Preventing Flu and SSIs
Nancy Church, RN, MT, CIC
Providence St. Vincent Medical Center
Nancy Church, chaired the state Oregon Partnership to Immunize Children, the influenza immunization of healthcare personnel (HCP), a cause for which she campaigned vigorously.
Church, manager of Infection Prevention and Control, Wound and Ostomy department at Providence St. Vincent Medical Center in Portland, Oregon, believes that unless you confront healthcare workers with facts, they will continue to resist immunization, even if the issue is mandated via a condition of employment.
“I go to healthcare workers and tell them it’s really about protecting them and their family. If they perceive there’s a risk based on negative publicity, then the science is lost,” said Church. “However, when our first pregnant patient came in one week post delivery with H1N1 and remained in ICU for six weeks (she survived), the staff took one look at her and the word spread quickly. We’re now at 75 percent immunization of HCP overall, and at 90 percent in ICU.”
Church believes that the key to convincing HCP to agree to vaccination in greater numbers is to offer them a choice; such as pre-filled syringes with no preservatives, Thimerosal, or latex, to remove one of their fears.
“If the vaccine if preserved, some people don’t want it because of their fear of mercury,” said Church. “You have to listen to their concerns and offer them a vaccine without the preservative, and then we get takers.”
While the St. Vincent Medical Center has not yet implemented a Condition of Employment policy, whereby one must be vaccinated for influenza in order to be employed at the hospital, new hires are questioned as to their status of immunizations.
“We’ve turned down a healthcare worker who refused all immunizations,” said Church. “We must ascertain the status of the employee’s immunity to various diseases on hire. If they refuse vaccinations, they should not work in direct patient care.”
When not striving for the immunization of HCP, Church dedicates her work to surgical site infections reduction, using a team of people reviewing each of the high-risk, high-volume surgical infections within the St. Vincent 521-bed facility.
“We have worked together to understand what might be the cause of the infection and to make sure we have implemented best practices, such as use of chlorhexidine for preoperative showers, MRSA screening for implant surgery, and standardization of the skin preparation for specific procedures. Using targeted MRSA reduction strategies we have reduced our MRSA in-house transmission to < 0.06 percent (total confirmed MRSA/ total hospital admissions. Targeting zero helps the team understand what is and what may not be preventable,” said Church, adding, “What I love about infection control is it’s never the same two days in a row.”