Degree Name

Master of Science in Nursing (MSN)

Document Type



School of Nursing




Seasonal influenza is a serious public health problem that contributes to significant morbidity and mortality locally, nationally, and globally. The Centers for Disease Control and Prevention (CDC) estimates that influenza has caused between 9.2 million and 60.8 million illnesses, between 140,000 and 710,000 hospitalizations, and between 12,000 and 56,000 deaths annually since 2010, and approximately 80- 90 percent of influenza related deaths occurred in people 65 years and older. In 2012, prompted by the mounting\ evidence of the risk of nosocomial influenza infection for patients and low influenza vaccination rates of health care workers, the Rhode Island Department of Health (RIDOH) amended its Rules and Regulations for Immunization and Testing for Healthcare Workers. This amendment included mandatory influenza vaccinations for all health care workers, students, volunteers, and trainees who have direct patient contact within a health care facility. The purpose of this study was to evaluate the impact of the regulation of mandating influenza vaccination for health care workers in Rhode Island on influenza incidence, hospitalizations, and deaths of residents of long-term care facilities (LTCF). Surveillance data for influenza incidence, hospitalizations, and deaths among residents of LTCF pre and post the policy implementation are analyzed and results presented. Policy and practice implications for public health nursing are discussed.