This document provides information about flu clinics and vaccines. It discusses several flu vaccine brands (Sanofi, Novartis, GSK, MedImmune), appropriate age indications, thimerosal contents, and administration methods. Maxim's vaccine policies for different populations like pregnant women and children are outlined. Information is also provided about other vaccines like Tdap, pneumococcal, and proper storage, handling, administration technique, documentation, and waste disposal procedures.
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1. Wellness & HealthCare
Flu Clinics
by Tammy Marie Baker- Ortega R.N.
The Wellness Series
2. Sanofi Fluzone
Multidose Vials ~ PEDS: Prefilled .25 ml ~ Adult: Prefilled 25 mcg/0.5
Multi dose vial thimerosal content: 25mcg/0.5mL dose.
Prefilled Indicated for individuals Age 6 months and older
Maxim Standing policy 4 years and older
Prefilled syringes are Thimerisol free
3. Novartis Fluvirin
MDVs and pre filled syringes Indicated for individuals
Age 4 years and older.
Maxim Standing policy 4 years and older
MDV :Thimerosal content: 25mcg/0.5 mL dose
Prefilled syringe: Thimerosal content: 1 mcg mercury
per 0.5-mL dose.
Needles are supplied separately for pre filled doses
4. GSK FluLaval
**Indicated for individuals Age 18 years and older ONLY**
DO NOT GIVE TO PEDIATRIC PATIENTS!!
10 dose Vials
Thimerosal content: 25mcg/0.5 mL dose
5. MedImmune FluMist
Live attenuated influenza virus vaccine
indicated for individuals Age 2 49 years
Maxim policy: ages 4 - 49 unless stated otherwise on protocol
Contraindications: Pregnancy, Asthma and Immune Compromised
Do not to be used to immunize pregnant women in any state
INTRANASAL ADMINISTRATION ONLY -Never injected
6. Flumist
DO NOT GIVE TO PREGNANT WOMEN
MAXIM POLICY IS 4 YRS TO 49
DO NOT INJECT THIS IS INTRANASAL
ADMINISTRATION ONLY
ADMINISTERED 0.1 ML PER NOSTRIL
Total dosage = 0.2 mL
No active sniffing when administered
LIVE ATTENUATED VACCINE
7. What is the Maxim Policy?
Pregnant Woman
Can be given in
ANY TRIMESTER
PER CDC Standard Policy is
RECOMMENDATIONS Only Children >4 yrs old with parental
consent
(6 mos and up in controlled specialized
No Flumist for pregnant women in any clinics)
State
Standard Policy
We immunize individuals ages 4 and older
with parental Consent if under 18 unless
otherwise stated on protocol.
8. TDAP :Tetnus~Diptheria~Pertusis
NEW 2010
Tetnus~Diptheria~Pertusis Booster
Indications 10-64 years old
Boostrix :Indications 10-64 years old
損 Prefiled syringes
Adacel : Indications 11- 64 years
損 Single dose vials
Pregnant woman check with MD
9. Pneumovax 23
Was the person aged > 65 years at the time of last vaccination?
Yes* or No or unsure???
NO the Vaccination is indicated
If YES then Vaccination Not indicated
Unless? >5 years elapsed since the first
dose? then Vaccination indicated Yes
Note: For any person who has received a dose of
pneumococcal vaccine a age( >or = 65) years,
revaccination is not indicated.
10. Pneumovax 23
Do not pre fill syringes
Do not give to children under 18 with out MD order
Recommended once before 65
Once after if 5 years since last vaccine.
Check label before you administer
Keep refrigerated
Pregnant woman with specific
Doctor Prescription only**
11. Pre filing Syringes
Pre filling syringes is STRONGLY DISCOURAGED
Pre filled syringes can lead to mistakes.
Pre filled syringes can not be returned or used at another clinic
and must be wasted at end of clinic in sharps box
If you are at a very a large clinic and clients are lined up
out the door you may only pre fill 10 syringes at time.
They must be place in a zip lock bag ,labeled ,dated and initialed
with lot number.
The must be wasted and witnessed if not used at the end of
clinic.
DO NOT MIX VACCINATIONS TOGETHER
12. ? Question your Client ?
DO NOT ADMINISTER IF:
Sensitivity to latex?
Do not give if answer is yes
Allergy to chicken eggs or egg products?
Allergy to thimerosal?
Symptoms other than mild cough, runny nose or
diarrhea.?
History of Guillian Barre
History of serious reaction to previous flu or
pneumovax?
13. GIVING MORE THAN ONE VACCINE
RECOMMEND ONE INJECTION PER ARM
OR
1 INCH APART ON SAME ARM 15 MINUTES APART
Special precautions
FYI mastectomy or dialysis Dialysis Shunt
mastectomy
DO NOT GIVE ON AFFECTED SIDE.
Bilateral mastectomy must go to their physician
MAXIMS POLICY IS DELTOID ONLY
14. SPECIAL PRECAUTIONS
FYI mastectomy or dialysis
DO NOT GIVE ON AFFECTED SIDE.
