SlideShare a Scribd company logo
1 of 11
Download to read offline
Document Name: Vaccine AdministrationandDocumentation
Document Type: STANDARD OPERATING PROCEDURE
Department: Continuous Improvement
Authored By: Tara Sauers
Clinical Operations OMT
Approved By:
Date:
BarryMagnus, MD
Vice President for Medical Operations East Zone
04/01/2015
RevisedBy: Name
Title
Revision Approved By:
Date:
Name
Title
MM/DD/YYYY
Stakeholders: Clinical Operations
Change Summary: New
Next Review Date: 04/01/2016
Line of Business: Clinical Operations
Role(s): Medical Support Staff, Nurse, X-RayTechnician, Clinician
Prerequisites
The followingis necessarybeforethe procedurescontainedinthisguidecanbe successfullycompleted:
 Medical SupportStaff (MSS)/Nursesmustcomplete the Medication AdministrationClinical
Competency.
Background
The purpose of this Standard OperatingProcedure (SOP) istoinformMSS/Nursesaboutcorrect
operational patientservice processes ̶ includingVaccine Administration.
For Travel Healthor Influenzaonlyvaccineservices, refertothose specificprocessfordocumentationof
vaccine administered
 Pediatricprimarycare facilities administeringvaccinesforchildren lessthan7years oldare not
includedonthe Vaccine AdministrationRecord
 Facilitiesthatreceivepediatricvaccinesthrough VaccineForChildren(VFC) andotherprograms
have differentoradditional state guidelines forthe documentationof vaccines.
 Individual statesmayhave additional ordifferentrequirements thatpertaintoVaccine
Administration documentation,whichmustbe followed.
Note:MSS and nursesmay only administervaccineswhere allowedbyfederal,state, andlocal
regulations.
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 2 of11
Process Overview
Procedures
Step 1: Back Office ̶ Prepare/Provide the required Vaccination and Consent Forms
Complete the following stepstoprovidethe patientorparent/legal guardian withthe correct
documents andconsents needed tocomplete Vaccine Administration.
1. MSS/Nurse/Clinician reviews admission documents orworklistorder, andpreparesthe forms.
If... Then…
The patientisin the waitingroom MSS/Nurse/Clinician preparesdocumentsprior
to callingthe patient
If the patientisalreadyina treatmentroom
for injury/illnessornon-injury care
MSS/Nurse/Clinician prepares the
documents ̶ afterthe clinicianexaminesthe
patient,asindicatedbythe worklist or
clinicianorder ̶ before enteringthe
treatmentroom
2. Required Vaccine Administration formsinclude:
a. Vaccine Disclosure and InformedConsent (VDIC)
b. Vaccine InformationStatement (VIS)
c. Vaccine ScreeningQuestionnaire(VSQ)
d. Vaccine Administration Record(VAR)
Note:Separate VARsandVSQsforms forminors.
Step 1: Back Office ̶
Prepare/Provide the
requiredVaccination &
Consent Forms
Step 2: Back Office &
Clinician ̶ Review
Vaccine Screening
Questionnaire to
determine next steps
Step 3:ClinicianReviews
& Signs the Vaccine
Administration Record
(VAR)
Step 4: Back Office ̶
Staff/Clinicianprepares
Vaccine
Step 5: Back Office ̶
Staff & Clinicianobtain
Patient's Consent and
administer Vaccine
Step 6: Back Office ̶
Provide Post-Vaccination
Care andcomplete
VAR
Step 7: Front Offi ce ̶
Complete CheckOut
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 3 of11
3. MSS/Nurse/Clinician provides the patientorparent/legal guardianwiththe required
documents:
 VIS
 VSQ
Note:The VARand VDICare notgivento the patientorparent/legal guardianatthistime.
4. MSS/Nurse/Clinician allowsthe patientorparent/legalguardianenoughtimeto review,
complete,andsignVaccine Administration documents.
Note:MSS maychoose to leave the examroom duringthisstep.
5. MSS/Nurse/Clinician retrievesthe completed/signedVSQfromthe patientorparent/legal
guardian.
6. Note: Onlyquestions1-10on the VSQmust be completedforstandardvaccinations. Questions
11-19 onthe VSQ apply onlyto Travel Healthvaccinationservices..
Step 2: Back Office ̶ MSS/Nurse and Clinician review the VSQ to determine next steps
Complete the following stepsforclinicianreviewof the VSQ.
1. MSS/Nurse givespatientformstothe clinicianincluding:
a. CompletedandsignedVSQ
b. VAR
i. Fieldscompletedonthe VARatthistime include:
o PatientName
o PatientDate of Birth
2. Clinician reviewsandsignsthe VSQ.
3. If the Cliniciandeterminesthatmore evaluationisneededbasedonthe VSQ1
:
 Patientorparent/legal guardianare toldthatthe clinicianwillreview the VSQ withthem
 Additional admissionforthisservice is notrequired
 The clinicianadvises the nextstepstothe MSS/Nurse and patient,orparent/legal guardian
If… Then…
Clinicianfindsthatvaccinationcannotoccur  The vaccine is notgiven
 The cliniciandirectsthe patient,parent,
or legal guardiantofollow upwith their
PrimaryCare Physician(PCP) with
appropriate documents
 If admissionoccurredinOccuSource,
Front Office Specialist(FOS) walksout
visit,nocharge for service
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 4 of11
 If admissionoccurredinGE Centricity,
FOS will checkthe visitoutof GE withthe
correct billingexception,if applicable and
vaccine onlyservice
 Contact employerasdetailedin the
service package/employernotes
 Cancel orderin Allscripts,viathe "entered
inerror" function,if applicable
Clinician determines thatavaccinationcan
occur:
 Cliniciansignsthe VSQ2
 ProceedtoStep3
1 ̶ See Vaccine ScreeningQuestionnaire Clinical Protocol inResources
2 ̶ See Medication& Vaccine Administration andPolicySetinResources
Step 3: Clinician Reviews and Signs VAR
Complete the followingstepstoprovidethe MSS/Nurse withthe clinician'sorderforthe vaccine:
1. Clinicianreviewsthe VAR.
2. Cliniciansignsanddatesthe correspondingline forthe vaccine the patientwill receive3
.
Note:The VARsignedbythe clinician isanorderfor vaccination fornon-injury services.Forinjury/illness
services, workorderrequestsmustbe documentedin Allscripts, inadditiontothe VAR.
3 ̶ See the Resourcessectionforclinicianordersignature imageon the VAR.
If... Then…
There isan acceleratedoptionfor the
vaccinationschedule
Clinicianshouldcircle the appropriate column
underschedule onthe VAR
Vaccine isa rabies vaccine Clinicianindicateswhethervaccine isfor
pre-exposure orpost-exposure
(SeeVaccination Administration Record Clinical
Protocolin Resources)
Vaccine isa series ̶ where follow-up
vaccinationsare required
Patientorparent/legal guardian isinformedof
timingrequirementsforvaccine series
Vaccinationisa followupthatispart of a series Ensure the propertime has elapsedsince
previousvisit
 Withclinicianapproval,vaccinesmay be
administeredupto fourdays earlierthan
recommended interval
 Withclinicianapproval,vaccinesmaybe
administeredlaterthanscheduled
(SeeVaccination Administration Record Clinical
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 5 of11
Protocolin Resources.)
Vaccine isnot a pre-populatedoptiononthe
VAR
Hand write immunizationsthatare ordered,but
not pre-populatedonthe VAR
Step 4: Back Office ̶ MSS/Nurse/Clinician prepares Vaccine following the Administration
Guideline
Complete the following stepstoprepare the vaccine tobe administered:
Note:MSS and nursesmay dispense vaccinesonlywhereallowedbyfederal,state, andlocal
regulations.
1. Confirmclinician's orders
2. MSS/Nurse/Clinician createsorderin Allscripts,if service is vaccine only
a. See Allscripts StandingOrderQuickGuide formore information
3. Readlabelsand note:
a. Medications thatmay have similarnamesorpackaging
b. Look alike andsound-alike vaccines
c. Medications thatare not commonlyusedorprescribed
d. Commonlyused vaccines towhichmany patientsare allergic(e.g.,antibiotics,opiates,
and nonsteroidal anti-inflammatory drugs)
e. Checkexpirationdate
f. Double-checkdosage,route,andcalculationspriorto administering the vaccine
g. Properhandwashingandaseptictechnique shouldbe usedatall times(Referto
