Introduction
Influenza is a highly contagious, viral respiratory infection that has capacity to cause severe illness and death, especially among high-risk hospitalized patients who are very young, very old, or immunocompromised (Quinn, 2014). The rate of influenza infection tends to be high among health care workers, with as many as 75 percent of these employees continuing to work after showing symptoms of having contracted the infection (Riphagen-Dalhuisen et al, 2013). Because health care workers can spread the influenza virus to the patients, research demonstrates that providing influenza vaccines to health care workers is an important step in preventing the spread of the infection among high-risk patient groups (Riphagen-Dalhuisen et al, 2013). However, health care workers all over Europe routinely do not receive the influenza vaccine (Quinn, 2014). The research studies in this essay evaluate what knowledge health care workers in Europe have about influenza vaccines, their rationale for not receiving the vaccines, and what improvements, if any, health care facilities can make to encourage more health care workers to receive the influenza vaccine.
Background
Studies have shown that influenza vaccines are highly effective at preventing infection, especially when the people receiving the vaccine are young and healthy (Riphagen-Dalhuisen et al, 2013). Influenza vaccines cannot prevent every case of influenza from happening (Quinn, 2014). But, studies have shown that when groups of people receive influenza vaccines, the contagion rate is reduced by as much as 59 percent within the group, and those who do contract the infection have fewer symptoms and recover faster (Riphagen-Dalhuisen et al, 2013). Additionally, research demonstrates that when more health care workers receive annual influenza vaccines, fewer of the health care workers contract the infection, and the health care workers spread the infections to fewer patients (Riphagen-Dalhuisen et al, 2013). Despite this evidence, the rate of influenza vaccination among health care workers all across Europe remains low (Quinn, 2014). As a result, unvaccinated health care workers are one of the largest reasons that the influenza virus spreads among patients in a hospital setting (Riphagen-Dalhuisen et al, 2013).
Rationale for the Study
Because the number of health care workers who receive annual influenza vaccines in Europe is low, some researchers sought to discover what factors influenced this trend (Quinn, 2014). Additionally, other researchers sought to discover if any interventions could reverse this trend and encourage more European health care workers to receive the influenza vaccine (Riphagen-Dalhuisen et al, 2013).
One set of researchers used a broad qualitative research approach to gather perceptions and experiences with annual influenza vaccines from registered nurses who provide care to elderly patients in a long-term care facility in Ireland (Quinn, 2014). The purpose of the study was to determine what knowledge the nurses had about influenza, how the virus spreads, the effectiveness of the influenza vaccine, and their rationale for not receiving the vaccine (Quinn, 2014).
Another set of researchers developed and implemented an Intervention Mapping (IM) strategy geared towards increasing influence vaccine knowledge with the intent of modifying the behaviors of the health care workers who worked in Dutch acute care hospitals (Riphagen-Dalhuisen et al, 2013). The strategy included providing increased education about the efficiency of influenza vaccines to the health care workers in several formats, including distributing educational materials, hospital intranet, badges, stickers, and posters (Riphagen-Dalhuisen et al, 2013). These researchers qualitatively and quantitatively evaluated the results of this increased education via web-based questionnaires provided to the health care workers at the end of each influenza season in 2010 and 2011 (Riphagen-Dalhuisen et al, 2013).
Methods
In the Ireland study, 11 health care workers who provide care to elderly patients in a long-term care facility participated (Quinn, 2014). Of these participants, all were registered nurses, with experience ranging between 7 to 22 years, who have advanced specialization in the care of elderly people (Quinn, 2014). All of the nurses indicated that they were committed to providing the best possible care for their elderly patients and fully supported any initiatives that would improve the health and well-being of those under their charge (Quinn, 2014). Researchers used qualitative type questions to gather perceptions and experiences related to voluntary and mandatory influenza vaccines for staff and patients (Quinn, 2014).
For the Dutch study, researchers displayed printed materials about the effectiveness of influenza vaccines in strategic locations about the hospitals during the annual influenza season. At the end of the influenza season, the researchers provided web-based questionnaires to 2,255 health care workers, including doctors and nurses, during the 2010 influenza season, and received 678 responses (Riphagen-Dalhuisen et al, 2013). Researchers provided the web-based questionnaires to 4,885 health care workers, including doctors and nurses, during the 2011 influenza season and received 908 responses (Riphagen-Dalhuisen et al, 2013).
Results
It is important to note that the patients in each of the facilities are very different, due to the differences in the type of facility. In the Ireland study, the patients resided in a long-term care facility and there was little turnover among the patients and the health care workers (Quinn, 2014). Alternatively, in the Dutch study, the patients remained in the hospital for shorter durations, and there were constant levels of turnover among the patients and the health care workers (Riphagen-Dalhuisen et al, 2013).
Of those who participated in the Ireland study, the nurses expressed an understanding that receiving the influenza vaccine would decrease patient exposure to the virus (Quinn, 2014). But, nurses also expressed that a primary reason for not taking the influenza vaccine voluntarily was due to risks of contracting the illness from the vaccine (Quinn, 2014). Nurses also expressed concerns that if the vaccine could cause the infection, mandatory injection of the vaccine into the patients was unethical since it could cause the death of the patient (Quinn, 2014). Additionally, the nurses expressed that they obtained most of their knowledge about influenza vaccines through the media, and there was not enough information made available to make a more professional decision (Quinn, 2014).
Of those who responded to the Dutch study, all of one who responded to the questionnaire said that the hospital intervention increased their knowledge and awareness of the effectiveness of the influenza vaccine, and that the posters displayed around the hospital were the most effective (Riphagen-Dalhuisen et al, 2013). The majorities of those who responded were female nurses who worked in pediatric departments and were older than 45 years of age (Riphagen-Dalhuisen et al, 2013).
Conclusion
Historically, European health care workers do not receive the influenza vaccine, even though they express knowledge that it decreases the spread of the virus (Quinn, 2014). These studies demonstrate that the lack of knowledge about influenza vaccines is a primary reason that health care workers do not receive the influenza vaccine. But, the study also demonstrates that is possible to develop strategies for increasing the rate of influenza vaccination by health care workers in hospital settings by increasing education (Riphagen-Dalhuisen et al, 2013). These studies show that there are opportunities to improve the quality of nursing care as related to the spread of infectious diseases and influenza by providing advanced training by trusted individuals to nurses, including access to printed information year around.
References
Quinn, G. (2014). Nurses’ experiences of the seasonal influenza
vaccine in residential care. British Journal of Nursing, 23(17), 942-948. doi:10.12968/bjon.2014.23.17.942
Riphagen-Dalhuisen, J., Frijstein, G., van der Geest-Blankert,
N., Danhof-Pont, M., de Jager, H., Bos, N., . . . Hak, E. (2013). Planning and process evaluation of a multi-faceted influenza vaccination implementation strategy for health care workers in acute health care settings. BMC Infectious Diseases, 13(1), 235-235. doi:10.1186/1471-2334-13-235
