Influenza Preparedness Peer Vaccination Campaign in a Community Hospital By; Patricia Mc Enery-Noonan A/Director of Nursing Listowel Community Hospital 19 th September 2018
Peer To Peer Vaccination Seasonal Influenza Peer Vaccination Programme 2018-2019 Lead by The National Immunisation Office Occupational Health
Peer Vaccination Programme Aim & Objective: Vaccinate all Healthcare Workers. Facilitate & Improve Influenza Vaccination uptake. Provide increased availability & Local knowledge of the influenza vaccine. Collect Data & Maintain Logs
Training to become a Peer Vaccinator Basic Life Support every 2 years Anaphylaxis Treatment every 2 years Injection Technique. Must attend relevant education programme specific to the medicine protocol, provided by Centres of Nursing and Midwifery Education Follow best practice in accordance with the Seasonal Influenza Peer Vaccination Programme, Local Policy & Guidelines.
Training provided by the Centres for Nursing and Midwifery Education This training includes: Influenza Virus information Inactivated influenza vaccine (Split Virion) BP Information Barriers to getting the vaccine Promotion of the Inactivated influenza vaccine (Split Virion) BP
Training provided by the Centres for Nursing and Midwifery Education Planning an Influenza Vaccination Clinic Running an Influenza Vaccination Clinic Management of Adverse Events Data management and statistics
Role of the Peer Vaccinator Follow Guidelines & Best Practice to: Set up, Plan and Run Local Clinics Follow Medicinal Protocal: Storage, Handling & Administration Guidelines Advertise, Educate & Administer the Influenza Vaccine to all Healthcare Workers
Peer Vaccinator s Are responsible for their own clinical practice Be familiar with and adhere to the practices as set out in Peer vaccinator Program Guidelines (developed by the National Immunisation Office and the National Clinical Lead in occupational health). Be familiar with and adhere to the Immunisation Guidelines for Ireland (http://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/a Practical Guide to Immunisation, National Immunisation Office, 2008 http://www.hse.ie/eng/health/immunisation/hcpinfo/trainingmanual). Be available to answer queries from those being vaccinated and other health care workers.
Peer Vaccinator Check that Check equipment necessary for the administration of the vaccines and complete equipment list and check sheet at clinic location. Appropriate drugs and equipment are available for resuscitation. Prepare for and carry out clinics as per peer Vacciantor guidelines. Keep a clinic summary document after each clinic. Return consent forms to the Occupational Health Service for the purpose of updating employee records and statistical analysis. Ensures that adverse events are notified to the Health Products Regulatory Authority (HPRA).
Planning a Vaccination clinic Vaccination Clinics should be run by A Registered Medical Practitioner (RMP) A RMP with a Peer Vaccinator Two or more Registered Nurses who have been trained as peer vaccinators Clinic location must be in an appropriately ventilated room, preferably at ground level, with a minimum of 2 chairs and a table, preferably a couch and sufficient space for clinic equipment.the room must allow for privacy to respect the dignity of the staff member being vaccinated.
Planning a Vaccination Clinic There must be sufficient waiting space beside the room to allow for staff to read and sign the consent form and wait in the area for 15 minutes as required following vaccination. Inactivated influenza vaccine (Split Virion) BP must be ordered in advance of the clinic and stored in accordance with the National Cold Chain requirements. Clinic equipment should be prepared in advance checklist
Running a vaccination clinic: Set-up clinic Check Sheet. A designated person should take responsibility for ensuring that all the equipment necessary for the administration of the vaccines is in compliance with best practice. A designated person should ensure that sufficient Inactivated influenza vaccine (Split Virion) BP is brought to each vaccination session, that the vaccines are in date and stored and maintained within cold chain conditions. A designated person should take responsibility for bringing the resuscitation kit to the vaccination session and for ensuring that all the necessary resuscitation equipment and drugs are available and in date.
Vaccine administration: Prior to administration of the vaccine the vaccinator must adhere to the following: Verify the client s name, date of birth and ensure that informed consent for vaccination has been given. Assess staff member s suitability for immunisation on the day. Vaccines should not be given if the staff member has an acute febrile illness. Outline the process of vaccination to the staff member. Administer the vaccine as per protocol, and record.
