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Flu Clinic Injury Prevention
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Transcript of Flu Clinic Injury Prevention
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