Every year when flu season hits, the fear in nursing homes is real. Interdisciplinary team leaders worry, while they do everything possible to prevent a seasonal influenza outbreak. An important task is encouraging staff immunization. Doing this in creative, fun, and organized ways has had made a positive difference for some long-term care communities.
“At Golden Living, we have a flu czar,” said James A. Avery, MD, chief medical officer and senior vice president, Golden Living. “By designating someone specifically to handle this, we make it clear how important this is. We have a great campaign for vaccinations.”
Five-Point Strategy
Golden Living uses a five-point flu strategy (see box, page 2). “We don't see vaccinations as the end-all,” said Dr. Avery, who is also at Mount Sinai School of Medicine, New York. “Our strategy starts by building a moat to keep the virus from getting in at all.” This involves consistent, widespread use of masks and sanitizers, faithful reporting of warning signs and symptoms, as well as vaccinations. The flu-prevention strategy plans for the many what-ifs of flu pandemics, he said. Toward that end, “we've stored extra masks and goggles at a central location that we can distribute to facilities attacked by the virus.”
The jumping off point for staff immunization, said “flu czar” Dorothy Reid, RN, Golden Living's national director of clinical education, is an 18-minute DVD from AMDA, “Influenza Immunization and the Health Care Worker.” The video dispels the myths of vaccinations and lets viewers hear health care workers speak candidly about why they get immunized.
Golden Living put the video on its learning-management system and made it required viewing for all staff. “After we showed the video, we experienced higher rates of immunization,” said Ms. Reid. “The video is powerful. Aides said they could relate to it.”
She encouraged other facilities to take advantage of the video as a springboard for discussion. “People need to be able to verbalize their fears about vaccines. They need to have a chance to speak and be heard,” she said.
On the other hand, Ms. Reid stressed that the video is only one component of Golden Living's flu awareness and prevention initiatives. “We have an Internet site that includes flu updates, clinical information, and algorithms to follow for suspected cases of flu in both residents and staff.
“We also have facility flu-prevention checklists, and we push normal practices such as hand washing.” The Web site includes a map showing the location of facilities with confirmed cases of pandemic influenza A(H1N1), so that staff can track the illness.
Flu Facts and Figures
Flu awareness and prevention can be an upbeat, team-building experience for staff. The 2009 slogan for Gold Living's flu campaign is “What will you do this year?” Ms. Reid's team produces buttons and posters, and everyone is encouraged to get involved.
Recently, Golden Living held a conference call to share flu information and allow people to ask questions. “Boy, were there questions,” said Ms. Reid. “The inquiries were very practical and addressed issues such as the use of antivirals and when staff with flu can return to work.” Interestingly, she said, there were few questions from the hundreds of participants about pandemic H1N1.
Kindred Healthcare Inc., which runs long-term acute care hospitals and skilled nursing centers, also has a broad flu-awareness and prevention campaign. In addition to the distribution of tools such as procedures, forms, and educational materials, the Kindred campaign involves informational table tents, stick-on badges for residents and employees who receive the vaccine, and labels to be placed on the medication-administration record when a resident receives the flu vaccine. Kindred also has an employee-vaccination contest, and the center with the highest percentage of employees vaccinated per region will receive $2,500 for capital expenditures.
Culture of Trust
Dr. Avery noted that it's not just the message but who delivers it and how it is delivered that matter. “When we dedicate a site to this and appoint a flu czar, people realize it's important. As a result, the vaccine message has more credibility, more stick-ability. [A] culture of trust is important to make these kinds of programs successful.”
Trust is particularly important because some people are resistant to the idea of vaccines. “In some rural centers, we got resistance to mandatory vaccinations and concerns about this being a type of government control. People don't want these things forced on them,” Dr. Avery said. Ms. Reid added, “The video transcends distrust. It shows a concerned, compassionate, knowledgeable physician explaining the benefits of vaccines, and you see people responding. That is why [the video] is so effective and powerful in its persuasiveness.”
Personal stories indeed are powerful. At Golden Living, an employee who was pregnant died as a result of influenza, and the leadership cites this story in their discussions. “This makes the implications of vaccination real to people, and they can see that if they don't get vaccinated, it can affect others besides themselves,” said Ms. Reid.
Messages should be tailored to their various audiences, said Dr. Avery. “My messages about the flu for our leadership are very different than what we say to CNAs and other front-line staff. One size does not fit all when it comes to flu information and education.”
The DVD “Influenza Immunization and the Health Care Worker” can be ordered at www.amda.com/order.
Senior contributing writer Joanne Kaldy is a freelance writer in Hagerstown, Md., and a communications consultant for AMDA and other organizations.
‘Because I Care’
The following quotes are from the DVD “Influenza Immunization and the Health Care Worker.” They are spoken by health care practitioners and workers explaining why they get an annual flu shot.
“It's important that I get the flu shot every year … not only to help myself but to help others.”
—Nursing Assistant
“As a dietitian, I work with elderly patients on a daily basis. … My job is to nurture them … and make them stronger … That is why it is important that I get the flu shot every year.”
—Dietitian
“I get the flu shot because I want to protect the residents that I take care. … They need a little extra protection to keep them from becoming ill. I'm here to protect my residents from injury and illness.”
—Nursing Assistant
“It's very important to get a flu shot if you have asthma. I have four children with asthma. … It [the flu shot] helps keep some of the germs down. You have to protect your inside as well as the outside.”
—Nursing Assistant
“In my country, the flu shot was not an option. It was never offered. But now I take it every year because I have a school-aged child I have to protect. I also have to protect myself and the patients I work for.”
—Nursing Assistant
“I get the vaccine every year because I care.”
—Physician
Five-Point Flu Strategy
▸ Reduce transmission of the virus into our living centers.
▸ Reduce transmission of the virus within our living centers.
▸ Reduce the severity of illness and the mortality of infected residents.
▸ Reduce the severity of the illness and the mortality of infected staff.
▸ Protect the critical supply and staff infrastructure of each living center.
Source: Golden Living
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