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      Understanding barriers to effective management of influenza outbreaks by residential aged care facilities

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          Abstract

          Objective

          To identify the perceived barriers to the implementation of the Australian national guidelines on influenza outbreak management with Sydney Local Health District ( SLHD) residential aged care facility ( RACF) staff.

          Methods

          All SLHD RACFs were invited to participate in a telephone interview. The questionnaire collected information about demographic characteristics and participants' level of agreement with statements regarding perceived barriers to implementing the national guidelines for influenza outbreak management.

          Results

          Twenty‐eight of 61 RACFs (46%) participated in the study. The three most common barriers identified were as follows: scepticism towards staff influenza vaccination (n = 13, 46%); the effort required to read the national guidelines (n = 11, 39%); and lack of infrastructure to physically separate residents during an outbreak (n = 10, 36%).

          Conclusions

          We recommend implementing and evaluating programmes which address misconceptions about influenza vaccination amongst RACF staff. Further, all RACF staff, including care staff, should receive targeted education on the role of infection control in influenza outbreak management.

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          Most cited references10

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          Requiring influenza vaccination for health care workers: seven truths we must accept.

          In this paper we outline the seven primary truths supporting the call for requiring influenza immunization of all health care workers. We view this as a serious patient safety issue, given the clear and compelling data regarding the frequency and severity of influenza infection. In addition, clear-cut safety, efficacy, economic, legal, and ethical platforms support the use of influenza vaccine. Unfortunately health care workers have demonstrated, over almost 25 years that they are unwilling to comply with voluntary influenza immunization programs utilizing a variety of education and incentive programs, at rates sufficient to protect the patients in their care. We suggest that an annual influenza immunization should be required for every health care worker with direct patient contact, unless a medical contraindication or religious objection exists, or an informed declination is signed by the health care worker. High rates of health care worker immunization will benefit patients, health care workers, their families and employers, and the communities within which they work and live.
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            Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza season.

            Health care personnel (HCP) working while experiencing influenza-like illness (ILI) contribute to influenza transmission in health care settings. Studies focused on certain HCP occupations or work settings have demonstrated that some HCP often continue to work while ill.
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              Immunosenescence and Challenges of Vaccination against Influenza in the Aging Population.

              Influenza is an important contributor to morbidity and mortality worldwide. Accumulation of genetic mutations termed antigenic drift, allows influenza viruses to inflict yearly epidemics that may result in 250,000 to 500,000 deaths annually. Over 90% of influenza-related deaths occur in the older adult population. This is at least in part a result of increasing dysregulation of the immune system with age, termed immunosenescence. This dysregulation results in reduced capacity to cope with infections and decreased responsiveness to vaccination. The older adult population is in dire need of improved vaccines capable of eliciting protective responses in the face of a waning immune system. This review focuses on the status of immunity, responses to influenza vaccination, and strategies that are currently being explored to elicit enhanced immune responses in this high risk population.
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                Author and article information

                Contributors
                leena.gupta@health.nsw.gov.au
                Journal
                Australas J Ageing
                Australas J Ageing
                10.1111/(ISSN)1741-6612
                AJAG
                Australasian Journal on Ageing
                John Wiley and Sons Inc. (Hoboken )
                1440-6381
                1741-6612
                10 December 2018
                March 2019
                : 38
                : 1 ( doiID: 10.1111/ajag.2019.38.issue-1 )
                : 60-63
                Affiliations
                [ 1 ] Sydney Local Health District Public Health Unit Sydney New South Wales Australia
                [ 2 ] School of Public Health Sydney Medical School University of Sydney Sydney New South Wales Australia
                Author notes
                [*] [* ]Correspondence to: Dr Leena Gupta, Sydney Local Health District, Public Health Unit. Email: leena.gupta@ 123456health.nsw.gov.au
                Author information
                http://orcid.org/0000-0002-2919-9485
                Article
                AJAG12595
                10.1111/ajag.12595
                6590128
                30537166
                ee0201ec-4b76-42f7-a8c3-13eac6c87396
                © 2018 Sydney Local Health District. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 0, Tables: 2, Pages: 4, Words: 3326
                Categories
                Brief Report
                Brief Reports
                Custom metadata
                2.0
                ajag12595
                March 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:24.06.2019

                disease outbreaks, infection control,influenza, human,surveys and questionnaires,vaccination

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