“In every chain of reasoning, the evidence of the last conclusion can be no greater than that of the weakest link of the chain, whatever may be the strength of the rest.”   ~ Thomas Reid, Essays on the Intellectual Powers of Man, 1786
With the release of the latest 2013-2014 flu figures from the CDC, it’s no surprise the nonclinical areas are again the weakest link in flu vaccinations. By occupation, both healthcare assistants/aids and nonclinical personnel were vaccinated at a rate below that of the current national goal.
As would be expected, those in clinical areas reported a higher participation in flu vaccinations:  physicians 92.2%, nurse practitioners/physician assistants 89.6%, nurses 90.5%, other clinical personnel 87.4% and pharmacists 85.7%. However, nonclinical personnel such as administrative staff and managers as well as nonclinical support staff such as food service workers, housekeeping staff, maintenance staff, janitors and laundry workers reported a lower participation rate of 68.6% while healthcare assistants and aides had the lowest rate at 57.7%. In fact, compared to the previous 2012-2013 season, healthcare assistants/aids who received flu vaccinations actually dropped slightly from the previous rate of 58.2%.
Many would assume these individuals don’t need a flu vaccination since they are not directly around patients or in patient care areas. If you still doubt the need for flu vaccinations for everyone in a healthcare setting, including those who work mainly in offices and conference rooms, you may want to make note of a recent study showing just how fast a virus, such as flu, can spread. The study, presented as part of the American Society for Microbiology’s 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), demonstrated that contamination of just a single doorknob or table top resulted in the spread of viruses throughout office buildings, hotels, and healthcare facilities within 2 to 4 hours.
In the study, researchers placed a surrogate for the human norovirus, which spreads the same way as flu, on one or two commonly touched surfaces at the beginning of the day. After a couple of hours they began checking to see how far the surrogate virus had spread. They tested 60 to 100 various surfaces throughout the building such as table tops, push buttons, coffee pot handles, sink tap handles, phones and computer equipment for the surrogate virus. Within 2 to 4 hours of placing the surrogate virus in one or two locations, the virus was detected on 40 to 60 percent of the other commonly-touched objects.
Clinical and non-clinical staff and visitors share the same entry doors, elevator buttons, restroom door pulls and coffee pot handles. The CDC states healthy adults can infect others beginning one day before any symptoms develop and up to 5-7 days after becoming sick. Since symptoms start 1-4 days after the virus enters the body, a co-worker may be able to pass the virus on the stair rail, the office door or the creamer carton before they even know they are sick.
The only way to make the flu chain strong enough to reach the quality improvement requirement goal of 90% flu vaccination rate for healthcare personnel by 2020 is for everyone in a healthcare facility, including those who are not directly around patients, to get a flu vaccination every year. Requiring flu vaccinations of administrative staff, as well as commercial visitors, not in patient care areas can only make your facility’s flu chain stronger. The ReptraxTM vendor credentialing system and the new IntelliCentrics SEC3URETM credentialing and privileging service allows hospitals to outsource and automate credentialing and privileging for every individual who enters the hospital. Don’t let the weakest link prevent you from achieving your flu vaccination goals!

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