SAMPLE. PGD Reviewed by: Chris Faldon, John Maloney, Tim Patterson, Adrian MacKenzie, Claire Stein

Transcription

1 Patient Group Direction for the supply or administration of haemophilus influenzae type B and meningococcal conjugate vaccine to children requiring immunisation as part of the national childhood vaccination programme attending immunisation clinics in NHS Borders This document authorises the supply or administration of haemophilus influenzae type B and meningococcal conjugate vaccine to children requiring immunisation as part of the national childhood vaccination programme who meet the criteria for inclusion under the terms of the document The registered nurse seeking to administer haemophilus influenzae type B and meningococcal conjugate vaccine must ensure that all clients have been screened and meet the criteria before supply takes place The purpose of this Patient Group Direction is to improve access to haemophilus influenzae type B and meningococcal conjugate vaccine ensuring adequate population vaccination rates. PGD Reviewed by: Chris Faldon, John Maloney, Tim Patterson, Adrian MacKenzie, Claire Stein This direction was authorised on 1/11/2007 The direction will be reviewed by 1/11/2009 Clinician Responsible for Training and Review: Chris Faldon, Malcolm Clubb

2 Patient Group Direction for administration of Haemophilus Influenzae type B and Meningococcal conjugate vaccine without a prescription for a named individual by registered nurses employed by NHS Borders 1.This Patient Group Direction relates to the following specific Vaccine preparation: Name of Vaccine Legal status Storage Dose Route/method Frequency Total dose number Advice Haemophilus Influenzae type B and Meningococcal conjugate vaccine (Menitorix) Prescription Only Medicine (POM) Store in a refrigerator (2 C 8 C). Do not freeze. Discard if frozen and consult with pharmacy if kept above 8 C Store in the original package in order to protect from light. Primary vaccination in infants at 12 months old One dose, of 0.5 ml, should be given. HIB catch up for children who have had their preschool boosters without HIB until 2009 One dose, of 0.5 ml, should be given. Intramuscular injection only, preferably in the anterolateral thigh region. In children 12 to 24 months of age, the vaccine may be administered in the deltoid region. Once only As above Inform of possible side effects and their management These may include fever, irritability, drowsiness, loss of appetite, local reactions (pain, erythema, induration, oedema) mostly within 48hours of vaccination. Follow up Arrangements Relevant Warnings Anaphylaxis is a rare but resuscitation equipment should be available. Parents should receive advice on temperature control

3 and a Patient Information Leaflet. Any serious adverse reaction to the vaccine should be documented in a child s health records and on their medical records. GP should also be informed and a yellow card submitted as appropriate. 2. Clinical condition Clinical condition to be treated Criteria for inclusion Criteria for exclusion Given as part of childhood vaccination programme Consent has been given to receive the vaccine Patient requiring a booster dose in previously vaccinated children from 12 months of age as part of the immunisation schedule. Patient requiring HIb booster as part of the HIb catch up in children who have received their preschool boosters without HIb. These patients were born on or between 4 April 2003, and 3 September 2005 and will be aged between two years and two months old and four years and seven months old as at 5 th November Patients who have an: Acute severe febrile illness Definite history of severe local or general reaction to a preceding dose. Hypersensitivity to any component of the vaccine including tetanus toxoid. Children less than 12 months. Children who have received Meningococcal polysaccharide ACWY vaccine (for e.g. travel purposes) within the previous six months. Action if excluded Reschedule appointment if the child is currently unwell. Refer to GP

4 Action if declines Interactions with other medicaments and other forms of interaction Specialist advice must be sought on the vaccines and circumstances under which they should be given. The risk to the individual of not being immunised must be taken into account. Advise about protective effects of the vaccine and the risks of infection and disease complications. Document advice given. Inform or refer to GP as appropriate. Haemophilus Influenzae type B and Meningococcal conjugate vaccine must not be mixed with any other vaccine in the same syringe. Pneumococcal Vaccine should not be given at the same time as Haemophilus Influenzae type B and Meningococcal conjugate vaccine. Separate injection sites should be used if more than one vaccine is being administered.

5 3. Records-GPASS or GP Patient Record 1. The following records should be kept (either paper or computer based) The GP practice, clinic, hospital, and ward or department The patient name and CHI number The medicine name, dose, route, time of dose(s), and where appropriate, start date, number of doses and or period of time, for which the medicine is to be supplied or administered Drug batch number and expiry The signature and printed name of the approved healthcare professional who supplied or administered the medicine The patient group direction title and/or number Whether patient met the inclusion criteria and whether the exclusion criteria were assessed Quantity supplied / received and current stock balance (Appendix 4) 2. Preparation, audit trail, data collection and reconciliation- Stock balances should be reconcilable with Receipts, Administration, Records and Disposals on a patient by patient basis. 3. Storage- Store in a refrigerator (2 C 8 C). Do not freeze Store in the original package in order to protect from light. 4. Anaphylaxis Emergency Treatment (if appropriate for individual vaccination PGDs) When giving any vaccination the following should be available: Access to the patients notes Epinephrine (Adrenaline) 1 in 1000 for i.m use in emergency (NB: check expiry dates regularly) Syringes and needles of suitable size and capacity for dose. Epinephrine (Adrenaline) 1 in1000 For intramuscular injection (1mg/ml) Age Volume of epinephrine (adrenaline) 1 in 1000 (1mg/ml) Under 6 months 0.05ml 6months to 6 years 0.12ml 6 12 years 0.25ml Adults and adolescents 0.5ml These doses may be repeated if necessary at 5 minute intervals according to blood pressure, pulse and respiratory function. Special cautions: see BNF Epinephrine/ Adrenaline

6 BNF (52nd edition) section page 168 and Professional Responsibility - All Health Professionals will ensure he/she has the relevant training and is competent in all aspects of medication, including contraindications and the recognition and treatment of adverse effects. He/she will attend training updates as appropriate. For those involved in immunisation, regular anaphylaxis updates are mandatory. Nurses will have due regard for the NMC code of Professional Conduct: standards for conduct, performance and ethics (0704) and NMC Guidelines for administration of medicines (0104) Sources of Evidence used for this PGD. BNF version 53 March 2007 CMO letter (2007) (7) HAEMOPHILUS INFLUENZAE TYPE B (HIB) VACCINE FOR YOUNG CHILDREN CATCH-UP PROGRAMME August 2007 Department of Health 2006 Immunisation against infectious disease (Green Book) SPC GSK Last updated 22 nd December 2005

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