American Journal of Infection Control
Vol 41 | No. 4 | April 2013 | Pages 285-388
http://www.ajicjournal.org/current

Measuring influenza immunization coverage among health care workers in acute care hospitals and continuing care organizations in Canada
Susan Quach, MSc, Jennifer A. Pereira, PhD, Jemila S. Hamid, PhD, Lois Crowe, BA, Christine L. Heidebrecht, MSc, Jeffrey C. Kwong, MD, MSc, Maryse Guay, MD, Natasha S. Crowcroft, MD, PhD, Allison McGeer, MD, MSc, Larry W. Chambers, PhD, FACE, HonFFPH (UK), FCAHS, Sherman D. Quan, MSc, Julie A. Bettinger, PhD, MPH, Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network PCIRN Vaccine Coverage Theme Group, Canadian Healthcare Influenza Immunization Network

Abstract
Background
Immunizing health care workers against influenza is important for preventing and reducing disease transmission in health care environments. We describe the ability of Canadian health care organizations to measure influenza immunization coverage among health care workers and identify factors associated with comprehensive influenza immunization measurement.

Methods
A Web-based survey was distributed to influenza immunization campaign planners responsible for delivering the 2010-2011 influenza vaccine to health care workers working in acute care hospitals or long-term continuing care organizations. The primary outcome was the ability to comprehensively measure influenza immunization coverage.

Results
Of the 1,127 health care organizations approached, 721 (64%) responded. Ninety-one percent had incomplete immunization coverage measurement; 7% could not measure coverage among any personnel. After multivariable adjustment, organizations with a written influenza immunization implementation plan (odds ratio, 2.0; 95% confidence interval, 1.1-3.5) or a policy or procedure describing how to calculate or report immunization rates (odds ratio, 2.1; 95% confidence interval, 1.2-3.9) were more likely to have comprehensive measurement of influenza immunization coverage than organizations without these practices.

Conclusion
Most organizations demonstrated incomplete measurement of influenza immunization among health care workers. Given the use of influenza immunization coverage as a measure of quality of care, further work is needed to develop a standardized approach to improve its measurement.