Flu SeasonRisk Reducing Strategies for Public Health Nurses

VIHA

October 2009

Key Principles for Setting up Mass Imms ClinicImmunization stations should be

well spaced to allow for privacy and noise control

ILI imms stations should be close to entry and separate from other stations by at least 2 meters

Post imms observation area for ILI clients should be next to ILI station if possible

Other SuggestionsSeparate entrance and exit if

possibleTraffic control person – second

may be needed if entry and exist the same

To avoid accidental immunization using a larger bore needle – use separate station to reconstitute pH1N1 – also provides a break from sitting

ILI ClientsAll clients presenting at clinic should

be screened for influenza like illness

acute onset of respiratory illness with fever and cough with one of following:Sore throatArthralgia, myalgia or prostration

The very young and elderly may not present with fever

Precautionary Measures for ILI

Client wears maskSeat them at least 6 ft away from

othersNurse immunizing them wears

gown and mask

Keep separate from healthy clients

The key injury risk factors for nurses are: repetition and awkward postures

The usual areas affected are dominant shoulder (the arm you

hold the needle in)

the lower back.

General Tips

Maintain neutral upright spine posture while seated

Attention Areas

·     Stand up for 10 secs once every 30 mins to reduce stress on the spine ( at least 5 times in a 2 ½ hour flu clinic - more is better)

        ·     Consider switching sides of the table

after an hour OR at least every second day set yourself up on the opposite corner of the table

 

Pair a left and right handed nurse together at one table

Ensure the client is sitting exactly where you need them to be. (They are only there

for three minutes but you are there all day, so your comfort is the priority)

Strategies to Consider Avoid repetitive side bending while seated as this places

stress on the disc and ligaments of the spine.

Consider putting the sharps bin on a chair behind or beside the patient.

Avoid reaching across your body’s midline to drop syringes into sharps bin.

 

Review

Ensure you are comfortableDon’t forget a stretch break every

30 min.Make sure equipment is within

easy reachMake sure you don’t have to twist

or turn to reach supplies

Working with new single antigen immunizers

Professional Scope RNs now authorized per HPA:

RN/NP Regulation to

diagnose and manage conditions (including prevention), e.g. Anaphylaxis

administer certain medications to treat conditions or prevent disease/disorders, e.g. immunization for influenza

No order, transfer of function or delegation required

Reserved Titles Defined scope of practice

– “Restricted Acts”– With/without an order

Requirements on practice – “additional education” – CRNBC Certified Practice

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HPA - RN/NP Regulation

Professional Responsibilities

CRNBC requires RNs to have “additional education” to administer influenza* without an order (as determined by their employer)

and “strongly recommends” use of evidence-informed clinical decision support tools (“DSTs” or “CDSTs”) to guide practice, e.g. protocols, clinical practice guidelines, order sets, etc.

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Educational Process for CYFCH Single Vaccine Immunization

Educational component – Attend an Influenza

education session or review Influenza materials

Clinical – Immunization of

clients >5 years– Observation of 5

immunizations– Be observed doing

5 immunizations– Skills Checklist

Yearly Review

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PHN’s Role

You may be asked to: Let a nurse observe you at

clinic To observe a nurse perform 5

immunizations To assist nurse to complete a

skills checklist To “buddy” with a new

immunizer and help with questions and concerns