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WILSON MEMORIAL GENERAL HOSPITAL P.O.BAG “W” MARATHON, ONTARIO P0T 2E0 POLICY AND PROCEDURE MANUAL DEPARTMENT POLICY/PROCEDURE NO. SUBJECT DATE OF ISSUE DISTRIBUTION REVISION DATES Nursing Administration of Influenza Vaccine October 29, 2007 Nursing APPROVAL October 30, 2008 PAGE 1 of 2 Administration of Influenza Vaccine by Nurses Background: Administration of influenza vaccine by nurses will improve influenza immunization rates in the community. Implementing Persons: Registered Nurses; Registered Practical Nurses. Inclusion Criteria: This policy applies to any patient who is 1 year or older. Contraindications: Any of the following timing-related contraindications: 1. Patient has already received influenza vaccine for the current influenza season (unless < 9 years old, received 1 or 0 doses of vaccine last year, and has never received 2 doses of vaccine within a single season). 2. Patient has already received 2 doses of influenza vaccine for the current influenza season. 3. Patient presents less than 4 weeks since previous influenza vaccine dose. 4. Current acute febrile illness (defer until symptoms have abated). 5. Current active neurologic disorders (defer until the disease process has been stabilized). Any of the following medical contraindications: 6. Previous anaphylactic reaction to influenza vaccine. 7. History of anaphylactic-type allergy to eggs or egg products. 8. History of anaphylactic-type allergy to thimerosal, neomycin, or any other component of the vaccine. 9. History of developing of Guillain-Barré Syndrome within 8 weeks of a previous influenza immunization. 10. Immunization should be delayed in a patient with an active neurological disorder, but should be considered when the disease process has been stabilized. Situational Conditions Required: WMGH Influenza Vaccine Form Emergency Treatment readily available – Inform ER nurse of flu clinic wheel chair available. Procedure: For patients 6-35 months, administer 2008-2009 influenza split-virus vaccine 0.25 ml intramuscularly. For children 3-8 years, administer 2008-2009 influenza split-virus vaccine 0.5 ml intramuscularly. For children >9 years 0.5ml administer 2008-2009 influenza split-virus vaccine 0.5ml intramuscularly. Previously unvaccinated children under the age of nine require two doses of vaccine four weeks apart. If a child has only had one dose in any previous year, only 1 dose is required. Preferred site of administration is the deltoid in adults and children ≥ 12 months. 25g 1 inch adult 25g 5/8 inch children 1. Pediatric vaccine is not to be pre-drawn. 2. Nurses to be aware of anaphylaxis policy and procedure and have easy access to ER department. 3. Determine if the patient meets the criteria and if there are any contraindications. 4. Give pamphlet about the vaccine and discuss possible side effects. 5. Examine each vial and do not use if any extraneous particulate of discoloration is evident. Shake vial to uniformly distribute the suspension. 6. Determine the dose according to age as per the product monograph for the specific drug used and WMGH medical directive. 7. The patient is encourage to wait for 20 minutes post injection in case of possible anaphylaxis. Documentation: Report of Adverse Reaction Form Vaccination Coverage Data Form Patients yellow immunization card or immunization card (WMGH) initialed and dated. Reference: Product monograph supplied with the vaccine Statement on Influenza Vaccine from the National Advisory Committee on Immunization (NACI) – provided annually Canadian Immunization Guide, Edition 2007