ANA Congress on Nursing Practice and Economics Fall, 2007 Influenza Vaccination AMERICAN NURSES ASSOCIATION Report to the Congress on Nursing Practice and Economics from the ANA Department of Occupational and Environmental Health Only 43% of nurses and other healthcare workers involved with direct patient care received the seasonal influenza vaccine in the 2004-2005 influenza season according to the Centers for Disease Control and Prevention. This number is typical of the dismal rate of vaccination for this group despite the Advisory Committee on Immunization Practices rank of healthcare workers in the list of priority groups. Patients are at risk of becoming infected with influenza from a healthcare worker with asymptomatic or symptomatic influenza. Discussion is being generated to mandate seasonal influenza vaccination for healthcare workers due to insufficient voluntary acceptance of the vaccine in this group, including nurses. ANA launched a campaign entitled Everyone Deserves a Shot at Fighting Flu in November, 2005 to address the unacceptably low rate of acceptance of seasonal influenza vaccine amongst nurses and other health care workers. Media interviews and press releases were held to report on the results of a survey ANA conducted with funding from GlaxoSmithKline to identify barriers to receiving and accepting the vaccine. Additionally the 2006 ANA HOD adopted a resolution addressing influenza vaccination which was further addressed by the ANA BOD in December. Best Practices in Seasonal Influenza Immunization In January 2007, ANA obtained a grant from Sanofi to develop and conduct the Best Practices in Seasonal Influenza Immunization Recognition Campaign. This program is a recognition campaign designed to identify the top five organizations that have demonstrated the best strategies in their influenza immunization programs that resulted in increasing the seasonal influenza vaccination rates of their employees. Components of the success stories will be compiled into a guide booklet describing Best Practices for Seasonal influenza Immunization strategies to achieve increasing the seasonal influenza vaccination rates of registered nurses and other HCP in hopes of helping other facilities improve their low influenza vaccination rates. Recognized facilities will be presented an award from ANA commending their excellent leadership in increasing influenza vaccination rates of registered nurses and other health care personnel. The Best Practices in Seasonal Influenza Immunization Recognition Campaign announcement was distributed and is posted on NursingWorld.org. Submission deadline is April 20, 2007. Fall, 2007 CNPE Action Report Page 1
The Best Practices in Seasonal Influenza Immunization Recognition Campaign received submissions about employee seasonal influenza programs from nine organizations. The Center for Occupational & Environmental Health Staff independently read each proposal and scored it with a standardized evaluation criteria sheet. The top five programs received a recognition letter from President Rebecca Patton. These top programs will also receive an ANA recognition award to display at their facility. Articles about the programs are planned for publication in the September issue of American Nurse Today. Based on the best practices submitted, A Best Practices in Seasonal Influenza Vaccination brochure and other materials will be developed using success stories and components from the nine programs that were submitted to the Best Practices in Seasonal Influenza Immunization Recognition Campaign. The materials will illustrate innovative strategies for increasing vaccination rates among HCP and act as a resource to others for use in their programs. The recognition award to Emory Healthcare was presented to John Fox, Emory Healthcare CEO, Cynthia Hall, RN, COHN-S/CM, Assistant Director of Employee Health Services and other members of the Emory HealthcareInfluenza Steering Committee by ANA President Rebecca Patton; ANA CEO Linda J. Stierle; Deborah Hackman, CAE, Chief Executive Officer GNA; Linda Easterly, RN, BSN, MS, COHN-S, President GNA; ANA BOD members Debbie Hatmaker (GA), Linda Warino and Margarete Zalon in Atlanta, Georgia on June 20, 2007. National Foundation for Infectious Diseases (NFID): Diabetes and Influenza The National Foundation for Infectious Diseases (NFID) is calling for the medical and public health community to increase alarmingly low influenza vaccination rates among persons with diabetes -- the fifth deadliest disease in the United States. The recently received Call to Action report entitled, "Improving Influenza Vaccination Rates in Adults and Children with Diabetes: Identifying and Overcoming Immunization Barriers in this High-risk Population," was developed from proceedings of a roundtable meeting held November 2006 in Washington, D.C. ANA participated in the roundtable meeting. The report outlines useful tactics and interventions that can be applied within various clinical settings that treat patients with diabetes. NFID's Call to Action marks the beginning of a new initiative targeting improved influenza vaccination efforts for persons with diabetes, which is supported by more than 15 of the nation's key medical and Fall, 2007 CNPE Action Report Page 2
