1725. Addressing Presenteeism: Variability in Facility Healthcare Personnel Work Restriction Policy Monitoring and Enforcement
Session: Oral Abstract Session: The World Around Us: Reducing Exposures to Pathogens in the Healthcare Environment
Saturday, October 6, 2018: 8:45 AM
Room: S 156
Background: Presenteeism, or working while ill by healthcare personnel (HCP) experiencing influenza-like illness (ILI), increases the likelihood of illness transmission to coworkers and patients. The CDC recommends that HCP with ILI not work until they are afebrile for at least 24 hours. Operationally, hospital policies and practices may not facilitate HCP staying home when ill.

Methods: In March 2018, the Emerging Infections Network surveyed their national network of infectious diseases physicians with hospital epidemiology responsibilities or interests to describe institutional experiences with and policies for HCP working with ILI.

Results: 367/715 (51%) ID physicians responded. 135 of 367 were not aware of institutional policies and opted out of the rest of the survey. Of the remaining 232 respondents, 206 (89%) reported that their inpatient facility had institutional policies regarding work restrictions for HCP with influenza or ILI, but only 63% said that this policy was communicated to staff at least annually.

Work restrictions were most often enforced for staff by sending ill HCP home and by encouragement to call in sick if necessary, while work restrictions for physicians-in-training and attending physicians were most often not enforced or variably enforced. A majority of respondents (53%) reported that adherence to work restrictions was not monitored.

96% reported that lab confirmed influenza in patients was tracked by their facility, while 37% reported tracking patient ILI. For employees, 47% reported tracking of lab-confirmed influenza and 23% reported tracking ILI. For independent physicians, 13% reported tracking lab-confirmed influenza and 5% reported tracking ILI. 63% reported that antiviral prophylaxis was provided to at least some employees after occupational exposures, while 9% reported provision of antiviral prophylaxis after non-occupational (e.g., household) exposures.

Conclusion: Most institutions have policies to prevent HCP from working while ill. However, the dissemination, monitoring, and enforcement of these policies is highly variable. Improving communication about work restriction policies, as well as monitoring and enforcement of these policies, may help prevent the spread of infections from HCP to patients.

Hilary Babcock, MD, MPH, Washington University School of Medicine, St Louis, MO, Susan E. Beekmann, RN, MPH, University of Iowa Carver College of Medicine, Iowa City, IA and Philip M. Polgreen, MD, Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA


H. Babcock, None

S. E. Beekmann, None

P. M. Polgreen, None

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