-based system to record direct patient care tiers and vaccination data for healthcare personnel was identified. A plan that was to be implemented in stages over several seasons was developed.Results.Direct patient care tiers were defined by consensus opinion on the basis of the extent, frequency, and intensity of direct contact with patients. The definitions of these tiers evolved over 3 seasons. Direct patient care classifications were assigned and recorded in a computerized database, and data regarding the receipt of vaccination were tracked by using the same database. Data were extracted to generate reports of individual, departmental, and institutional vaccination rates, both overall and according to direct patient care tiers.Conclusions.Development of a computerized database to record direct patient care tiers for individual healthcare workers is a daunting but manageable task. Widespread use of these direct patient care definitions will facilitate uniform comparisons of vaccination rates between institutions. This computerized database can easily be used by infection control personnel to accomplish several other key tasks, including vaccination triage in the context of shortage or delay, prioritization of personnel to receive interventions in times of crisis, and monitoring the status of other employee health or occupational health measures.


2020 ◽  
Vol 41 (S1) ◽  
pp. s27-s28
Author(s):  
Gita Nadimpalli ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
David Calfee ◽  
...  

Background: Estimates of contamination of healthcare personnel (HCP) gloves and gowns with methicillin-resistant Staphylococcus aureus (MRSA) following interactions with colonized or infected patients range from 17% to 20%. Most studies were conducted in the intensive care unit (ICU) setting where patients had a recent positive clinical culture. The aim of this study was to determine the rate of MRSA transmission to HCP gloves and gown in non-ICU acute-care hospital units and to identify associated risk factors. Methods: Patients on contact precautions with history of MRSA colonization or infection admitted to non-ICU settings were randomly selected from electronic health records. We observed patient care activities and cultured the gloves and gowns of 10 HCP interactions per patient prior to doffing. Cultures from patients’ anterior nares, chest, antecubital fossa and perianal area were collected to quantify bacterial bioburden. Bacterial counts were log transformed. Results: We observed 55 patients (Fig. 1), and 517 HCP–patient interactions. Of the HCP–patient interactions, 16 (3.1%) led to MRSA contamination of HCP gloves, 18 (3.5%) led to contamination of HCP gown, and 28 (5.4%) led to contamination of either gloves or gown. In addition, 5 (12.8%) patients had a positive clinical or surveillance culture for MRSA in the prior 7 days. Nurses, physicians and technicians were grouped in “direct patient care”, and rest of the HCPs were included in “no direct care group.” Of 404 interactions, 26 (6.4%) of providers in the “direct patient care” group showed transmission of MRSA to gloves or gown in comparison to 2 of 113 (1.8%) interactions involving providers in the “no direct patient care” group (P = .05) (Fig. 2). The median MRSA bioburden was 0 log 10CFU/mL in the nares (range, 0–3.6), perianal region (range, 0–3.5), the arm skin (range, 0-0.3), and the chest skin (range, 0–6.2). Detectable bioburden on patients was negatively correlated with the time since placed on contact precautions (rs= −0.06; P < .001). Of 97 observations with detectable bacterial bioburden at any site, 9 (9.3%) resulted in transmission of MRSA to HCP in comparison to 11 (3.6%) of 310 observations with no detectable bioburden at all sites (P = .03). Conclusions: Transmission of MRSA to gloves or gowns of HCP caring for patients on contact precautions for MRSA in non-ICU settings was lower than in the ICU setting. More evidence is needed to help guide the optimal use of contact precautions for the right patient, in the right setting, for the right type of encounter.Funding: NoneDisclosures: None


2021 ◽  
Vol 12 (01) ◽  
pp. 141-152
Author(s):  
Vimla L. Patel ◽  
Courtney A. Denton ◽  
Hiral C. Soni ◽  
Thomas G. Kannampallil ◽  
Stephen J. Traub ◽  
...  

Abstract Objectives We characterize physician workflow in two distinctive emergency departments (ED). Physician practices mediated by electronic health records (EHR) are explored within the context of organizational complexity for the delivery of care. Methods Two urban clinical sites, including an academic teaching ED, were selected. Fourteen physicians were recruited. Overall, 62 hours of direct clinical observations were conducted characterizing clinical activities (EHR use, team communication, and patient care). Data were analyzed using qualitative open-coding techniques and descriptive statistics. Timeline belts were used to represent temporal events. Results At site 1, physicians, engaged in more team communication, followed by direct patient care. Although physicians spent 61% of their clinical time at workstations, only 25% was spent on the EHR, primarily for clinical documentation and review. Site 2 physicians engaged primarily in direct patient care spending 52% of their time at a workstation, and 31% dedicated to EHRs, focused on chart review. At site 1, physicians showed nonlinear complex workflow patterns with a greater frequency of multitasking and interruptions, resulting in workflow fragmentation. In comparison, at site 2, a less complex environment with a unique patient assignment system, resulting in a more linear workflow pattern. Conclusion The nature of the clinical practice and EHR-mediated workflow reflects the ED work practices. Physicians in more complex organizations may be less efficient because of the fragmented workflow. However, these effects can be mitigated by effort distribution through team communication, which affords inherent safety checks.


2018 ◽  
Vol 89 (10) ◽  
pp. A4.4-A4
Author(s):  
Brennan M ◽  
Tyagi A ◽  
Leach JP

Provision of acute liaison in-patient neurology reduces demand on neurology out patient services, reduces unnecessary investigations and use of medical beds by patients waiting on in-patient neurology review and allows speedier access to necessary neurological services for those with a neurological illness.The pressure on acute neurology beds at QEUH Glasgow is immense and there is considerable delay in patients waiting for admission to the ward. An audit of the acute on call service in mid 2015 showed a 100% increase in the number of phone calls received by the on call registrar when compared to a similar audit in 2008. The number of requests for ward visiting to review medical inpatients at the Queen Elizabeth University hospital increased by more than 100% over the previous year.In June 2016 an Acute Neurology rota was introduced whereby a Consultant Neurologist supervised and delivered patient care for the acute neurology wards, referrals from medical wards and acute receiving, as well as twice a week acute neurology clinics. This has led to a significantly improved care for patients referred with neurological problems as perceived by trainees, consultants and referring medical physicians, as evident on a survey carried out in 2017.


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