A qualitative analysis of the impact of healthcare personnel influenza vaccination requirements in California
A qualitative analysis of the impact of healthcare personnel influenza vaccination requirements in California
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DOI：
10.1016/j.vaccine.2013.06.077
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发表时间：
2014-05-23
期刊：
影响因子：
5.5
通讯作者：
Harris, Katherine
中科院分区：
文献类型：
--
作者：
Khodyakov, Dmitry;Uscher-Pines, Lori;Harris, Katherine
目的：采用定性方法，我们探讨了实施加州的2007年流感疫苗接种要求的医院为基础的医疗保健人员（HCP.Methods）：我们进行了9个案例研究的加州医院与不同的HCP疫苗接种率和政策。案例研究包括采访13家医院的代表和分析相关的医院文件，包括流感政策。我们还进行了13个半结构化的电话采访，主要国家和县的公共卫生官员，工会代表，和各种专业healthcare organizations.Results的官员：我们的定性结果表明，加州的疫苗接种要求可能不会增加HCP之间的流感疫苗接种摄取。法律的力度不足以迫使疫苗接种率较低和中等的医院改进其疫苗接种工作，而疫苗接种率较高的医院能够通过继续做他们已经在做的事情来完全遵守法律-即向HCP提供疫苗接种，提供有关流感风险和疫苗接种益处的教育，并从那些拒绝接种疫苗的人那里获得签名拒绝。尽管如此，我们发现，通过在公共安全和医疗质量的背景下公开提出流感疫苗接种问题，加州的法律鼓励医院开发和实施数据系统，以监测疫苗接种推广工作的有效性，并引发讨论，在某些情况下，在医院或县一级采用更严格的疫苗接种要求。我们的研究结果总体上支持了文献的观点，即允许的流感疫苗接种要求虽然在政治上是可行的，但几乎没有直接激励医院集中精力提高HCP疫苗接种率。(C)2013爱思唯尔有限公司保留所有权利。
Objective: Using qualitative methods, we explored the implementation of California's 2007 influenza immunization requirements of hospital-based health care personnel (HCP).Methods: We conducted nine case studies of California hospitals with different HCP vaccination rates and policies. Case studies consisted of interviewing 13 hospital representatives and analyzing relevant hospital documents, including influenza policies. We also conducted 13 semi-structured phone interviews with key state and county public health officials, union representatives, and officials of various professional healthcare organizations.Results: Our qualitative results suggest that California's vaccination requirements likely did not increase influenza vaccination uptake among HCP. The law was not strong enough to compel hospitals with low and medium vaccination rates to improve their vaccination efforts, and hospitals with high vaccination rates were able to comply fully with the law by continuing to do what they were already doing - namely offering vaccinations to HCP, providing education about the risks of influenza and the benefits of vaccination, and obtaining signed declinations from those who refuse vaccination. Nonetheless, we found that by publicly raising the issue of influenza vaccination in the context of public safety and healthcare quality, California's law encouraged hospitals to develop and implement data systems to monitor the effectiveness of vaccination promotion efforts and prompted discussions, and, in some cases, adoption of stricter vaccination requirements at hospital or county levels.Conclusions: Our findings generally support the literature that suggests that permissive influenza vaccination requirements, though politically feasible, provide little direct incentive for hospitals to focus efforts on increasing HCP vaccination rates. (C) 2013 Elsevier Ltd. All rights reserved.