public health organizations that all play a key role in treating this at-risk population. ANA is a supporting organization of this initiative. There is no additional information to report at this time. Pandemic and Avian Influenza Pandemic influenza is a virulent viral strain of influenza causing a global outbreak of influenza spreading from human to human because there is little natural immunity in the human population. Pandemic preparedness planning is critical to reduce the lethal impact a global pandemic can have on human suffering and death. Avian influenza continues to threaten to be the next pandemic influenza if the H5N1 influenza virus mutates to allow for human to human transmission. Even seasonal influenza is an annual challenge as it claims an associated 36,000 deaths and approximately 200,000 hospitalizations annually, predominantly among persons aged > 65 years and those < 2 years of age in addition to persons of any age who have medical conditions placing them at risk of complications from influenza. Respiratory protection for health care workers and others in the form of an N-95 respirator vs. surgical masks had been the subject of great debate in guidelines for pandemic and avian influenza planning, including the national pandemic plan. COEH presented a poster session titled, The American Nurses Association s Efforts to Increase Seasonal Influenza Vaccination of Registered Nurses at the Seasonal and Pandemic Influenza Summit 2007 in Arlington, VA from January 31 to February 2. The poster presentation provided an overview of some of ANA s efforts to increase vaccination rates of registered nurses. The Summit was endorsed by the American Academy of Pediatrics, the Centers for Disease Control and Prevention, the Infectious Diseases Society of America, the National Institute of Allergy and Infectious Diseases and the Society for Health care Epidemiology of America. ANA was represented at the Institute of Medicine workshop entitled, Personal Protective Equipment for Healthcare Workers In The Event of Pandemic Influenza: Next Steps and Research Directions held in Washington, DC on February 22, 2007. There is no additional information to report at this time. National Occupational Research Agenda (NORA) Fall, 2007 CNPE Action Report Page 3
The National Institute for Occupational Safety and Health (NIOSH)-, in partnership with the National Safety Council celebrated the success of the first decade of the National Occupational Research Agenda (NORA) and launched its second decade at the NORA Symposium in April, 2006, in Washington D.C. For the past nine years the National Occupational Research Agenda (NORA) has served as a framework to guide national occupational safety and health research efforts. Town Hall Meetings have been sponsored by the National Institute of Occupational Health and Safety (NIOSH) in preparation for setting a new research agenda for the next decade. ANA, through its CMAs, contacted nurse members across the country to testify at these Town Hall Meetings to ensure that the occupational safety and health concerns of nurses be included. ANA s priority topic areas for occupational research include: musculoskeletal disorders; chemical exposures; worker fatigue; bloodborne pathogen exposure; respiratory protection and workplace violence. NORA work group will write a technical report on the state of the NIOSH Health Care and Social Assistance sector. The report will be divided into topic areas and present what is known, and identify what knowledge gaps exist. This technical report will be written for an audience of experts. From this technical report two shorter reports will be written, one being a shorter document to target decision makers, and the other a bulleted fact sheet written for the general public. ANA has taken part in initial conference calls assisting in helping to write the Chemicals and Other Hazards section of this technical report. As of June, ANA is working on the Organization of Work and Stress work group division of the report. The NORA Health Care and Social Assistance Sector Council meeting was held in Washington, DC on June 11 th and 12 th. The next meeting is planned for November in a location to be determined. NIOSH Hazardous Drugs Work Group The National Institute for Occupational Safety and Health (NIOSH) sponsored a multidisciplinary work group to review the existing guidance and, in light of new data accrued, make updated recommendations on hazardous drug safe handling which is based on the industrial hygiene hierarchy of control technologies. Since the work group s inception ANA has taken an active part in the process and had a representative at all work group meetings. The culmination of the first years of this group s work was the NIOSH produced Alert; Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings published in 2004. No information to report at this time. NIOSH is in the process of updating a list of hazardous drugs for the NIOSH Alert. ANA will be acting as an outside reviewer of the proposed changes to the list. There are two meetings Fall, 2007 CNPE Action Report Page 4
