Long-Term Care

Tip of the week: Save money by encouraging employees to get the flu vaccine

Contemporary Long-Term Care Weekly, October 16, 2008

In the past, there have been court battles in Washington over the legality of healthcare organizations requiring nurses to get flu vaccinations—or lose their jobs. Although there is no federal law that requires flu shots, professional nursing associations, as well as the Centers for Disease Control and Prevention, strongly encourage nurse vaccinations.

In addition to the obvious infection control issues that a vaccinated staff can avoid—especially in the communal quarters of a nursing home—administrators should be aware of the financial benefits that immunized employees can bring to the institution.

Cost of sick time

Healthcare employees top the list of people who transmit the flu bug, said James Marx, MS, RN, NHA, founder of Broad Street Solutions, an infection control consulting business in San Diego, during the American College of Health Care Administrators national conference in April. Because nursing home residents are more prone to complications from the flu due to weaker immune systems, administrators should make an extra effort to keep the virus at bay, Marx said.

Besides the obvious health benefits, administrators can save money across the board because the flu vaccine has been proven to reduce the following, according to Marx:

 

  • Physician office visits by 34%–44%
  • Lost work days by 32%–45%
  • Antibiotic use by 25%

    Offer the vaccine by October to ensure that staff are protected for the upcoming flu season, which takes place between October and March.

    Cost of vaccination

    The following three barriers often keep flu vaccination programs in nursing homes on the back burner, Marx said:

    1. Staff fear the pain of the shot or becoming sick afterward

    2. Nurses think a flu vaccination campaign will bring them more paperwork

    3. Administrators think the cost is too high to put a flu shot program in place

    Staff should know that if they’re getting the vaccine for the first time, they may have flu-like symptoms, but the shot doesn’t actually make them sick. As for paperwork, Marx suggested that staff work with preprinted forms to save time.

    Marx offered tips on removing financial barriers to flu vaccination, such as billing separately for the vaccine and administration. You can bill both flu and pneumococcal vaccines under Medicare Part B.

    Flu shot incentives

    Offer employees incentives to get vaccinated, such as a $50 gift certificate for each employee who receives the flu shot, Marx said.

    Require those who choose not to take the shot to sign a declination statement. Word it harshly, so that employees know the consequences of refusing immunization. The form may include the following sentences, Marx said:

  • I am aware that influenza is the sixth leading cause of death in the elderly, contributing to the mortality of 36,000 elders a year.
  • I understand that by choosing not to receive a flu shot, I may put myself, coworkers, and residents at risk of infection.

    Require outside healthcare providers (e.g., physicians and volunteers) to sign the declination statement as well.

    Know the basics

    Reacquaint your staff with how influenza spreads to encourage them to take proper precautions, Marx said. Host a mandatory flu education class to ensure that all of your employees are informed about flu. Cover facts such as the following:

  • The infectious period for adults is one day before and five days after symptoms appear
  • In the elderly, the infectious period may be six days before and 10 days after the start of symptoms
  • Symptoms include sudden onset of the following:
  • Fever
  • Myalgia, or muscle aches
  • Headache
  • Severe malaise
  • Nonproductive cough
  • Sore throat
  • Runny nose
  • Complications of influenza may include the following problems:
  • Progressive pneumonia (rare)
  • Bronchial mucosal sloughing
  • Loss of ciliated epithelia
  • Alteration of white-cell function
  • Bronchoconstriction
  • Bacterial super infection

     

    A healthy survey

    Your facility will also need to show state surveyors that you work to keep influenza outbreaks under control. Define an influenza case for your facility and put it in your policy, Marx said. A written definition may include the following:

  • Sudden onset of fever greater than 100.4 degrees
  • Three or more of the following symptoms from December to March:
  • Headache or eye pain
  • Myalgia
  • New or increased dry cough
  • Chills
  • Sore throat
  • Malaise or loss of appetite
  • Laboratory-confirmed influenzan

     

    Prevent an outbreak

    Flu shots aren’t a guarantee against an influenza outbreak. There are other measures staff can take to keep everyone healthy, such as the following list from James Marx, MS, RN, NHA, founder of Broad Street Solutions, an infection control consulting business in San Diego:

  • Hand hygiene: Reinforce proper hand-hygiene techniques, including the use of hand rubs and covering one’s mouth while coughing. Put up posters with friendly reminders in high-traffic areas of the facility.
  • Tissue availability: Increase the availability of tissues and disposal containers around your nursing home.
  • Take precautions: If residents develop flu symptoms, have them wear surgical masks, if possible, when in communal settings. Have staff wear them upon entry to these residents’ rooms.
  • Stay home: Remind staff that it’s all right to stay home if they are sick.
  • Be restrictive: Consider restricting admissions, group activities, communal dining, and visitation when an outbreak occurs at your facility.
  • Notify authorities: Call your local health department to report any outbreaks so that officials can accurately follow trends in your region. Also, let your own quality improvement committee or infection control committee know about the outbreak.

     

    • Comments

    0 comments on “Tip of the week: Save money by encouraging employees to get the flu vaccine ”

     

    Most Popular

    Related Articles