Expanding on why these healthcare workers chose to show up to work while sick, Dr. Linam said that many believed they would let their patients or colleagues down otherwise, and they believed to be abiding by the “cultural norm.” Some shared that they were not aware of what is considered “too sick” to work, “especially as it relates to respiratory viral illness.”
In this same study, more than half of the respondents claimed they would continue to go to work if they exhibited “acute onset of significant respiratory tract symptoms,” while approximately 75% would continue working with a “cough or rhinorrhea only.” However, as noted in the study alluded to above, about one third of symptomatic workers shed virus.
Ultimately, Dr. Linam recommended a “tiered strategy to address healthcare worker illness.” First and foremost, the focus should be at the hospital-level, he said. “[We should work] with our [human resources] departments, leadership, infection prevention, and occupational health, in trying to make as clear as possible the definitions of what is considered too ill to work. This is pretty easy if you’re talking about fever and [gastrointestinal] illnesses. It becomes more challenging when you’re talking about respiratory symptoms and what’s too ill.” Paid sick-leave, relaxing doctors’ notes requirements, and creating nonpunitive sick leave policies are all strategies Dr. Linam believes may contribute to decreasing the rate at which healthcare workers spread infections throughout healthcare facilities. He stressed that we should “make it easier for healthcare workers to do the right thing. They already feel bad about not coming to work, we shouldn’t make it harder.”
Most importantly, leadership—both at the senior level and unit-leadership level—should be supportive, and should provide resilient staffing during infection seasons, such as the flu season. This may make those sick days easier to manage for the institution. “What’s interesting is that residency programs have been doing this for years. Most residencies have a jeopardy program, [which means] when you’re sick, there’s a pool of people to step-in and cover your shift.” This strategy can help institutions better plan for infection seasons, “instead of standing around on a burning platform.” At the individual level, healthcare workers should support their colleagues by providing assistance in the times of illness.
While infection prevention strategies focus on healthcare-associated infections originating from patients, one should not forget that healthcare workers can also unknowingly spread infections throughout healthcare facilities. Practicing proper hand hygiene, getting vaccinated for preventable infections, and staying home while ill are all actions that healthcare workers can take to prevent transmitting infections to susceptible patients.
SOURCE: SHEA Spring 2017 Conference
PRESENTATION: Preventing Respiratory Viral Healthcare Associated Infections in Children
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