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Institutional predictors of hepatitis B vaccination rates: a statewide study of health care workers.

Doebbeling-BN; Rohrer-JE; Kohout-FJ
11th Annual Association for Health Services Research Meeting, San Diego, CA. Washington, DC: Association for Health Services Research, 1994 Jun; :146
PROBLEM AND OBJECTIVES. A recent study of hospitals and chronic care facilities in Iowa was performed to document current rates of hepatitis B virus (HBV) vaccine acceptance and evaluate current vaccine implementation programs. In addition, a series of vaccine delivery program components associated with institutional vaccination rates (IVR) are identified. DATA AND METHODS. The study population is comprised of hospitals and the largest chronic care facilities in Iowa in the Iowa Statewide Surveillance System (ISSS). We surveyed 141 ISSS facilities (94% participation) in 1992 prior to OSHA's Bloodborne Pathogens Rule becoming enforceable to determine mean IVR in different occupational groups. Vaccine delivery program characteristics were categorized according to the following factors: community and hospital demographics, clinical leader involvement, educational and occupational health program characteristics, access to care, and HBV experience. A longitudinal study funded by NIOSH is underway to measure the impact of OSHA's guidelines. RESULTS AND CONCLUSIONS. Vaccine delivery characteristics and IVR varied by size of institution and rural vs. urban location. Mean IVR ( greater than or equal to 3 doses) ranged from 51% among physicians, 62% among housekeepers, 62% among nursing assistants, 73% among licensed practical nurses, 77% among registered nurses, and 83% among laboratory workers. The regression model of IVR identified the importance of active encouragement of and participation in vaccination by leaders, frequency of educational programs and invitations to receive the vaccine, provision at the worksite, and a requirement of vaccination for physicians. IMPLICATIONS FOR AUDIENCE: Taken together, these data suggest that an active vaccine implementation program supported by clinical leaders in an institution is independently associated with the institution-wide vaccination rate. Since a requirement of HBV vaccination of workers is also associated with the IVR, the mandatory informed refusal approach of OSHA is expected to be effective in increasing HBV vaccine acceptance among health care workers.
NIOSH-Grant; Grants-other; Health-care-personnel; Viral-infections; Vaccines; Occupational-exposure; Sociological-factors; Age-factors; Psychological-factors; Health-protection; Medical-surveys; Universal-precautions; Infection-control; Infectious-diseases; Bloodborne-pathogens
Internal Medicine University of Iowa 200 Hawkins Drive Iowa City, IA 52242
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11th Annual Association for Health Services Research Meeting, San Diego, CA
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University of Iowa, Iowa City, Iowa