Immunization of Health Care Workers

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Health care workers are at a high risk of contracting communicable diseases at the place of their work. Health care workers may easily spread these diseases to other people including patients. The vaccine-preventable diseases include rubella, influenza, pertussis, and measles. Faced with this situation of high exposure to these diseases, it is, therefore, recommendable to maintain immunity at the working centers. This will help to stop transmission of these diseases to and from health care workers and patients. It is recommendable for health care workers to receive the vaccine within a minimum of first weeks of employment, except for influenza, which is administered annually. Immunization is essential for safety of sick persons and also for protection of health care workers. It is advisable for health care centers to develop a broad policy that will guarantee immunization of all the workers. A policy in this case will be the following: health care workers are required to have influenza vaccination every year and an informed refusal should be received from employees that refuse for reasons other than medical.

Issues requiring change

Change of influenza vaccines

One of the issues that necessitate change in the vaccination of health care workers is the change of flu vaccine. The change of vaccine is due to a change in the nature of flu viruses going round each year (Gardam, & Lemieux, 2013).

Change of voluntary influenza vaccination to mandatory vaccination

Voluntary influenza vaccination of health care workers has failed to meet goals of health organizations. There is a need to make vaccination compulsory for every health care worker. It is unlikely that pure deliberate programs will increase the influenza vaccination coverage. The experimental evidence indicates that moral duties alone are not enough to motivate health care workers to become vaccinated. The same evidence shows that the best way to increase the vaccination rate is to make annual vaccination of health care workers compulsory (Russi, & Baltimore, 2012).

Legal issues

Laws need to be amended in order to be in line with the mandatory influenza vaccination. When the state of New York authorized mandatory vaccination for health care workers, most workers moved to courts arguing that their constitutional rights guaranteed by the Fourteenth and the First Amendments were violated. The rights claimed to be violated include the right to freedom of religion.

Strengths of the policy

Strengths of vaccine administration among the health care workers include availability of programs that eliminate possible barriers and encourage voluntary vaccination. The programs have been successful in increasing the vaccination rates. Another strength is that health care agencies have provided for a mandatory influenza vaccination for their health care providers. Other factors that increase the vaccination rates include small incentive to the workers who get vaccinated, active promotion and fast access to free vaccination. Lastly, training aimed at supporting the understanding of influenza, enhanced infection control (IC) processes, and accessibility and use of antiviral prescriptions will result to a decreased chance of disease spread. Given the seriousness of disease transmission, the mandatory vaccination is morally warranted.

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Barriers to the change/policy

Barriers to vaccination include lack of accessibility. The influenza vaccine is not easily available in most health care centers. Its unavailability makes immunization of workers difficult or impossible. The current vaccine, known as trivalent inactivated influenza vaccine (VIT) for prevention of influenza, is limited. Health care workers differ significantly in their culture, education and race. These factors considerably affect the use of vaccine (Douville, Myers, Jackson, & Lantos, 2010). Mandatory vaccination is likely to face resistance because of the interference of personal choice of health care workers. Another barrier for vaccination is the fact that most people dislike injections. The attitude most persons have towards injections discourage them from undergoing the process of vaccination. As a result, the vaccination rate decreases. Another barrier related to the vaccine is its effects. The flu vaccine is connected with the following effects: headache, mild nasal congestion, and painful throat. Grave effects of the flu vaccine are rare. Lack of time is another barrier to vaccination. Most of health care workers are always occupied to the extent that they require time to carry out other activities not related to their work. Lack of time is a factor that has significantly reduced the vaccination rate. So, this is the factor that most workers forget. Influenza vaccine is administered once a year, the possibility of most health care workers to forget is very high.

Another factor that has significantly lowered the vaccination rate is the fact that very few people believe that the vaccine is effective. The majority of workers have a formed opinion that the vaccine is ineffective and, therefore, there is no need of it. Others understand that there is no need of vaccine. Some health care workers think that as they have not contracted the disease, there is no need to have the vaccination. Others will have the vaccine on the ground that they believe they will not get the flu (Douville et al., 2010).

Finally, lack of awareness of the existence of the vaccine is the major barrier to the influenza vaccination. Most health care workers are not informed on the existence of the vaccine and those who know, do not talk about it. The education program on the influenza vaccine is not widespread presenting the major challenge in its administration.

