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Study: most healthcare workers ignore policy, work while ill

Hospital Safety Insider, October 10, 2019

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By Jay Kumar, PSQH

A study published this week found that nearly 90% of long-term care facility staff members who had an acute respiratory illness during five months of surveillance continued to work while they were ill. This was in spite of the facility’s policies prohibiting working while sick, according to the study published in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

“Changes in sick leave and work exclusion policies to minimize the pressure on staff to come to work while sick would protect patients and other healthcare personnel,” said Hilary M. Babcock, MD, MPH, professor of medicine in the Infectious Diseases division at Washington University School of Medicine in St Louis and medical director for the Infection Prevention and Epidemiology Consortium of BJC HealthCare, in a release. “Respiratory infections at this facility were more common in staff than in patients and staff frequently worked while ill.”

Researchers conducted active surveillance at a 120-bed long-term care facility from December 2015 to April 2016 looking for respiratory viral infections among residents and healthcare providers. Staff and patients in the study were monitored for acute respiratory infection symptoms; nasal and throat swabs were taken when symptoms were reported and at the end of the study period, when researchers asked participants again about symptoms.

Of the 76 staff members and 105 patients participating in the study, 18 staff and four patients reported acute respiratory illnesses. And 16 staff members, or 89% of those who had reported an illness, said they worked while they were sick even though facility policy prohibited working while ill.

The study authors also noted that the findings show that facilities must strengthen their communication and enforcement of work restriction policies. It also proves that active acute respiratory illness surveillance can be implemented for patients and staff in a long-term care facility.

Larger surveillance studies looking at respiratory infection rates at other long-term care facilities are needed to examine patterns of respiratory infection in facilities with different patient mixes and lower staff flu vaccination rates. In addition, larger studies are needed to investigate the relationship between respiratory infections

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