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Reliability and Validity of a Standardized Measure of Influenza Vaccination Coverage among Healthcare Personnel

Published online by Cambridge University Press:  02 January 2015

Tanya E. Libby ,
Megan C. Lindley ,
Suchita A. Lorick ,
Taranisia MacCannell ,
Soo-Jeong Lee ,
Carmela Smith ,
Anita Geevarughese ,
Monear Makvandi ,
David A. Nace  and
Faruque Ahmed
Tanya E. Libby*
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
Megan C. Lindley
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
Suchita A. Lorick
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
Taranisia MacCannell
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging, Zoonotic, and Infectious Diseases, CDC, Atlanta, Georgia
Soo-Jeong Lee
Affiliation:
University of California, San Francisco, School of Nursing, San Francisco, California
Carmela Smith
Affiliation:
CDC Contractor to New Mexico Department of Health, Santa Fe, New Mexico
Anita Geevarughese
Affiliation:
New York City Department of Health and Mental Hygiene, New York City, New York
Monear Makvandi
Affiliation:
Epidemiology and Response Division, New Mexico Department of Health, Santa Fe, New Mexico
David A. Nace
Affiliation:
University of Pittsburgh, Pittsburgh, Pennsylvania
Faruque Ahmed
Affiliation:
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
*
California Emerging Infections Program, 360 22nd Street, Suite 750, Oakland, CA 94612 (tlibby@ceip.us)
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Abstract

Objective.

To evaluate the reliability and validity of a standardized measure of healthcare personnel (HCP) influenza vaccination.

Setting.

Acute care hospitals, long-term care facilities, ambulatory surgery centers, physician practices, and dialysis centers from 3 US jurisdictions.

Participants.

Staff from 96 healthcare facilities randomly sampled from 234 facilities that completed pilot testing to assess the feasibility of the measure.

Methods.

Reliability was assessed by comparing agreement between facility staff and project staff on the classification of HCP numerator (vaccinated at facility, vaccinated elsewhere, contraindicated, declined) and denominator (employees, credentialed nonemployees, other nonemployees) categories. To assess validity, facility staff completed a series of case studies to evaluate how closely classification of HCP groups aligned with the measure's specifications. In a modified Delphi process, experts rated face validity of the proposed measure elements on a Likert-type scale.

Results.

Percent agreement was high for HCP vaccinated at the facility (99%) and elsewhere (95%) and was lower for HCP who declined vaccination (64%) or were medically contraindicated (64%). While agreement was high (more than 90%) for all denominator categories, many facilities' staff excluded nonemployees for whom numerator and denominator status was difficult to determine. Validity was lowest for credentialed and other nonemployees.

Conclusions.

The standardized measure of HCP influenza vaccination yields reproducible results for employees vaccinated at the facility and elsewhere. Adhering to true medical contraindications and tracking decimations should improve reliability. Difficulties in establishing denominators and determining vaccination status for credentialed and other nonemployees challenged the measure's validity and prompted revision to include a more limited group of nonemployees.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 4 , April 2013 , pp. 335 - 345
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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