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Spurred by historically poor flu immunization compliance in an age of patient safety, some powerful health care forces are converging to make the annual flu shot a new professional standard for health care workers.
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According to the National Foundation for Infectious Diseases, these are the key strategies to establish a successful flu immunization program for health care workers.
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Moving to clear up the considerable confusion of the last flu season, the Centers for Disease Control and Prevention (CDC) has drafted new guidelines for health care workers who receive the live attenuated influenza vaccine (LAIV), Hospital Infection Control has learned. The CDCs Advisory Committee on Immunization Practices (ACIP) is expected to soon release new guidelines that will allow the LAIV nasal spray vaccine to be used more liberally in health care settings with fewer restrictions on immunized workers.
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Shedding of virus after use of live attenuated influenza vaccine (LAIV) in adults occurs the first few days after vaccination, but is minimal by one week after immunization. The data suggest that the recommendations for LAIV use in health care workers could be modified to include separation from patients for, at most, seven days after vaccination, reports Tom Tolbert, MD, MPH, instructor of medicine in the division of infectious diseases at Vanderbilt University Medical Center in Nashville, TN.
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In a strategy somewhat reminiscent of the state-by-state battle to get needle safety laws enacted, consumer advocates are taking their cry for open hospital infection rate reporting to one legislature at a time. Pennsylvania and Illinois have enacted laws, and bills are under discussion in a variety of other states.
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When it comes to treating lipids in patients with heart disease, the mantra may be, The lower the LDL, the better. Data from the multicenter Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial indicate that aggressive reduction of atherogenic lipoproteins prevents progression of disease.
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Influenza had a major impact on the nations hospitals this season, filling up intensive care units and leading to staff shortages. Currently, there is no standard that requires immunization of health care workers, but the Joint Commission requires hospitals to be in compliance with applicable laws and regulations. A vaccine against the H5N1 virus could be in clinical trials by this summer.
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The use of serum procalcitonin helps to differentiate bacterial from viral lower respiratory infections and may reduce the use of unnecessary antibiotics.
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The common and increasing practice of opioid treatment for chronic pain is reviewed. Randomized trials support this therapy, however the risk benefit decision is complicated by new evidence of hazards making this practice more difficult.
