Cross-sectional study on factors hampering implementation of measles pre- and post-exposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

Monday, 22nd of May 2017

Am J Infect Control. 2017 May 16. pii: S0196-6553(17)30188-8. doi: 10.1016/j.ajic.2017.02.033. [Epub ahead of print]

Cross-sectional study on factors hampering implementation of measles pre- and post-exposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

Fievez LCR¹ Wong A² Ruijs WLM³ Meerstadt-Rombach FS³ Timen A³.

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Abstract

BACKGROUND:

This study examined adherence to national recommendations on measles pre- and postexposure measures including immunization of health care workers (HCWs) in Dutch hospitals during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and organizational issues hamper implementation.

METHODS:

This was a cross-sectional survey among all general and academic hospitals in The Netherlands. An online structured questionnaire (48 questions) was administered. Analysis was performed using descriptive statistics and logistic regression.

RESULTS:

Of 88 hospitals 70 (79.5%) were included. Of 68 hospitals 48 (70.6%) assessed susceptibility to measles in HCWs. Of 70 hospitals 61 (87.1%) offered vaccination to susceptible HCWs. Of 63 hospitals 42 (66.7%) had post- exposure policies consistent with national recommendations. Of 62 hospitals 30 (48.4%) implemented all these measures which is the minimum set of measures considered necessary to adequately prevent measles in HCWs. Logistic regression suggests that hospitals with several locations hospitals with more employees and hospitals where infectious disease experts designed infection prevention policies while occupational health experts implemented the policy less often implemented this minimum set of measures (P < .001 P < .01 and P < .001 respectively).

CONCLUSIONS:

During a national measles outbreak most hospitals took measures to prevent measles in HCWs but less than half implemented the minimum set of measures required. Implementation strategies in hospitals need to be improved especially in large-sized hospitals and hospitals with several locations and with respect to the assignment of responsibilities for infection prevention policies.