Bilateral Mastectomy must
GO TO THEIR PHYSICIAN
MAXIMS POLICY IS DELTOID ONLY
Apologize to the Patient
And refer them back to their MD
Mastectomy Dialysis Shunt
15. Reactions ?
Vasovagal Syncope versus Anaphalaxis
Did the client faint or are they having an
Allergic reaction?
Anaphylaxis
Symptoms Feeling of impending doom, flushed, rash, difficulty breathing,
wheezing, low BP , increased HR
Emergency Kit ready and on site.
Epinephrine solution 1:1000
Adults 0.1 mL per 10 kg ( 10 kg = 22 lbs) subcutaneous
Dosage may be repeated in 5-10 minutes if initial dose was 0.5 mL x one
dosage
Children Administer 0.01 ml per kg ( 10 kg = 22 lbs) maximum dose = 0.5
subcutaneous DO NOT REPEAT DOSE.
16. Cold Chain Policy
-Do not Freeze the Vaccine
-Keep Vaccine in hard plastic Cooler
-WARM MARIK TEMPERTURE CARDS IN
COOLER
-Keep above 36-46 degrees F
-Temp log on Refrigerator BID
-No food in Medication Refrigerator
BMW STICKER ON REFRIDGE
17. NEW COLD CHAIN 2010
Warm Mark Time Temperature Labels
Adhesive backed tag records warming temperatures for shipping
and storage.
Monitors temperatures from 8 to 48 hours, depending on model.
Red coloring indicates exposure to warmer-than-acceptable
conditions
Available in a variety of response temperatures ranging from -18属C
(0属F) to 37属C (99属F)
HARD Accuracy 賊 1属C
COOLERS Dimensions: 1.81 x 0.75 x 0.06 (Length x Width x Thickness)
WarmMark Time Temp Tags are a convenient, accurate tool for
monitoring temperature during shipping and storage of drug and WARM MARK
medical products, vaccines, blood, plasma, diagnostics, gelatin
capsule products, chemicals, paint, and temperature sensitive food TEMP CARDS
products.
Response temperatures and run-out times (length of exposure time
to a certain temperature) vary with each Warm Mark model.
The red coloring indicates exposure to temperatures above the rated
temperature for that tag. Color movement through the windows
indicates passage of time. If the temperature cools below the
threshold, the color stops moving.
18. THE 5 RIGHTS
Drug- check the vaccine vial twice
Patient ID and insurance or paid
Dosage - 0.5 ml
Route IM in Deltoid
Time Patient must stay 15 minutes after
injection to rule out reaction.
19. BD Integra Syringe
Retracting Syringes
What sets the BD Integra Syringe apart from other syringes on the market? Its
design. The BD Integra Syringe with Retracting BD Precision Glide Needle was
designed to provide clinicians with superior clinical benefits.
Detachable Needle*
Low Waste Space... Maximize Medication... Experience It!
Low Waste Space*
Dosing Accuracy*
BD Precision Glide Needle Technology*
NEEDLE SAFETY
Possible to obtain
11 to 12 doses
from a Single Influenza Vial
21. The Injection
Technique, Accuracy, and Nursing Skill Maxim Nurses are on the Mark
Tighten needle
Check vaccine type and brand twice , Avoid medication Errors
Wipe off vial with alcohol
Inject .05 ml of air into vaccine vial before drawing up
Draw up vaccine
Inoculate client at 90 degree angle into Deltoid muscle
Retract needle downward and away from client after the injection
Properly Dispose of the syringe into the sharps box
22. BIOHAZARD DISPOSAL
Wear gloves
Make sure lid is snapped on tightly Lock and Load
Do not over fill container.
Proper tight Syringe disposal
Empty Vaccine vials are returned to office biohazard
drop site
Any left over Pre filled vaccine syringes are discarded in
a biohazard container on site
All gloves and garbage is properly bagged at site and
returned to Office bio hazard drop site
23. Verify and Validate
VERIFY AND VALIDATE
Check your Vaccine vials three times
1. arrival at clinic
2. drawing up
3. Administration
4. Initial and Date your vaccine vials when opened
Keep your vaccinations in Separate coolers if possible
Label vials in Zip locks
Know your Medications
A SMART NURSE IS SAFE NURSE
Be Cautious and Proactive
Prevents Mistakes
24. 2010 STRAINS
Pandemic H1N1
a poor yielding strain
Now included in the Seasonal vaccine
an A/California/7/2009 (H1N1)like virus
Perth
first time being produced As of 6/14, yielding good results
an A/Perth/16/2009 (H3N2)like virus
B Brisbane
very poor yielding strain that caused much of the seasonal delay in 2009
a B/Brisbane/60/2008like virus 25
25. Honesty~ Integrity ~ Professionalism
You Represent The Profession of Nurses
Compliance is our Hallmark
Please carry and conduct yourself accordingly
Dress Appropriately Treat the client with respect
No eating in the clinic Be polite
No smoking on site Be courteous