Infection prevention leaders at Florida’s 3,700 nursing homes and assisted living facilities (ALF) say their facilities require flu vaccinations for health care workers despite the high risk to residents. That’s just 11%, according to a study published last week in the American Journal of Infection Control. .
From December 2022 to February 2023, a team led by researchers from the University of Florida College of Public Health and Health Professions in Gainesville surveyed 3,690 infection prevention and control (IPC) professionals. Responses to a long-term needs assessment survey were collected. Florida Long-Term Care Facilities (LTCFs). The state has the fourth-highest number of LTCFs in the nation and ranks second for the percentage of residents age 65 and older.
High risk of infection and antibiotic resistance
Respondents worked in ALFs (37.5%), skilled nursing facilities (SNFs; 36.1%), and nursing homes (21.7%) and included infection preventionists (IPs), administrators, and directors of nursing.
The 90-question survey is a modified version of the Centers for Disease Control and Prevention’s (CDC) 2016 Infection Prevention and Control Assessment Tool for Long-Term Care Facilities.
“LTCF residents have multiple risk factors for contracting infections, including underlying medical conditions and treatments that can suppress the immune system, indwelling devices, and open wounds,” the researchers noted. . “Infection and colonization with multidrug-resistant organisms (MDROs) is a particular problem in LTCFs.”
To address these issues, the Centers for Medicare and Medicaid Services issued a final rule in 2016 requiring LTCFs to establish IPC programs.
Influenza vaccine uptake rate is low
Survey responses indicated good compliance with recommended hand hygiene, sharps safety, and staff training, but of the 304 respondents, only 30% of respondents said their facilities required flu shots. Only 11.2% of respondents said they were
Despite recommendations, low influenza vaccination rates among Florida’s LTCF personnel suggest the need for stronger vaccination policies and education campaigns.
“Unfortunately, influenza vaccine uptake does not appear to be widespread among health care workers (HCWs) in the state, with only a small percentage of health care workers vaccinated in skilled nursing facilities in 2022-2023. “At 31%, the District of Columbia ranked 48th out of 50 states,” the authors wrote. “Despite recommendations, low influenza vaccination rates among Florida’s LTCF personnel suggest the need for stronger vaccination policies and education campaigns.”
Nearly one-third (30%) of those surveyed reported a shortage of registered nurses, certified assistant nurses, and certified nursing assistants, but fewer said they had a limited supply of personal protective equipment. It was only 5%.
SNFs and nursing homes were more likely than ALFs to have gloves in or near every room and to have N95 respirators available (98.5% vs. 81.6% and 100% vs. 91.9%, respectively). SNFs and nursing homes were also more likely to perform N95 fit testing (86.2% vs. 54.3%).
Of the 155 LTCF respondents, 47.7% devoted at least 40 hours to IPC activities each week, 36.8% between 20 and 38 hours, and 15.5% between 1 and 15 hours. Most (82.1%) conducted staff education within in-person services, 56.6% used online materials, 25% used live online group training, and 5.4% used other training methods .
Survey results will inform customized education
Among IPs, 81.0% had less than five years of experience in IPC, and 83% said they had been in their current position less than three years.
“While this relatively inexperienced workforce may reflect burnout among more experienced IPs, it also points to high turnover rates and short tenures for new IPs at LTCF. “possibly,” the researchers wrote. “More importantly, this highlights the urgent need for enhanced training and support systems, including ongoing professional development opportunities and peer mentoring.”
Respondents’ limited knowledge of HVAC and air purification systems indicates a gap in IPC training, and comprehensive education on these systems is needed to maintain a safe care environment. is.
When asked to rank their knowledge of the Infection Control and Epidemiology Certification Board’s IPC core competencies, excluding surveillance and epidemiological studies, more than half of respondents said they were knowledgeable in all areas.
Based on the responses, participants had little knowledge about their facility’s heating, ventilation, and air conditioning (HVAC) system, and most did not know what types of filters were used in their HVAC system.
“Respondents’ limited knowledge of HVAC and air purification systems indicates a gap in IPC training, and maintaining a safe care environment requires comprehensive education on these systems. “is necessary,” the researchers wrote. “Knowledge of these systems is essential as they play a critical role in limiting the spread and transmission of infectious agents among the population and health care workers.”
The authors said the findings could help establish tailored education opportunities for infection prevention specialists in Florida nursing homes.
