HOMES AND SENIORS SERVICES
Medical Directive for Administration of the Influenza Vaccine for County of Elgin Staff Order/Delegated Procedure:
The Attending physician delegates the authority to Registered Nurses and Registered Practical Nurses to administer the influenza vaccine to County of Elgin staff members provided the conditions outlined in this directive and the product monograph(s) are met.
This medical directive is to be used in conjunction with Infection Control policy and procedure 3.4 “Immunization – Staff Influenza”.
Authorized Implementers:
The Registered Staff may administer the influenza vaccine to eligible County of Elgin staff members according to the applicable manufacturer’s instructions after performing a health assessment, reviewing contraindications and receiving informed consent.
Recipients:
Those who are eligible for vaccination based on the following:
Publicly funded immunization schedule for the province of Ontario
Canadian Immunization Guide recommendations
Public Health Ontario recommendations
Recommendation of the Medical Officer of Health
Nursing Assessment Indications:
All individuals who work at the home are eligible and recommended for the publicly funded influenza vaccine provided they have no contraindications. The Canadian Immunization Guide states that there should be a special focus on certain high risk groups including:
Adults 65 years of age and older
Individuals of any age who are residents in long term care homes or other chronic care facilities
Individuals with underlying health condition (e.g. cardiac/pulmonary disorders, renal disease, morbid obesity, diabetes and cancer or weakened immune systems
Pregnant women
Individuals capable of transmitting influenza to those at high risk:
o Health care workers
o Household contacts of those at high risk
Vaccines for specific age groups will be as directed by public health and attending physician.
DRAFT REVISIONS October 2015 HOMES AND SENIORS SERVICES
Contraindications:
See applicable product monographs and consent form.
Consent:
Informed consent is obtained and documented.
Risks and benefits of the vaccine are explained to the person.
Education resources from the health unit or other government agencies may be given to the person (i.e. fact sheets)
Procedure:
1. The person is assessed to determine eligibility and suitability for vaccine administration according to the following: a) the publicly funded immunization schedule for the province of Ontario; b) National Advisory Council on Immunization recommendations; c) available vaccination records; d) a health status review with a focus on adverse vaccination events, allergies, and sensitivities, and e) vaccine indications and contraindications.
2. Informed consent is obtained and documented.
3. The vaccine is administered according to the manufacturer’s instructions.
4. The person is asked to remain in the clinic waiting area for 15 minutes to ensure he/she does not experience an adverse reaction. Adverse reactions are managed according to policy and procedure for fainting and anaphylaxis.
5. Epinephrine HCL (1:1000) is immediately available should the person experience an anaphylactic reaction to any component of the vaccine.
6. The immunization is documented in the client’s health record.
Review and Quality Monitoring Guidelines:
If there is any question that the person should NOT receive the immunization, the
immunization will be held and the staff member will follow up with their own physician.
If the person experiences any immediate adverse effects, they will be managed according to policy. The person will be counselled regarding the signs and symptoms of delayed adverse effects and how to manage them.
Authorizing Signatures:
Attending Physician Date:
Manager of Resident Care Date:
DRAFT REVISIONS
October 2015 HOMES AND SENIORS SERVICES
Medical Directive for Administration of the Influenza Vaccine for County of Elgin Homes Residents
Order/Delegated Procedure:
The Attending physician delegates the authority to Registered Nurses and Registered Practical Nurses to administer the influenza vaccine to County of Elgin Homes' residents provided the conditions outlined in this directive and the product monograph(s) are met.
This medical directive is to be used in conjunction with Infection Control policy and procedure 3.3 “Immunization – Residents (Influenza, Pneumovax, and Antiviral)”.
Authorized Implementers:
The Registered Staff may administer the influenza vaccine to eligible residents according to the applicable manufacturer’s instructions after performing a health assessment, reviewing contraindications and receiving informed consent.
Recipients:
Those who are eligible for vaccination based on the following:
Publicly funded immunization schedule for the province of Ontario
Canadian Immunization Guide recommendations
Public Health Ontario recommendations
Recommendation of the Medical Officer of Health
Nursing Assessment Indications:
All individuals who reside at the home are eligible and recommended for the publicly funded influenza vaccine provided they have no contraindications. The Canadian Immunization Guide states that there should be a special focus on certain high risk groups including:
Adults 65 years of age and older
Individuals of any age who are residents in long term care homes or other chronic care facilities
Individuals with underlying health condition (e.g. cardiac/pulmonary disorders, renal disease, morbid obesity, diabetes and cancer or weakened immune systems
Pregnant women
Individuals capable of transmitting influenza to those at high risk:
o Health care workers
o Household contacts of those at high risk
Vaccines for specific age groups will be as directed by public health and attending physician.
DRAFT REVISIONS
October 2015 HOMES AND SENIORS SERVICES
Contraindications:
See applicable product monographs and consent form.
Consent:
Informed consent is obtained and documented.
Risks and benefits of the vaccine are explained to the person.
Education resources from the health unit or other government agencies may be given to the person (i.e. fact sheets)
Procedure:
1. The person is assessed to determine eligibility and suitability for vaccine administration according to the following: a) the publicly funded immunization schedule for the province of Ontario; b) National Advisory Council on Immunization recommendations; c) available vaccination records; d) a health status review with a focus on adverse vaccination events, allergies, and sensitivities, and e) vaccine indications and contraindications.
