Pre-loader and Immunizer (NEW!) Shifts in Durham

0. During Clinic:
   
1.  

o Information on labels is correct (e.g. Label 1: vaccine manufacturer, lot #, and expiration and Label 2 diluent if applicable)

o The vaccine has not expired

• ❑  Flag next client in line that you are available by raising green “Available” communication card.
• ❑  Verify client identity by verbally confirming client’s name and date of birth (refer to PHD P&P 5.110 Verifying Client Identity Prior to Providing Care).
• ❑  Verify client meets eligibility criteria as per Medical Directive #52 and Current Eligibility document found in the Quick Reference folder in OneDrive.
• ❑  Search for client in COVax using demographic information and/or OHIP number. Advise Clinic Leader if client cannot be found in COVax system.

  o If you notice a potential duplicate client in the system, compare demographics with the client to confirm if the client is a duplicate. Notify Clinic Leader #2.

• ❑  Conduct Pre-Screening Assessment in COVax (refer to COVax Vaccine Administration User Manual).
• ❑  In the event a client sits with an immunizer but does not receive the vaccine due to contraindication or refusal in the chair, the immunizer will:

  o Document the reason why client did not receive the vaccine in COVax.
  o DRHD Staff will document the assessment in Encounter.
  o Agency Staff will document the assessment on paper-based interaction record and place in the blue folder.

• ❑  Ensure all client’s questions have been answered and obtain client consent as per the Health Care and Consent Act, 1996 (refer to Procedure Manual 4.40 Consent and Authority).
• ❑  Administer vaccine as per Medical Directive #52 and Rights of Vaccine Administration.
• ❑  If the client experiences anaphylaxis or an untoward event, advise CL #2 and respond to event (refer to P&P 4.90 Management of Anaphylaxis and Untoward Events and Procedure Manual 10.0 AEFIs, Anaphylaxis and Untoward Events).
• ❑  Provide client with end of recovery time on a sticky note and direct client to recovery area.

o Standard recovery time is 15 minutes. Use black or blue ink.
o If client has an allergy to medication or food, the recovery time is 30 minutes. Use red ink.

o Instruct client that once recovery time is completed, they should leave sticky note on their chair and proceed to check-out area.

❑ If the client is eligible to be booked for second dose at the 21 or 28 day interval, please write on a sticky note and provide to client. This information is to be provided to check out staff to book subsequent appointment.

• ❑  Ensure vaccine administration is documented in COVax (refer to COVax Vaccine Administration User Role Training Manual).
• ❑  Ensure proper disinfection of all surfaces (table, chairs, pens, mat) in between clients. (refer to Procedure Manual 8.10 Infection Prevention and Control (IPAC))
• ❑  Ensure safe disposal of all sharps (refer to 4.260 Management of Sharps and Biomedical Waste).
• ❑  Hold up yellow “vaccine” communication card to flag supply runner when: o Sharps container is full, and a new container is required.
  o Running low on supplies.
  o Running low on vaccine.
• ❑  Raise red “support” communication card to flag CL #2 for any of the following:

o Clients who require additional support with immunization (i.e requires additional room for wheelchair or requires private immunization area)

o Adverse Events Following Immunization (historical)

o Vaccine Wastage.

o Incidents (i.e. needle stick)
o Questions or concerns

❑ When you leave your immunizing station ensure you:
o Lock your laptop or iPad screen.
o Leave the iPad that you have been assigned for the day with a neighboring immunizer.

o Temporarily lock your sharps container.
o Give your bin of vaccine to a neighboring immunizer or turn bin over if empty.

• ❑  Clients NOT consenting to electronic documentation: If a client provides you with a paper consent form and the paper contingency plan has NOT been activated, this is because the client did not consent to electronic collection of information at registration. The vaccine administration will not be documented in COVax. Ensure consent form is complete and accurate and place in blue privacy folder. Provide client with paper receipt and instruct client to bring receipt back with them when they come for second dose.
• ❑  Contingency plan use: If the COVax system is not working, the Contingency plan will be enacted (Refer to Procedure Manual Section 9.70 COVax Contingency Plan).
• ❑  Immunize any clients who have privacy requirements in private recovery/first aid area as directed by CL#2
• ❑  Inventory Reconciliation – Correct data entry for incorrect lot numbers for administered immunizations as necessary.
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  End of Clinic Day:

• ❑  If contingency plan was used: Check “to be fixed” folder and reconcile any documentation

  errors on paper consent forms. Provide to CL#2.

• ❑  Participate in post-clinic Zone #2 huddle, led by CL#2.
• ❑  Return any unused loaded syringes to the runner.
• ❑  Disinfect all surfaces and ensure the station is orderly (refer to Procedure Manual Section 8.0 Infection Control).
• ❑  Ensure a fully stocked immunizing supply basket is available if clinic continues after shift is over. If it is the end of the clinic’s hours of operation, ensure supplies are properly stored and secured.
• ❑  For agency/contract staff with laptops/iPads:

o Disinfect laptop/iPad. CSIT staff will collect the iPads for charging overnight and to ensure that they are secured in the locked storage area.

o Submit time using the attendance form found in One Drive or at www.durham.ca/clinicattendanceform.

• ❑  For Physicians:

  o Sign out the Physician Clinics Attendance form

• ❑  Assist with clinic take-down.
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  Information Required Training/Reading Prior to Clinic

  ❑ General Orientation
  ❑ COVID-19 Mass Immunization Clinics Procedure Manual ❑ Pre-Loading and Vaccine Administration PowerPoint
  ❑ AEFI Orientation PowerPoint

  ❑ COVID Clinic Roadmaps
  o AEFI & Untoward Events o Communication

  ❑ Medical Directives
  o #52 COVID-19 mRNA Vaccines o #1 Epinephrine

  ❑ Health Education References: o COVID-19 Vaccines

o Novel Coronavirus (COVID-19)
o Adverse Events Following Immunization (AEFI)

❑ Facts About:
o COVID-19 Vaccines

❑ Non-DRHD Resources
o CDC Moderna COVID-19 Vaccine Preparation and Administration Summary
o Ministry of Health (MOH) COVID-19 Administration of Pfizer-BioNTech COVID-19 Vaccine

o Ministry of Health (MOH) COVID-19 Administration of Moderna COVID-19 Vaccine o MOH COVID-19 Vaccine Obtaining Informed Consent Script for HCPs
o Moderna Product Monograph
o Pfizer BioNTech COVID-19 Vaccine Product Monograph

❑ COVax Training:
o Ministry End-to-End Demonstration
o Ministry Clinic Flow
o COVax Vaccine Administration Role Training Manual

❑ P&Ps for Review (as needed) o PHD P&P Manual

3.130 Medication Administration
3.140 Adverse Events Following Immunization (AEFI)
3.160 Management of Sharps and Biomedical Waste
3.170 Management of Anaphylaxis and Untoward Events

5.300 Consent for Services
5.110 Verifying Client Identity Prior to Providing Care