Post Vaccination After administering the vaccine the vaccinator completes the administration details including Vaccine name, batch number, manufacturer and expiry date, using peel off sticker from vaccine if available. Dose administered, Site used, Date vaccine was given. Vaccinator must sign their name on the consent form and record PIN. Record that the vaccine was given under medicine protocol under prescriber box on consent form as appropriate. Ensures the vaccination record card is completed and given to the HCW before they leave.
Post Vaccination Ensures that each HCW client remains in the practice under observation for 15 minutes as most anaphylaxis episodes begin within 15 minutes of vaccination. Gives information on common side effects after the vaccination. Takes any queries about possible adverse reactions that occur post vaccination. Provides appropriate contact details if there are any concerns following vaccination. Reports adverse events to the Health Products Regulatory Authority (HPRA).
Adverse Reaction Anaphylaxis Algorithms for management of anaphylaxis from the Immunisation Guidelines must be kept with anaphylaxis kits. Nurse and Midwife peer vaccinators should be familiar with Directions for nurses and midwives for the management of a patient who develops anaphylaxis incorporating Medicine Protocol for the Administration of Epinephrine (adrenaline) Injection BP 1:1000 by intramuscular injection by nurses and midwives for the management of a patient with anaphylaxis (HSE 2016), available at http://www.hse.ie/eng/health/immunisation/hcpinfo/fluinfo/adrenalineprot ocol.pdf. Anaphylaxis kits must be provided in accordance with the Immunisation Guidelines of Ireland.
Ordering of Influenza Vaccines All services must arrange delivery of Inactivated influenza vaccine (Split Virion) BP via the HSE National Cold Chain Service. A vaccine stock sheet should be kept to record the date and stock on hand and quantity ordered to facilitate fortnightly ordering. Vaccines should be ordered by a specific date as per a prescribed schedule from the National Cold Chain Service (NCCS). On receipt of vaccines, they must be checked against the order for any damage or discrepancy and stored in the vaccine fridge immediately. Vaccines must be placed immediately in the vaccine fridge and must never be left at room temperature.
Governance Structures/Planning September/ October Campaign Launched Commence Clinics September/October Run full Campaign Clinics, Talks, Communications Focus Groups Returns October-February Evaluation March Returns Planning for next season March-August Launch end of Aug-Sept Run Campaign until season end
Challenges Tackle the flu myths Anti-vaccine culture / Met with Avoidance of the subject of Vaccinating Staff needing to be advised that they put themselves, their patients and family members at risk by choosing not to avail of the vaccine. The responsibility lies with each individual staff member to avail of the vaccine.
What we did Well? We advertised, promoted & offered Education: Posters, Information Flyers The HSE Influenza Information Leaflet Staff Meetings Held Flash Information sessions at Ward Report Time. Gave staff a Sticker to wear Post vaccine, Pens, Hold all bags.
What Went Well Peer vaccinators reported that the training was comprehensive and felt equipped to undertake vaccination. No adverse reactions Staff reported that it was convenient and vaccination process was efficient and timely. Easy for management for collating data of staff vaccinated. Great support from occupational health Peer vaccinators enjoyed the role of vaccination and of enhancing the service.
Who, What & Where Poster Influenza Vaccinations Listowel Community Hospital Date: Monday 30 TH September Times: 9.00hrs and 18.00hrs Peer Vaccinators: Eimear Falvey and Marie Therese Duff
What could be improved upon Earlier Advertising More planned sessions at varying times Provide statistics and data of deaths owing to flu. Provide research on the effectiveness of vaccination for health care workers. Holding more MDT Education Sessions A staff survey (Survey Monkey)
What could be improved upon Communication-Reminder via group text Raffle/reward within the community hospital Refreshments after vaccination-catering department.
Improvement with Peer Vaccination Over 30% uptake by staff on site in 2016/2017 Increase in 2017/2018 Anticipate with better planning,more clinics and awareness to increase this figure for 2018/2019.
Questions??