InfectionControl protocol)
h. Use correct equipment forpreparationof vaccinationorvaccine (e.g.correctdiluent)
4. Prepare the vaccine toadminister(permanufacturer'sguidelines)
 The clinicianordermustbe verifiedbyadditional MSS/Nurse/Clinicianpriorto
administration
 Vaccines mustbe verifiedbyadditionalmedicalsupportcolleaguesorclinicians, priorto
administration
If … Then…
Vaccine administration will documentedin
Allscripts
Documentthe vaccination andclinician
order ̶ as verifiedbythe additional
MSS/Nurse/Clinician ̶ by selectingthe
colleague whocompletedthe verificationin
the drop-downselectionbox inthe "Visually
VerifiedBy"sectionof the record
administration
(SeeResources section below for image)
Vaccine Administration will not be
documentedin Allscripts
Additional MSS/Nurse orclinicianwill initial
nextto clinicianorderbox of VAR,indicating
theyhave completedsecondary medication
and orderverification
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 6 of11
Step 5: Back Office ̶ Staff and Clinician obtain Patient’s Consent and administers Vaccine
Following the Administration Guidelines
Complete the followingstepsinordertocomplete VaccineAdministration:
1. The patientor parent/legal guardiancompletes the VDIC.
a. Patientorparent/legal guardianinitialsthe "accept"portionof the VDIC
Note:If the patientor parent/legalguardiandeclinesthe vaccine,the clinicianshouldbe informed.
Moreover,the patientorparent/legal guardianinitials shouldbe inthe decline portionof the VDIC
form.
b. Patientorparent/legal guardianandwitness signaturesanddate of service mustbe
completed to proceed with Vaccine Administration
c. Askthe Patientor parent/legal guardianif theyhave anyquestionsto discuss withthe
clinician, priortoadministering the vaccine
2. Askif the patientorparent/legal guardianhasahistoryof syncope/fainting orpre-syncope
If... Then…
Patientindicatestheyhave ahistoryof
syncope/faintingorpre-syncope
 Informpatientorparent/legal guardian
that the MSS/Nurse/Clinician givingthe
vaccine will observe the patientfor5
minutes post-vaccinationinthe exam
room forsafetyconsiderations
 Instructthe patientorparent/legal
guardianthat we will request they
waitin the checkout/lobbyareafor10
minutes post-injection;toreportany
additional symptomsthatmayoccur as
a potential reactiontothe vaccination
 Educate the patientorparent/legal
guardianto reportany symptoms
immediately
Patientindicatestheydo nothave ahistory
of syncope/faintingorpre-syncope
 Instructthe patientorparent/legal
guardianthat we will requestthey
waitin the checkout/ lobbyareafor15
minutespost- injection;inorderto
reportany additional symptoms that
may occur as a potential reactionto
the vaccination
 Educate patientor parent/legal
guardianthat anysymptomshouldbe
reported rightaway
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 7 of11
3. Verifycorrectpatientorparent/legal guardianbyaskingfull name anddate of birth
4. Recheckforallergies
5. Use the 7 Rightsof Medication Administration4
before givingthe vaccine
a. The Right Patient
b. The Right Drug or Vaccine
c. The Right Dose
d. The Right Route
e. The Right Time
f. The Right Site
g. The Right Documentation
4 ̶ See Medication&Vaccine Administration Policy SetunderResources
6. Administerthe vaccine(s)tothe patientfollowingMedicationAdministrationguidelines,
regulatoryrequirements,andclinical competencyguidance
a. Clinical CompetencyMedicationAdministration
Step 6: Back Office ̶ Provide Post-Vaccination Care Instructions and complete VAR
1. Patientorparent/legal guardianreceivespost-vaccinationinstructionsfromthe
MSS/Nurse/Clinician
a. Post-vaccine instruction isdeterminedby the patient's history of syncope/faintingor
pre-syncope
If... Then…
Patienthasa historyof syncope/fainting or
pre-syncope
Observe patientone-onefor5 minutespost-
vaccine
If… Then…
No symptomsoccur
after5 minutes
 Escort the
patienttothe
waitingroom
withinstructions
to waitanother
10 minutes
duringcheckout
 Advise patient
or parent/legal
guardianof time
vaccine given
Symptomsoccur
after5 minutes
Call clinicianSTAT
and follorthe
Allergic&
Anaphylactic
Reactionsfollowing
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 8 of11
Medicationor
Vaccine
Administration
Clinical Protocol
Patienthasno historyof syncope/fainting
or pre-syncope
 Requestthe patient waitincheckoutarea
for 15 minutes post-vaccine totoallowfor
rapidassistance if new symptomsdevelop
 Advise patientorparent/legal guardianof
time vaccine given
 Instruct patientorparent/legal guardianto
reportany symptomsto FOS at checkout
If… Then…
Patientreportsany
symptomstoFOS
Immediatelynotify
the
MSS/Nurse/Clinician
2. Complete Vaccine Administration Documentation inAllscripts (if applicable) andon paperVAR
a. Documentationincludescompletionof VAR
i. Date vaccine andVISgiven
ii. Applicable schedule dates/seriesnumbercompleted
iii. VISversiondate
iv. Vaccination Dose
v. Vaccination Route
vi. Vaccine Information
o Manufacturer
o Lot Number
o ExpirationDate
vii. Site
o Hemisphere
o BodyPart
viii. Administered by:SignatureandDate
ix. ClinicianOrder: Signature andDate
x. Vaccination andordersecondaryverification
3. Scan all completed/signed documentsinto Allscripts,“patientinformation”folder,if applicable
4. If vaccine-only service, clinician will receive a Submit Res Enc Task to submit the charge in
Allscripts
5. Printelectronicvaccinationrecordfrom Allscripts,if applicable
6. Provide HepatitisBWalletCardwith follow upschedule datespopulated,if applicable
7. Escort patienttofront office forcheckout
Step 8: Front Office ̶ Complete Check Out
Complete the followingsteps tocompletethe checkoutprocessforservicesincluding Vaccine
Administration.5
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 9 of11
Note:Checkout may occur inback office,if fast-trackservice occurred.
1. FOS completescheckout
2. FOS photocopiesthe completedVARand providesacopyto the patientorparent/legal
guardian
3. If patientor parent/legal guardianreportsanysymptomsto FOSduringcheck out, they
mustensure patientsafetyand notifythe MSS/Nurse/Clinician forimmediateassistance
5 ̶ See Site OperationsCheck OutPlaybook inResources
Terms
Term Definition
FOS Front Office Specialist
MSS Medical Support Staff
Syncope Temporarylossof consciousnesscausedbyafall inbloodpressure
VAR Vaccine Administration Record
VIS Vaccine InformationStatement
VSQ Vaccine ScreeningQuestionnaire
VDIC Vaccine Disclosure andInformedConsent
Resources
1. Refertothe following linksforadditionalinformation:
 AllergicandAnaphylacticReactionsFollowing VaccineAdministration Protocol
 Allscripts QuickGuide - ImmunizationStandingOrder
 Clinical Competency - MedicationAdministration
 Medication & VaccineAdministration Policy Set
 Site OperationsPlaybookCheckInChapter
 Site OperationsPlaybookCheckOutChapter
 Vaccine Administration Clinical Protocol
 Vaccine Administration RecordClinical Protocol
 Vaccine Administration Record(Adult)
 Vaccine Administration Record(Pediatric)
 Vaccine Disclosure andInformedConsent
 Vaccine Disclosure andInformedConsentClinicalProtocol
 Vaccine InformationStatementClinicalProtocol
 Vaccine ScreeningQuestionnaireClinical Protocol
 Vaccine ScreeningQuestionnaire–Adult(English)
 Vaccine ScreeningQuestionnaire–Children&Teens(English)
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 10 of11
2. Helpful FormHints
o Clinicianreview of the VSQisindicatedbythe cliniciansignature presentonthe
"Form Reviewedby"line
o Clinicianorderforvaccinationisindicatedbythe cliniciansignature onthe VAR
o VaccinationandOrdervisuallyverified byadditional MSS/Nurse/ClinicianorClinicianin
Allscripts
Vaccine Administration and Documentation
Confidential – Internal Use Only
Page 11 of11

