Joseph Browne

297‘Flu and Far Between’ - Evaluation of Influenza Vaccination among Eligible Patients with Prolonged In-hospital Stay.

Background: Influenza is an important global cause of morbidity and mortality in older people. Vaccination remains the single best public health initiative. Much of the focus to date has been on community vaccination, however in 2015 there was a large outbreak of nosocomial related influenza in older people at St. James’s Hospital. Aim: The aim of this audit was to assess compliance with influenza vaccination guidelines in long-stay patients. Methods: Data was collected from 104 inpatients who had a length of stay (LOS) of >40 days. Demographic data was collected in those over the age of 65 or had COPD. An email reminder was circulated to clinicians highlighting the importance of vaccination, and identifying those patients under their care who had yet to be vaccinated. Following this intervention, a subgroup of 42 of the original cohort were re-audited. Results: Of the 104 patients reviewed, 20% received vaccination. 24% MedEl patients were vaccinated compared to 17% medical, and 18% surgical. Average age of patients reviewed was 77 years, 86% were >65. On re-audit of 42 unvaccinated patients that remained in hospital 4 weeks later, a further 8 patients had been vaccinated although overall vaccination rates remained low at 19%. Conclusion: Delayed discharge of older patients out of the acute hospital environment necessitates consideration of this important public health intervention for those patients with prolonged admissions. Awareness of the need for influenza vaccination among hospital physicians and surgeons is low, with only 20% of eligible patients receiving vaccination. Despite prompting, a re-audit showed persistently low levels of uptake. Given the strong indications for vaccination and prior inpatient outbreaks, we recommend hospital-wide physician education with regards to influenza vaccination of patients. Compliance will be optimised in the next influenza season through use of reminders on electronic prescribing for older people.