2. Informed consent is obtained and documented.
3. The vaccine is administered according to the manufacturer’s instructions.
4. The person is asked to remain in a designated area for 15 minutes to ensure he/she does not experience an adverse reaction. Adverse reactions are managed according to policy and procedure for fainting and anaphylaxis.
5. Epinephrine HCL (1:1000) is immediately available should the person experience an anaphylactic reaction to any component of the vaccine.
6. The immunization is documented in the client’s health record.
Review and Quality Monitoring Guidelines:
If there is any question that the person should NOT receive the immunization, the
immunization will be held and the concerns passed onto the residents’ attending physician.
If the person experiences any immediate adverse effects, they will be managed according to policy. The person will be counselled regarding the signs and symptoms of delayed adverse effects an how to manage them.
Authorizing Signatures:
Attending Physician Date:
Manager of Resident Care Date:
Director of Homes and Seniors Services/Administrator Date:
DRAFT REVISIONS October 2015 HOMES AND SENIOR SERVICES
Medical Directive for Administration of Epinephrine and Benadryl for the Management of Anaphylaxis Related to Vaccine Administration
Order/Delegated Procedure:
The Attending physician delegates the authority to Registered Nurses and Registered Practical Nurses to administer Epinephrine and Benadryl, in the event of an adverse reaction to a vaccination, to County of Elgin Homes residents and staff provided the conditions outlined in this directive, the product monograph(s) and Infection Control Policy and Procedure 2.6 “Management of Fainting and Anaphylaxis Related to Vaccine Administration” are met.
This medical directive is to be used in conjunction with Infection Control policy and procedures 3.3 “Immunization - Residents (Influenza, Pneumovax, Antiviral)”, and 3.4
“Immunization - Staff Influenza & Surveillance of Infections”.
Authorized Implementers:
The Registered Staff may administer Epinephrine and Benadryl to eligible residents or staff according to the applicable manufacturer’s instructions after performing a health assessment in an emergency situation only.
Directive: Epinephrine and Benadryl according to Infection Control policy and procedure 2.6 “Management of Fainting and Anaphylaxis”in the event of an adverse reaction to a vaccination.
Recipients:
Those residents who are eligible for influenza/pneumovax vaccination; and staff who are eligible for influenza vaccination, and have had an adverse reaction to same.
Indications:
All individuals who work or reside at the home are eligible in the event of an adverse reaction to the influenza or pneumococcal vaccination as per ICP 2.6 Management of Fainting and Anaphylaxis”.
Contraindications:
See applicable product monographs.
Consent:
Not applicable in an emergency situation.
Procedure:
1. Follow Infection Control policy and procedure 2.6 Management of Fainting and Anaphylaxis
Authorizing signatures:
Attending Physician Date
Manager of Resident Care Date
DRAFT REVISIONS
HOMES AND SENIORS SERVICES
POLICY & PROCEDURE NUMBER:
DEPARTMENT: Nursing SUBJECT: Medical Directives- Influenza vaccine APPROVAL DATE: April 2004 REVISION DATE: December 2008
REVISION DATE: November 2015
Page 1 of 1
PURPOSE:
The Registered staff at Elgin County Homes may provide influenza immunizations to residents and to Corporation of the County of Elgin staff, provided that:
Resident:
A current physicians order if placed on the chart for all residents,
A current Medical Directive for Influenza vaccine administration and the management of adverse reactions which is signed and dated by the residents’ attending physician; and signed and dated by any administrative authority that is approving the directive of each respective home on an annual basis.
Staff:
The Home shall ensure that informed consent is given prior to the administration of the vaccine as per current Public Health Guidelines. The County shall annually review policies and procedures to ensure alignment with Public Health and Best Practice Guidelines”.
A current Medical Directive for Influenza vaccine administration and the management of adverse reactions which is signed and dated by the Homes’ attending physician; and signed and dated by any administrative authority that is approving the directive of each respective home on an annual basis.
The Medical Directive must coincide with the College of Nurses of Ontario standard of practice and include the specific medication(s), specific condition(s) that must be met; and any specific circumstance(s) that must exist before the directive can be implemented.
DRAFT REVISIONS
HOMES AND SENIOR SERVICES
POLICY & PROCEDURE NUMBER:
DEPARTMENT: Nursing SUBJECT: Medical Directives
APPROVAL DATE: April 2004 REVISION DATE: May 2008 REVISION DATE: Nov. 2015
Page 1 of 1
POLICY:
1. It is the policy of Elgin County Homes that medical directives are available to registered nursing staff to follow for residents for the treatment and management of medical symptomology, allergic reactions, palliative and end-of-life care, INR protocol and immunization protocols.
2. The medical directives must coincide with the College of Nurses of Ontario standards of practice.
3. The Medical Director shall annually review, revise as needed, and sign the existing medical directives.
4. The original medical directives will be dated and signed by the Medical Director, Manager of Resident Care and Administrator of each home. The original will be filed for safekeeping in the Manager of Resident Care’s office.
5. Admission, medication, palliative/end-of-life, INR protocol and immunization medical directives must be confirmed by contacting the attending physician.
6. Medical Directives are individualized and reviewed with each quarterly medication review.