resource from : Evaluating HPV vaccination pilots: practical experience from path publication title Vaccination session observation checklist India publisher Centre for Operations Research and Training publication date 2009 This document is available online at: www.rho.org/hpv-evaluating-pilots.htm
Confidential for research purpose only VACCINATION SESSION OBSERVATION CHECKLISTS INDIA CORT S project identification ASSESSMENT OF HPV VACCINE DEMONSTRATION PROJECT Supported by PATH Study area: Andhra Pradesh... 1 Gujarat... 2 Study block: Bhadrachalam... 1 Dabhoi 4 Kothagudem... 2 Kawant... 5 Thirumalaipalem... 3 Sinor... 6 Immunization session:... AWC 1 School... 2 Serial number (office use only) O I Designation of the respondent: Time starting Time ending Date of interview: Date: Month: Year: Name of the interviewer Name of the supervisor For office use only Name of office editor Signature of the investigator Signature of the Supervisor Name of data entry operator Centre for Operations Research and Training 402 Woodland Apartment, Race Course, Vadodara 390 007 1
CHECKLIST FOR SCHOOLS Q. NO. QUESTIONS AND FILTERS 101 ANM is vaccinating the girls CODING CATEGORIES SKIP TO 102 Vaccine carrier with four preconditioned ice packs 103 Estimated number of girls to be vaccinated that day 104 Number of HPV vaccine vials (supply should be 5% more than estimated number of girls to be vaccinated that day) 105 Number of auto-disable (AD) syringes (0.5ml) (Supply should include 10% more AD syringes that estimated number of vials of vaccine) 106 Table/desk covered with cloth Lead lines to string up a privacy curtain 107 Hub cutter or puncture-proof waste management containers (one container per 100 doses of vaccine) 108 Containers for used/empty vaccine vials and swabs Yes 1 No... 2 Number Number Yes 109 Cotton swabs, soap, and water No 110 Paracetamol (liquid or tablets) or other medications for mild side effects 111 Juice or sugar water for lightheadedness, dizziness, or feeling faint 112 Forms/registers Immunization register Adolescent immunization cards for HPV with counterfoils (based on Mamta cards) First information report for AEFI 113 Safety kit for management of anaphylactic shock 2
CHECKLIST FOR ANGANWADI CENTRE (AWC) Q. NO. QUESTIONS AND FILTERS 101 ANM is vaccinating the girls CODING CATEGORIES SKIP TO 102 Vaccine carrier with four preconditioned ice packs 103 Estimated number of girls to be vaccinated that day 104 Number of HPV vaccine vials (supply should be 5% more than estimated number of girls to be vaccinated that day) 105 Number of auto-disable syringes (0.5ml) (Supply should include 10% more AD syringes than estimated number of vials of vaccine) 106 Table/desk covered with cloth Lead lines to string up a privacy curtain 107 Hub cutter or puncture-proof waste management containers (one container per 100 doses of vaccine) 108 Containers for used/empty vaccine vials and swabs Yes 1 No... 2 Number Number Yes No 109 Cotton swabs, soap, and water 110 Paracetamol (liquid or tablets) or other medications for mild side effects 111 Juice or sugar water for lightheadedness, dizziness, or feeling faint 112 Forms/registers Immunization register Adolescent immunization cards for HPV with counterfoils (based on Mamta cards) First information report for AEFI 113 Safety kit for management of anaphylactic shock 3
STEP-1 STEP-2 Step-by-step instructions for administering HPV vaccines (TO OBSERVE AND RECORD FOR EACH CASE) Activity Washed hands with soap and water, and drip dry Held the HPV vaccine vial between the thumb and middle finger Vaccine vial was checked for: a) expiry date b) presence of any particles c) any discoloration Observations STEP-3 STEP-4 STEP-5 STEP-6 STEP-7 STEP-8 STEP-9 STEP-10 STEP-11 If any of the above was present, vaccine should not have been used Vaccine is mixed by shaking the vial Package for the 0.5 ml AD syringe opened All the contents of the HPV vaccine drawn from the vial into the 0.5ml AD syringe AD is pulled until a click is felt Asked the client if she preferred vaccination to be administered in her left or right arm. Encouraged the girl to relax her arm using the jelly arm technique Cleaned the injection site using a swab and clean water Injected the entire contents of the syringe into the deltoid region of the upper arm. [Injections should be given with the syringe at a perpendicular angle (90º) to the arm. If there is reduced muscle mass, the needle can be inserted slightly obliquely, using an angle greater than 65º] Placed a swab on the injection site and requested the client to hold firmly the injection site to prevent any bleeding (Injection site should not be massaged) Used syringes was put in puncture-proof container (PPC) at the outreach site or cut using the hub cutter at the fixed site (The used syringe and needle should not be recapped) STEP-12 Asked the girl to stay around the vaccination site for 15-30 minutes to observe her condition and see if she became light-headed, dizzy, or felt faint Informed the girl about pain and swelling that is expected Informed the girl that there is no need to do hot fomentation Advised the girl to take paracetamol if pain is unbearable Thanked the girl for coming Reminded the girl about the timing for subsequent doses Stressed the importance of getting all 3 doses If this was her 3 rd dose, congratulate the girl for completing the HPV vaccination schedule STEP-13 Washed hands before administering vaccine to next girl or whenever necessary 4
OBSERVATION OF THE SESSION Q NO QUESTIONS AND FILTERS CODING CATEGORIES SKIP TO 101 Time when session started 102 Time when session finished 103 Total time of the session 104 Vaccination register is used by the assistant Yes... and/or the ANM to track eligible girls who No... 2 receive vaccine and date of vaccination for each dose of HPV vaccine 105 Was visual and audible privacy maintained at the place of vaccination? 106 Is the waiting area for girls and parents covered? 107 How was the management of girls who were afraid of vaccination? 108 How was the management of girls who had queries regarding the vaccination? 109 How were the parents who brought the girls for vaccination managed? 110 How were the parents who had queries about vaccination managed? 111 How was the vaccination criteria for girls verified? 112 How was the management of the onlookers who were not eligible for the vaccination? 113 Were the vaccination cards filled correctly? 114 Did the ANM give sufficient time to each girl? 115 Number of girls who received the vaccine for: Dose 1 Dose 2 Dose 3 116 Who assisted in conducting the session? No... 2 Yes... 1 ANM 1 AWW... 2 School teacher... 3 Village leader... 4 Others... 7 5