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Monthly CardioLAN Webinar
Third Thursdays | 2-3pm (ET)
About Today’s Guest Speaker
Mary McGoldrick, MS, RN, CRNI
Home Care and Hospice Consultant
Saint Simons Island, GA
Seasonal Influenza:
Best Practices for Preventing
and Controlling Influenza in
Home Care
Mary McGoldrick, MS, RN, CRNI
Home Care and Hospice Consultant
Saint Simons Island, GA
“Nothing to Disclose”
Learning Objectives
At the end of the webinar, the participant will be
able to:
• Discuss the 2014-2015 influenza season
• Discuss influenza vaccination coverage
• Implement best practices to prevent and control
the spread of seasonal influenza
2014-2015 Influenza Season
Influenza Vaccination Coverage
Influenza Vaccination Coverage
by Occupation
Influenza Vaccination Coverage
by Work Setting
Coverage by Employer Mandate
Influenza Vaccination
by Place of Vaccination
Reasons for Accepting the
Influenza Vaccination
Reasons for Declining the
Influenza Vaccine
Influenza Vaccination:
Employer Best Practices
• Influenza immunization program
• Vaccination/declination requirements
• Tracking influenza vaccination status
• Staff education
• Leadership talking points for clinicians
• Business case for staff immunization rates
• Evaluate influenza vaccination program
Influenza Prevention:
Best Patient Care Practices
• Influenza vaccination
• Antiviral drugs
• Hand hygiene
• Standards precautions:
• Respiratory hygiene/cough etiquette
• Use of personal protective equipment
• Droplet precautions
Best Practices for Preventing and
Controlling Influenza in Home Care
• 2014-2015 influenza season
• Influenza vaccination
• Best practices to prevent and control the spread of
seasonal influenza
Questions?
Mary McGoldrick, MS, RN, CRNI
Home Care and Hospice Consultant
Home Health Systems, Inc.
Phone: (912) 634-0469
Fax: (800) 649-0017
E-mail: [email protected]
Web: HomeCareandHospice.com
Immunizations and Cardiovascular Health
 CDC recommends the following vaccines for people
with heart disease, stroke, or other cardiovascular
disease:
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–
–
–
–
–
Influenza vaccine
Pneumococcal polysaccharide vaccine
Tdap vaccine
Zoster vaccine if > 60 years
HPV vaccine series for women up to age 26 and men up to age 21
MMR vaccine if born in 1957 or after and have not gotten this vaccine
or have immunity
– Varicella vaccine if born in 1980 or after and have not gotten two
doses of this vaccine or have immunity
CDC, 2013
Risk for Influenza Complications
 People with heart disease and those who have had a stroke are at
high risk for developing serious complications from the flu
 Among adults hospitalized with the flu during the 2013-2014
influenza season, heart disease was among the most commonly
occurring chronic conditions
– 37% of adults hospitalized with the flu during the 2013-2014 flu season had heart
disease
– Studies show influenza is associated with an increase of heart attacks and stroke
– Heart disease includes but is not limited to coronary artery disease [heart attack or
myocardial infarction, acute coronary syndrome and angina (chest pain related to
heart disease)]. It also includes the following common conditions:
•
•
•
•
•
•
Heart failure
Hypertensive heart disease
Pulmonary heart disease
Heart valve disorders
Arrhythmias including atrial fibrillation
Congenital heart defects
CDC, 2014
Influenza Immunization & CVH
 Live Attenuated Influenza Vaccine (LAIV) – nasal vaccine
– Do not give to a person who meets any of the following criteria
(give Inactivated Influenza vaccine (IIV) – IM or intradermal
instead):
• Has a history of either an anaphylactic or non-anaphylactic
hypersensitivity to eggs
• Is pregnant
• Is age 50 years or older
• Has chronic pulmonary (including asthma), cardiovascular
(excluding hypertension), renal, hepatic, neurologic/neuromuscular,
hematologic, or metabolic (including diabetes) disorders
• Has immunosuppression, including that caused by medications or
HIV
Summary of Recommendations for Adult Immunizations
www.immunize.org
Influenza Vaccine & CVH Outcomes
 Recent study indicates getting the influenza vaccine lowers a person’s
odds of a having heart attack, stroke, heart failure, or other major cardiac
event—including death—by about a third over the following year
 Greatest treatment effect was with highest-risk patients with more
coronary disease
Association Between Influenza Vaccination and
Cardiovascular Outcomes in High-Risk Patients, JAMA, 2013
 Another recent study shows flu vaccine stimulates the immune system to
produce antibodies that switch on certain processes in cells
– These processes lead to the production of molecules that protect the
heart
Flu vaccine may hold key to
preventing heart disease. ScienceDaily, 2014
Influenza Vaccination Rates Still Low
"The rate of administering flu vaccinations is
disappointingly low, even in developed countries,"
added Dr. Veljkovic.
"We hope that our results will encourage more people
to get vaccinated before the flu season starts."
Pneumococcal Immunization & CVH
 Recommendations for people age 64 years or
younger include many health issues including the
following CVH factors:
– Cigarette smoker
– Chronic cardiovascular disease (e.g., congestive heart
failure, cardiomyopathies)
Standing Orders for Administering
Pneumococcal (PPSV23 and PCV 13) Vaccine to Adults
www.immunize.org
Pneumococcal Vaccine & CVH Outcomes
 Recent study shows if a person is at risk for a heart attack,
getting a pneumonia vaccine could cut the risk in half,
 Study focus is on patients with risk factors for heart disease,
(e.g., high blood pressure or diabetes)
 Findings indicated pneumonia vaccines appeared to offer two
years of heart protection
 Not clear how the vaccine does helps, but doctors know that
pneumonia
Pneumococcal vaccination and risk of myocardial infarction,
Canadian Medical Association Journal, 2008
HHQI Best Practice Intervention Package:
Immunizations and Infection Prevention
Available on the Best Practices page under the Education tab at:
www.HomeHealthQuality.org
Questions?
Save the Date!
Next CardioLAN Webinar:
Smoking & Cardiovascular Health
Thursday, February 19, 2015
2:00pm – 3:00pm (ET)
Invitations will be sent to all CardioLAN members on February 18, 2015.
This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting the
Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of
the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy.
Publication number 11SOW-WV-HH-MMD-011515