Post on 14-Jan-2016
description
Minnesota Healthcare Setting Employee Influenza Vaccination
Program Survey
Denise Dunn, RN, MPHAdult/Adolescent Immunization CoordinatorMinnesota Department of HealthAugust 2009
Overview
Survey background Survey methods Initial findings Dissemination of results
Survey background
National healthcare worker vaccination rate is about 45%*
Interest in what Minnesota’s rate might be Strong backing from MIPAC Influenza
Subgroup to survey MN MDH decides to survey 2008-09 season
*National Health Interview Survey (NHIS), 2006-07
Survey background
Decision to do more than just a declination survey
Interest in obtaining Minnesota-specific information about employee influenza vaccination programs and rates in health care settings
Purpose of survey
To collect:– Minnesota-specific employee influenza vaccination
rates in health care settings to give us a benchmark to mark progress;
– Information on various employee influenza vaccination program activities used by organizations;
– Data on the perceived barriers to vaccination; and – Baseline information on utilization/usefulness of the
Minnesota Immunization Information Connection (MIIC), our statewide immunization registry, for tracking employee influenza vaccinations.
Coverage & sampling
Survey population = all hospitals and long-term care facilities in Minnesota
Surveyed all hospitals (N=145) and a random sample of long-care facilities (N=135)
Total facilities surveyed = 280 Facility lists obtained from Compliance
Monitoring Division (MDH)
Survey methods
Online survey available mid-April through May 2009
Paper version was available, but no requests for it
Pre-letter to administrators, followed by instructional letter to infection control staff (if known) or again to administrators, by default
ICP email list used, as available
Survey methods
Reminders sent either via mail or email Response rate = 62%
– Excluded 6 incomplete surveys– Total responses; N = 173
Response deadlines were extended – Last 2 weeks of original timeframe were
extremely busy for hospitals with H1N1 Analysis is still underway
Survey findings
Overall employee influenza vaccination rate (all facilities combined) = 70.1%
VaccinatedUnvaccinated
Survey findings
Influenza vaccination rates by facility type:– Hospital = 78%– LTC = 63%– Both = 73%– Other = 77%
Survey findings
100% of healthcare facilities surveyed provided influenza vaccination to all employees during the 2008-09 season
Survey findings
In addition to employees, who was included in your vaccination program?– Volunteers 61%– Licensed independent contractors 42%– Students 31%– Community providers 11%– Vendors 6%
Survey findings
99% of facilities provided vaccination onsite 86% provided vaccination during all work
shifts 99% provided vaccination at no cost
Vaccination delivery methods
Vaccination clinics/fairs 73% Peer-vaccinators 60% Mobile carts 50% Coordination with other programs 39% Occupational health site 28% Using congregating areas 25% Flu captains/teams 12%
Promotional activities
Respondents used the following promotional activities to enhance vaccination programs:
– Reminders 91% – Promotional campaign 70%– Strong support by admin 49%– One on one counseling 42%– Incentives 38%– Rates reviewed by admin 35%– Rates shared within facility 32%– Kick off event 21%– Influenza champions 12%
Educational activities
92% of facilities provide education as part of their employee vaccination program
Of those facilities that provided education:– In 34%, education was required– In 66%, education was not required
Survey findings
Respondents track employee influenza vaccinations using:– Paper forms 88%– Other computer application 23%– MIIC 10%– Other, included consent forms, checklists, sign up
sheets, employee health records
Survey findings
Barriers cited to using MIIC to track employee vaccinations:– Lack of time for entering data 26%– Prefer own system 25%– Lack of awareness about MIIC benefits 21%– Lack of trained personnel 13%– General difficulty in use 4%– Privacy concerns 2%
Declination
Did your organization use a declination form as part of its employee influenza vaccination program during the 2008-09 season?
– Yes 70%– No 30%
YesNo
Declination
For those who used declinations forms, was it mandatory for employees to return the form?
– Yes 72.7%– No 27.3%
YesNo
Declination
Reasons given for not using declination forms:– Lack of time or personnel resources 25%– Not convinced of value 21%– Leadership does not endorse 17%– Union barriers 6% – Other included: never used before, unaware of
form, employee rights, tried with little effect
Declination
Will your organization use a declination process next influenza season?
– Yes 67%– No 5%– Unknown 28%
YesNoUnknown
Findings
Vaccination rate comparison:
– Used declination form = 75%
– No declination form = 60%
0
10
20
30
40
50
60
70
80
% vaccinated
Useddeclination
Nodeclination
Declination reasons
Fear of adverse events 9% Fear of getting sick from vaccine 6% Fear of injections 5% Medical contraindications 3%
*average % reported, of those facilities that use declination forms
Initial findings
Program characteristics of facilities with high vaccination rates (close to or >90%):– Provide flu vaccine at no cost to employee– Provide vaccination during all work shifts– Expand vaccine offerings to “other” workers– Use reminder methods
Initial findings
Program characteristics of facilities with high vaccination rates (close to or >90%):– Most had a strongly motivated administrator
leading the vaccination drive– Most held kick-off events and campaigns– Almost all provide education on influenza and flu
vaccine to staff– Most used declination forms and required their
return
Initial findings
Program characteristics of facilities with high vaccination rates (close to or >90%):– All evaluate influenza vaccination rates annually– All set influenza vaccination rate goals annually– Almost all track reasons why employees choose
not to participate– All track the previous season’s data
Data analysis continues
Still analyzing data Continue analyzing specific activities
associated with high-rate facilities Compare vaccination rates of facilities that
use declination forms to those that do not Look at nonresponders
Dissemination of results
Internal MDH stakeholders MIPAC Influenza Subgroup CDC site visit “Brown bag” for additional MDH employees Fact sheet with summary of results / web MN Influenza Vaccination Plan 2009-10 State, regional, and/or national conferences
What’s next
Amend sample declination form Finish analysis and disseminate results Plan to repeat survey next year
– Possibly add sampling of clinics
H1N1 vaccine campaign may complicate next year’s survey
Questions/Discussion
Denise Dunn: – Denise.Dunn@state.mn.us– 651-201-5560