Private Duty

Implement flu prevention program for patients, staff to achieve positive outcomes

Although this year’s flu vaccine is only about 30% effective against this year’s dominant flu strain, it’s still important to make sure clients and staff get the vaccine.

That’s because the vaccine can reduce the severity of symptoms and the duration of the illness, even if you get the flu, says Mary McGoldrick, a home care and hospice consultant for Georgia-based Home Health Systems Inc.

Agencies also should strongly consider developing an influenza prevention and education program to help both patients and caregivers fend off the flu.

Doing so has helped one Maryland agency providing both home health and private duty services to achieve positive patient outcomes and avoid significant burdens associated with a flu outbreak among staff.

Such a program is particularly worthwhile in light of this year’s flu season.

In early February, 49 out of 50 states were experiencing widespread flu activity. And hospitalizations were on pace with the 2014-2015 flu season — one of the longest and most severe flu seasons in recent years, according to the CDC.

During this season and in 2014-2015, a strain of the flu typically associated with more flu cases, hospitalizations and deaths was predominant.

Build a seasonal flu education program

Health at Home in Baltimore takes this guidance to heart and has made flu vaccination a priority.

The private duty agency earned the top rating of 5 stars in quality of care in Medicare-certified home health.

It also scored 87.3% on the flu measure in the January 2018 refresh of Home Health Compare. That rate is a little over 10% higher than the national average of 77.2%.

The agency’s success is in part due to a flu education and prevention program supported by parent company US CareNet in Augusta, Ga.

The agency starts putting its flu program in place in July to get ahead of the season. Staff distribute informational material to clients, posters hang in the agency office itself, caregivers are reeducated on flu prevention techniques and the agency facilitates a flu vaccination clinic for both clients and caregivers.

“Our organization overall is very focused on our employees getting vaccinated as well,” says Debbie Keith, chief nursing officer with US CareNet.

This step has multiple benefits because it builds awareness for caregivers who then encourage clients to get vaccinated, protects caregivers themselves and by extension protects clients, Keith says.

The agency covers the cost of having employees vaccinated if they aren’t covered by insurance.

“It’s well worth the investment, because having an employee out for the flu is really costly all around,” Keith says.

Each year, the company evaluates its flu program and outcomes related to the flu and make changes based on that information.

Consider flu prevention techniques

  • Encourage sick staff to stay home. Making sure caregivers and office staff who have the flu stay home should be a priority for management, McGoldrick says. “It’s got to start with office management,” McGoldrick says. “If they hear that someone is sick, they need to tell them to stay home.” She acknowledges this can be a challenge, because agencies may struggle to make visits with reduced staffing levels. But the cost is too high to allow sick staff into patient homes, she adds. “I know it’s hard to tell people to stay home, but we’ve got to do the right thing for our patients and even our other employees,” McGoldrick says. “The last thing you want to have going around is that the patient got sick because your staff went in for a visit while sick.”
  • Require a face mask. For employees who have not received the flu vaccine, it should be mandatory to wear a face mask, McGoldrick says. Some states and counties actually require this. Caregivers who have had the flu and return to work with a residual cough also should wear a face mask on visits. Clients may be somewhat nervous at the sight of a caregiver wearing a mask. To alleviate those fears, caregivers should explain, “I was recently sick, I feel absolutely fine, I have had no fever for [designated time], but sometimes I cough spontaneously and I don’t want that to happen while I’m here in your home,” McGoldrick says.
  • Resist touching your face. Most people subconsciously touch their faces, wipe their noses or rub the corner of the eye, McGoldrick says. This can lead to virus exposure. “If you just don’t touch your face, you won’t self-inoculate yourself with the virus,” McGoldrick says.
  • Wash your hands. Always wash your hands before and after touching the client to prevent the spreading of germs, McGoldrick says. Use alcohol-based hand hygiene product routinely throughout the course of client visits. If hands become visibly soiled, after wiping the nose for instance, caregivers should use soap and running water.
  • Focus on education. Educate staff on the importance of getting vaccinated and how to best encourage clients to get vaccinated. The CDC offers free resources for agencies can use for this education, including fact sheets on how to make a strong flu vaccine recommendation. — Kirsten Dize (

Related link: View CDC resources for health providers at