Outbreak reveals stakes of HCW flu vaccine

Rehab unit shut during seasonal outbreak

The duty to protect patients from the flu has a very personal meaning at Central Maine Healthcare in Lewiston.

Two years ago, a flu outbreak forced Central Maine Medical Center to shut down an inpatient rehab unit to new admissions. Both patients and staff had been exposed and infected. The hospital used Tamiflu to treat ill patients and employees as well as for prophylaxis.

An outbreak has a way of sharpening the focus on prevention. "You don't think you're going to get sick or infect patients," says Clark Phinney, WSO-CST — employee health and workers' compensation coordinator — of employees who are reluctant to get the flu shot. "That absolutely drove home the quality and patient care piece to a lot of folks."

The three-hospital system now uses a consent form that includes education about the "myths" of the flu vaccine and a strongly worded declination statement: "I'm declining, but in doing so I know I'm putting myself, my co-workers and my patients at risk." Employees are asked why they are declining the vaccine.

With the help of a part-time volunteer who keys the consents and declinations into a database, Phinney tracks who has received the vaccine and who has declined. By the first week in December, each department manager receives a report so they can follow up with employees who have not gotten the vaccine or signed a declination.

Employee health also blitzes the hospitals with flu education, through interoffice email, articles and forms on the intranet, and newsletters that are included with employee paychecks. The health system's efforts were recognized by the American Nurses Association as one of the top five "best practices in seasonal influenza immunization." Phinney also was asked to present his program at the Institute for Healthcare Improvement conference in Orlando, FL, held in December.

In 2006, Central Maine Healthcare vaccinated about 65% of the 1,900 employees on the Lewiston campus. Phinney expects the final numbers to be even higher for this flu season.

The declination statements play an important role, says Phinney. They make employees think about their decision rather than just skipping the vaccine because they don't want to be bothered, he says. "They get their questions answered," he says. "[Some say], 'I was going to decline, but you know, I'm going to get it."

Yet Phinney and his colleagues also work hard to make the annual flu campaign fun and appealing. On Halloween, employee health urged health care workers to "say boo to the flu." Phinney wore a giant purple hat and his colleague, Jen Messenger, RN, BSN, COHN-S, CCM, clinical lead RN in employee health, dressed as a "flu fairy," with a pink wig, tiara and wand. Of course, they handed out candy along with flu shots.

On a different night, they promoted a late-night game show theme they called "Late and live," making rounds throughout the night shift. Phinney dressed as an '80s-era "preppy" and Messenger dressed as a "Valley girl." They held a Bop-It contest, allowing anyone who got the flu vaccine to play. The winning department received a trophy.

Just showing up in the wee hours of the night has an impact, says Messenger. "[It says,] 'We care enough about this that we're here,'" she says. In some units, nurses were lined up waiting for the flu vaccine, she says.

But beyond the fun and games, Central Maine Healthcare keeps a spotlight on the serious message. "If I remember correctly, when we all got into health care, we all promised to do no harm," says Phinney. "Infecting a patient with flu because you didn't get a shot is doing harm."