Increasing influenza immunization rates among healthcare providers in an ambulatory-based, University Healthcare Setting☆.

OBJECTIVE: Despite its 'best practice' status as an intervention to combat healthcare-related influenza, many healthcare personnel (HCP) do not seek vaccinations themselves. The objective of this study was to achieve the Healthy People [HP] 2020's influenza vaccination goal of 90% among our HCP. DESIGN: The study utilized the model for improvement, consisting of Plan-Do-Study-Act (PDSA) cycles. Each influenza season served as a PDSA cycle until the HP 2020 vaccination goal was achieved. The quality improvement (QI) study was conducted over four influenza seasons (i.e. 2014-15; 2015-16; 2016-17 and 2017-18). SETTING: The study's setting was an ambulatory-based, university health center within a suburban university located in central New Jersey. PARTICIPANTS: Adapting the National Vaccine Advisory Committee's definition of HCP, clinical and non-clinical staff members (n = 110) participated in the QI-study. INTERVENTIONS: QI-interventions were centered on staff education/outreach, improved accessibility to influenza vaccines and frequent communication to staff over several PDSA cycles. MAIN OUTCOME & RESULTS: The QI-interventions significantly increased our overall vaccination coverage on our influenza vaccination status survey from 70.2% (2011-14 influenza seasons; n = 102) to 84.9% (2014-15 influenza season; n = 93) in PDSA 1, and 91.1% (2015-16 influenza season; n = 90) in PDSA cycle 2 (χ2 = 309.53, P < 0.001). Vaccination rates remained above the 90% performance goal during our quality control/assurance measuring periods (i.e. the 2016-18 influenza seasons). CONCLUSIONS: This study demonstrates that influenza vaccination coverage can significantly improve among HCP through the application of concurrent and multifaceted QI-interventions.

Failure of college students to complete an online alcohol education course as a predictor of high-risk drinking that requires medical attention.

BACKGROUND: AlcoholEdu® for College and other computer-based education programs have been developed to reduce alcohol use and related problems among students. OBJECTIVES: This study investigated whether the failure of incoming first-year students to complete AlcoholEdu predicts future high-risk drinking that requires medical attention. METHODS: A review of clinical records kept by a single university's health service identified 684 undergraduates (classes of 2007-2011) who had presented for an alcohol event (September 2003 through June 2008). We used survival analysis to determine whether students who partially completed the course or failed to take it were disproportionately represented among student patients who presented with elevated blood alcohol concentration (BAC). RESULTS: Students who failed to take the online course were 4.64 times more likely than those who completed it to experience an alcohol event (p < .0001), while those students who had partially completed the course were 1.52 times more likely (p < .0001). Amount of online alcohol education and gender were not significantly related to students' measured BAC level. CONCLUSION: Students who had completed AlcoholEdu were less likely to present for an alcohol event than were students who partially completed or failed to take the course. Campus administrators should consider whether students who fail to complete an online alcohol course should be flagged for more focused interventions (e.g., brief motivational interview, mandatory education classes). SCIENTIFIC SIGNIFICANCE: This is the first study to show a relationship between first-year college students' non-completion of an online alcohol course and subsequent high-risk drinking that requires medical attention.

First Use of a Serogroup B Meningococcal Vaccine in the US in Response to a University Outbreak.

BACKGROUND: In 2013-2014, an outbreak of serogroup B meningococcal disease occurred among persons linked to a New Jersey university (University A). In the absence of a licensed serogroup B meningococcal (MenB) vaccine in the United States, the Food and Drug Administration authorized use of an investigational MenB vaccine to control the outbreak. An investigation of the outbreak and response was undertaken to determine the population at risk and assess vaccination coverage. METHODS: The epidemiologic investigation relied on compilation and review of case and population data, laboratory typing of meningococcal isolates, and unstructured interviews with university staff. Vaccination coverage data were collected during the vaccination campaign held under an expanded-access Investigational New Drug protocol. RESULTS: Between March 25, 2013, and March 10, 2014, 9 cases of serogroup B meningococcal disease occurred in persons linked to University A. Laboratory typing results were identical for all 8 isolates available. Through May 14, 2014, 89.1% coverage with the 2-dose vaccination series was achieved in the target population. From the initiation of MenB vaccination through February 1, 2015, no additional cases of serogroup B meningococcal disease occurred in University A students. However, the ninth case occurred in March 2014 in an unvaccinated close contact of University A students. CONCLUSIONS: No serogroup B meningococcal disease cases occurred in persons who received 1 or more doses of 4CMenB vaccine, suggesting 4CMenB may have protected vaccinated individuals from disease. However, the ninth case demonstrates that carriage of serogroup B Neisseria meningitidis among vaccinated persons was not eliminated.