Background
While many health care workers (HCWs) who have respiratory infections take sick leave,
others work following illness onset. Little is known about attendance practices of
HCWs caring for persons with spinal cord injuries (SCI), a group at high risk for
respiratory complications.
Methods
Cross-sectional survey of HCWs. Logistic regression identified factors associated
with having a respiratory infection and examined if awareness of facility level institutional
control measures and/or individual level factors influenced working while symptomatic.
Results
Response rate was 53% (n = 820). Respiratory infections were reported by 36%; of those,
86% attended work while symptomatic. HCWs aged 50 and above were less likely (odds
ratio [OR] 0.58, P = 0.003) and those with a chronic condition were more likely (OR 2.24, P < 0.000) to have had a respiratory infection. HCWs who indicated that their facility
institutes droplet precautions (OR 0.42, P = 0.034), restricts staff movement between wards, (OR 0.26, P = 0.002), and restricts contact between patients (OR 0.32, P = 0.009) were significantly less likely to work while symptomatic.
Conclusions
It is alarming that 86% of HCWs attended work while symptomatic, given the consequences
that respiratory infection can have on persons with SCI. HCW awareness of outbreak
control measures within their facilities appeared to influence their attendance decisions,
suggesting the importance of policy placement and information dissemination.
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References
Centers for Disease Control and Prevention. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). MMWR. February 24, 2006;55(RR02):1-16.
- Influenza control in acute care hospitals.Am J Infect Control. 1997; 25: 357-362
- Influenza A among hospital personnel and patients: implications for recognition, prevention, and control.Arch Intern Med. 1989; 149: 77-80
- Occupationally acquired infections in health care workers: part I.Ann Intern Med. 1996; 125: 826-834
- An outbreak of influenza A (H3N2) in a well immunized nursing home population.J Am Geriatr Soc. 1992; 40: 589-592
- Influenza surveillance in an acute-care hospital.Arch Intern Med. 1988; 148: 113-116
- Absenteeism among hospital staff during an influenza epidemic: implications for immunoprophylaxis.CMAJ. 1984; 131: 449-452
Centers for Disease Control and Prevention. Detection and control of influenza outbreaks in acute care facilities: jointly developed by the National Center for Infectious Diseases & The National Immunization Program. Department of Health and Human Services. September 2001.
- Nosocomial influenza infection among post-influenza-vaccinated patients with severe pulmonary diseases.J Infect. 2003; 46: 129-132
- Epidemiological and clinical aspects of influenza.in: Beare A.S. Applied influenza research. CRC Press, Boca Raton (FL)1982: 11-49
- Transmission of influenza: implications for control in health care settings.Clin Infect Dis. 2003; 37: 1094-1101
- Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients.J Infect Dis. 1997; 175: 1-6
- Vaccines for persons at high risk due to medical conditions, occupation, environment, or lifestyle, 2005.J Fam Pract. 2005; 54: S27-S36
Veterans Health Administration. Influenza Vaccine: Recommendations for 2002-2003. VHA Directive 2002-044. Department of Veterans Affairs. July 29, 2002.
- Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP).MMWR. 2005; 54: 1-40
- Disruption of services in an internal medicine unit due to a nosocomial influenza outbreak.Infect Control Hosp Epidemiol. 2002; 23: 615-619
- Effectiveness and cost benefit of an influenza vaccination program for health care workers.Can J Infect Dis. 1991; 2: 101-107
- Absenteeism among hospital staff during influenza epidemic.CMAJ. 1985; 133: 641-642
- Effectiveness of influenza vaccine in health care professionals.JAMA. 1999; 281: 908-913
- Analysis of sickness absence among employees of four NHS trusts.Occup Environ Med. 1999; 56: 702-708
- Barriers to influenza vaccine acceptance: a survey of physicians and nurses.Am J Infect Control. 1989; 17: 202-207
- Respiratory dysfunction in spinal cord disorders.in: Lin V. Cardenas D.D. Cutter N.C. Frost F.S. Hammond M.C. Lindblom L.B. Spinal cord medicine: principles and practice. Demos Medical Publishing, Inc, New York2003: 155-168
National Spinal Cord Injury Statistical Center. Facts and Figures at a Glance. June 2005. Available from: http://www.spinalcord.uab.edu/show.asp?durki=21446. Accessed August 14, 2006.
- Virulent epidemics and scope of healthcare workers' duty of care.Emerg Infect Dis. 2006; 12: 1238-1241
- Requiring influenza vaccination for health care workers: seven truths we must accept.Vaccine. 2005; 23: 2251-2255
- Work factors as predictors of sickness absence attributed to airway infections; a three month prospective study of nurses aides.Occup Environ Med. 2004; 61: 45-51
- Sickness absence and ‘working through’ illness: a comparison of two professional groups.J Public Health Med. 1997; 19: 295-300
- Sickness absence in hospital physicians: 2 year follow up study on determinants.Occup Environ Med. 2001; 58: 361-366
- Sickness absence as risk-taking behaviour: a study of organizational and cultural factors in the public sector.Health Risk Soc. 2000; 2: 7-21
- Presenteeism: at work but out of it.Har Bus Rev. 2004; 82: 49-59
- Effect of influenza B virus infection on human performance.Br Med J. 1993; 306: 760-761
- Effects of upper respiratory tract illnesses on mood and performance over the working day.Ergonomics. 2000; 43: 752-763
- Presenteeism in nursing. A clear and present danger to productivity.J Nurs Adm. 2005; 35: 300-303
- Exposure workups.Infect Control Hosp Epidemiol. 1997; 18: 850-871
- Licensed nurse staffing and adverse events in hospitals.Med Care. 2003; 41: 142-152
- Nurses' reports on hospital care in five countries.Health Aff (Millwood). 2001; 20: 43-53
- Some impacts of nursing on acute care hospital outcomes.J Nurs Adm. 1999; 29: 25-33
- Nurse staffing levels and adverse events following surgery in US hospitals.Image J Nurs Sch. 1998; 30: 315-321
- Comparing the contributions of groups of predictors: which outcomes vary with hospital rather than patient characteristics?.J Am Stat Assoc. 1995; 90: 7-18
- Nursing: An important component of hospital survival under a reformed health care system.Nurs Econ. 1993; 11: 192-199
Article info
Footnotes
This material is based upon work supported by the Office of Research and Development, Health Services Research, and Development Service of the Department of Veterans Affairs.
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Copyright
© 2007 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
