It's the start of flu season. Your organization has likely already begun to encourage patients to get vaccinated and may have implemented wellness strategies, such as hand sanitizer, and face masks to be used by coughing visitors. But what are you doing to address the annual challenge of getting your own employees to get flu shots to protect themselves and, more importantly, patients and residents?

A proactive and positive approach—with a combination of education and incentives—tends to work best to overcome this seasonal and often sensitive topic.

Last flu season, less than two-thirds of all health care workers—64.3 percent—got flu shots, according to the latest data from the Centers for Disease Control and Prevention. By facility setting, the percentage was highest at hospitals, where 78.7 percent of workers were vaccinated. Where was it lowest? Nursing homes, where only 54.4 percent of the staff got flu shots. Those numbers, particularly the nursing homes, are way too low.

In recent years, it's estimated that between 80 percent and 90 percent of seasonal flu-related deaths have occurred in people 65 years and older. This is a very serious population health issue for long term care facilities since flu mortality is very preventable.

Some states have mandated flu vaccines for health care workers, as have thousands of health care facilities across the country, as a condition of employment. At other facilities, employees who don't get flu shots are often required to wear surgical masks to protect against the spread of the flu virus. Yet the staff flu vaccination rates numbers still lag. So what can be done to encourage higher staff participation?

Employee Education Should Address Barriers to Getting Flu Vaccines

The first step in the process is finding out why some health care workers are refusing to get vaccinated. Facilities can use their flu vaccine declination form (the form facilities require workers to sign if they decline to get a flu shot) to find out.. The form should ask detailed questions about why they are declining. Then facilities can review and analyze the responses and pro-actively design an internal educational program targeting those barriers.

The two most common reasons cited by health care workers for not getting vaccinated are (1) that they didn't think the vaccine works and (2) that they don't need the vaccine. Often, support staff doesn't think that they need the vaccine because they don't see themselves as health care providers. However, if they are coming into contact with residents or patients, it is critical support staff be vaccinated. Health care facilities can provide educational packets and ongoing educational programming to address both of these issues. Start early and utilize department heads and staff leaders to spread the word. [Related: Flu Prevention Resources for Long Term Care]

Three Ways Health Care Facilities Can Incentivize Workers to Get Flu Vaccines

In addition to education, workers need to be better motivated to get vaccinated and that starts at the top with the institutional culture. There must be strong administrative support for a culture in which annual flu vaccines for employees is an expectation and a source of pride in the staff.

One method is to make flu vaccines free for employees at work. Eliminating the cost barrier and making access as easy as possible demonstrates that a high flu vaccination rate is a priority for senior leadership.

Another method is making it fun by setting up an internal competition among hospital and facility floors and departments to determine which can achieve the highest vaccination rate among their staffs. Senior leadership can support that internal competition with rewards and incentives like gift cards or health insurance premium rebates, and even a vaccination party.

Another very low cost way to encourage health care workers to get flu shots is to have staff members who have been vaccinated wear stickers or buttons indicating their vaccination status, putting subtle pressure on those who haven't been vaccinated. That subtle pressure also can come from patients, residents and their families who will undoubtedly notice that some staff are wearing stickers or buttons and others aren't.

Preventing influenza is the best way to reduce the risk of influenza-associated complications in your facility. Patient, resident and staff vaccination is the number one recommendation for prevention, alongside universal/standard precautions, like hand washing and disinfecting. Remember that incentives are more effective than penalties, and targeted education will do more to raise vaccination rates than mandates and requirements.

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About the author

Patricia is a Clinical Support Manager at McKesson Medical-Surgical. Her skills and work experience includes facility and corporate level positions in Nursing Homes, Sub-acute Care Centers, Assisted Living and Home Care, as well as having her own business serving elders and the long term care community.

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