Influenza infection control guidance provided to staff at Veterans Affairs facilities for veterans with spinal cord injury during a pandemic

Abstract

Context/objective

To assess guidance provided to staff at Veterans Affairs (VA) healthcare facilities on H1N1 influenza infection control for veterans with spinal cord injuries and disorders (SCI/D).

Study design

Cross-sectional qualitative semi-structured interviews.

Setting

Thirty-three VA healthcare facilities from throughout the United States that provide care to veterans with SCI/D.

Participants

Thirty-three infection control key informants, each representing a VA healthcare facility.

Interventions

None.

Outcome measures

Infection control practices, including vaccination practices, hospital preparedness, and recommendations for future pandemics, both in general and specifically to SCI/D.

Results

Most (n = 26, 78.8%) infection control key informants believed veterans with SCI/D were at increased risk for influenza and complications, but only 17 (51.5%) said veterans with SCI/D were treated as a priority group for vaccination at their facilities. There was little special guidance provided for treating veterans with SCI/D, and most (n = 28, 84.8%) informants said that infection control procedures and recommendations were applied universally. Yet, 10 key informants discussed ‘unique challenges’ to infection control in the SCI/D population. Informants discussed the potential for infectious agents to be spread through shared and common use equipment and the necessity of including caregivers in any vaccination or educational campaigns.

Conclusion

Greater input by experts knowledgeable about SCI/D is recommended to adequately address pandemic influenza within healthcare facilities where individuals with SCI/D receive care.

Keywords:

• Infection control
• Hygiene
• Vaccination
• Immunization
• Patient education
• Veterans
• Spinal cord injuries
• Paraplegia
• Tetraplegia
• Influenza
• Human
• Pandemics
• Access to care

Acknowledgements

This material is based on work supported by the Office of Research and Development, Health Services Research and Development, and Spinal Cord Injury Quality Enhancement Research Initiative, of the Department of Veterans Affairs (Project number: RRP 10-046). This study reflects only the authors' opinions and does not necessarily reflect the official position of the Department of Veterans Affairs.