Download Protocol for the administration of 23

ENTER NAME OF ORGANISATION
Protocol for the administration of 23-valent Pneumococcal Polysaccharide vaccine to
adults by Health Care Assistants
Purpose of Protocol
To enable suitably trained Health Care Assistants working for or on behalf of ENTER
ORGANISATION NAME who have undertaken relevant training (as outlined below), to
administer pneumococcal vaccine to adults as a single dose, as a duty delegated by the
General Practitioner or a registered nurse.
Staff characteristics
Staff group(s)
Additional
requirements
Health Care Assistants
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Continuing
training
requirement
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Completion of HCA training course on administration of
pneumococcal vaccines to adults
Completion of period of supervised practice and completion of
assessment of competence
Training and competence in the correct procedure of
administering medication via intra-muscular injection
Knowledge of ENTER ORGANISATION NAME policy on
management of Anaphylaxis in the community
Access to and knowledge of the DH guidance ‘Immunisation
against infectious disease’
Annual update in Basic Life Support and treatment of
anaphylaxis.
Demonstration of competence in relation to this medication
within the PDP and appraisal process
Annual immunisation update.
Consent
Refer to organisation’s policy on consent
Clinical condition
Clinical condition to be treated: All High-risk patients requiring pneumococcal vaccination
Criteria for inclusion
Please see latest chapter of the
Green Book available at:
https://www.gov.uk/government/upl
oads/system/uploads/attachment_d
ata/file/263318/Green-BookChapter-25-v5_2.pdf
All patients aged 65 and over
Any adult (over the age of 18 years) who has a
confirmed diagnosis of one of the following diseases:
 Chronic heart / renal /liver/ respiratory disease,
 Diabetes,
 Asplenia or dysfunction of the spleen,
 Immunosuppression (after consultation with GP),
 Cochlear implants,
 CSF shunts
 Welders
Criteria for exclusion
Patients with one of the following:
 Aged under 18 years
 Current acute illness
 Pregnancy/breastfeeding
 Previous severe reaction to any vaccine or vaccine
component
 Unable to give valid consent
 Healthy adults under the age of 65 years
 Previous pneumococcal vaccination with the
exception of those with absent or dysfunctional
spleen or chronic renal disease
 Patients with Hodgkins Disease who have received
extensive chemotherapy or nodal irradiation
Circumstances for further
advice/action
1. Consent not given: Counsel with regards to the
risks of pneumococcal infections and the protective
effect of the vaccine
2. Pregnancy or breast feeding: Refer to GP
3. Acute febrile illness: Re-arrange vaccination at
appropriate date
Recommended treatment, route
and legal status
Pneumococcal polysaccharide vaccine to be
administered by intramuscular injection into the
deltoid muscle
If administering influenza immunisation at the same
time, use different site of injection
Prescription Only Medicine (POM)
Dosage & Criteria
Adults 0.5ml
Frequency of administration &
maximum dosage
Normally a once only injection
Routine booster every 5 years for those with no spleen
or splenic dysfunction or chronic renal disease
Follow-up & advice
Re-immunisation is not normally advised
Side effects & their management
Local side effects: Redness, swelling, hardness at
injection site
Systemic side effects: Low grade fever
Treat with paracetamol
Special
considerations/Concurrent
medication
No drug interactions known
The immune response to pneumococcal vaccination is
reduced in those who are immunosuppressed or
immunodeficient, including HIV patients. Patients
should be individually assessed by the GP for the risk
vs benefit of immunisation
Immunosupressant therapy e.g. Corticosteroids,
chemotherapy or radiotherapy may result in reduced
antibody response. The benefits are such that
immunisation should be considered. Refer to GP for
advice.
