Immunizations and Health Promotion – Pneumonia Vaccination ProtocolSECTION: 24.03

Strength of Evidence Level: 3__RN__LPN/LVN__HHA

PURPOSE:

To reduce morbidity and mortality from pneumonia by vaccinating all adults who meet the criteria established by the Centers for Disease Control’s (CDC) Advisory Committee on Immunization Practices. Under these standing orders, eligible nurses may vaccinate patients who meet any of the criteria below and under the following guidelines.

CONSIDERATIONS:

  1. Identify patientswho need pneumonia vaccine according to CDC guidelines.
  2. Screen patientsfor contraindications and precautions for pneumonia vaccination.

EQUIPMENT:

None

PROCEDURE:

  1. Following agency’s protocol for Cold Chaininstructions for refrigerated vaccines, remove pneumonia vaccine from your agency refrigerator and prepare for transport.
  2. Children should receive 23-valent pneumococcal polysaccharide vaccine and adults should receive pneumococcal vaccine. Correct injectable vaccine amount is 0.5 mL.
  3. Assemble necessary supplies for administration of pneumonia vaccine. Includes, but not limited to:
  4. Consent Form.
  5. Most current Vaccine Information Sheet (VIS).
  6. Gloves.
  7. Size appropriate syringe and/or needle.
  8. Alcohol swabs.
  9. Bandages.
  10. Sharps container.
  11. Anaphylactic kit.
  12. Have patient, or patient’s guardian, read the VIS. Ask if they have any questions. Patient to keep VIS.
  13. Have patient, or patient’s guardian, read the Consent Form. Ask if they have any questions.
  14. Ensure patient does NOT have any contraindications as stated on the VIS and Consent Forms.
  15. Have patient, or patient’s guardian, sign the Consent Form.
  16. Use the appropriate syringe and needle for size of patient and draw up appropriate vaccine amount (see 2). Unless medically contraindicated, always use the LEFT side of the patient. Cleanse the LEFT deltoid area of the patient with an alcohol swab in a circular motion. Instruct patient to relax muscle and inject the vaccine INTRAMUSCULARLY. Dispose of syringe and needle in sharps container. Apply bandage.
  17. Complete the Consent Form with the vaccine’s manufacturer name, the Lot Number of the vaccine, the date, the way the vaccine was administered (intramuscularly), the site (LEFT deltoid) and the signature of the nurse administrating the vaccine. Observe client for 15 minutes after vaccine administration to ensure there is no reaction.
  18. Assure availability of a working telephone on the premises for the patient to contact emergency personnel in the event of a delayed adverse reaction. Have appropriate telephone numbers listed for emergency personnel and agency.
  19. Be prepared to follow anaphylaxis protocol.
  20. Report all adverse reactions to pneumonia vaccine to the federal Vaccine Adverse Event Reporting System (VAERS) at or 800- 822-7967. VAERS report forms are available at

AFTER CARE:

  1. Document administration of influenza vaccination onthe consent form and in the health record, when appropriate.

REFERENCE:

CDC. (n.d.). CDC. Retrieved from

Immunize. (n.d.) Immunize. Retrieved from

.