Nursing Practice Problem
It has been established that nurses and other healthcare workers have increased risk of contracting influenza. In some countries, it is mandatory for all healthcare workers to be given influenza vaccination so as to reduce the incidence of the diseases. Research on the topic of the effects influenza vaccination for healthcare workers has interested many researchers. The issue of mandatory vaccination has also been researched on the basis of ethics in such practices.
PICOT Question
In registered nurses how does mandatory vaccination of influenza over a period of five years, compared to no mandatory influenza vaccination influence the incidence of influenza?
P- Registered nurses
I- Mandatory influenza vaccine
C- No mandatory influenza vaccine
O- Incidence of Influenza
T- Mandatory influenza vaccination provided for a period of two years in a local healthcare.
Registered nurses are usually exposed to conditions that makes it easy for them to contract influenza. The risk increases when the nurses have not been given influenza vaccine. It is estimated that 13-23% of people working I a health setting are infected with influenza every year. Furthermore 50% of the infected people only present with mild symptoms (Vieira, 2012). Studies by Amodio et al, Dancun et al, Friedl et al, Galanakis et al, Maitre and Olsen are all significant studies that can be applied in hospital set up to address the issue of influenza among healthcare workers.
Literature Search
Amodio, E., Restivo, V., Firenze, A., Mammina, C., Tramuto, F., & Vitale, F. (2014). Can influenza vaccination coverage among healthcare workers influence the risk of nosocomial influenza-like illness in hospitalized patients?. Journal of Hospital Infection, 86(3), 182-187.
This study aimed to provide an analysis of the risk of patients contracting nosocomial influenza-like illness (NILI) in relation to healthcare workers being given influenza vaccination. Quantitative methodology was applied for the study. The study found that the rate of NILI among patients is inversely associated with vaccination among healthcare workers. The study concluded that influenza vaccination should be increased among health care workers as it is a cost-effective approach (Amodio et al, 2014).
Duncan, I. G., Taitel, M. S., Zhang, J., & Kirkham, H. S. (2012). Planning influenza vaccination programs: a cost benefit model. Cost Effectiveness and Resource Allocation, 10(1), 10.
The background of this research was the question of whether influenza immunization is a cost-benefit approach or not. The research aimed to do a comparison of cost-benefit of strategies used for influenza vaccination from the perspective of the employer, employee and society. Qualitative approach which included actual model of literature search and quantitative method was used. The results show that influenza vaccinations is cost beneficial to employers if they offer vaccine to more than 37% people in a non-traditional setting such as pharmacy. A base line in which 50% of people are vaccinated in non-traditional setting results in a net saving of $6. Programs were limited to traditional setting ($31 PV) people target when they are high-risk ($83 PV) or seniors ($107 PV) increased cost benefit. Sensitivity analysis indicates scenario-based findings to be true (Duncan et al, 2012). Both target based and universal influenza vaccination is beneficial if correctly used.
Friedl, A., Aegerter, C., Saner, E., Meier, D., & Beer, J. H. (2012). An intensive 5-year-long influenza vaccination campaign is effective among doctors but not nurses. Infection, 40(1), 57-62.
The objective of the research was doubling vaccination of hospital workers from 20% to 40% using specific interventions within a period of 5 years (2005-2009) so as to compare the effects of H1N1 in the pandemic period of 2009 (Friedl et al, 2012). A quantitative approach was employed. The results showed that the increase in physicians was 34% to 62%, when two years were added it increased to 66%. That of nurses however dropped from 18% to 15% and when two more years are added to 15%. The research concluded that intervention was more successful to physicians than it was for nurses but had no significant effect on nurses although the uptake of vaccine was high during the A?H1N1v pandemic.
Galanakis, E., Jansen, A., Lopalco, P. L., & Giesecke, J. (2013). Ethics of mandatory vaccination for healthcare workers. Euro Surveill, 18(45), 20627.
The aim of this research was to review the issue of ethics involved in mandatory influenza vaccination. A qualitative approach using relevant literature was adopted. The results indicates that there is moral imperative in mandatory vaccination to healthcare workers since public health outweighs the autonomy of individual (Galanakis et al 2013). The research concluded that mandatory influenza vaccination given on a fair basis is proper and should be implemented by healthcare workers.
Maitre, D. A. (2013). An Evidence-Based Intervention to Improve Vaccination Rates for Seasonal Influenza Among Registered Nurses
The purpose of the study was to evaluate if education intervention that address the issue of myths and misconceptions can lead to increased voluntary vaccination of health workers. The study also aimed to dispel misconceptions and myths about vaccines. A mixed (both quantitative and qualitative) research approach was used whereby presentations on influenza over a period of two weeks was done (Maitre, 2013). The results from the study indicate that after the intervention more health workers took the vaccine however the rate of vaccination remained constant. The researchers also observed differences in vaccination based on age, history of vaccination and race/ethnicity. The conclusion was that more studies should be done on the area of influenza vaccination.
Olsen, D. P. (2010). Point counterpoint: mandatory flu vaccination for health care workers. AJN The American Journal of Nursing, 110(1), 27-28.
This study was done to respond to the low rate at which health workers take vaccines. The objective was to analyze the advantages and disadvantages of mandatory influenza vaccination. A qualitative approach that was based mainly on expert opinion was utilized. The research exposed various effects of mandatory vaccination in healthcare setting (Olsen, 2010). The conclusion is that since nurses’ care about their health and are well informed they should be allowed to weigh the pros and cons of influenza vaccine and make a choice to either be vaccinated or not.
References
Amodio, E., Restivo, V., Firenze, A., Mammina, C., Tramuto, F., & Vitale, F. (2014). Can influenza vaccination coverage among healthcare workers influence the risk of nosocomial influenza-like illness in hospitalized patients?. Journal of Hospital Infection, 86(3), 182-187.
Duncan, I. G., Taitel, M. S., Zhang, J., & Kirkham, H. S. (2012). Planning influenza vaccination programs: a cost benefit model. Cost Effectiveness and Resource Allocation, 10(1), 10.
Friedl, A., Aegerter, C., Saner, E., Meier, D., & Beer, J. H. (2012). An intensive 5-year-long influenza vaccination campaign is effective among doctors but not nurses. Infection, 40(1), 57-62.
Galanakis, E., Jansen, A., Lopalco, P. L., & Giesecke, J. (2013). Ethics of mandatory vaccination for healthcare workers. Euro Surveill, 18(45), 20627.
Maitre, D. A. (2013). An Evidence-Based Intervention to Improve Vaccination Rates for Seasonal Influenza Among Registered Nurses.
Olsen, D. P. (2010). Point counterpoint: mandatory flu vaccination for health care workers. AJN The American Journal of Nursing, 110(1), 27-28.
Vieira, R. H. G., Erdmann, A. L., Andrade, S. R. D., & Freitas, P. F. (2012). Influenza vaccination among nursing professionals: reality and challenges. Acta Paulista de Enfermagem, 25(SPE2), 104-109.
