Storage and Handling 101
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1 Storage and Handling 101 Becky Prall RN Immunization Nurse Educator/AFIX Coordinator Kansas Immunization Program Objectives Vaccine Storage and Handling Define the vaccine cold chain and recommended vaccine storage range Break down steps for temperature monitoring and documentation Analyze temperature trends Apply and integrate information provided into practice to decrease the incidence of vaccine temperature excursions Discuss and review vaccine storage units and storage unit set ups Our ultimate goal is to prevent vaccine loss and monetary loss due to improper vaccine storage and handling Storage and Handling is a We love it when everything goes right We hate it when everything goes wrong 1
2 What is VFC? The Vaccines For Children (VFC) program is a federally funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay VFC it s not free ,126 Doses $30,160, VFC Wastage $900,000 2
3 Vaccine Wastage $35,000, $30,000, $25,000, $20,000, $15,000, $10,000, $5,000, $ VFC Total 2016 VFC Wastage COLD CHAIN Vaccine temperature needs to be maintained through all of the Cold Chain steps. Starts at the Manufacturer Through transit (FedEx, UPS, USPS) **To your facility (where it is signed for)** Into your vaccine storage unit Concludes when the vaccine is administered to your patient 3
4 Recommended Vaccine Storage Temperatures Refrigerator store vaccines between 36 F and 46 F, 2 C and 8 C Freezer store vaccines between -58 F and +5 F, -50 C and -15 C Monitoring and Recording Vaccine Temperatures At the first of the clinic day. Allows you to check temperature prior to administering vaccines. Has there been any temperature excursions over night? At the end of the clinic day Are temperatures in range before you leave? Is the door closed? Manual Vaccine Temperature Logs Courtesy of Immunize.org, and the Kansas Immunization Program 4
5 Proper documentation and monitoring How to monitor temperatures WHO DID IT WHEN DID THEY DO IT WHAT WAS THE TEMPERATURE 5
6 Don t just write in a temperature Is the temperature in range? The red shaded areas mean something Temperature Trends Data Logger Temperature Trend 6
7 HOW TO. temperature excursions the unit is maintaining proper temperatures 1. QUARANTINE THE VACCINE (MARK IT DO NOT USE) 2. CONTINUE TO STORE AT RECOMMENDED TEMPERATURES CONTACT VACCINE MANUFACTURER S FOR RECOMMENDATIONS TEMPERATURE EXCURSIONS If in doubt move it out!! 7
8 Cumulative time The total number of hours a vaccine is exposed to out of range temperatures Each time the vaccine is out of range, time accumulates This cumulative time needs to be communicated to the manufacturer Cumulative Time The XYZ Vaccine Manufacturer has told you that the vaccine exposed to out of range temperatures between 47ºF and 77ºF for a total cumulative time of 72 hours. The first temperature excursion was for 2 hours at 66ºF. The second temperature excursion was for 10 hours at 55ºF How much cumulative time is left? Can you tell which vaccine is viable? Photo Source CDC 8
9 NOT ALL THERMOMETERS ARE THE SAME Photos courtesy of the CDC Storage and Handling Tool Kit CDC Storage and Handling Tool Kit Thermometer with a certificate of calibration Certificate to contain: Model Name or Number Serial Number Date of Calibration Accredited testing Recommended uncertainty of +/-0.5 C (+/-1 F) or less Certified by: ISO IEC ILAC/MRA NIST ASTM 9
10 CDC Recommends Data Loggers Photo Source CDC THE DATA LOGGER SHOULD ALWAYS BE WITH THE VACCINE EMERGENCY PLAN An Emergency Plan tells you everything you need to know about a vaccine storage and handling emergency Who do you need to contact Where are the emergency supplies located Where does the vaccine need to go 10
11 Vaccine storage why does it matter 11
12 Courtesy of California Dept of Public Health, EZIZ 12
13 OUR ULTIMATE GOAL Is this. Not this 13
14 Questions 14
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