Winnipeg Regional Health Authority Guidelines for Large-Scale Influenza Immunization Clinics

Transcription

1 Winnipeg Regional Health Authority Guidelines for Large-Scale Influenza Immunization Clinics These guidelines have been developed to assist with planning large-scale influenza immunization clinics delivered by population and public health staff with the goal of providing the most efficient and safe delivery of influenza vaccine to eligible clients. PLANNING CONSIDERATIONS: This document provides general guidance to help ensure smooth operations at largescale vaccination clinics under 8 major headings: 1. Leadership roles 2. Human resource needs 3. Vaccine Storage and Transportation 4. Immunization clinic location 5. Clinic lay-out and specifications 6. Crowd management outside of the clinic 7. Crowd management inside of the clinic 8. Clinic advertising 9. Clinic security LEADERSHIP ROLES: Designate local clinic leaders for overall vaccination campaign operations Designate a clinic manager and a team leader each for supplies, logistics, medical personnel, support functions and their respective backups HUMAN RESOURCE NEEDS: Ensure each of the following positions are designated - greeters-educator, eligibility client screener, registration personnel, medical screener (more applicable during an influenza pandemic), clinic flow controller, vaccination assistant, immunizer, security and emergency medical personnel Meet the language needs of the community using multi-lingual staff Prepare staff members to know and execute their responsibilities and be able to correctly answer questions from clients. September 2007

2 Cross-train staff members, if possible, to enable flexibility in meeting needs at various stations as demands fluctuate. One person may have multiple roles depending on the size of the clinic. Make provisions for surge capacity staffing, particularly at clinic opening time when large numbers of clients are anticipated Ensure staff well-being by scheduling times for rests and snacks in a designated area VACCINE STORAGE AND TRANSPORTATION: Proper vaccine storage and secure transportation are key issues Local clinic leader will coordinate the transportation of vaccine to distribution centres Influenza vaccine must be refrigerated to maintain potency Vaccine will be transported and maintained at immunization clinics in insulated coolers. IMMUNIZATION CLINIC LOCATION: Central locations such as schools, churches, auditoriums, community centres or other large public places are ideal for large-scale immunization clinics. Ensure location accessible to the elderly and persons with disabilities and able to accommodate the number of persons anticipated Other important considerations include access to mass transit, ample parking, separate entry and exit doors, adequate lighting and heating, functional and accessible restrooms, and adequate space for all clinic functions such as screening, registration, vaccine storage, vaccination, and staff breaks Select a facility with adequate capacity to handle expected flow with space for a large number of people to gather in and out of the clinic CLINIC LAY-OUT AND SPECIFICATIONS: Set up for unidirectional client flow from an external gathering area clinic entrance eligibility screening area (multiple stations) facility waiting area(s) registration/question and answer/form completion area (multiple stations) medical screening/treatment area (if needed) immunization area (multiple stations) post immunization recovery area exit at a location distant from the entrance To facilitate flow of clinic traffic, the clinic should be set up with large clear signs, in multiple languages if needed, to direct flow from station to station inside the clinic and in outside waiting areas (rope may also be used) Provide seating for clients at each vaccination station May need to provide an immunization station with surrounding screens so clients can discreetly bare their arms for vaccination Section off private area(s) where clients who experience acute adverse events after immunization or those who have medical problems can be evaluated and treated 2

3 Ensure the presence of an onsite emergency medical kit and a designated trained health care professional who can administer treatment for allergic reactions and address urgent medical problems as they arise Use current system to track and monitor adverse vaccine reactions Area Staff Function Clinic Entrance and Reception Security Greeter Reception area is in the designated lobby area Meet and greet clients Supervised by security at all times Reception and Screening Greeters and Volunteers Nurse Assessor Clients are reminded re eligibility Visual assessment for those who appear ill Orientation and Registration and Waiting Area Immunization Area Recovery Area Post Immunization Washrooms Administration Space Storage Space Staff Room Area Welcome Clerk Volunteers Nurse Assessor Pre and post immunization helper Immunizer Clinic runner Nurse coordinator Volunteer observers Exit clerk/security CROWD MANAGEMENT OUTSIDE OF THE CLINIC: The largest room Clients are provided with information about the vaccine Informed consent Fill out documents Refer to medical area as needed Wait for immunization Smaller area where immunizations are administered Room where patients can wait 15 minutes Monitored by health care staff for emergencies Ideally with an exit door monitored by security staff Public and staff washrooms should be available A room for filing and ordering of supplies Available for meetings of supervisory staff Equipped with phone, fax and computer A room that can be locked Can accommodate bulk supplies 1 large fridge for storing of vaccines Ideally located to receive deliveries Rest and break area Meeting area Schedule appropriate number of screeners to reduce crowd size and waiting times by rapidly identifying eligible clients Schedule staff to arrive at least 1 hour prior to clinic opening to welcome and screen clients as there is usually a surge of people at the beginning of the clinic Arrange accommodations for special-needs clients (e.g., persons with disabilities, very advanced age or fragility) Screeners will direct 25 to 30 clients at a time to orientation and registration room Update clients on their estimated waiting times to be screened and number of doses available at clinic Provide eligible clients an up-to-date listing of alternative influenza immunization clinics 3

4 CROWD MANAGEMENT INSIDE OF THE CLINIC: Clients receive information (written and verbal) on risk of disease and complications, vaccine risks and benefits, contraindications to immunization, possible adverse events and how to report them, how to complete consent forms (provide language translation services as needed); Immunize clients in the order of their arrival Arrange accommodations for special-needs clients (e.g., persons with disabilities, very advanced age or fragility) Communicate clinic updates and wait times for vaccination so that clients are free to leave and return to be immunized Provide entertainment materials, TV and/or refreshments if wait times are anticipated to be long Utilize runners to keep staff stocked with ample supplies so that they can remain at their stations Maintain a steady flow of clients through the clinic so that immunizers are never without a client at their stations; redirect clients who create bottlenecks Prepare just enough vaccine to meet the clinic s ongoing needs Discard any vaccine-filled syringes remaining after the clinic closes Provide adequate facilities (e.g., waiting areas, restrooms, water) to meet the needs of the clients and staff CLINIC ADVERTISING: Promote influenza immunization and increase public awareness of influenza and methods of preventing the spread of influenza Health Links/Info Santé is the information hotline and an adverse vaccine event hotline. Public needs to be informed to call Health Links/Info Santé for influenza immunization clinic dates, locations and times as well as any information inquiry Advertise clinic dates, locations, and times on WHRA web site, Winnipeg Free Press, Winnipeg Sun, local community newspapers. o Use of mobile signs to promote public clinics CLINIC SECURITY (applicable to an influenza pandemic): Important to plan for security for staff, vaccine storage, transportation and clinic locations Require all staff to wear identification cards color coded for their job functions Consider using uniformed presence to act as security and assist in managing crowds Employ security personnel to monitor the mood of waiting crowds and communicate deteriorating situations to the clinic manager Recruit local volunteers familiar to clinic customers since they may be especially effective in diffusing crowd-related tension 4

5 Adapted from CDC Guidelines for Large-Scale Influenza Vaccination Clinic Planning, , Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, Georgia. 5