521. Effect of Web-based Education and Nurse Champions on Employee Influenza Vaccination in an Integrated Health Care System
Session: Poster Abstract Session: Influenza Vaccines
Friday, October 21, 2011
Room: Poster Hall B1
  • FLU POSTER IDSA 2011.pdf (658.4 kB)
  • Background: 

    Nurse coordinators and online educational programs can increase influenza vaccination rates for healthcare workers in outpatient settings, but their effect in tertiary care systems is unknown.   We hypothesized that implementation of these strategies in a large integrated health care system would increase vaccination rates.


    In 2006, an online educational tool on influenza vaccination, including a survey of comprehension and reasons for declination, was implemented in our tertiary health care system.  From 2007-2009, a revised educational tool and unit-based nurse champions were employed at the intervention site, while control sites received education only.   We collected influenza vaccination status, survey answers, reasons for declination, age, gender, job description, and job location for all employees in 2007-2009.  Trends in vaccination rates were analyzed using logistic regression and descriptive statistics were used to describe vaccination rates by employee demographics.


    We studied 10,400 employees (89% at intervention site and 11% at 2 control sites).  Employees at control sites were older (mean age 46.3±12.7 vs. 42.8±12.5 years, p<0.0001) and less likely to be physicians (0.9% vs. 8.6%, p<0.0001).  Across 2 influenza seasons, vaccination rate increased at the intervention site (37% vs. 41%), but not in the control site (41% vs. 41%) (test of parallel slopes p=0.01).  Vaccination rates varied by nursing unit from 11% to 60% and were highest in labor and delivery (60%) and intensive care (58-59%).  In multivariable modeling, vaccination was most strongly associated with age >40 years (OR 1.32, 95% CI 1.28-1.38) and previous vaccination (OR 4.4, 95% CI 4.1-4.7).  The top reasons for declination were the same across job types: “healthy” (27%), “the vaccine does not work” (16%) and “had a past reaction” (14.6%). 


    In a tertiary care health system, nurse champions had a positive impact on influenza vaccination, but rates remained low and misconceptions about vaccination persisted.

    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Justine Miranda, MD1, Michael Rothberg, MD, MPH2, Sarah Haessler, MD2, Paul Medrek, MD, MPH2, Mary Ellen Scales, RN2, Jennifer Friderici2, Amy Rist2, Paul Visintainer, PhD2 and Melisha Cumberland, MD2, (1)Infectious Diseases, Baystate Medical Center, Springfield, MA, (2)Baystate Medical Center, Springfield, MA


    J. Miranda, None

    M. Rothberg, None

    S. Haessler, None

    P. Medrek, None

    M. E. Scales, None

    J. Friderici, None

    A. Rist, None

    P. Visintainer, None

    M. Cumberland, None

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