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Minnesota Healthcare Setting Employee Influenza Vaccination Program Survey

Minnesota Healthcare Setting Employee Influenza Vaccination Program Survey. Denise Dunn, RN, MPH Adult/Adolescent Immunization Coordinator Minnesota Department of Health August 2009. Overview. Survey background Survey methods Initial findings Dissemination of results. Survey background.

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Minnesota Healthcare Setting Employee Influenza Vaccination Program Survey

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  1. Minnesota Healthcare Setting Employee Influenza Vaccination Program Survey Denise Dunn, RN, MPH Adult/Adolescent Immunization Coordinator Minnesota Department of Health August 2009

  2. Overview • Survey background • Survey methods • Initial findings • Dissemination of results

  3. 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

  4. 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

  5. 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.

  6. 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)

  7. 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

  8. 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

  9. Survey findings • Overall employee influenza vaccination rate (all facilities combined) = 70.1%

  10. Survey findings • Influenza vaccination rates by facility type: • Hospital = 78% • LTC = 63% • Both = 73% • Other = 77%

  11. Survey findings • 100% of healthcare facilities surveyed provided influenza vaccination to all employees during the 2008-09 season

  12. 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%

  13. Survey findings • 99% of facilities provided vaccination onsite • 86% provided vaccination during all work shifts • 99% provided vaccination at no cost

  14. 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%

  15. 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%

  16. 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

  17. 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

  18. 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%

  19. 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%

  20. Declination • For those who used declinations forms, was it mandatory for employees to return the form? • Yes 72.7% • No 27.3%

  21. 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

  22. Declination • Will your organization use a declination process next influenza season? • Yes 67% • No 5% • Unknown 28%

  23. Findings • Vaccination rate comparison: • Used declination form = 75% • No declination form = 60%

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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

  31. Questions/Discussion • Denise Dunn: • Denise.Dunn@state.mn.us • 651-201-5560

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