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Healthcare Facilities Should Require Staff Vaccinations to Prepare for H1N1

 |  By HealthLeaders Media Staff  
   September 03, 2009

The Association for Professionals in Infection Control and Epidemiology (APIC) urged healthcare organizations to mandate that staff members in direct contact with patients are vaccinated during the upcoming flu season.

The group made its recommendation earlier this week as predictions continued to surface about the number of Americans who may be infected with the H1N1 virus during the upcoming flu season. Last week, a presidential panel estimated that up to half of the U.S. population could become infected, and 1.8 million people could become hospitalized, resulting in up to 90,000 deaths. APIC issued a similar recommendation during the 2008-2009 flu season.

"Immunization will be especially critical for healthcare personnel during the 2009-2010 flu season because we will have more than one virus circulating," says Christine J. Nutty, RN, MSN, CIC, president of APIC. "All healthcare workers, including those who are pregnant, need to be immunized against seasonal influenza and 2009 H1N1 virus when vaccines become available. This is vitally important to healthcare worker and patient safety."

APIC issued a similar recommendation during the 2008-2009 flu season. Currently, rates of healthcare provider vaccination hover at the 42% mark, which has not budged much in the last 10 years. The Centers for Disease Control and Prevention, as well as APIC, recommend that all healthcare workers in direct contact with patients get a flu vaccination to keep patients safe. However, some staff members employed at private organizations see mandatory vaccination requirements as infringements on privacy.

One health system that is requiring all staff members are vaccinated for the seasonal flu by November 1 is Marshfield (WI) Clinic. Mandating vaccination for H1N1 hasn't been discussed and won't be until the CDC confirms there will be H1N1 vaccine available, says Bruce Cunha, RN, MS, COHN-S, manager of employee health and safety.

Because Marshfield, which is a clinical system, is made up of 45 facilities and serves more than 7,000 employees, the leadership team wanted to make sure that as many staff members as possible are vaccinated, he adds.

"This year [the executive committee] decided they wanted all employees [who] can be vaccinated to be vaccinated," says Cunha. "Persons with a medical condition that preclude them from being vaccinated would be excluded, but need to wear an isolation mask during the flu season while at work."

In the past, Marshfield has encouraged employees to be vaccinated during the flu season, offering educational programs and incentives. The facility even created a humorous educational video to get staff members on board with receiving the vaccination. Although the employee vaccination rate for the seasonal flu did increase, the rate had not met the administration's goal.

"This is a patient-centered policy in that we're an advocate for patient safety and we want to provide as safe an environment for our patients and employees as we can," says Cunha. "We know that vaccination of as many employees as we can is part of that safety effort."

APIC wants facilities to take a step further by obtaining informed statements from employees who decide not to vaccinate themselves for nonmedical reasons, acknowledging that their actions put patients at risk.

"Employees who are not vaccinated can transmit both seasonal flu and H1N1 virus to vulnerable patients in healthcare institutions," said Nutty. "Current rates of healthcare worker immunizations are appallingly low and must not be tolerated. It's time for hospitals to require flu shots—and hold employees accountable for declining the vaccine."

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