Clinical aspects
The following will be required:
1. Patient specific direction – written by the General Practitioner or Independent Nurse
Prescriber
2. Patient identification – required prior to the administration of medication (confirmed by the
patient declaring his or her name, date of birth and home address)
3. Consent – Informed consent must be obtained from the patient. Health Care Assistants are
advised to familiarise themselves with the ENTER ORGANISATION NAME Consent Policy
4. Record Keeping – The following should be recorded in the patients notes or on the
computer system according to the GP practice system
o Name of drug, dose, route and site of administration
o Date administered
o Batch number and expiry date
o Signature of person administering – written or electronic.
o Checklist for influenza and pneumococcal immunisations
o Patients assessed as not appropriate for vaccination and any alternative action
taken
o If the patient has declined the vaccination and any alternative action taken
o Any reaction should be recorded in the clinical record
Adverse reactions
Health Care Assistants must ensure that Adrenaline 1:1000 or an Anaphylactic shock pack is
available.
If a general adverse reaction does occur:
 Record in patients notes
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Inform patients General Practitioner as soon as possible
Local reactions should be seen by either the general Practitioner or practice nurse
If anaphylactic reaction occurs:
 Give treatment in accordance with the organisation’s policy on the Management of
Anaphylaxis in the community
 Record in patients notes
 Inform patients General Practitioner as soon as possible
 Complete Yellow Card if suspected severe reaction.
Relevant training
1. Health Care Assistants will undertake training covering the following aspects of the
administration of the 23-valent pneumococcal polysaccharide vaccine
 Appropriate anatomy and physiology
 Correct procedure for the administration of the vaccine via intra-muscular injection
 Vaccine delivery, storage and stock control requirements, maintaining the cold chain
 Cautions and side effects related to the administration of 23-valent pneumococcal
vaccine
 Documentation
 Legal aspects of drug administration using Patient Specific Directions
2. Health Care Assistants will have successfully completed a relevant course/qualification.
This could be NVQ3 or an accredited course (Foundation or Level1) from an academic
institution. They should have completed a course in Basic Life Support
3. Health Care Assistants will undergo a period of supervised practice and assessment and
will be directly observed administering intramuscular injections of the 23-valent pneumococcal
polysaccharide vaccine by the general practitioner or nurse mentor
Assessment of competence
General practitioner or registered nurse mentor will provide supervised practice and
assessment of completion of competency. Health Care Assistants will be assessed by written
assessment.
Competence will be assessed by direct observation and questioning of the Health Care
Assistants ability to:
 Prepare the patient for the procedure
 Safely administer the medication (including choice of site, needle size and injection
technique) and observation of the patient post procedure
 Correct disposal of clinical waste
 Correct documentation
 Correct procedure followed for delivery, storage and stock control of the vaccine
Significant events
Any significant event which occurs during or as a result of administration of medication
must be reported to the Practice Manager / General Practitioner (GP employee) or the
Registered Nurse / Manager (PCT employee), and the incident reported via the PCT
significant event reporting framework.
Audit: Health Care Assistants will be expected to participate in audit in relation to patient
outcomes and the development of this role.
Health Care Assistants must be familiar with the following documents:
ENTER ORGANISATIONs DOCUMENTS AS APPROPRIATE e.g.
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Consent Policy
Documentation Policy
Significant Event Reporting Policy
NMC Guidelines for the Administration of Medication
NMC Guidelines for Records and Record Keeping
References
Immunisation against Infectious Disease (Green Book) DH
National Minimum Standards and Core Curriculum for Immunisation Training for
HealthCare Support Workers 2015
This protocol has been devised by:
Signature:
Date:
Signature:
Date:
This protocol has been accepted by ENTER ORGANISATION NAME Medicines
Management Group:
Signature
Date:
Review: It is the responsibility of the lead of the staff groups to whom this protocol
applies to ensure the review process takes place.
This protocol becomes valid on ENTER DATE and becomes due for review on
ENTER DATE
Protocol for 23-valent Pneumococcal Polysaccharide Vaccine
Agreement for Health Care Assistants within ENTER ORGANISATION NAME
This protocol is to be read, agreed and signed by all Health Care Professionals it
applies to:
Approved base: …………………………………………………………………..
Staff name:
……………………………………………………………………
Designation:
……………………………………………………………………
Signature:
…………………………………………………………………….
Date:
……………………………………………………………………..
Managers signature: ………………………………………………………………
Date:
…………………………………………………………………….
The Health Care Professional should retain a copy of the document after signing
and the original be retained in their personal file.