More Related Content

What's hot

presentation in JCIA awareness week
presentation in JCIA awareness weekpresentation in JCIA awareness week
presentation in JCIA awareness weekDralaa Holiel , Ph.D
 
JCI Internal Audit Checklist By-Dr.Mahboob Khan Phd
JCI Internal Audit Checklist  By-Dr.Mahboob Khan Phd JCI Internal Audit Checklist  By-Dr.Mahboob Khan Phd
JCI Internal Audit Checklist By-Dr.Mahboob Khan Phd Healthcare consultant
 
The use of guidelines and clinical pathways
The use of guidelines and clinical pathwaysThe use of guidelines and clinical pathways
The use of guidelines and clinical pathwaysJoven Botin Bilbao
 
P8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIA
P8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIAP8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIA
P8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIAhafizahhoshni
 
JCI Frequently asked Questions by Dr.Mahboob ali khan Phd
JCI Frequently asked Questions by Dr.Mahboob ali khan Phd JCI Frequently asked Questions by Dr.Mahboob ali khan Phd
JCI Frequently asked Questions by Dr.Mahboob ali khan Phd Healthcare consultant
 
Chl hp-ipsg .01 patient identification-4
Chl hp-ipsg .01 patient identification-4Chl hp-ipsg .01 patient identification-4
Chl hp-ipsg .01 patient identification-4cicaklomen
 
Acc chapter presentation for JCI awarness week
Acc chapter presentation for JCI awarness weekAcc chapter presentation for JCI awarness week
Acc chapter presentation for JCI awarness weekDralaa Holiel , Ph.D
 
Standards & survey process orientation sspo cbahi
Standards  & survey  process orientation sspo cbahiStandards  & survey  process orientation sspo cbahi
Standards & survey process orientation sspo cbahiMEEQAT HOSPITAL
 
Performance improvement 3
Performance improvement 3Performance improvement 3
Performance improvement 3Inas Alassar
 
