Flu Vaccination
With growing evidence that influenza (flu) can be transmitted from healthcare workers to patients, BIDMC is rolling up its sleeves – literally – to get vaccinated this fall.
The medical center is strongly urging all direct patient-care staff to get vaccinated. “Last year, only about 24 percent of BIDMC direct-care providers got an available flu shot,” says Dieter Affeln, MD, medical director, employee occupational health services. “We can do better – for ourselves, our families, our co-workers and especially the patients who put their trust in us.”
Adds Sharon Wright, MD, MPH, director, infection control/hospital epidemiology, ”we are especially concerned about patients who cannot receive a flu shot or are immunocompromised, such as newborns, oncology patients and those who have received solid organ transplants.”
This year, look for posters featuring BIDMC staff and their reasons for getting a shot – “Who do you do it for?” The program will also include:
• Four weeks of full-day vaccination clinics on both campuses
• Raffles and a trivia contest
• Resources on the portal
The goal: at least 60 percent vaccination of direct patient-care staff.
Common Flu Vaccine Myths
“I can’t spread the flu if I don’t have symptoms”
The flu presents with no symptoms in 30% of influenza cases, but you are
still contagious.
“I’ll stay home a couple of days if I get the flu”
If you do develop symptoms, you are at risk of spreading the virus for one day before symptoms show, and for seven days thereafter. Staff outbreaks and shortages impact quality of patient care and cost the medical center.
“I’m too busy”
Four weeks of full-day clinics will be offered on both campuses.
“I’m taking a flu shot away from a patient”
The medical center allots vaccine amounts for both patients and healthcare workers. When faced with shortages, the medical center prioritizes supplies. By vaccinating yourself, you are also protecting your patient.
“The shot gives me the flu”
You can’t get the flu from a flu shot. It can sometimes temporarily worsen another viral infection that you already had brewing prior to vaccination.
“It’s really not that big of a deal”
In 2007, JCAHO is requiring vaccination percentage reporting for direct care providers as a core quality measure.
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Team Tackles Infection Rate
Venous access nurse Carmel Mullee, RN, prepares for an insertion.
In a demonstration of extraordinary teamwork over the past
18 months, a group of BIDMC clinicians has worked to dramatically reduce central line-associated bloodstream infections (CL-BSI), making these infections an increasingly
rare event, which is good news
for patients.
Central lines are intravenous catheters placed in large veins, such as those located deep in a patient’s chest. The lines are used to deliver fluid, intravenous nutrition, and medications, and can be found in surgical and medical patients throughout BIDMC. Because central lines lead directly into the bloodstream and can be in place for several months or more, they put patients at increased risk for bloodstream infections and require special care.
PEVA nurse consultants Blanche Murphy, RN (left), and Andrew Mackler, RN (right), consult with hospitalist Henry Feldman, MD.
BIDMC’s rate of CL-BSI had consistently been lower than national comparisons, but Josef Fischer, MD, FACS, chairman of the Roberta and Stephen R. Weiner Department of Surgery, challenged the medical center to achieve the best practice seen among hospitals nationally. “The department of surgery was willing to devote resources, time and innovative thinking to take on this issue,” says Fischer. “What better way to help ensure that our patients receive the best care, from procedure to floor to discharge?”
Mark Zeidel, MD, chair of the department of medicine, and Dianne Anderson, RN, MS, senior vice president of clinical operations, joined Fischer in advocating that this become one of BIDMC’s top patient safety priorities. With their support, Sharon Wright, MD, MPH, director of infection control/hospital epidemiology, expanded the scope and clinical representation on BIDMC’s existing central line workgroup. The group, with representation of physicians and nurses from medicine, surgery, anesthesia, critical care, emergency medicine, radiology, and other specialties and units, adopted a zero tolerance approach to preventable CL-BSI.
Interventions introduced by the group standardize practices related to the insertion and maintenance of central lines. They include:
• a comprehensive guideline for line insertion and care;
• a “cockpit” checklist of steps that must be observed and checked off by a nurse and physician before a line is inserted;
• the introduction of parenteral and enteral venous access (PEVA) consultants, nurses who monitor patients with central lines and consult with physicians and nurses on line management; and
• a packet that includes all of the supplies needed to insert a line and assure sterile technique that will be introduced soon.
In recent months the rate of CL-BSI in the ICUs has been as low as zero to two infections per month.
“The central line workgroup has demonstrated that by working as a team we can make dramatic improvements in patient safety,” observes Ken Sands, MD, vice president of healthcare quality.