Patient Safety

Resources

The presentation here [ PADOH_HCW Flu Vax Program_Patient Safety Module_1-5_July 2011] includes patient safety perspective from CHOP and the PA Patient Safety Authority.

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Employee Vaccination and Patient Safety Training
June 2011
James Davis, BSN RN CCRN CIC
[10-slide Powerpoint presenting overview of patient safety issues with cost impact analysis and nursing home survey data on mandatory programs and impact. Selected slides used in final overview presentations]

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Literature

Vaccine
Volume 28, Issue 51 pp. 8049-8226 (29 November 2010)
Reviews
Reflections on the influenza vaccination of healthcare workers
Review Article
Pages 8061-8064
Stuart McLennan, Sabine Wicker
Abstract
Despite all that is known about the dangers of nosocomial transmission of influenza to the vulnerable patient populations in our healthcare facilities, and the benefits of the influenza vaccination, the low rates of influenza vaccination among healthcare workers (HCWs) internationally shows no sign of significant improvement. With the current voluntary ‘opt-in’ programmes clearly failing to adequately address this issue, the time has undoubtedly come for a new approach to vaccination to be implemented. Two different approaches to vaccination delivery have been suggested to rectify this situation, mandatory vaccination and ‘opt-out’ declination forms. It is suggested, however, that these two approaches are inadequate when used by themselves. In order to protect the most vulnerable patients in our healthcare facilities as best we can from serious harm or death caused by nosocomial transmission of influenza, while at the same time respecting HCWs autonomy, and in many jurisdictions, the related legal right to refuse medical treatment, it is recommended that ‘op-out’ declination forms should be used in conjunction with restricted mandatory vaccination. This ‘combined’ approach would allow any HCW to refuse the influenza vaccination, but would make the influenza vaccination a mandatory requirement for working in areas where the most vulnerable patients are cared for. Those HCWs not willing to be vaccinated should be required to work in other areas of healthcare.

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Occup Med (Lond). 2002 Aug;52(5):249-53.
Nosocomial transmission of influenza.
Stott DJ, Kerr G, Carman WF.
Source
Academic Section of Geriatric Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow G4 0SF, UK. d.j.stott@clinmed.gla.ac.uk
Abstract
Influenza is a common nosocomial infection. Serious outbreaks occur typically in elderly long-term patients, but have also been reported in renal, transplant and oncology units, neonatal intensive care and paediatrics. It is likely that staff-patient cross-infection is common. Prompt diagnosis of an outbreak lies at the heart of an effective influenza control programme. This requires effective virological surveillance. There are a variety of strategies that can help to prevent spread of influenza in health care settings. Basic infection control should include isolating infected residents, restricting circulation of nursing staff between patients, and restriction of visitors. Annual influenza immunization should be offered to elderly patients, subjects with chronic disease, and those in long-term residential or nursing home care. Vaccination of health care workers has been shown to be effective in protecting elderly patients in long-term care. Use of oral amantadine or rimantadine is an additional possible strategy for prophylaxis or treatment during an outbreak.

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