planned. Both are in Washington, DC. The first meeting will occur in August with the second meeting date to be determined later in 2007. NIOSH Workplace Fatigue Project The ANA Health and Safety Survey conducted in September, 2001 revealed that health and safety concerns have an impact on the kind of nursing work performed and on nurses continued practice in the field of nursing. ANA has a long history of working with the National Institute for Occupational Safety and Health (NIOSH) on occupational issues such as safe patient handling and movement. ANA has been involved over the past two years to assist in the development of proposals with NIOSH staff to obtain internal NIOSH funding to partner on projects that advance ANA s initiatives. One such funded proposal was the safe patient handling and movement curriculum development initiative that complements ANA s Handle with Care campaign. ANA will be partnering with NIOSH on a project in 2007 to develop and evaluate a training program to educate student nurses about the risks associated with demanding work schedules and the strategies to reduce these risks. The NIOSH Workplace Fatigue project will develop and beta test a work schedule risk prevention video training program to educate workers and managers about these hazards and strategies to reduce risks and have a multidisciplinary focus. This training will fill a need for widely available, low cost training that presents information that has accumulated in the scientific community but has not been sufficiently disseminated to the public. The training will be developed to train workers and managers across all sectors, including healthcare. Beta testing will include focus groups and a pre- and post-training evaluation. A focus group of retail workers and one of miners will assess perceived usefulness of the training program. A survey will compare 100 student nurses for self Fall, 2007 CNPE Action Report Page 5
reported knowledge, attitudes, and intended behaviors before training and 1 month after training. ANA will be assisting to recruit schools of nursing and collect data on a sample of 100 students. ANA will serve on a training development committee to give input into the development of the training video. The start date for the project is to be determined, however anticipated date is June, 2007. Anticipated start of this project is upcoming. Health and Safety Presentations ANA frequently is called upon to offer presentations at various meetings or other venues. This section reports on the presentations that have been presented during the report period. There is no additional update to report at this time. HHS PHEMC Enterprise Stakeholders Presentation ANA will be presenting on July 31 st by invitation on a moderated panel at the Department of Health and Human Services Public Health Emergency Medical Countermeasures Enterprise Stakeholders Workshop to be held July 31 st - August 2, 2007 in Washington, DC. The presentation will address ANA s perspective on HHS Chemical, Biological, Radiological and Nuclear Threat medical countermeasure preparedness efforts to date and on issues the Department should consider as they move forward. Handle With Care Campaign Handle With Care Initiative The Handle with Care initiative officially launched in September 2003 campaign mounted a profession-wide effort to prevent back and other musculoskeletal injuries through greater education and training, and increased use of assistive equipment and patient-handling devices. Fall, 2007 CNPE Action Report Page 6
The campaign also seeks to reshape nursing education and federal and state ergonomics policy by highlighting the ways technology-oriented safe-patient handling benefits patients and the nursing workforce. ANA gave a presentation titled, Overview of Safe Patient Handling and Movement of Patients in the Perioperative Setting, at the 9 th Annual Perioperative Symposium held at the Jewish Hospital Rudd Heart and Lung Center in Louisville, Kentucky on February, 24, 2007. The program was sponsored by Jewish Hospital in partnership with Kentuckiana Association of perioperative Registered Nursing (AORN). ANA continues to promote Handle With Care in articles published in American Nurse Today for March and April. ANA continues to be called upon as a content expert in safe patient handling and