Veterinary Medical Records as a Defense to Your License
Veterinary Medical Records as a Defense to Your LicenseVeterinary Medical Records as a Defense to Your License
Veterinary Medical Records as a Defense to Your LicenseJustin Hein
 
Healthcare
HealthcareHealthcare
HealthcareShamsuak
 
Jcia outline by Dr.Mahboob ali khan Phd .
Jcia outline by Dr.Mahboob ali khan Phd .Jcia outline by Dr.Mahboob ali khan Phd .
Jcia outline by Dr.Mahboob ali khan Phd .Healthcare consultant
 
Pme lecture 2012presentationpart3
Pme lecture 2012presentationpart3Pme lecture 2012presentationpart3
Pme lecture 2012presentationpart3University of Miami
 
List of Policies & Procedure for QIP
List of Policies &  Procedure for QIPList of Policies &  Procedure for QIP
List of Policies & Procedure for QIPDr Jitu Lal Meena
 
Gap analysis of NABH 3rd and 4th Edition
Gap analysis of NABH 3rd and 4th EditionGap analysis of NABH 3rd and 4th Edition
Gap analysis of NABH 3rd and 4th EditionDr.Deepak Rajendiran
 

What's hot (20)

presentation in JCIA awareness week
presentation in JCIA awareness weekpresentation in JCIA awareness week
presentation in JCIA awareness week
 
JCI Internal Audit Checklist By-Dr.Mahboob Khan Phd
JCI Internal Audit Checklist  By-Dr.Mahboob Khan Phd JCI Internal Audit Checklist  By-Dr.Mahboob Khan Phd
JCI Internal Audit Checklist By-Dr.Mahboob Khan Phd
 
The joint commission Q & A.
The joint commission Q &  A.The joint commission Q &  A.
The joint commission Q & A.
 
The use of guidelines and clinical pathways
The use of guidelines and clinical pathwaysThe use of guidelines and clinical pathways
The use of guidelines and clinical pathways
 
P8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIA
P8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIAP8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIA
P8 INCIDENT REPORTING AND LEARNING FROM ERROR HOUSEMANSHIP MALAYSIA
 
JCI Frequently asked Questions by Dr.Mahboob ali khan Phd
JCI Frequently asked Questions by Dr.Mahboob ali khan Phd JCI Frequently asked Questions by Dr.Mahboob ali khan Phd
JCI Frequently asked Questions by Dr.Mahboob ali khan Phd
 
Chl hp-ipsg .01 patient identification-4
Chl hp-ipsg .01 patient identification-4Chl hp-ipsg .01 patient identification-4
Chl hp-ipsg .01 patient identification-4
 
Acc chapter presentation for JCI awarness week
Acc chapter presentation for JCI awarness weekAcc chapter presentation for JCI awarness week
Acc chapter presentation for JCI awarness week
 
tracer tool
tracer tooltracer tool
tracer tool
 
JCIA PRESENTATION
JCIA PRESENTATIONJCIA PRESENTATION
JCIA PRESENTATION
 
Standards & survey process orientation sspo cbahi
Standards  & survey  process orientation sspo cbahiStandards  & survey  process orientation sspo cbahi
Standards & survey process orientation sspo cbahi
 
Performance improvement 3
Performance improvement 3Performance improvement 3
Performance improvement 3
 
Veterinary Medical Records as a Defense to Your License
Veterinary Medical Records as a Defense to Your LicenseVeterinary Medical Records as a Defense to Your License
Veterinary Medical Records as a Defense to Your License
 
Jci most common question
Jci most common questionJci most common question
Jci most common question
 
Healthcare
HealthcareHealthcare
Healthcare
 
Jcia outline by Dr.Mahboob ali khan Phd .
Jcia outline by Dr.Mahboob ali khan Phd .Jcia outline by Dr.Mahboob ali khan Phd .
Jcia outline by Dr.Mahboob ali khan Phd .
 
Pme lecture 2012presentationpart3
Pme lecture 2012presentationpart3Pme lecture 2012presentationpart3
Pme lecture 2012presentationpart3
 
Justavino, Jessica
Justavino, JessicaJustavino, Jessica
Justavino, Jessica
 
List of Policies & Procedure for QIP
List of Policies &  Procedure for QIPList of Policies &  Procedure for QIP
List of Policies & Procedure for QIP
 
Gap analysis of NABH 3rd and 4th Edition
Gap analysis of NABH 3rd and 4th EditionGap analysis of NABH 3rd and 4th Edition
Gap analysis of NABH 3rd and 4th Edition
 

Viewers also liked

Amos presentation
Amos presentation Amos presentation
Amos presentation juanf490
 
FINANCIAL FITNESS
FINANCIAL FITNESSFINANCIAL FITNESS
FINANCIAL FITNESSTien Bui
 
2.2.1 project based learning
2.2.1 project based learning2.2.1 project based learning
2.2.1 project based learningYosti Saban
 
Jornada do consumidor
Jornada do consumidor Jornada do consumidor
Jornada do consumidor CRP Mango
 
Curs selecció de música per a la biblioteca pública. Desembre 2009
Curs selecció de música per a la biblioteca pública. Desembre 2009Curs selecció de música per a la biblioteca pública. Desembre 2009
Curs selecció de música per a la biblioteca pública. Desembre 2009Josep Lluís Villanueva Fontanella
 
Completed project list for mark shaw 160614
Completed project list for mark shaw 160614Completed project list for mark shaw 160614
Completed project list for mark shaw 160614Mark Shaw
 
Agile and waterfall the additional value
Agile and waterfall the additional value Agile and waterfall the additional value
Agile and waterfall the additional value Lior Israel
 
AMC2014 Demystifying Mass Emailing with Free and Open Source Software
AMC2014 Demystifying Mass Emailing with Free and Open Source SoftwareAMC2014 Demystifying Mass Emailing with Free and Open Source Software
AMC2014 Demystifying Mass Emailing with Free and Open Source SoftwareRhsalzman
 
Delivering business presentations
Delivering business presentationsDelivering business presentations
Delivering business presentationscdecoudres
 
