SCHOOL FLU CLINIC PROJECT GUIDE

Step / Task to Complete / Office Responsible
  1. Preliminary Work (July)
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  • Obtain school calendar
  • Set tentative clinic dates based on estimated arrival of flu vaccine.
  • Finalize contents of consent packet
  • Send consent packet to printer for hardcopies
  • Create flyer (use DPH logo) for school open house to promote flu clinics. Include links to district and school website where consent forms can be downloaded. Also include message that consent forms will be sent home with students in the near future.
  • Once hardcopies are received from printer, create and print labels for return envelopes that are included in consent packet.
  • Labels to include: School name, tentative clinic dates, consent form deadline, message about 2nd doses
  • Deliver hard copies to CHD
  • Upload consent packet to district website.
  • Send electronic version to county health departments
/ District
  1. Make contact with school (July-August)
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  • Contact school …
To inform them you will be bringing blank consent packets at beginning of the school year
To ask if consent packet can be uploaded to school website. Get the name and email address of person who would be responsible for uploading school packet.
To explain that an exact clinic date will not be finalized until we are confident of when the flu vaccine will arrive.
To request at least one school staff be dedicated to being the contact person for the health department and helping the day of the school flu clinic.
For pre-K through 3rd grade, inform school that an adult (nurse, teacher, parapro) needs to be with the class to verify information
To request student electronic spreadsheet compatible with Microsoft Excel. Information needed: First/Middle/Last name, address, school, grade, homeroom, gender, race, ethnicity, date of birth
Note: Gender, race, ethnicity are included for statistical purposes. Requested by the state
  • Send electronic version of consent packet to school’s website contact person for them to upload to school website
/ CHD
  1. Scheduling (August – September)
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  • Once date of flu vaccine arrival is determined, finalize clinic dates (1st, 2nd, and makeup doses)
  • Set staffing schedule and email staff to confirm.
/ District
  1. Consent form review(August – September)
See attachment A /
  • Schools return consent forms to CHD by established deadline. Suggestion - Allow 1 week grace period but accept no more after that.
  • CHD review consent forms. Suggested system for reviewing forms per school is below.
  1. Sort forms by insurance
  2. Verify insurance – note if insurance is active or inactive. Print page that shows status and staple to consent form
  3. Nurse reviews form, calls parents to clarify information if necessary, determines type of vaccine (mist or shot) the child should receive, determines which funding pot (public or private) the child should receive vaccine from, and note if they will need a 2nd dose
  4. Alphabetize consent forms for entire SCHOOL – not by grade and homeroom
/ CHD
  1. Creating worksheets/rosters(September)
See attachment B /
  • Receive electronic spreadsheet from schools.
  • Save the original copy of the spreadsheets on computer and save an additional copy to work with. After forms have completed review process, mark on the workable school spreadsheet (not original) which students returned a consent form and enter any missing data that you have obtained from the consent form (ex. insurance, ethnicity, race, etc.)
  • Suggestion for marking which students returned the consent form – create an additional column and enter a “1” for those who returned the consent form. Then, you can sort the spreadsheet by that column so all “1” are grouped together. Delete the remaining students when all consent forms have been turned in.
  • Save this file as the school name (ex. SCHD school example_December 2013)
  • Within this excel spreadsheet (file), you will create 3 worksheets (individual sheets within the spreadsheet) - Master, Clinical, School
  • Create “Master” worksheet
  1. Using the current worksheet, rename worksheet to “Master”. Delete unnecessary columns; rename existing column headings (using list below) to the appropriate name; add additional columns for the remainder of the columns listed below. Enter column headings, and organize the columns in the order listed below.
  2. Column headings should include (in this order)…
  1. Aegis number
  2. Last Name
  3. First Name
  4. Middle Name
  5. Address
  6. Grade
  7. Homeroom
  8. Date of birth
  9. 2nd dose needed – this column only needs to be used for elementary, primary, prek schools/daycares(See attachment F)
  10. Gender
  11. Race
  12. Ethnicity
  13. Servcode
  14. CPT code
  15. Vaccination Date
  16. Charge, Paid, Adjustment
  17. Insurance Code
  18. School
  19. Mist – Private
  20. Inj – Private
  21. Mist – Public
  22. Inj – Public
Note: I would work off the “Master” worksheet/roster until you feel confident that all consent forms have been turned into CHD. When you are no longer accepting consent forms and all relevant information has been added to master worksheet, then create your “Clinical” and “School” rosters.
  • Create “Clinical” worksheet – This roster will be used by health department staff at the clinic.
  1. Create a copy of the master roster and re-name the worksheet “clinical”
  2. Delete all columns but name, date of birth, grade, homeroom, 2nd dose needed, vaccine type (#19-22)
  3. Alphabetize by last name
  4. At the bottom of the 6 vaccine columns, enter the following formula so each column will add the number of each vaccine type.
=sum(e2:e30)
  1. The letter represents the column so make sure it’s different for each column labeled with the vaccine type. The number after the letter represents the rows you are adding.
  • Create “School” worksheet – School will use this roster to call students
  1. Create a copy of the “clinical roster” and re-name the worksheet “school”
  2. Delete all columns but the name, grade, homeroom
  3. Sort first by grade, then homeroom, then by last name
  4. Don’t forget to save often
/ CHD
  1. Before clinic
See attachment C, D, E /
  • Print “Clinical” and “School” rosters
  • Gather clinical and clerical supplies
  • Create vaccine labels to be placed on consent forms.
  • Compare consent forms with rosters to make sure no form is missing and that the correct vaccine is marked on the roster.
  • Review which children will need a 2nd dose of flu vaccine. Prepare consent forms for those children.
  • Call school to remind them about flu clinic
/ CHD
  1. Clinic Day
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  • Pick up supplies and vaccines at health department
  • Arrive at school 15-20 minutes early for set up
  • Need 2-3 chairs and a table for clerical staff.
  • Nurses need 2-3 tables and 4-6 chairs depending on number needing vaccination.
  • As children arrive, clerical staff should ask for the child’s first, middle, and last name and birthday and then highlight the student’s name on the roster
Notes:
  1. If you have any doubt about who the child is, DO NOT ADMINISTER VACCINE!
  2. PreK-3rd grade needs an adult present to verify information.
  3. Nurses should periodically double check lot numbers on vaccine and forms.
  • Mark students who are absent.
  • After vaccination, give “Your Child Received” handout.
  • Once all children have been vaccinated, review clinical and school rosters to make sure no child has been missed.
  • Give the school the consent forms for children who need a 2nd dose of flu vaccine
  • Review consent forms to be sure all clinical information is completed – nurse signature, date, vaccine label

