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Increasing Annual Influenza Vaccination Rates through Primary Prevention Strategies Among Health Care Workers in a Psychiatric Long-term Care Facility: An Evidence-based Approach

Abstract Background: Influenza is a highly infectious, serious respiratory virus that causes almost 226,000 hospitalizations and averages 36,000 deaths annually in the United States (U.S.). Those at the highest risk for influenza-related complications and death include the elderly, the very young, those with chronic disease, and people with weakened immune systems. Since 1981, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee for Immunization Practices (ACIP) have recommended that all medically eligible healthcare workers (HCWs) receive an influenza vaccination annually. Despite recommendations, many HCWs decline the seasonal influenza vaccination putting themselves and their patients at risk. The CDC reports that U.S. vaccination rates for HCWs in long-term care settings averaged just 69.2% for the 2015-2016 flu season. Healthy People 2020 has set a goal of 90% compliance among eligible HCWs by 2020. Methods: This research translation project examined the effects of evidence-based primary prevention strategies of personalized education and mentoring on increasing vaccine compliance among 105 HCWs in a long-term forensic psychiatric facility. A synthesis of evidence-based practice interventions and associated factors to improve flu vaccine uptake is included, discussing barriers and facilitators to implementation in this special population and unique setting. Results: Although individualized education and mentoring are recommended evidence-based practice interventions to increase vaccine rates in HCWs they resulted in only a 3% increase in uptake, well below the 10% goal. Conclusions: Mitigating factors, including personal belief systems, cultural factors, and health literacy continue to impact vaccination rates negatively and are contributing factors to low influenza vaccine rates especially among unlicensed, assistive HCWs