กล ม Electron ภาระก_จท__ 2
กล  ม Electron ภาระก_จท__ 2กล  ม Electron ภาระก_จท__ 2
กล ม Electron ภาระก_จท__ 2Kung Kaenchan
 
Prosecution history analysis
Prosecution history analysisProsecution history analysis
Prosecution history analysisSmriti Jain
 
Konsep-pendekatan-scientific-rev-final-1
 Konsep-pendekatan-scientific-rev-final-1 Konsep-pendekatan-scientific-rev-final-1
Konsep-pendekatan-scientific-rev-final-1Yosti Saban
 
La escuela en la democracia. entrevista
La escuela en la democracia. entrevistaLa escuela en la democracia. entrevista
La escuela en la democracia. entrevistaVilmati Corradetti
 
104.2.28台南行程
104.2.28台南行程104.2.28台南行程
104.2.28台南行程ten1985
 
2010 Shaighai Day4
2010 Shaighai Day42010 Shaighai Day4
2010 Shaighai Day4ten1985
 
Binder buku linux_networking_02-2008
Binder buku linux_networking_02-2008Binder buku linux_networking_02-2008
Binder buku linux_networking_02-2008Sinta Bahari
 

Viewers also liked (20)

Raise children
Raise childrenRaise children
Raise children
 
Amos presentation
Amos presentation Amos presentation
Amos presentation
 
FINANCIAL FITNESS
FINANCIAL FITNESSFINANCIAL FITNESS
FINANCIAL FITNESS
 
2.2.1 project based learning
2.2.1 project based learning2.2.1 project based learning
2.2.1 project based learning
 
Jornada do consumidor
Jornada do consumidor Jornada do consumidor
Jornada do consumidor
 
Curs selecció de música per a la biblioteca pública. Desembre 2009
Curs selecció de música per a la biblioteca pública. Desembre 2009Curs selecció de música per a la biblioteca pública. Desembre 2009
Curs selecció de música per a la biblioteca pública. Desembre 2009
 
Completed project list for mark shaw 160614
Completed project list for mark shaw 160614Completed project list for mark shaw 160614
Completed project list for mark shaw 160614
 
상상화
상상화상상화
상상화
 
Agile and waterfall the additional value
Agile and waterfall the additional value Agile and waterfall the additional value
Agile and waterfall the additional value
 
AMC2014 Demystifying Mass Emailing with Free and Open Source Software
AMC2014 Demystifying Mass Emailing with Free and Open Source SoftwareAMC2014 Demystifying Mass Emailing with Free and Open Source Software
AMC2014 Demystifying Mass Emailing with Free and Open Source Software
 
Delivering business presentations
Delivering business presentationsDelivering business presentations
Delivering business presentations
 
กล ม Electron ภาระก_จท__ 2
กล  ม Electron ภาระก_จท__ 2กล  ม Electron ภาระก_จท__ 2
กล ม Electron ภาระก_จท__ 2
 
Prosecution history analysis
Prosecution history analysisProsecution history analysis
Prosecution history analysis
 
Konsep-pendekatan-scientific-rev-final-1
 Konsep-pendekatan-scientific-rev-final-1 Konsep-pendekatan-scientific-rev-final-1
Konsep-pendekatan-scientific-rev-final-1
 
La escuela en la democracia. entrevista
La escuela en la democracia. entrevistaLa escuela en la democracia. entrevista
La escuela en la democracia. entrevista
 
Numeración de pagina en word 2013
Numeración de pagina en word 2013Numeración de pagina en word 2013
Numeración de pagina en word 2013
 
104.2.28台南行程
104.2.28台南行程104.2.28台南行程
104.2.28台南行程
 
2010 Shaighai Day4
2010 Shaighai Day42010 Shaighai Day4
2010 Shaighai Day4
 
Portfolio 2012
Portfolio 2012Portfolio 2012
Portfolio 2012
 
Binder buku linux_networking_02-2008
Binder buku linux_networking_02-2008Binder buku linux_networking_02-2008
Binder buku linux_networking_02-2008
 

Similar to 1068-vaccine-administration-sop-final

Credentialing and privileging of clinicians
Credentialing  and privileging of cliniciansCredentialing  and privileging of clinicians
Credentialing and privileging of cliniciansJoven Botin Bilbao
 
The health care manager
The health care managerThe health care manager
The health care managerBrijesh Shukla
 
Annual ed core measures.09 10
Annual ed core measures.09 10Annual ed core measures.09 10
Annual ed core measures.09 10capstonerx
 
Module 2 KEY POLICIES.pptx
Module 2 KEY POLICIES.pptxModule 2 KEY POLICIES.pptx
Module 2 KEY POLICIES.pptxMariaCecilia94
 
INTERNATIONAL PATIENT SAFETY GOALS.pptx
INTERNATIONAL PATIENT SAFETY GOALS.pptxINTERNATIONAL PATIENT SAFETY GOALS.pptx
INTERNATIONAL PATIENT SAFETY GOALS.pptxFarahAndleebMalik
 
MR documentation Presentation
MR documentation PresentationMR documentation Presentation
MR documentation PresentationAlaa Elbaraa
 
Mcs Hospital
Mcs HospitalMcs Hospital
Mcs Hospitalkgnmatin
 
Web application for clinicians - SidekickCV
Web application for clinicians - SidekickCVWeb application for clinicians - SidekickCV
Web application for clinicians - SidekickCVAaron Duthie
 
Pharmacovigilance Process Work Flow - Katalyst HLS
Pharmacovigilance Process Work Flow - Katalyst HLSPharmacovigilance Process Work Flow - Katalyst HLS
Pharmacovigilance Process Work Flow - Katalyst HLSKatalyst HLS
 
Self assessment tool kit for NABH-converted.docx
Self assessment tool kit for NABH-converted.docxSelf assessment tool kit for NABH-converted.docx
Self assessment tool kit for NABH-converted.docxQASGR
 
Patient safety goals effective january 1, 2016
Patient safety goals effective january 1, 2016Patient safety goals effective january 1, 2016
Patient safety goals effective january 1, 2016Hisham Aldabagh
 
Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOW
Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOWAppropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOW
Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOWBESLER
 
Annual ed patient safety
Annual ed patient safetyAnnual ed patient safety
Annual ed patient safetycapstonerx
 

