Assessment of Immunization Policies and Practices in 
West Virginia Long-Term Care Facilities (WV LTCF)

David Elliott, Pharm.D., Kristy Lucas, Pharm.D.  
School of Pharmacy
West Virginia University – Charleston Division

Purpose:  To assess infection control policies and practices among WV LTCF, focusing on resident and employee vaccination procedures.

Methods:  A survey was mailed to all LTCF registered with the WV Healthcare Association  (n=126). Telephone introduction and follow-up completed by a research assistant ensured investigator blinding. The 39-question survey collected LTCF demographics, information about policies for recommending and documenting influenza and pneumococcal vaccines, and information about policies for influenza outbreaks.    

Results:  56 demographically diverse WV LTCFs completed surveys. Upon admission, 80% of homes assess each resident’s need for influenza vaccination, while 73% assess pneumococcal vaccination status. 73% recommend employee vaccination against influenza. 55% recommend per diem staff vaccination. 64% recommend vaccination of contracted non-employees or volunteers (e.g., podiatrists, dentists, pharmacists, haridressers). Information about resident influenza and pneumococcal vaccination is kept in the medical record by 93% and 79% of the respondents, respectively. Influenza and pneumococcal vaccination is recorded in a central log in 50% and 34% of the homes, respectively. Wile 98% of respondents report having an organized program for resident vaccination of influenza, only 69% have a program for pneumococcal vaccination. Interestingly, only 16% of respondents have a written policy regarding the use of anti-viral agents for influenza outbreaks in their facility. Only 7 WV LTCFs were able to give an estimate of the number of influenza outbreaks they experienced in the previous two years. Most of these could not subsequently characterize what occurred regarding vaccination and treatment of staff and other residents during an outbreak.

Conclusion:  Through recommending vaccination, most LTCF demonstrate a desire to prevent influenza and pneumococcus infections in their homes. However, many WV LTCF do not have a clear, uniform policy for documenting vaccination or for treatment of influenza outbreaks. Considering the highly contagious nature of these illnesses, efforts to improve infection control via policies influencing employee and other outside vectors may potentially reduce the overall rate of such infections. This survey demonstrates a need for development and implementation of such policies.

Supported by:  CAMC Health Education and Research Institute