Implementation strategy

Strategy

In order to achieve the goal of the policy of increased influenza immunization coverage of health care workers, a detailed analysis of factors that promote and those that hinder the change is essential. Some of the forces against the change include: workers’ attitude towards vaccination, ethics, regulation, and past practices. Addressing these factors, several measures need to be implemented: first, education of health care workers on the importance of vaccination. Education programs should aim at creating of positive attitude towards immunization. Imposition of mandatory influenza vaccination is viewed as violation of the rights of individual freedom and liberty. Such an opposing force to this change can be dealt with by trying to show that such vaccination is for the common good of workers. The principle was reinstated in the case of Jacobson v. Massachusetts (1905) (Navaneelan, 2012) that the state could compel the vaccination for the common good. Mandatory vaccination is a challenging policy issue that requires the system to balance public health with personal liberty. Other strategies to help in the implementation of mandatory influenza vaccination is to have a good leadership approach, and management approaches, such as implementation of rewards to health workers who agree on the vaccination process. Motivation of health workers will not only increase the rate of vaccination but also reduce the number of individuals who decline vaccination on other grounds rather that medical. Another management approach is that an employer can have a policy, which states that vaccination is a precondition to the employment contract. Owing to the fear of unemployment most health care workers will comply with the protection exercise. A strict employer will impose several stringent measures of compliance with the policy. Other leadership styles that an employee can exercise to ensure compliance include: promotion of health care workers and incentives aimed at motivating workers.

Desirable outcomes

The application of a novel treatment tracking process and hospital policy necessitating influenza vaccination or declination resulted to a dramatic improvement in the health care worker vaccination rates (Navaneelan, 2012). Also, the implementation of inclusive strategies with strong leadership can result to considerable improvement in the vaccination rate among health care workers even in the absence of compulsory treatment program.

Implementation process

Voluntary vaccination programs, which passed in different forms over many decades, have been futile in achieving of satisfactory rates of health care worker influenza vaccination. Despite many decades of influenza vaccination in the US among health care workers, vaccination coverage remains around 50% (Babcock, Gemeinhart, Jones, Dunagan, & Woeltje, 2010). Influenza vaccination of health care workers is therefore a mandate that should not only be carried out by health care organizations, but also by the federal government through its various relevant agencies. In authorizing health care worker vaccination, health care organizations must first ensure that vaccination is an informed procedure. Health care workers should be told that vaccination is given to their benefit. They should also be informed in advance of the potential risks linked with the influenza vaccination. Health care workers should also be informed that the vaccine is being administered free of charge. Other important considerations, such as religious and medical needs, should be put in place. The implementation of mandatory vaccination must also consider addressing of unsupported fears and mistaken belief surrounding safety of vaccine. In order to ensure effective implementation of the mandatory influenza vaccination, health care organizations may opt to offer bigger financial incentives together with education and sanctions. States play very significant role in the implementation process of mandatory influenza vaccination. The New York state amended its law in 2009 to require every health care worker to get vaccinated against influenza and offered exception on the ground of medical reasons only.

Evaluation

Evaluating the relative success of various strategies for increasing influenza vaccination is essential in guiding health care centers’ policies to improve vaccine uptake. Evaluation will entail assessing the impact of mandatory influenza vaccination. From the evaluation, the rate of health care worker vaccination significantly increased, and the number of health workers who declined vaccination, markedly reduced. A compulsory influenza vaccination for health care workers is vital to achieving the improved rate of vaccination uptake. The program seems to adequately capture a good proportion of health care workers who though are not against the vaccine, but have not made vaccination a priority.

Conclusion

Immunization of health care workers is a salient process in nursing practices. It has advocated welfare of workers and safety of patients. Specifically, immunization against influenza is done annually. In practice, the vaccination has been a voluntary affair but due to the seriousness of diseases and fear of transmission, there is a need to make the exercise compulsory for every health care worker. Most jurisdictions in the US have adopted a policy of compulsory vaccination and, as a result, there is the increased rate of vaccination among health care workers. The adaptation of right strategies to implement the new policy will ensure that the rate of vaccination goes high and reduces the number of workers who decline the exercise. The implementation procedure also adopted is holistic, involving not only health care providers but also the state in formulation of relevant health policies for common good. Evaluation of strategies and procedures of implementation will also help in the implementation procedure. Evaluation will help to assess effectiveness of the policy and provide recommendations. Success of the policy, therefore, is dependent on various strategies adopted to ensure compliance among the health care workers.

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