has been presenting and attending events as invited. ANA presented on safe patient handling to the Health Guidelines Revision Committee Patient Lifts Work Group at their conference in Baltimore, MD on April 18, 2007. This group is working on revisions to the 2010 Guidelines for Design and Construction of Health Care Facilities. Time To Care: Changing Care International Safe Patient Handling and Movement Event ANA participated in the invitational Time to Care Forum in Denmark in May. The event was organized by Guldmann A/S. The forum was an international network of leaders within healthcare exchange event to provide an opportunity for cross cultural dialogue, exchange of experiences and shared solutions related to the theme. The event included an additional day to tour the safe patient handling and movement program of Glostrup Hospital in Copenhagen, Denmark. Creating a Mosaic of Care Summit Presentation ANA gave a keynote presentation titled, Providing the Evidence: Safe Patient Handling at the Creating a Mosaic of Care summit held by Ascension Health in Jacksonville, Florida in May. The summit was a two day meeting of Ascension Health nursing community to celebrate the gains made in the prevention of facility-acquired pressure ulcers and to plan the next step in integrating this work with improved bariatric care, prevention of falls and in developing a system wide safe patient handling program. PREMUS 2007: Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders ANA has had an abstract entitled, American Nurses Association Handle with Care Campaign for a poster presentation at the Premus 2007 international conference on Safe Patient Handling Fall, 2007 CNPE Action Report Page 7
and Movement in Boston, Massachusetts on August 27-30, 2007. This is the first time this conference is being held in the United States in ten years. Safe Patient Handling and Movement Nursing School Curriculum Module ANA received funding in 2004 from NIOSH to launch the Safe Patient Handling and Movement Nursing School Curriculum pilot project. ANA partnered with the National Institute of Occupational Safety and Health (NIOSH) and the Tampa Veterans Administration Patient Safety Center of Inquiry to develop the curriculum and introduce safe patient handling and movement concepts in to the curriculum of nursing schools. Twenty-six schools of nursing served as test sites and three served as control sites. Invitations were extended to faculty to attend the 5th Safe Patient Handling and Movement Conference (2005) as part of preparation to implement the curriculum which was developed as part of the grant. A focused post- conference session prepared the nursing school faculty to implement the curriculum. The project was initially planned to be completed within 24 months but due to delays of implementing the test curriculum in to the timing of some of the test site programs, the project was been extended by 12 months. New completion date of the project will be August, 2007. The data analysis of the project has been completed. ANA is co-authoring two companion articles being written about the project data. Further dissemination of information about this project and a toolkit based on the project are being developed. ANA is participating in the award presentation to the recipients of school curriculum project awards ceremony held at the Safe Patient Handling and Movement conference. The first article published on this project was published in Nurse Educator in the May/June edition. The title of the article is, Preventing Musculoskeletal Disorders in Nurses: A Safe Patient Handling Curriculum Module in Nursing Schools, Vol. 32, No. 3, pp. 130-135. ANA was a co-author of the article. Two additional articles are being written for future publication. 7th Annual Safe Patient Handling and Movement Conference Since 2000, an annual safe patient handling and movement conference hosted by the Department of Veterans Affairs, James A. Haley Veterans Hospital, Patient Safety Center of Inquiry has been held to provide participants with up to date information, feature best practices, display new technology available and to present research findings related to safe patient handling and movement. ANA has been a co-sponsor of the conference since 2003. Fall, 2007 CNPE Action Report Page 8
The 7 th Annual Safe Patient Handling and Movement Conference will be held at Disney s Contemporary Resort in Lake Buena Vista, Florida on March 12-16, 2007. ANA is cosponsoring the upcoming conference for the 5 th year. The ANA President will be providing opening remarks and moderating a session on the first day of the conference. The 8 th Annual Safe Patient Handling and Movement Conference will be held on March 11-13, 2008. ANA is involved in the planning and will be doing two presentations in addition to moderating beginner sessions throughout the conference. Fall, 2007 CNPE Action Report Page 9