Health care workers who engage with patients are strongly encouraged to get the flu vaccine. And if the virus becomes widespread in Rhode Island, as it did last year, the employees who don’t get their flu shot could be required to wear masks.
With that as an alternative, the percentage of health care workers who got their flu vaccination crept up last season, to 86 percent of those employed at facilities that are required to report data to the R.I. Department of Health.
That’s better than it was in years past, but the state thinks everyone could do better. The goal is 92 percent of workers vaccinated by the 2020-21 flu season.
Although the early indications hint that this year may have a less-severe occurrence of flu, based on the experience this season of the Southern Hemisphere, the push is on for workers to get their shots.
By mid-May, 302 facilities in Rhode Island will be required to report their data to the state. They include large employers, such as hospitals and nursing homes, as well as businesses that supply workers for home-care patients. The results, sorted by facility, are posted online by the state.
The state also is posting the names and locations of the facilities that failed to report their data. Last year, 20 were on the list.
Last year, hospitals, kidney-disease treatment centers, physician ambulatory surgery centers and freestanding ambulatory surgery centers were the industry leaders – each hit the goal of 92 percent of workers vaccinated.
It’s easier said than done.
Resistance to getting the flu shots runs the gamut, from employees with busy lives who meant to get it done but forgot, to those who tell management in charge of infection prevention: No way.
Health officials are pushing hard, given the severity of last year’s season.
According to state statistics, influenza-related deaths in Rhode Island rose to 60 in 2017-18 from 33 in 2016-17.
Another 1,390 Rhode Island patients were hospitalized with the flu, a 14 percent increase from 2016-17.
Why is it so important for workers to get the shot?
Tricia Washburn, chief of the R.I. Department of Health’s Office of Immunization, said the issue is they’re working with a vulnerable population, including high-risk patients who may be elderly.
The senior population, which makes up the bulk of residents in long-term facilities, tends to have a higher hospitalization rate and higher death rates associated with the flu.
The hospitals, which have a 92 percent vaccination rate on average, tend to be among the most successful at getting workers vaccinated because they have longstanding policies and systems in place to encourage vaccination, Washburn said.
Smaller organizations, such as businesses that provide home health workers, just may not be at the point of encouraging vaccination, she said. For example, the home care providers, as an industry, had a 55 percent vaccination rate last year for employees, well short of the 92 percent goal. Hospice providers and freestanding emergency care centers also fell short of the 60 percent threshold.
Washburn’s office is working with the individual facilities that are below the 50 percent mark and trying to help them identify best practices that will boost their numbers.
One institution that’s had success in boosting its vaccination rate is South County Hospital.
For the past three years, it’s had 99.6 percent compliance. It’s achieved that slowly, after a period of trial and error, and working with the employees. But eventually, after plateauing in the high 80 percent rate, the hospital adopted a mandatory vaccination policy.
In other words, getting the flu vaccine is now a condition of employment, said Lee Ann Quinn, the director of infection prevention for the hospital, located in South Kingstown.
If a hospital worker who works directly with patients has an allergy, or some other issue with the vaccine, they can get a notification from a doctor and wear a mask instead. And a few people did last year.
But by and large, nurses and other health care workers don’t want to wear masks. It’s a bit uncomfortable and makes it harder to communicate, Quinn noted.
The R.I. Department of Health now has a policy that workers who have interaction with patients have to wear the mask if they haven’t received their shot, after a declaration of widespread flu in Rhode Island.
“Do you know how many times you have to go into a patient’s room and the patient is saying, ‘Why do you have a mask on?’ thinking they’ve got something,” Quinn said. “And then they find out the employee has it on because they haven’t gotten their flu shot. There were a lot of comments from patients and families saying, ‘I don’t want that person in my mother’s room if she hasn’t gotten a flu shot.’ ”
The hospital made the move to a mandatory policy after years of trying to increase compliance. In the early years of the push, the hospital was able to get people vaccinated by making it convenient – holding the vaccination clinics on-site.
But some of the nurses were resistant. “I had the same people every year saying, ‘Don’t come 2 inches closer to me with that thing. Highly educated people,” Quinn said.
The bottom line is the vaccination isn’t a guarantee against catching flu but it’s the best method. “We’re recognizing patient safety,” she said.
Mary MacDonald is a staff writer for the PBN. Contact her at Macdonald@PBN.com.