title: An effective strategy for influenza vaccination of healthcare workers in Australia: experience at a large health service without a mandatory policy.
abstract: BACKGROUND
  Annual influenza vaccination of healthcare workers (HCWs) is recommended in Australia, but uptake in healthcare facilities has historically been low (approximately 50%). The objective of this study was to develop and implement a dedicated campaign to improve uptake of staff influenza annual vaccination at a large Australian health service.
  
  
  METHODS
  A quality improvement program was developed at Alfred Health, a tertiary metropolitan health service spanning 3 campuses. Pre-campaign evaluation was performed by questionnaire in 2013 to plan a multimodal vaccination strategy. Reasons for and against vaccination were captured. A campaign targeting clinical and non-clinical healthcare workers was then implemented between March 31 and July 31 2014. Proportional uptake of influenza vaccination was determined by campus and staff category.
  
  
  RESULTS
  Pre-campaign questionnaire responses were received from 1328/6879 HCWs (response rate 20.4%), of which 76% were vaccinated. Common beliefs held by unvaccinated staff included vaccine ineffectiveness (37.1%), that vaccination makes staff unwell (21.0%), or that vaccination is not required because staff are at low risk for acquiring influenza (20.2%). In 2014, 6009/7480 (80.3%) staff were vaccinated, with significant improvement in uptake across all campuses and amongst nursing, medical and allied health staff categories from 2013 to 2014 (p < 0.0001).
  
  
  CONCLUSIONS
  A non-mandatory multimodal strategy utilising social marketing and a customised staff database was successful in increasing influenza vaccination uptake by all staff categories. The sustainability of dedicated campaigns must be evaluated.
authors: Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, P.O. Box 315, Prahran, VIC 3181, Australia. K.Heinrich-Morrison@alfred.org.au.
authors: Kristina
authors: K
authors: Heinrich-Morrison
authors: Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, P.O. Box 315, Prahran, VIC 3181, Australia. s.mclellan@alfred.org.au.
authors: Sue
authors: S
authors: McLellan
authors: Public Affairs Unit, Alfred Health, Prahran, Australia. u.mcginnes@alfred.org.au.
authors: Ursula
authors: U
authors: McGinnes
authors: Public Affairs Unit, Alfred Health, Prahran, Australia. b.carroll@alfred.org.au.
authors: Brendan
authors: B
authors: Carroll
authors: Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, P.O. Box 315, Prahran, VIC 3181, Australia. k.watson@alfred.org.au.
authors: Kerrie
authors: K
authors: Watson
authors: Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, P.O. Box 315, Prahran, VIC 3181, Australia. p.bass@alfred.org.au.
authors: Pauline
authors: P
authors: Bass
authors: Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, P.O. Box 315, Prahran, VIC 3181, Australia. l.worth@alfred.org.au.
authors: Leon J
authors: LJ
authors: Worth
authors: Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, P.O. Box 315, Prahran, VIC 3181, Australia. a.cheng@alfred.org.au.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. a.cheng@alfred.org.au.
authors: Allen C
authors: AC
authors: Cheng
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D019983:Guideline Adherence; D006282:Health Personnel / Q000706:statistics & numerical data; D006293:Health Promotion; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D009313:National Health Programs; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
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