Similar to 1068-vaccine-administration-sop-final (20)

Ipsg
IpsgIpsg
Ipsg
 
Credentialing and privileging of clinicians
Credentialing  and privileging of cliniciansCredentialing  and privileging of clinicians
Credentialing and privileging of clinicians
 
The health care manager
The health care managerThe health care manager
The health care manager
 
Annual ed core measures.09 10
Annual ed core measures.09 10Annual ed core measures.09 10
Annual ed core measures.09 10
 
Patient safety
Patient safetyPatient safety
Patient safety
 
Module 2 KEY POLICIES.pptx
Module 2 KEY POLICIES.pptxModule 2 KEY POLICIES.pptx
Module 2 KEY POLICIES.pptx
 
Thomson poster proof
Thomson poster proofThomson poster proof
Thomson poster proof
 
Risk Management Trends
Risk Management TrendsRisk Management Trends
Risk Management Trends
 
Vaishali chadha
Vaishali chadhaVaishali chadha
Vaishali chadha
 
INTERNATIONAL PATIENT SAFETY GOALS.pptx
INTERNATIONAL PATIENT SAFETY GOALS.pptxINTERNATIONAL PATIENT SAFETY GOALS.pptx
INTERNATIONAL PATIENT SAFETY GOALS.pptx
 
MR documentation Presentation
MR documentation PresentationMR documentation Presentation
MR documentation Presentation
 
Mcs Hospital
Mcs HospitalMcs Hospital
Mcs Hospital
 
Lessons learnt from phase 1 roll-out of COVID-19 vaccines
Lessons learnt from phase 1 roll-out of COVID-19 vaccinesLessons learnt from phase 1 roll-out of COVID-19 vaccines
Lessons learnt from phase 1 roll-out of COVID-19 vaccines
 
Web application for clinicians - SidekickCV
Web application for clinicians - SidekickCVWeb application for clinicians - SidekickCV
Web application for clinicians - SidekickCV
 
Pharmacovigilance Process Work Flow - Katalyst HLS
Pharmacovigilance Process Work Flow - Katalyst HLSPharmacovigilance Process Work Flow - Katalyst HLS
Pharmacovigilance Process Work Flow - Katalyst HLS
 
Self assessment tool kit for NABH-converted.docx
Self assessment tool kit for NABH-converted.docxSelf assessment tool kit for NABH-converted.docx
Self assessment tool kit for NABH-converted.docx
 
Ipsg patient safety
Ipsg  patient safetyIpsg  patient safety
Ipsg patient safety
 
Patient safety goals effective january 1, 2016
Patient safety goals effective january 1, 2016Patient safety goals effective january 1, 2016
Patient safety goals effective january 1, 2016
 
Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOW
Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOWAppropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOW
Appropriate Level of Care and the 2– Midnight Rule Where It Stands as of NOW
 
Annual ed patient safety
Annual ed patient safetyAnnual ed patient safety
Annual ed patient safety
 

