VACCINE V STORA accine St GE & HANDLING orage and Handling Session 5

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1 VACCINE Vaccine STORAGE Storage & and HANDLING Handling Session 5

2 Learning Outcomes Following completion of this session practitioners will be able to follow the correct procedure for: Storage of vaccines Handling of vaccines Disposal of vaccines

3 The Vaccine Cold-Chain The efficacy of vaccines depends on maintaining the cold chain. The cold chain is the system of transporting and storing vaccines within the safe temperature range of +2 O C to +8 O C. It begins with the manufacturer and ends with the local immunisation provider at the time of administration.

4 The Vaccine Cold-Chain Cont. transport distribution t d m s s/a manufacture storage Storage before administration Store between 2 C - 8 C

5 We have a responsibility as practitioners to maintain the cold chain. We must be able to prove that a product given to a patient has been stored according to the manufacturer s licence.

6 What Might Happen if the Chain is Broken? Too Cold Vials may freeze and crack, potentially contaminating contents. Freezing causes immediate loss of potency in most vaccines. Too Hot Stored above 8 C vaccines become destabilised. Live vaccines may breakdown and be rendered toxic.

7 National Guidance Manufacturer s Summary of Product characteristics & Patient Information Leafletsavailable at Public Health England Vaccine Incident Guidance Health Protection Scotland Guidance on Vaccine Storage and Handling (2013) World Health Organisation, Temperature Sensitivity of Vaccines (2006) The Green Book

8 Local Policy and Procedures Look for your NHS Board s Policies for: Vaccine storage and handling Medicines fridges Use of cool boxes and vaccine transport

9 Whose Responsibility is it? The overall responsibility for the storage of vaccine remains with the Registered Healthcare Practitioner or Healthcare Support Worker administering the vaccine. They must ensure the vaccines have been stored in accordance with the manufacturer s recommendations BEFORE they are administered.

10 Ordering and Receipt of Vaccines Each health board area has a vaccine holding centre which supplies all vaccine for childhood vaccination programmes. Minimum quantities should be ordered to reduce risk and minimise waste. Vaccines must be transported within the coldchain at all times and must be checked and put into a vaccine fridge immediately on delivery.

11 STORAGE 2 c to 8 c Maximum and Minimum temperatures must be checked and recorded at the same time everyday. Then the thermometer is re-set. STRIVE FOR FIVE If the minimum is below 2 c or the maximum is above 8 c the vaccines must not be used until advice is sought about their safety and effectiveness.

12 Storage Is the fridge big enough? It should never be filled to more than 75% of capacity to allow good airflow As with all medicines - vaccine fridges must be locked at all times when not in use Stocks in Vaccine fridges should be kept to a minimum remember to use shortest expiry dates first. Is it hard-wired into the electricity socket? This prevents the fridge from being accidentally switched off

13 Thermometers Make sure you know how to read and operate the maximum/minimum thermometer. Make sure all appropriate members of staff know how it works, and what action to take if it is out-of-range.

14 Thermometers Cont. Do you or the person reading the thermometer daily know what to do if they record a temperature which is out-with the required range i.e. below 2 o C or above 8 o C?

15 Broken Chain A recorded temperature of 1 O C or below usually results in vaccines having to be disposed of. A recorded temperature of over 8 0 C may result in vaccines having to be disposed of. ALWAYS ASK PHARMACY FOR ADVICE

16 Cool Boxes and the Vaccine Delivery Vehicles Cool Boxes must have been validated by Pharmacy before they are approved for use Health Boards must have a transport vehicle which enables vaccines to be transported with 2 O C - 8 O C

17 Safe use of Cool Boxes Follow written procedures in COPM Monitor temperature regularly throughout vaccination session. Chilled ice packs are used in the smaller vaccine carriers, and in some of the new type large carriers. Follow written procedures in COPM Frozen ice packs are used in picnic style large vaccine carriers.

18 Training Coaching Mentoring Learning Ensure all staff understand their responsibilities Attend Annual Immunisation update days Keep up to date with the Green Book changes Consider requesting individual/group education sessions for your team

19 AUDIT another link in the chain Robust audit procedure should be in place for all fridges which hold vaccine and for the whole of the cold-chain All medicines fridges should be audited at least once a year The vaccine transport vehicle must also is validated monthly and audited There should be reporting and follow up procedures in place after audit

20 Further Learning http-- discipline-pharmacy-about-nes-pharmacy-educational resources-resources-by-topic-admin,-mgt-and-prep-of medicines-administration-of-medicines-the-storage-and handling-of-vaccines.aspx

21 Don t Break the Chain