Assessing influenza vaccine coverage among the elderly receiving long-term care services, and nurses' knowledge and attitudes towards influenza vaccination

University of Tampere School of Health Sciences CHRISTOPHER KIPKORIR: ASSESSING INFLUENZA VACCINE COVERAGE AMONG THE ELDERLY RECEIVING LONG-TERM CARE SERVICES, AND NURSES’ KNOWLEDGE AND ATTITUDES TOWARDS INFLUENZA VACCINATION. Master’s Thesis, 45 pages, 5 appendices Supervisor: Pekka Nuorti, Professor Resource persons: Outi Lyytikäinen, Research Professor and Matti Mäkelä, Senior Medical Officer from THL. Health Sciences (Public Health) May 2017____________________________________________________________ Influenza occurs annually and has been found to be a major cause for morbidity and mortality among the elderly who are among the risk groups. The elderly residing in long-term care facilities (LTCFs) are at an even higher risk due to the confined nature of the environment and the possibility of a rapid spread in case of an outbreak. Nurses working in LTCFs often have direct contact with their patients. This puts them at greater risk of contracting influenza and also transmitting it to their patients. It is for this reason that influenza vaccination is recommended to both nurses and the elderly among other risk groups. Unfortunately, the coverage remains low for these groups. Therefore, understanding the relationship between these two groups and the factors influencing the uptake is crucial. The aim of this study was to determine trends in influenza vaccine uptake among the elderly within the LTCFs participating in the RAI-evaluation project in Finland. Additionally, the study explored the nurses’ knowledge and attitudes towards influenza vaccination by means of a survey. Aggregate data on RAI-HC were obtained from the Finnish National Institute for Health and Welfare. The data contained information on different service types, the year, vaccination coverage, poor cognition, poor functioning in activities of daily living (ADL) as well as age (≥80). A survey on the nurses’ knowledge and attitudes was also conducted among 89 nurses with different professional designations. Data were analyzed using SPSS and STATA. There were annual variations in influenza vaccination coverage among the 3 different service types during the years 2008-2015: 62% (57-68%) in homecare, 73% (69-76%) in residential care and 65% (54-77%) in service housing. Different patient characteristics including the service types and year of data collection were associated with vaccination coverage. Among the nurses, better knowledge and attitudes were positively associated with their vaccination status, other background factors such as professional designation and gender also affected but were not statistically significant. Even though the data used are not directly related, it supports the notion that there might be a relationship between nurses’ vaccination status, knowledge and attitudes and the coverage among the elderly. This relationship can be seen by how the nurses’ vaccination status affect their ability to recommend vaccination to their patients. As this relationship is being further explored, targeted vaccination programs should be developed towards meeting the needs of both nurses and their residents within respective service types. Based on the results, the coverage remains lower among both nurses and patients. With the knowledge that influenza vaccination still remains the most important preventive measure against influenza, focus on achieving a higher uptake among nurses and patients should be the goal. For patient safety, nurses should remember that it is their obligation and duty to get vaccinated and to advocate the same for their patients. Achieving the recommended coverage will lead to a reduction in morbidity and mortality leading to improved patient outcomes and a healthy workforce.