1068-vaccine-administration-sop-final

  • 1. Document Name: Vaccine AdministrationandDocumentation Document Type: STANDARD OPERATING PROCEDURE Department: Continuous Improvement Authored By: Tara Sauers Clinical Operations OMT Approved By: Date: BarryMagnus, MD Vice President for Medical Operations East Zone 04/01/2015 RevisedBy: Name Title Revision Approved By: Date: Name Title MM/DD/YYYY Stakeholders: Clinical Operations Change Summary: New Next Review Date: 04/01/2016 Line of Business: Clinical Operations Role(s): Medical Support Staff, Nurse, X-RayTechnician, Clinician Prerequisites The followingis necessarybeforethe procedurescontainedinthisguidecanbe successfullycompleted:  Medical SupportStaff (MSS)/Nursesmustcomplete the Medication AdministrationClinical Competency. Background The purpose of this Standard OperatingProcedure (SOP) istoinformMSS/Nursesaboutcorrect operational patientservice processes ̶ includingVaccine Administration. For Travel Healthor Influenzaonlyvaccineservices, refertothose specificprocessfordocumentationof vaccine administered  Pediatricprimarycare facilities administeringvaccinesforchildren lessthan7years oldare not includedonthe Vaccine AdministrationRecord  Facilitiesthatreceivepediatricvaccinesthrough VaccineForChildren(VFC) andotherprograms have differentoradditional state guidelines forthe documentationof vaccines.  Individual statesmayhave additional ordifferentrequirements thatpertaintoVaccine Administration documentation,whichmustbe followed. Note:MSS and nursesmay only administervaccineswhere allowedbyfederal,state, andlocal regulations.
  • 2. Vaccine Administration and Documentation Confidential – Internal Use Only Page 2 of11 Process Overview Procedures Step 1: Back Office ̶ Prepare/Provide the required Vaccination and Consent Forms Complete the following stepstoprovidethe patientorparent/legal guardian withthe correct documents andconsents needed tocomplete Vaccine Administration. 1. MSS/Nurse/Clinician reviews admission documents orworklistorder, andpreparesthe forms. If... Then… The patientisin the waitingroom MSS/Nurse/Clinician preparesdocumentsprior to callingthe patient If the patientisalreadyina treatmentroom for injury/illnessornon-injury care MSS/Nurse/Clinician prepares the documents ̶ afterthe clinicianexaminesthe patient,asindicatedbythe worklist or clinicianorder ̶ before enteringthe treatmentroom 2. Required Vaccine Administration formsinclude: a. Vaccine Disclosure and InformedConsent (VDIC) b. Vaccine InformationStatement (VIS) c. Vaccine ScreeningQuestionnaire(VSQ) d. Vaccine Administration Record(VAR) Note:Separate VARsandVSQsforms forminors. Step 1: Back Office ̶ Prepare/Provide the requiredVaccination & Consent Forms Step 2: Back Office & Clinician ̶ Review Vaccine Screening Questionnaire to determine next steps Step 3:ClinicianReviews & Signs the Vaccine Administration Record (VAR) Step 4: Back Office ̶ Staff/Clinicianprepares Vaccine Step 5: Back Office ̶ Staff & Clinicianobtain Patient's Consent and administer Vaccine Step 6: Back Office ̶ Provide Post-Vaccination Care andcomplete VAR Step 7: Front Offi ce ̶ Complete CheckOut
  • 3. Vaccine Administration and Documentation Confidential – Internal Use Only Page 3 of11 3. MSS/Nurse/Clinician provides the patientorparent/legal guardianwiththe required documents:  VIS  VSQ Note:The VARand VDICare notgivento the patientorparent/legal guardianatthistime. 4. MSS/Nurse/Clinician allowsthe patientorparent/legalguardianenoughtimeto review, complete,andsignVaccine Administration documents. Note:MSS maychoose to leave the examroom duringthisstep. 5. MSS/Nurse/Clinician retrievesthe completed/signedVSQfromthe patientorparent/legal guardian. 6. Note: Onlyquestions1-10on the VSQmust be completedforstandardvaccinations. Questions 11-19 onthe VSQ apply onlyto Travel Healthvaccinationservices.. Step 2: Back Office ̶ MSS/Nurse and Clinician review the VSQ to determine next steps Complete the following stepsforclinicianreviewof the VSQ. 1. MSS/Nurse givespatientformstothe clinicianincluding: a. CompletedandsignedVSQ b. VAR i. Fieldscompletedonthe VARatthistime include: o PatientName o PatientDate of Birth 2. Clinician reviewsandsignsthe VSQ. 3. If the Cliniciandeterminesthatmore evaluationisneededbasedonthe VSQ1 :  Patientorparent/legal guardianare toldthatthe clinicianwillreview the VSQ withthem  Additional admissionforthisservice is notrequired  The clinicianadvises the nextstepstothe MSS/Nurse and patient,orparent/legal guardian If… Then… Clinicianfindsthatvaccinationcannotoccur  The vaccine is notgiven  The cliniciandirectsthe patient,parent, or legal guardiantofollow upwith their PrimaryCare Physician(PCP) with appropriate documents  If admissionoccurredinOccuSource, Front Office Specialist(FOS) walksout visit,nocharge for service
  • 4. Vaccine Administration and Documentation Confidential – Internal Use Only Page 4 of11  If admissionoccurredinGE Centricity, FOS will checkthe visitoutof GE withthe correct billingexception,if applicable and vaccine onlyservice  Contact employerasdetailedin the service package/employernotes  Cancel orderin Allscripts,viathe "entered inerror" function,if applicable Clinician determines thatavaccinationcan occur:  Cliniciansignsthe VSQ2  ProceedtoStep3 1 ̶ See Vaccine ScreeningQuestionnaire Clinical Protocol inResources 2 ̶ See Medication& Vaccine Administration andPolicySetinResources Step 3: Clinician Reviews and Signs VAR Complete the followingstepstoprovidethe MSS/Nurse withthe clinician'sorderforthe vaccine: 1. Clinicianreviewsthe VAR. 2. Cliniciansignsanddatesthe correspondingline forthe vaccine the patientwill receive3 . Note:The VARsignedbythe clinician isanorderfor vaccination fornon-injury services.Forinjury/illness services, workorderrequestsmustbe documentedin Allscripts, inadditiontothe VAR. 3 ̶ See the Resourcessectionforclinicianordersignature imageon the VAR. If... Then… There isan acceleratedoptionfor the vaccinationschedule Clinicianshouldcircle the appropriate column underschedule onthe VAR Vaccine isa rabies vaccine Clinicianindicateswhethervaccine isfor pre-exposure orpost-exposure (SeeVaccination Administration Record Clinical Protocolin Resources) Vaccine isa series ̶ where follow-up vaccinationsare required Patientorparent/legal guardian isinformedof timingrequirementsforvaccine series Vaccinationisa followupthatispart of a series Ensure the propertime has elapsedsince previousvisit  Withclinicianapproval,vaccinesmay be administeredupto fourdays earlierthan recommended interval  Withclinicianapproval,vaccinesmaybe administeredlaterthanscheduled (SeeVaccination Administration Record Clinical
