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Table 1 Description of the 3 to 5-steps multimodal strategy for nosocomial influenza prevention

From: Effect of a multimodal strategy for prevention of nosocomial influenza: a retrospective study at Grenoble Alpes University Hospital from 2014 to 2019

Measure Details and evolution Units Evaluation
Promotion of vaccination among HCWs - Communication and information (emails, posters etc.) on vaccination All units Vaccination rate among HCWs determined with data from the occupational health unit
  - Vaccination in the occupational health unit during all epidemic seasons   
  - Delocalized vaccination in units by a referent nurse was implemented from 2017–2018 onwards   
  - A survey on vaccine hesitation was carried out during the 2017–2018 epidemic season   
  - Delocalized vaccination at the hospital lunchroom was implemented from 2018–2019 onwards   
  - Interventional studies with implementation intention or impact of threat were carried out during the 2018–2019 and 2019–2020 epidemic seasons [31]   
Implementation of an epidemiologic surveillance - Daily surveillance of the number of cases within the hospital All units Conformity rate for adherence to droplet precautions
  - Collection of information for all patients with a positive influenza test   
  - Check of droplet precautions’ application and oseltamivir treatment and reminder if necessary   
  - Determination of nosocomial status by an infection control practitioner   
  - Outbreak control measures if > 2 cases with nosocomial transmission within one unit   
Communication - Local recommendation available about management of influenza cases (precautions, treatment, outbreak management, etc.…) All units NA
  - Communication on influenza and vaccination to HCWs, patients and visitors with posters dispatched within the hospital   
  - Weekly emails on vaccination for HCWs   
  - Feed-back: weekly feedback to staff on outbreak evolution through the intranet portal during the epidemic period, reports in institutional commissions and in risk units at the end of the epidemic   
Implementation of systematic surgical masks use - Systematic surgical masks use Risk units* Conformity rate for HCWs and visitors determined with biweekly audits in risk units during the epidemic period
  - Implementation for all HCWs and visitors regardless of their vaccination status for the duration of the epidemic period   
  - Benchmarking (weekly feedback for each unit with comparison to the global results)   
Improvement of diagnosis capacities - Serial tests with RT-PCR R-DiaFlu® (≈ 5 h, performed in the virology laboratory on weekdays and Saturday mornings): used during the 5 epidemic seasons Risk units* Number of tests performed during the epidemic period
  - Rapid tests with RT-PCR GeneXpert® (≈ 35 min, performed in the virology laboratory):   
      - for emergencies only in 2014–2015   
      - in routine practice for risk units in 2015–2016 (weekdays and Saturday mornings)   
      - in routine practice for risk units and ICUs, and on specific demand for non-risk units with justification by clinician from 2016–2017 onwards (weekdays and Saturday mornings only in 2016–2017 and 2017–2018, extended to nights and weekends in 2018–2019)   
  - Rapid point-of-care tests with Cobas® Liat System (≈ 20–25 min, performed in the ED): assessment over a 2-weeks period during the 2017–2018 season [32]; then fully available during the 2018–2019 epidemic season   
  - Respifinder® 2Smart (≈ 4–5 days, performed in the virology laboratory on weekdays): used during the 5 epidemic seasons used during all epidemic seasons for patients hospitalized in intensive care units (ICUs) or on specific demand   
  1. Table presents a description of the 3 to 5-steps multimodal strategy that was implemented at Grenoble Alpes University Hospital for the prevention of nosocomial influenza from the 2015–2016 epidemic season onwards
  2. HCW healthcare worker, NA not applicable, ICU intensive care unit, ED emergency department
  3. *Risk units: adult emergency department, geriatric units, internal medicine units, infectious diseases unit, post-emergency unit, pathological pregnancies unit