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Robert S Jones DO FACP FIDSA Reading Health System

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Clinical trials Sanofi Pasteur Cempra Actelion Serono

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I also have conflicts in that I get up every morning determined to both change the world and have one hell of a good time. Sometimes this makes planning my day difficult. -EB White

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1. True 2. False

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1. True 2. False

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1. Influenza is nothing more than a bad cold 2. Influenza hospitalizes over 200,000 people a year and can kill up to 40,000 people a year 3. More people are killed by AIDS than by influenza each year 4. The flu is only dangerous to the elderly

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1. 40-50% 2. 50-60% 3. 60-70% 4. 70-80% 5. 80-90%

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1. Flu seasons are predictable 2. Flu vaccine is the best way to protect yourself, family and patients from flu 3. Pregnant women are at higher risk complications related to flu 4. Severely obese persons are at higher risk for complications from the flu

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Which of the following statements is false? A. Flu seasons are predictable B. Flu vaccine is the best way to protect yourself, family and patients from flu C. Pregnant women are at higher risk complications related to flu D. Severely obese persons are at higher risk for complications from the flu

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Those who do not remember the past are condemned to repeat it. -George Sanayana

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http://www.youtube.com/watch?v=J83DZQcDFy8

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Contagious respiratory illness caused by influenza virus Characterized fever (often high), cough, body aches, headache, malaise, rhinnitis Yearly winter epidemics Peak activity usually in January and February Sporadic, unpredictable pandemics

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Seasonal in U.S. Average 6-7% adults and up to 30% children ill 36,000 deaths, >200,000 hospitalizations 20,000 hospitalizations in

Influenza vaccination is an evidence based infection prevention practice Mounting evidence over past 5 years shows the most consistent method to attain immunization rates of > 95% is to make annual influenza vaccination a condition of both initial and continued HCP employment and /or professional privileges, and volunteers

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100% HCP vaccination affords 43% risk reduction in acute and 60% in chronic care HCP vaccination is cost effective strategy to prevent patient morbidity HCP vaccination reduces patient mortality

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Proven means of reduction of infection and transmission of influenza virus in healthy adults Even in years of mis-match, vaccine is partially effective Voluntary absenteeism not completely reliable since HCP can be contagious the day before onset of symptoms of influenza

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Beneficence acting in best interest of patient Nonmaleficence not placing patient at risk of harm Placing patient interest first Safe work environment Educating HCP and patients of best, safe practices Existing requirement for vaccines or proof of immunity (MMR, Varicella, Hepatitis B)

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Currently >30% of RHS HCPs remain unvaccinated for reasons not supported in scientific evidence. Declination option has done virtually nothing to increase vaccination rates. Despite many years of trying clever ideas, posters, incentives, handouts, education, etc our rates have only marginally improved.

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National Patient Safety Foundation Society for Healthcare Epidemiology of America Association for Professionals in Infection Control and Epidemiology American Pharmacists Association National Foundation for Infectious Disease American College of Physicians Infectious Diseases Society of America National Quality Forum Association of Perioperative Registered Nurses American Medical Association DOD (2008) Department of Defense National Patient Safety Foundation American Academy of Family Physicians American Academy of Pediatrics American Hospital Association

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University of Pennsylvania Philadelphia CHOP, Philadelphia Aria Health, Langhorne Bradford Regional Medical Center, Bradford Abington Memorial, Abington Charles Cole Memorial Hospital, Coudersport Communities at Indian Haven, Indiana Crozer Chester, Upland Delaware County Memorial, Drexel Hill DuBois Regional Medical Center, DuBois Einstein Healthcare Network, Philadelphia Geisinger Health System, Danville Geisinger Wyoming Valley, Wilkes- Barre Grand View Hospital, Sellersville Hanover Hospital, Hanover Jersey Shore Hospital, Jersey Shore Lankenau Medical Center, Wynnewood Lehigh Valley, Allentown Main Line Health System, Bryn Mawr Springfield Hospital, Springfield St. Christophers Hospital for Children, Philadelphia St Joseph Hospital, Reading Taylor Hospital, Ridley Park Thomas Jefferson University Hospital, Philadelphia Wellspan Health, York

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Approval by MEC winter of 2013 Developed team: ID, IP, IM resident, chaplain, employee health, pharmacy, nursing, HR, ethics, pediatrics, and communication services Multiple, multiple meetings Medical and religious exemption forms developed along with policy Three person team to evaluate exemptions Two phases of roll out First year all employees, volunteers, students, etc Second year all medical personnel on staff and anyone who comes into the hospital for professional reasons

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Medical: egg allergy (no longer, now an egg-free vaccine); documented severe adverse effect from prior immunization (eg. GBS within 6 weeks of vaccine); Religious - few religions prevent vaccination; risk to patient requires mask use to be consistent; SHEA does not endorse Personal/philosophical - contrary to fundamental principle of patient safety

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Early identification of Influenza infection Isolation of known or suspected flu cases Mask use by patients and HCPs Private rooming or cohorting Hand hygiene and cough etiquette Voluntary absenteeism of ill HCPs Vaccination of HCPs Antiviral medication Visitor limitations under special circumstances

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Influenza season and severity is not predictable Influenza is serious disease that can lead to hospitalization and sometimes death Everyone over the age of 6 months should be vaccinated Mandatory flu vaccination among HCP has been the only successful way to achieve >90% vaccination rates Nasal vaccine should be used in children ages 2-8 Influenza vaccination is safe during pregnancy and should be administered

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1. True 2. False

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1. True 2. False

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1. Influenza is nothing more than a bad cold 2. Influenza hospitalizes over 200,000 people a year and can kill up to 40,000 people a year 3. More people are killed by AIDS than by influenza each year 4. The flu is only dangerous to the elderly

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1. 40-50% 2. 50-60% 3. 60-70% 4. 70-80% 5. 80-90%

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1. Flu seasons are predictable 2. Flu vaccine is the best way to protect yourself, family and patients from flu 3. Pregnant women are at higher risk complications related to flu 4. Severely obese persons are at higher risk for complications from the flu

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