2. + Preventing Influenza: Should Vaccinations Be Mandatory for hospital personnel? By: Denise Montero and Kristen Kubik

3. + Influenza A contagious respiratory infection Symptoms: fever, cough, muscle and body aches, headaches, fatigue, and sore throat Patients most at risk are the elderly and young children Spread through droplets CDC, ACIP and HICPAC recommend all healthcare workers to be vaccinated each season

4. + Influenza Vaccine Pros: Most effective way to prevent the flu Up to 25% of staff can spread the flu without displaying symptoms Vaccinated staff decrease patient mortality by 40%, risk of nosocomial infections by 43% and absenteeism by 20-30% Increases mass immunity Fiduciary responsibility (John Hopkins, 2015) Cons: Staff can have adverse reactions Violation of personal liberty Weakens our immune system Toxic ingredients Strains can be inaccurate

5. + Assessment of the Healthcare Environment Financial Implications: National burden of $83.3 billion Direct medical costs for adults $8.7 billion Influenza-attributable illness causing $4.5 billion Indirect costs of 6.2 billion 17 million workdays are lost

6. + Assessment of the Healthcare Environment Policies Mandatory influenza vaccinations Events on facility resources Employee resistance

7. + Assessment of the Healthcare Environment Latest Analysis There was an increase in healthcare facility mandating of the vaccine Mandatory flu vaccinations of healthcare workers was tied into Obama Care If facilities did not vaccine a certain percentage it jeopardized their government reimbursement Mandatory vaccines caused loss of jobs However, after the increase in mandating it is found the benefit is not as strong as thought Evidence-based public health practice shows no evidence that mandatory flu vaccines are beneficial to preventing the spread (CDC Study, 2015).

8. + Assessment of the Healthcare Environment Root Cause Analysis: Why is the influenza vaccine becoming mandatory? Why are we only at 45% vaccination rate? Why do nurses have these perceived barriers? Why are there adverse affects? Why is there minimal testing?

9. + Healthcare Worker Influenza Immunization: Mandates, Benefits, Concerns: Mandates Preventing spread of influenza to patients Worker absenteeism during busy influenza season Modeling preventive health behaviors to patients (CDC, 2012)

10. + Healthcare Worker Influenza Immunization: Mandates, Benefits, Concerns: Benefits The seasonal flu vaccine protects against the most common strains It causes antibodies to form about two weeks post-shot Enhanced patient safety

11. + Healthcare Worker Influenza Immunization: Mandates, Benefits, Concerns: Concerns Lost of jobs Risk of Guillain-Barre Syndrome Not very effective in flu prevention No long-term safety testing-experimental vaccine No studies regarding giving a person the same shot every year Billions of dollars spent of a vaccine that might or might not work Violation of HIPPA privacy law

12. + CDC Recommendations Annual flu vaccine for everyone 6 months or older Take everyday prevention against germs Cover your nose and mouth with a tissue during a cough or sneeze Wipe down work stations and phones with disinfectants wipes Avoid touching your eyes, nose and mouth Maintain standard precautions If you are displaying flu like symptoms (especially a fever) stay home Take medications as prescribed by your doctor

13. + Conclusion Influenza (the flu) can be a serious disease that can lead to hospitalization and sometimes even death. Anyone can get very ill from the flu, including people who are otherwise healthy. You can get the flu from patients and coworkers who are sick with the illness. If you get the flu, you can spread it to others, even if you don’t feel sick. By getting vaccinated, you help protect yourself, your family at home, and your patients (CDC, 2014).

14. + References CDC. (2013). Workplace health promotion. Centers for Disease Control. Retrieved from: http://www.cdc.gov/workplacehealthpromotion/evaluation/t opics/immunization.html CDC. (2014). Influenza information for health care workers. Centers for Disease Control and Prevention. Retrieved from: http://www.cdc.gov/flu/HealthcareWorkers.htm\ Centers for Disease Control and Prevention. Influenza vaccination coverage among health-care personnel -- 2011- 12 season, United States. MMWR. 61(38);753-757 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6138a1. htm?s_cid=mm6138a1_w

15. + References Health Impact News. (2015). CDC study: Mandatory flu vaccinations of health care workers offer no protection to patients. Health Impact News. Retrieved from: http://healthimpactnews.com/2013/cdc-study-mandatory-flu- vaccinations-of-health-care-workers-offer-no-protection-to- patients/ Johns Hopkins (2015). Frequently asked questions: Mandatory flu vaccine. Johns Hopkins Medicine. Retrieved from: http://www.hopkinsmedicine.org/mandatory_flu_vaccination/fa q.html Zimmerman RK, Lin CJ, Raymund M, Bialor J, Sweeney PM, Nowalk MP. Hospital policies, state laws, and healthcare worker influenza vaccination rates. ICHE. 34;8:854-7. http://www.jstor.org/stable/10.1086/671265