  1. Day after clinic
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  • Make sure that the vaccine given to each child matches the vaccine marked on the “Master” roster. Make changes on “Master” roster if necessary. The master roster needs to be an accurate representation of what you accomplished at each school.
  • Add vaccination date to master roster of the children vaccinated if have not already done so. Place an “A” in the vaccination date column for those who were absent. Do not delete. May vaccinate on make-up date.
  • Sort consent forms according to vaccine given. Enter into Aegis and GRITS.
  • Write Aegis number on top right corner of consent form.
  • Enter any missing information into the master roster that you have access to (ex. Aegis #, gender, race, ethnicity, insurance, etc) Use abbreviations.
  • Send billing department appropriate documentation.
/ CHD
  1. 2nd dose/Makeup Clinics
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  • Pick up consent forms from schools for children who need 2nd dose of flu vaccine.
  • Follow procedure for verifying insurance, sorting, entering into spreadsheet, etc. as you did for 1st dose flu clinic.
  • Create a 2nd dose/makeup flu clinic roster in your spreadsheet.
  • Upon completion of 2nd dose flu clinic or makeup clinic, enter information into master roster as you did for the first vaccination clinic. Make sure you enter all information you have access to (ex. Aegis #, ethnicity, insurance, etc.)
  • Once all information is entered into master roster, send to immunization coordinator.
  • Send billing information to district office as instructed.

  1. Attachments
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  • Attachment A – Checklist
  • Attachment B – Worksheet ExamplesVaccine Label Template
  • Attachment C – School Flu Clinic Supply List
  • Attachment D – Vaccine label template
  • Attachment E –“Your Child Received” handout
  • Attachment F - 2nd dose algorithm
  • Attachment G - Egg allergy algorithm
  • Attachment H – Ethnicity/Insurance Abbreviations