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With less than half of nurses and healthcare workers participating in the annual influenza vaccine, many hospitals are taking steps to boost their compliance rate in an effort to protect their patients and keep employees healthy against this preventable illness.

The Joint Commission Resources, an affiliate of The Joint Commission that provides educational services to assist in quality and safety improvements, recently launched an initiative to increase flu vaccination rates among hospital staff, noting that only 42% of surveyed healthcare workers received a vaccination during the 2005-06 flu season.

Chris Simkins, APRN, director of Occupational Healthcare at South Jersey Healthcare, Vineland, N.J., says containing the flu in the hospital is a very real concern. "Our goal is to vaccinate everyone in the hospital from clinical to nonclinical staff," he says. "The flu can result in an increase in mortality, especially for the elderly and for patients whose bodies are already under stress."

According to the Centers for Disease Control and Prevention, 5% to 10% of people get the flu each year, more than 200,000 people are hospitalized from flu complications, and about 36,000 people die from the flu.

Door-to-Door Service

Determined to bring its flu vaccination rate up hospitalwide, South Jersey Healthcare launched a major flu vaccination initiative last year that resulted in a 17% increase in flu vaccinations from 2006.

The thrust of the campaign combined education with aggressive delivery of the vaccination to employee workstations. Employee Health staff nurses traveled to every unit of the health system's three hospital campuses, as well as five outpatient facilities. South Jersey also offered 26 designated flu vaccine distribution dates at various locations throughout the system and set up tables where staff handed out information packets and administered the vaccine.

This was combined with a communication and education campaign to promote awareness and the positive benefits of the flu vaccination. Education was provided through e-mails, flyers, posters, and table tent cards in the employee cafeteria and staff lounges, as well as direct communication at employee staff meetings. Simkins says one of the strategies that had the greatest impact was delivery of the vaccine to individual departments.

"If I could offer one suggestion to all employee health nurses who perform flu vaccine clinics, it would be to be aggressive and active in the delivery of the vaccine," says Simkins. "Don't stay in your office waiting for employees to knock on your door because they won't. Many are too busy or won't take the time."

Following the campaign, the hospital conducted an employee-wide survey to identify concerns and attitudes about the vaccine and reasons staff members did not participate. Of the 1,894 respondents that completed the survey, nearly half indicated they "just didn't want to receive it." Other reasons included having schedule conflicts, an unwarranted fear of becoming ill after receiving the vaccine, or believing the vaccine won't help.

This year, a fact sheet with frequent questions and answers will be distributed to help dispel any negative myths about taking the vaccine, says Simkins.

To reach more staff during this year's vaccinations, South Jersey Healthcare plans to recruit nurses from various clinical units to assist Employee Health.

"We realize the most important thing is to make access to the vaccine convenient for the entire staff, which means actively visiting every area of the hospital and taking the vaccine to the employees," says Simkins.

Education about proper handling of flu patients, as well as awareness of the flu vaccination, was the primary strategy employed by St. Mary Medical Center, Langhorne, Pa., to bolster participation in the hospital's annual flu vaccination initiative. To prevent patient-to-patient transmission, the slogan "Wash-in, wash-out" was promoted hospitalwide. The hospital also enforced droplet isolation to those patients suspected of carrying the flu virus. This policy requires staff to wear masks when coming within 3 feet of patients, including staff who transport patients.

These practices have helped the medical center achieve a zero hospital-acquired flu rate, says Dawn Marie Rumovitz, RN, MSN, infection prevention manager at St. Mary Medical Center.

Myths Persist

A random poll conducted last year after the vaccination campaign at St. Mary indicated that one of the primary reasons healthcare workers fail to get vaccinated is they feel they are immune to the virus because they are around sick patients all of the time, says Rumovitz. Other flu myths also continue to percolate among staff, she says, including the belief that the vaccine will cause the flu.

Continued education and awareness will be a large focus of this year's initiative and will include e-mails, newsletters, posters, and displays as well as letters mailed to employees' homes reminding them to get vaccinated. The medical center also plans to set up vaccination stations at various hospital locations and visit each department with the vaccine.

Rumovitz says this year the plan is to follow up in person with individuals who choose not to get vaccinated and ask them to complete a survey to identify reasons why they declined.

"There are still a lot of misconceptions out there about the flu and the flu vaccine," says Linda DeWitt, RN, infection prevention nurse at St. Mary. "We think the more we get down to the individual level, the better chance we will have to change these perceptions."

Rumovitz says St. Mary's goal is to increase its 30% vaccination rate by 15% this year. "The vaccination not only helps protect patients, but it also protects our staff and their families."

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Susan Meyers is a freelance writer. To comment, e-mail editorPA@nursingspectrum.com.