Storage and Handling
Terri, Mandy, Carl, or as delegated are contacted when this occurs with the vaccine storage units
What is an excursion
Right patient, right vaccine with diluent if needed, right dose, right time (including right interval, age, and/or non-expired diluent/vaccine), right site, right documentation, right route/needle length/technique
What are the 7 rights of patient medication administration adapted for vaccine administration?
Per EHL policy and procedure, staff must wash the site with soap and water and then go to this place immediately after exposure to BBP.
What is Urgent Care or the Emergency Room?
ALL of the following items are found in the emergency kit (hint: there are 9)
What are the BVM, at least 3 doses of IM Epinephrine, Blood pressure cuff, Stethoscope, Flashlight, Pulse oximeter, Log, AED, batteries?
This is who decides if the vaccine is safe to administer after an excursion
Who is the Health Department or Manufacturer?
In this procedure, the side of nondominant hand is used to pull the skin horizontally prior to injecting with the dominant hand. The needle is directed at a 90 degree angle to the arm with a quick dart like motion and the plunger pressed over a count of 5 seconds. The needle and skin are held laterally for a count of 10 seconds, then the needle is withdrawn and the skin is released.
What is the z-method?
This is the first person to notify after a BBP exposure.
Who is the supervisor?
These 3 forms are filled out after helping a patient with anaphylaxis.
What is the Anaphylaxis form, VAERS, and Incident Report?
WHL uses these safeguards against temperature excursion. (hint: there are 4)
What are door alarms, locking cooling doors, a back-up generator, posted signs by electric outlets and power boxes?
This is given at registration and required to be given by law for every dose of a vaccine prior to vaccination.
What is the EUA?
The CDC doesn't recommend required use of this PPE for IM injections, but they are required to be worn by all staff for IM injections per WHL policy and procedure.
What are gloves?
Post-inoculation, sudden onset hypotension with rapid progression alone or 2 of the following: nausea, vomiting, shortness of breath, hives, loss of consciousness, a sense of impending doom, confusion, tachycardia, hoarseness...
What are the symptoms of anaphylaxis?
Staff notify their supervisor or vaccine clinic nurse clinical coordinator when this gets dropped, hit against the side of a storage unit, or is potentially damaged in any way.
What is a TMD?
Nurses may follow these without contacting the provider/clinical coordinator and they are kept in the vaccine prep room.
What are standing orders?
This is considered the incorrect thing to do after a needle stick or BBP exposure to a wound that is bleeding.
What is squeezing or milking the blood out of the puncture wound or cut?
This is given even when in doubt that true anaphylaxis is occurring.
What is epinephrine?
WHL policy dictates all staff keep vials in original packaging, immediately administer vaccine after prep, and return multiuse vials to the unit immediately after withdrawing a dose or covering it with brown plastic if keeping it at room temperature to help prevent this.
What is prolonged exposure to light?
Per WHL policy and best practice by the CDC, all nursing staff are required to do this prior to the inspecting or using the vaccine.
What is swirling/agitating the vaccine?
Per WHL policy and procedure, these forms must be submitted to the clinical coordinator and HR post BBP exposure in less than 24 hours.
What is the First Report of Injury form and the Needlestick or Sharp Object Injury Report form?
The nurse completes these steps when the patient complains of difficulty breathing, lightheadedness, and nausea after immunization.
1. Assess the patient- (ABC)
2. Calmly calls out for help, "I need some help over here," while laying the patient in the recumbent position.
3. Becomes the team leader in the emergency response and assigns roles to other nurses while caring for the patient.
i.e.(Designate someone to call 911, someone to be a recorder, someone to get the emergency kit, and another to take care of the other patients in the clinic and guide the medics from the entrance to the patient when they arrive).
Gives epinephrine IM and takes vital signs and assesses the patient every 5 minutes until stable or until EMS assumes care.