Immunisation of Children Protocol –

Aim

To immunise all children registered at Leslie Medical Centre according to the Schedules & Guidelines in 2Immunisation against Infectious Diseases”, Current Edition (Green Book).

Objectives

  • To provide accurate & consistent advice to all parents about all aspects of immunisation & vaccines
  • To immunise over 95% of children with the primary course of vaccines and appropriate school boosters

Personnel

Agreed nurses will immunise children provided there is a Doctor on the premises.

Immunisation by Nurses

In order to comply with the recommendations in the Green Book (current edition), a Doctor may delegate responsibility for immunisation to a nurse provided the following conditions are fulfilled:

  1. The nurse is willing to be professionally accountable for this work as defined in the NMC guidance on the “Scope of Professional Practice”
  2. The nurse has received training and is competent in all aspects of immunisation, including the contraindications to specific vaccines.
  3. Adequate training has been given in the recognition and treatment of anaphylaxis such as the Fife Anaphylaxis course
  4. Has a current Patient Group Directive (PGD) to give the immunisation.

Essential Training

CPR Session – updated annually

Anaphylaxis session – updated annually

General Principles for Nurses Undertaking Childhood Immunisations

Before administering immunisation the nurse must ensure the following criteria are adhered to: -

  • The child’s notes are to hand and the identity of the child matches the name on any paperwork.
  • The immunisation has been prescribed by a doctor or as a result of an advanced directive by a doctor.
  • The child has not had a severe reaction to a previous immunisation
  • The immunisation check list is gone through
  • The dosage and route if administration are correct
  • The child is receiving no other drugs, which would be incompatible with the immunisation.
  • The child does not have an active infection
  • If any doubt as to a baby’s fitness for immunisation exists it must be seen by a doctor prior to immunisation.
  • The parent/guardian has signed the consent form to give consent.
  • The vaccine is not past the expiry date and is not damaged.
  • The vaccine has been stored in accordance with the Operational Guidelines for Vaccine Handling. That the integrity of the cold chain is maintained.
  • Syringes & needles are suitably sized and sterile.
  • The nurse can recognise and initiate treatment of anaphylactic shock
  • An emergency tray containing Adrenaline1;1,000(1mg/1ml), Chloramphenamine and Hydrocortisone injections and a note of current doses is available
  • Seek help from child hood immunisation dept at Cameron hospital if any doubts in child’s schedule or from Public Health Dept for further advice.

Documentation

Once the immunisation has been given the nurse will:

  • Make full records in the patients notes, including the manufacturers name and batch number of the immunisation and which site given. Enter on pink continuation sheet and buff coloured immunisation sheet
  • Enter details in “red book” and on Health Board Immunisation date Sheet(SIRS)
  • Enter any contraindications on computer, patients notes and Health Board Immunisation sheet
  • Document parent/guardian permission
  • Record any adverse reaction and report immediately to GP

ANY CHILD WHO HAS 3 DEFAULT (did not attend/DNAs) MUST BE REFEREED TO A HEALTH VISITOR & DOCUMENTED IN CHILDS RECORDS & YELLOW ALERT BOX ON COMPUTER

Resources

  • Immunisation against Infectious Disease(2006)edition and then any updated edition
  • British National Formulary – current edition
  • Public Health Department or Cameron Hospital Child Immunisation Dept.

Ss/feb2008