University of Massachusetts Medical School Faculty Publications


Influenza infection control guidance provided to staff at Veterans Affairs facilities for veterans with spinal cord injury during a pandemic(dagger)

UMMS Affiliation

Department of Quantitative Health Sciences, Division of Health Informatics and Implementation Science

Publication Date


Document Type



Hospitals, Veterans; Humans; Infection Control; Influenza A Virus, H1N1 Subtype; Influenza Vaccines; Influenza, Human; *Pandemics; Risk; *Spinal Cord Injuries; United States; Veterans


Health and Medical Administration | Health Services Administration | Infectious Disease | Influenza Humans | Nervous System Diseases | Neurology


CONTEXT/OBJECTIVE: To assess guidance provided to staff at Veterans Affairs (VA) healthcare facilities on H1N1 influenza infection control for veterans with spinal cord injuries and disorders (SCI/D).

STUDY DESIGN: Cross-sectional qualitative semi-structured interviews.

SETTING: Thirty-three VA healthcare facilities from throughout the United States that provide care to veterans with SCI/D.

PARTICIPANTS: Thirty-three infection control key informants, each representing a VA healthcare facility.


OUTCOME MEASURES: Infection control practices, including vaccination practices, hospital preparedness, and recommendations for future pandemics, both in general and specifically to SCI/D.

RESULTS: Most (n = 26, 78.8%) infection control key informants believed veterans with SCI/D were at increased risk for influenza and complications, but only 17 (51.5%) said veterans with SCI/D were treated as a priority group for vaccination at their facilities. There was little special guidance provided for treating veterans with SCI/D, and most (n = 28, 84.8%) informants said that infection control procedures and recommendations were applied universally. Yet, 10 key informants discussed 'unique challenges' to infection control in the SCI/D population. Informants discussed the potential for infectious agents to be spread through shared and common use equipment and the necessity of including caregivers in any vaccination or educational campaigns.

CONCLUSION: Greater input by experts knowledgeable about SCI/D is recommended to adequately address pandemic influenza within healthcare facilities where individuals with SCI/D receive care.

DOI of Published Version



J Spinal Cord Med. 2013 Nov;36(6):666-71. doi: 10.1179/2045772313Y.0000000112. Epub 2013 Apr 13. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

The journal of spinal cord medicine

PubMed ID