Introduction

October through March is flu season and vaccination remains the single most effective preventive measure available against influenza, and can prevent many illnesses, deaths, and losses in productivity.

CMS is now requiring PPS hospitals to report their healthcare worker immunization rates for this flu season and have stated that critical access hospitals, long-term care facilities and ambulatory surgery centers will also be asked to do this in the near future.

Iowa has been working to improve hospital health care worker influenza immunization rates since 2006 and is now leading the nation in this CDC iniative with a rate of over 94%.

The purpose of this survey is to learn more from each Iowa LTCF, NF, SNF and ALP about their influenza vaccination practices with regard to staff. Your responses are very much appreciated and will assist stakeholders in improving the effectiveness of our state’s healthcare worker immunization programming, increase our reliability in terms of the effectiveness of our approaches, and ultimately help improve statewide healthcare worker immunization rates and health prior to mandatory CMS reporting in the future.

Individual responses will not be personally identifiable, and facility level responses will not be reported publicly.

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* 1. What is the name of your facility?

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* 2. What town/city is your facility located in?

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* 3. How many employees do you have in your facility? (Include all those who receive a direct paycheck from the reporting facility, regardless of patient contact.)

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* 4. During the 2012-2013 flu season how many of these employees were vaccinated for influenza?* (Either at your facility or provided proof of vaccination from another site.)
*Use "NA" if you did not track employee vaccination rates.

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* 5. How many volunteers do you have in your facility? (This includes volunteers that are in your facility on a routine basis of 5 or more hours a week.)

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* 6. During the 2012-2013 flu season how many of these volunteers were vaccinated for influenza?* (Either at your facility or provided proof of vaccination from another site.)
*Use "NA" if you did not track these vaccination rates.

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* 7. How many licensed independent practitioners are affiliated with your facility? (Not directly employed by your facility, but are in your facility on a routine basis. Examples include: Physicians; advanced practice nurses; physician assistants; physical therapists)

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* 8. During the 2012-2013 flu season how many of your facility's licensed independent practitioners were vaccinated for influenza?* (Either at your facility or provided proof of vaccination from another site.)
*Use "NA" if you did not track these vaccination rates.

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* 9. Do you have an employee policy regarding mandatory influenza vaccinations?

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