Urgent Care Providers' Knowledge and Attitude About Public Health Reporting and Pertussis Control Measures

Abstract

Objectives We assessed urgent care providers’ knowledge about public health reporting, guidelines, and actions for the prevention and control of pertussis; attitudes about public health reporting and population-based data; and perception of reporting practices in their clinic. Methods We identified the 106 providers (95% are physicians) employed in 28 urgent care clinics owned by Intermountain Healthcare located throughout Utah and southern Idaho. We performed a descriptive, cross-sectional survey and assessed providers’ knowledge, attitudes, beliefs, and behaviors associated with population-based data and public health mandates and recommendations. The online survey was completed between 11/1/2007 and 2/29/2008. Results Among 63 practicing urgent care providers (60% response rate), 19% knew that clinically diagnosed pertussis was reportable, and only half (52%) the providers correctly responded about current pertussis vaccination recommendations. Most (35–78%) providers did not know the prevention and control measures performed by public health practitioners after reporting occurs, including contact tracing, testing, treatment, and prophylaxis. Half (48%) the providers did not know that health department personnel can prescribe antibiotics for contacts of a reported case, and only 22% knew that health department personnel may perform diagnostic testing on contacts. Attitudes about reporting are variable, and reporting responsibility is diffused. Conclusion To improve our ability to meet public health goals, systems need to be designed that engage urgent care providers in the public health process, improve their knowledge and attitude about reporting, and facilitate the flow of information between urgent care and public health settings.

Should acellular pertussis vaccine be recommended to healthcare professionals?

“…Almost half (48%) were not aware of the need to prescribe prophylactic antibiotics for people exposed to pertussis, and only 22% knew that the patients' close contacts should also be tested 75 .…”

“…HCPs may contract pertussis and transmit the disease to their patients and hospital colleagues, thus causing disease outbreaks 1 24 ; however, other HCPs, such as nurses, physiotherapists and people who are in direct contact with patients are at greater risk of becoming infected 63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105 . Adults generally develop a milder form of the disease than children, however morbidity and the chances of complications are high 1,7,21,22,…”

“…Although pertussis hospital outbreaks involve only a small number of individuals, they may be very costly due to the recommended investigation and control measures that involve the temporary removal of the professionals from the working environment, the use of prophylactic antibiotics and laboratory tests of infected cases 65 In the United States, pertussis outbreaks in HCPs were reported more than three decades ago 105 and reports of pertussis outbreaks involving HCPs have become increasingly common since the 1990s, especially during pertussis epidemics which occur every three to four years even in vaccinated populations 10,11,66,67,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81 .…”

“…Despite this, prophylactic measures to avoid infections are not always adopted in a timely manner 63,64,65,66,67,68,69,70,71,72,73,74,75,76 .…”

“…Table 4 Factors associated with acceptance and refusal of acellular pertussis vaccines by health care professionals (HCPs) 17,75,81,87,88,89,90,91 .…”