Public health in emergency medicineAttitudes and Practices Regarding Influenza Vaccination Among Emergency Department Personnel
Introduction
In the United States, over 36,000 deaths and up to 114,000 hospital admissions annually are related to influenza (1, 2, 3). Influenza vaccinations are a safe, cost-effective means to prevent morbidity and mortality (4, 5, 6). To reduce the likelihood of infection, as well as to limit the rate of transmission to hospitalized patients, the Centers for Disease Control and Prevention recommend that all health care workers (HCW) involved in direct patient care receive influenza vaccinations annually (7). Research suggests that providers who get vaccinated themselves are more likely to recommend influenza vaccination to their patients (8, 9, 10). Moreover, an important determinant of patients' influenza vaccination behaviors is their provider's recommendation to get vaccinated (11, 12). However, despite long-standing recommendations for the routine influenza vaccination of HCWs, the vaccination rate in the United States is reported to be 38% (13).
The emergency department (ED) setting has been proposed as a venue for expanding vaccination coverage to adults at high risk for complications from influenza infection (14, 15, 16, 17, 18, 19, 20). A majority of unvaccinated ED patients indicated that they would accept vaccination if it were offered (14, 15). Over half of emergency physicians reported their willingness to prescribe influenza vaccination (16, 17). Still, every year in the United States, there are an estimated 2.8 million people treated in the ED setting with limited access to health care who are at high risk for influenza-related complications, but who go without being vaccinated (18). We sought to understand the factors that contribute to the professional and personal influenza vaccination practices of HCW in the ED setting by assessing their knowledge, attitudes, and practices with regards to the influenza vaccine. We hypothesized that barriers to being vaccinated against influenza among HCWs would differ by provider type. We also hypothesized that acceptance of influenza vaccination by HCWs in the ED was associated with support for an influenza vaccination program for ED patients.
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Study Design and Protocol
In September 2005, we performed a cross-sectional study of all full-time ED staff (nurses, emergency medicine residents, and emergency medicine faculty) at an urban academic medical center in Boston treating > 90,000 ED patients annually. We examined knowledge, attitudes, and practices regarding personal influenza vaccination and support of an ED-based influenza vaccination program using an anonymous, self-administered questionnaire. We excluded temporary or per diem ED personnel. Research
Results
Of 130 ED staff, 126 individuals completed the survey (97% response rate); 46% of respondents were nurses, 28% were residents, and 26% were attending physicians. The three groups did not differ significantly on gender distribution, age, or number of years of clinical practice (Table 1).
Overall, 69% of respondents reported that they were very or extremely likely to be vaccinated before the coming influenza season (Table 2). Residents (94%) and attending physicians (82%) were significantly more
Discussion
In this study of hospital ED staff, two-thirds of respondents reported they were very or extremely likely to be vaccinated. Resident and attending physicians were more likely than nurses to be vaccinated. Factors associated with increased likelihood of vaccination included the belief that the vaccination is effective, and having been vaccinated in the previous year. Factors associated with decreased likelihood of vaccination included the belief that the side effects were common, and having
Conclusions
Barriers to influenza vaccination among ED staff are similar to those among HCWs in other settings. Providing regular education on the efficacy of preventive vaccination therapy and dispelling misconceptions regarding adverse effects may reduce these barriers. An influenza vaccine educational initiative may result in widespread acceptance of influenza vaccination by ED providers themselves, which could result in increased support for an influenza vaccination program for ED patients.
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COVID-19 vaccine hesitancy and intent in California registered nurses
2022, Vaccine: XCitation Excerpt :When given the option to vaccinate against influenza, HCWs’ vaccination rates have historically been low [5]. This is significant from a patient care perspective as HCWs who report intended flu vaccine uptake are more likely to support hospital flu vaccination programs [6] and recommend flu vaccination to patients [7]. Emerging anecdotal evidence suggests a similar phenomenon where nurses’ COVID-19 vaccine hesitancy may lead to a reluctance to vaccinate others.
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2022, American Journal of Emergency MedicineCitation Excerpt :Healthcare provider survey results also demonstrate support for vaccinating patients against influenza in the ED when there is sufficient time, staffing, and resources available [33,36]. Only 69% of ED physicians and nurses report intention to receive annual influenza vaccinations [38], which may also influence their support of influenza vaccination programs in the ED and provision of education to patients on the importance of vaccination. Additional barriers encountered by other public health initiatives in the ED include cost, space, privacy, education and training, and patient follow-up [39-42].
Should we be vaccinating our patients against influenza?
2020, American Journal of Emergency MedicineFirst Do No Harm: Prevention Strategies for Influenza Season
2015, Journal of Emergency NursingCitation Excerpt :Health care personnel, including emergency nurses, with a high level of knowledge regarding the influenza vaccine efficacy and an understanding that adverse outcomes are uncommon are more likely to be vaccinated.8,9 They are also more likely to recommend vaccination to their patients.9 For this reason, it is critically important that emergency nurses know the facts about influenza vaccine so that they can make an informed decision and provide accurate education for people in their communities and under their care.
Commentary
2012, Annals of Emergency Medicine