Karen Bowers Angelique Kinyon Objectives Review influenza Educate on why vaccination should be mandated for health caregivers Increase awareness of national recommendation for health caregivers vaccination Determine the populations at high risk Review financial incentives Knowledge of morbidity and mortality Influenza Contagious viral respiratory illness Can cause mild to severe illness and death Vaccine is a priority in: Healthcare workers Immunocompromised individuals Seniors age 65 years and older Children age 6 months and older Pregnant women First line defense against getting the flu: vaccination (CDC, 2013) Health Care Personnel Centers for Disease Control and Prevention(CDC): ALL personnel should get vaccinated annually (CDC, 2014) 2013-14 flu vaccination coverage among healthcare workers was 62.9% (CDC, 2014) Healthy People 2020 Other Clinical Professionals Nurse Practitioners/ Physician Assistants Pharmacists Physicians Nurses 71.10% 77.80% 89.90% 84.30% 79.30% Percentage Vaccinated 2013-2014 Financial Hospital Aquired Infections Influenza: Hospital Value Based Purchasing(HVBP) IMM-2: Influenza immunization FY 2016 Patients can refuse Clinical Process Measures make up 10% of earnings Political Article I of the United States Constitution Public health/safety Public Health Service Act 48 Greater Common Good New York - 2009 Lawsuits filed Judge issued a temporary restraining order Ethical Considerations Dilemmas Health Concerns (Allergies, Adverse Reactions) Are influenza vaccines safe and effective? Religious Views Freedom of Religion Personal Views/ Autonomy Is the personal preference ethically justifiable over patient safety? Principles Nonmaleficence Avoidance of harm or hurt; core of medical oath and nursing ethics (ANA, n.d.) Beneficence Compassion; taking positive action to help others; desire to do good; core principle of our patient advocacy (ANA, n.d) Fidelity This principle requires loyalty, fairness, truthfulness, advocacy, and dedication to our patients (ANA, n.d.) Why are HCWs Refusing? Nurses Against Mandatory Vaccines - NAMV Violation of basic human rights Patient Bill of Rights Right to Refuse Unnecessary for healthy individuals Questionable severity of influenza Safety/long-term effects of annual vaccination Nursing Practice Self-reflection and Research Educate patient/family/caregivers Screen patient for influenza status Promote healthy behaviors and how to prevent the spread of infectious disease ANA Entrusted with care and protection of patients Alternative protection Quality and Safety Issues Morbidity: Disease state of an individual Incidence of illness in a population 200,000+ hospitalizations Mortality: Number of people who died within a population Average 24,000 deaths Healthcare workers working with the illness Root Cause Analysis Inadequate Staff Education Inadequate Patient Education Ethical Infringement upon Individuals Increasingly vulnerable patient populations Inadequate numbers of voluntary annual influenza vaccination. Need for mandatory vaccination policy with ethical alternatives in order to protect vulnerable patients Inferences and Implications and Consequences Refusal Termination of Employment Mandated mask use Spread of the disease Increase risk of complications due to influenza Mortality Compliance Protection Self Family Patients Decrease in incidence Increased quality of care Recommendations Mandatory Annual Vaccination for all HCWs Ethical Alternative (mask) Staff Education Patients Education Screening Administration Conclusion Mandatory health care workers vaccination Protects healthcare workers Protects patients Decreases morbidity Decreases mortality rates Decreases transmission of illness Increases patient safety References American Nurses Association [ANA]. (n.d.) Immunizations. Retrieved from: http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Improvi ng-Your-Practice/Immunizations APIC. (2014) Study: When hospital workers get vaccines, community flu rates fall. Retrieved from: http://www.apic.org/For-Media/News-Release/Article?id=e0b94274-5340-47ca-b86f- fdb64c90e793 Awali, R. A., Samuel, P. S., Marwaha, B., Ahmad, N., Gupta, P., Kumar, V., & ... Chopra, T. (2014). Understanding health care personnel's attitudes toward mandatory influenza vaccination. American Journal Of Infection Control, 42(6), 649-652. doi:10.1016/j.ajic.2014.02.025 Centers for Disease Control and Prevention [CDC]. (2013). CDC Influenza E- Brief and Prevention. Retrieved from: www.cdc.gov/washington/fluBrief/Sept2013FluBrief.pdf Centers for Disease Control and Prevention [CDC]. (2014). Seasonal Influenza (Flu). Retrieved from http://www.cdc.gov/flu/index.htm Nelson, W. A., & Lahey, T. (2013). The ethics of mandatory flu shots. Healthcare Executive, 28(6), 42-46. Retrieved from Proquest Database Ottenberg, A. L., M.A., Wu, Joel T, JD,M.A., M.P.H., Poland, G. A., M.D., Jacobson, R. M., M.D., Koenig, B. A., PhD., & Tilburt, Jon C,M.D., M.P.H. (2011). Vaccinating health care workers against influenza: The ethical and legal rationale for a mandate. American Journal of Public Health, 101(2), 212-6. Retrieved from Proquest Database Qualitynet. (2014). Hospital Value Based Purchasing. Retrieved from: www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTi er3&cid=1228772478206 Srejic, Elizabeth(2014). Key issues In Occupational Health. Infection Control Today(18), pp 8-12). U.S Department of Veterans Affairs, Office of Research and Development. (n.d). Why do some healthcare workers decline flu vaccination. Retrieved from: http://www.research.va.gov/news/features/flu_vaccination.cfm
