Online Program

Enhancing capacity for influenza vaccination among skilled nursing facility staff through partnership with the health department in Marin County, California

Wednesday, November 6, 2013

Matthew Willis, MD, MPH, Division of Public Health, County of Marin Department of Health and Human Services, San Rafael, CA
Sharayn Forkel, RN MS, Division of Public Health, County of Marin Department of Health and Human Services, San Rafael, CA
Background: Residents of skilled nursing facilities (SNF's) are at increased risk for both influenza infection and influenza mortality. Influenza vaccination of healthcare workers reduces transmission risk to residents. SNF's nationally have among the lowest staff vaccination rates among healthcare facilities. The Marin County Division of Public Health assessed local SNF staff influenza vaccination status and performed on-site interventions to improve staff vaccination rates. Methods: In December 2012, surveys were administered to all registered SNF's in Marin County, soliciting the total number of employees and the number of employees with documented influenza vaccine since August, 2012 (vaccination rate). Barriers to increased vaccination rates were also assessed. Based on responses, visits were conducted to facilities requiring additional assistance in reaching staff vaccination goals. Results: 9 of 13 SNF's responded to the survey. Of 1,086 SNF employees, 620 (57 percent) had received the influenza vaccine during the current flu season. Staff vaccination rates among facility respondents ranged from 18 to 86 percent. 4 facilities with low vaccination rates were visited by public health nurses, who administered a total of 52 vaccines on-site to unvaccinated employees and offered technical assistance to enhance internal capacity for employee vaccination services. Conclusion: A small scale public health intervention can assess and increase employee vaccination rates in SNF's, where staff are historically under-vaccinated. A targeted approach toward facilities with low vaccination rates can provide a model for partnership between health departments and SNF's to protect those most vulnerable to influenza related mortality.

Learning Areas:

Administration, management, leadership
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related nursing

Learning Objectives:
Discuss the rationale for prioritizing flu vaccine for health care workers in skilled nursing facilities (SNF's). Describe particular challenges SNF's face in acheiving high vaccination rates. List the steps public health nursing might take to assess and support facility based vaccination of skilled nursing faculity staff.

Keyword(s): Immunizations, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted multiple operational research studies funded through federal programs focusing on infection control in health care settings. As Public Health Officer for the County of Marin I have a particualr interest in fostering partnerships between resource contrained health care facilities and the health department toward feasible and efficient interventions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.