Infection Control and Vaccine Hesitancy in the Emergency Department

Castner, Jessica

doi:10.1016/j.jen.2020.09.003

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…Individual attitudes, beliefs, and perceptions are the most influential predictors of vaccine acceptance. 55 Our study expands on the 2021 work of Fernandez-Penny et al, which delved into vaccine hesitancy as it relates to attitudes/perceptions of the COVID-19 virus and disease and trust in the medical system. Vaccine-hesitant individuals in this survey felt they were in better health compared to vaccine-acceptant individuals, which falls in line with previous studies.…”

Section: Discussionmentioning

confidence: 81%

Survey of Vaccine Hesitancy in Patients Visiting Three Tertiarycare Emergency Departments in Southeast Louisiana

Cooper,

Harmon,

Alemayehu

et al. 2023

WestJEM

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Objectives Vaccine hesitancy has been a barrier to achieving herd immunity during the coronavirus 2019 (COVID-19) pandemic. Having low socioeconomic status and education levels, and being a person of color, are associated with higher COVID-19 infection risk and worse outcomes. These same groups are associated with higher vaccine hesitancy. The state of Louisiana has one of the lowest vaccination rates in the country. In this study we aimed to identify demographic, perspective, and health behavior factors associated with vaccine hesitancy in emergency departments (ED) in Southeast Louisiana. Methods A cross-sectional survey was distributed at three tertiary-care hospital EDs. Patients >18 years old and not in acute distress were recruited between April–July 2021. The 37-item questionnaire addressed socioeconomic demographics, social determinants of health, COVID-19 safety practices, thoughts and perceptions on COVID-19 and vaccines, sources of COVID-19 and vaccine information, and trust in the healthcare system. Results Overall, 247 patients completed our survey. Of those, 29.6% reported they were vaccine hesitant. These respondents were significantly more likely, when compared to vaccine-acceptant respondents, to never have married, to have some college education, make less than <$25,000 in household earnings yearly, be unsure whether vaccines prevent disease, not have discussed the COVID-19 vaccine with their primary care doctor, and to prefer to do their own research for COVID-19 vaccine information. We observed no statistically significant differences based on gender, race/ethnicity, parental status, area of living, or their perceived risk of needing hospitalization for treatment or dying from the virus. Conclusion Vaccine hesitancy was associated with multiple socioeconomic factors, perspectives, and beliefs. Vaccine-hesitant individuals were more uncertain about the safety of the COVID-19 vaccine, the feasibility of obtaining the vaccine, and its efficacy. Public health interventions aimed at these findings and improving public trust in healthcare systems are needed to increase vaccine acceptance.

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Section: Discussionmentioning

confidence: 81%

Survey of Vaccine Hesitancy in Patients Visiting Three Tertiarycare Emergency Departments in Southeast Louisiana

Cooper,

Harmon,

Alemayehu

et al. 2023

WestJEM

View full text Add to dashboard Cite

show abstract

“…Individual attitudes, beliefs, and perceptions are the most influential predictors of vaccine acceptance. 55 Our study expands on the 2021 work of Fernandez-Penny et al, which delved into vaccine hesitancy as it relates to attitudes/ perceptions of the COVID-19 virus and disease and trust in the medical system. Vaccine-hesitant individuals in this survey felt they were in better health compared to vaccineacceptant individuals, which falls in line with previous studies.…”

Section: Discussionmentioning

confidence: 81%

WestJEM Full-Text Issue

Valenzi

2023

WestJEM

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Buprenorphine is an evidence-based treatment for opioid use disorder that is underused in the emergency department (ED). In this study we evaluated changes in emergency physician knowledge, confidence, and self-efficacy regarding buprenorphine prescribing and working with patients who use drugs after implementation of an ED buprenorphine quality improvement (QI) initiative.Methods: An anonymous, online survey was administered to emergency physicians staffing four EDs in New England in 2019 and 2020 before and after an ED QI initiative. Survey questions included novel and previously validated questions to assess confidence, knowledge, self-efficacy, and attitudes about buprenorphine and working with patients who use drugs. Confidence, self-efficacy, and attitude responses were assessed on a Likert scale. Participants received a gift card for survey completion. We analyzed pre-and post-survey responses descriptively and compared them using t-tests. Using logistic regression we evaluated the factors associated with buprenorphine prescribing.Results: Of 95 emergency physicians, 56 (58.9% response rate) completed the pre-intervention survey and 60 (63.2%) completed the post-survey. There was an increase in the number of X-waivered adult emergency physicians and ED buprenorphine prescribing after program implementation. Physician confidence increased from a mean of 3.4 (SD 0.8) to 3.9 (SD 0.7; scale 1-5, p < 0.01). Knowledge about buprenorphine increased from a mean score of 1.4 (SD 0.7) to 1.7 (SD 0.5, p < 0.01). Physician attitudes and self-efficacy did not change. Post-initiative, increased confidence was associated with higher odds of buprenorphine prescribing (odds ratio 4.4; 95% confidence interval 1.07-18.4). Conclusion:After an ED QI initiative, buprenorphine prescribing in the ED increased, as did both physician confidence in working with patients who use drugs and their knowledge of buprenorphine. Increased confidence was associated with higher odds of buprenorphine prescribing and should be a focus of future, buprenorphine implementation strategies in the ED.

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“…and patient-centered care are largely compatible in government and other PHN work settings. For example,Thomas and Gray (2018) describes a population-based, person-centered end of life planning approach that focuses on maximizing quality of life and optimizing the understanding of individual end of life priorities through a population level education campaign and toolkit(Thomas & Gray, 2018).Authentic engagement and public health intervention co-development with communities and patient representatives has led to powerful and creative innovations in addressing a myriad of population health challenges from the opioid epidemic(Febres-Cordero et al, 2021) to vaccine hesitancy(Castner, 2020) and climate change. We recommend training resources and topics for PHNs include opportunities to create and implement integration of individual patient culture, experiences, and preferences in care decisions(Dang et al, 2021); meaningful community engagement processes (Organizing Committee for Assessing Meaningful Community Engagement in Health & Health Care Programs & Policies, 2022); and population health program design strategies authentically responsive to culture and context.…”

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confidence: 99%

Public health nursing workforce and learning needs: A national sample survey analysis

Castner¹,

Stanislo

Castner

et al. 2023

Public Health Nursing

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Objectives: Generate national estimates of the public health nursing workforce's (1) demographic and work characteristics and (2) continuing education learning needs in the United States. Design: Secondary data analysis of the 2018 National Sample Survey of Registered Nurses. Sample: Total 7352 of the 50,273 survey respondents were categorized as public health nurses (PHNs), representing an estimated 467,271 national workforce. Measurements: Survey items for demographics, practice setting, training topics, and language(s) spoken fluently were analyzed. Results: Workforce demographic characteristics are included. Mental health training was the most frequently endorsed topic by PHNs, followed by patient-centered care and evidence-based care. Training topic needs vary by practice setting. Conclusions:Results here can be used as a needs assessment for national public health nursing professional development and education initiatives. Further research is needed to refine and survey a nationally representative sample in a manner meaningful to public health nursing practice.

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Infection Control and Vaccine Hesitancy in the Emergency Department

Cited by 4 publications

References 36 publications

Survey of Vaccine Hesitancy in Patients Visiting Three Tertiarycare Emergency Departments in Southeast Louisiana

Survey of Vaccine Hesitancy in Patients Visiting Three Tertiarycare Emergency Departments in Southeast Louisiana

WestJEM Full-Text Issue

Public health nursing workforce and learning needs: A national sample survey analysis

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