Increasing influenza immunization for long-term care facility staff using quality improvement.
OBJECTIVE
To improve staff immunization rates for influenza in long-term care facilities (LTCFs).


METHODS
A quality improvement project.


METHODS
LTCFs ranging in size from 50 to 2,000 beds.


METHODS
Staff members at facilities.


METHODS
Change in staff influenza immunization rate.


RESULTS
Of the 13 nursing homes involved, 11 improved their staff influenza immunization rates; nine improved more than 10%, and six improved to a rate greater than 55%, a level that corresponds to substantial protection against outbreaks. Staff education was essential but insufficient. Direct encouragement and dramatic informative endeavors helped, as did financial incentives, competitions, and requiring unambiguously worded consents for refusals. Paying staff members $150 each achieved improvement rapidly.


CONCLUSIONS
Quality improvement increased staff immunization rates at LTCFs, which reduces the risk of an influenza outbreak. Based on the insights learned about effective changes, the project developed a change package for use by other LTCFs.
Sand
Kelly L
KL
RAND Health, Arlington, Virginia, USA.
Lynn
Joanne
J
Bardenheier
Barbara
B
Seow
Hsien
H
Nace
David A
DA
D000368:Aged; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control*; D006266:Health Education / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D007857:Leadership; D009042:Motivation; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data
D007252:Influenza Vaccines