Influenza Vaccine Screening 2016-2017 one patient, one record, one system Admission Navigator Influenza Immunization screening is completed within the Admission Navigator of the patient s chart. There are 3 sections involved with completing the screening: 1. Immunization History- a print group that displays any immunization a patient has received in their lifetime and recorded into Maestro Care 2. Influenza Vaccine screening- Smart form documentation 3. Influenza BPA Check- flowsheet row for attestation the screening has been completed and allows for BPAs to fire will still in the Influenza screening workflow. Immunization History Section Review the current immunization history. Ask the patient if they have received the influenza vaccine this season. If NO, continue to the vaccine screening section. If yes, confirm the vaccination date is included in the Immunization history section. If not found, update history by clicking on the Administer Immunizations link. Influenza Vaccination Screening Section 1
Begin the screening by selecting the appropriate answer for your patient: 1) Yes If the patient has received the influenza vaccine this season. This season s vaccine has been entered into the Immunization history- the screening section is complete. This season s vaccine has NOT been entered into the Immunization history- add the immunization history information. 2) Unable to Assess the nurse is not able to assess from the patient. When this choice is selected a required questions opens for nursing to enter text to explain as to why the patient could not be screened. 1) No or Unsure If the patient has not received the vaccine or is unsure of receiving the flu vaccine this season. When either choice is selected, a required question opens asking if the patient agrees to receive the vaccine. If the patient declines and the NO is documented. The screening section is completed. 2
If the patient agrees to receive the vaccine, once the Yes is documented another questions opens asking if the patient has any of the following conditions. The choice of None is a required choice if the patient does not have any of the above conditions. Conditions Present: The smart form allows for either one of multiple conditions to be documented Need Provider Review If the screening cannot be completed due to patient condition/ lack of information from chart/ patient/family--- physician review is needed. Click on the Other Concern not listed above check box. Selecting this button will open a text box. This is a free text box and any documentation entered in this row will appear in the Provider Influenza BPA. This BPA notifies the provider to review the patient s history and enter a vaccine order or a communication order documenting the reason for not ordering the vaccine. 3
Influenza BPA Check Section This section is a flowsheet row that allows nursing to attest that they have completed the screening. The filing of this row also allows the system to trigger BPAs, for example ordering the Influenza vaccine if the patient agrees and there are no conditions that interact with the vaccine. Nursing Ordering the Influenza Vaccine Once the Influenza BPA check or any other flowsheet documentation is saved, a BPA will appear with a link to order the appropriate influenza vaccine (Adult/ Peds). After the order is entered SCREENING IS COMPLETE. 4
Best Practice Advisories (BPAs) Allergy BPAs: BPA fires if. a. Egg Allergy: anaphylaxis to eggs is documented in the screening, and the allergy is not found in the Allergy Activity. b. Influenza Vaccine adverse reaction: adverse reaction is documented in the screening, and the allergy is not found in the Allergy Activity c. Latex Allergy: allergy documented in the screening, and the allergy is not found in the Allergy Activity When the Add Allergy button is selected in any of the allergy BPAs, the allergy can be documented from the BPA without having to leave the screen. 5
Need Provider Review: BPA fires to the provider when opening the orders side bar after the nurse documents needs provider review in the screening tool. The BPA will continue to fire until either the vaccine order or communication order is entered. Incomplete immunization order: BPA fires when there is an active immunization order, and a discharge order has been entered. This is a reminder to administer the vaccine before discharging the patient. 6