  • 5. Vaccine Administration and Documentation Confidential – Internal Use Only Page 5 of11 Protocolin Resources.) Vaccine isnot a pre-populatedoptiononthe VAR Hand write immunizationsthatare ordered,but not pre-populatedonthe VAR Step 4: Back Office ̶ MSS/Nurse/Clinician prepares Vaccine following the Administration Guideline Complete the following stepstoprepare the vaccine tobe administered: Note:MSS and nursesmay dispense vaccinesonlywhereallowedbyfederal,state, andlocal regulations. 1. Confirmclinician's orders 2. MSS/Nurse/Clinician createsorderin Allscripts,if service is vaccine only a. See Allscripts StandingOrderQuickGuide formore information 3. Readlabelsand note: a. Medications thatmay have similarnamesorpackaging b. Look alike andsound-alike vaccines c. Medications thatare not commonlyusedorprescribed d. Commonlyused vaccines towhichmany patientsare allergic(e.g.,antibiotics,opiates, and nonsteroidal anti-inflammatory drugs) e. Checkexpirationdate f. Double-checkdosage,route,andcalculationspriorto administering the vaccine g. Properhandwashingandaseptictechnique shouldbe usedatall times(Referto InfectionControl protocol) h. Use correct equipment forpreparationof vaccinationorvaccine (e.g.correctdiluent) 4. Prepare the vaccine toadminister(permanufacturer'sguidelines)  The clinicianordermustbe verifiedbyadditional MSS/Nurse/Clinicianpriorto administration  Vaccines mustbe verifiedbyadditionalmedicalsupportcolleaguesorclinicians, priorto administration If … Then… Vaccine administration will documentedin Allscripts Documentthe vaccination andclinician order ̶ as verifiedbythe additional MSS/Nurse/Clinician ̶ by selectingthe colleague whocompletedthe verificationin the drop-downselectionbox inthe "Visually VerifiedBy"sectionof the record administration (SeeResources section below for image) Vaccine Administration will not be documentedin Allscripts Additional MSS/Nurse orclinicianwill initial nextto clinicianorderbox of VAR,indicating theyhave completedsecondary medication and orderverification
  • 6. Vaccine Administration and Documentation Confidential – Internal Use Only Page 6 of11 Step 5: Back Office ̶ Staff and Clinician obtain Patient’s Consent and administers Vaccine Following the Administration Guidelines Complete the followingstepsinordertocomplete VaccineAdministration: 1. The patientor parent/legal guardiancompletes the VDIC. a. Patientorparent/legal guardianinitialsthe "accept"portionof the VDIC Note:If the patientor parent/legalguardiandeclinesthe vaccine,the clinicianshouldbe informed. Moreover,the patientorparent/legal guardianinitials shouldbe inthe decline portionof the VDIC form. b. Patientorparent/legal guardianandwitness signaturesanddate of service mustbe completed to proceed with Vaccine Administration c. Askthe Patientor parent/legal guardianif theyhave anyquestionsto discuss withthe clinician, priortoadministering the vaccine 2. Askif the patientorparent/legal guardianhasahistoryof syncope/fainting orpre-syncope If... Then… Patientindicatestheyhave ahistoryof syncope/faintingorpre-syncope  Informpatientorparent/legal guardian that the MSS/Nurse/Clinician givingthe vaccine will observe the patientfor5 minutes post-vaccinationinthe exam room forsafetyconsiderations  Instructthe patientorparent/legal guardianthat we will request they waitin the checkout/lobbyareafor10 minutes post-injection;toreportany additional symptomsthatmayoccur as a potential reactiontothe vaccination  Educate the patientorparent/legal guardianto reportany symptoms immediately Patientindicatestheydo nothave ahistory of syncope/faintingorpre-syncope  Instructthe patientorparent/legal guardianthat we will requestthey waitin the checkout/ lobbyareafor15 minutespost- injection;inorderto reportany additional symptoms that may occur as a potential reactionto the vaccination  Educate patientor parent/legal guardianthat anysymptomshouldbe reported rightaway
  • 7. Vaccine Administration and Documentation Confidential – Internal Use Only Page 7 of11 3. Verifycorrectpatientorparent/legal guardianbyaskingfull name anddate of birth 4. Recheckforallergies 5. Use the 7 Rightsof Medication Administration4 before givingthe vaccine a. The Right Patient b. The Right Drug or Vaccine c. The Right Dose d. The Right Route e. The Right Time f. The Right Site g. The Right Documentation 4 ̶ See Medication&Vaccine Administration Policy SetunderResources 6. Administerthe vaccine(s)tothe patientfollowingMedicationAdministrationguidelines, regulatoryrequirements,andclinical competencyguidance a. Clinical CompetencyMedicationAdministration Step 6: Back Office ̶ Provide Post-Vaccination Care Instructions and complete VAR 1. Patientorparent/legal guardianreceivespost-vaccinationinstructionsfromthe MSS/Nurse/Clinician a. Post-vaccine instruction isdeterminedby the patient's history of syncope/faintingor pre-syncope If... Then… Patienthasa historyof syncope/fainting or pre-syncope Observe patientone-onefor5 minutespost- vaccine If… Then… No symptomsoccur after5 minutes  Escort the patienttothe waitingroom withinstructions to waitanother 10 minutes duringcheckout  Advise patient or parent/legal guardianof time vaccine given Symptomsoccur after5 minutes Call clinicianSTAT and follorthe Allergic& Anaphylactic Reactionsfollowing
  • 8. Vaccine Administration and Documentation Confidential – Internal Use Only Page 8 of11 Medicationor Vaccine Administration Clinical Protocol Patienthasno historyof syncope/fainting or pre-syncope  Requestthe patient waitincheckoutarea for 15 minutes post-vaccine totoallowfor rapidassistance if new symptomsdevelop  Advise patientorparent/legal guardianof time vaccine given  Instruct patientorparent/legal guardianto reportany symptomsto FOS at checkout If… Then… Patientreportsany symptomstoFOS Immediatelynotify the MSS/Nurse/Clinician 2. Complete Vaccine Administration Documentation inAllscripts (if applicable) andon paperVAR a. Documentationincludescompletionof VAR i. Date vaccine andVISgiven ii. Applicable schedule dates/seriesnumbercompleted iii. VISversiondate iv. Vaccination Dose v. Vaccination Route vi. Vaccine Information o Manufacturer o Lot Number o ExpirationDate vii. Site o Hemisphere o BodyPart viii. Administered by:SignatureandDate ix. ClinicianOrder: Signature andDate x. Vaccination andordersecondaryverification 3. Scan all completed/signed documentsinto Allscripts,“patientinformation”folder,if applicable 4. If vaccine-only service, clinician will receive a Submit Res Enc Task to submit the charge in Allscripts 5. Printelectronicvaccinationrecordfrom Allscripts,if applicable 6. Provide HepatitisBWalletCardwith follow upschedule datespopulated,if applicable 7. Escort patienttofront office forcheckout Step 8: Front Office ̶ Complete Check Out Complete the followingsteps tocompletethe checkoutprocessforservicesincluding Vaccine Administration.5
  • 9. Vaccine Administration and Documentation Confidential – Internal Use Only Page 9 of11 Note:Checkout may occur inback office,if fast-trackservice occurred. 1. FOS completescheckout 2. FOS photocopiesthe completedVARand providesacopyto the patientorparent/legal guardian 3. If patientor parent/legal guardianreportsanysymptomsto FOSduringcheck out, they mustensure patientsafetyand notifythe MSS/Nurse/Clinician forimmediateassistance 5 ̶ See Site OperationsCheck OutPlaybook inResources Terms Term Definition FOS Front Office Specialist MSS Medical Support Staff Syncope Temporarylossof consciousnesscausedbyafall inbloodpressure VAR Vaccine Administration Record VIS Vaccine InformationStatement VSQ Vaccine ScreeningQuestionnaire VDIC Vaccine Disclosure andInformedConsent Resources 1. Refertothe following linksforadditionalinformation:  AllergicandAnaphylacticReactionsFollowing VaccineAdministration Protocol  Allscripts QuickGuide - ImmunizationStandingOrder  Clinical Competency - MedicationAdministration  Medication & VaccineAdministration Policy Set  Site OperationsPlaybookCheckInChapter  Site OperationsPlaybookCheckOutChapter  Vaccine Administration Clinical Protocol  Vaccine Administration RecordClinical Protocol  Vaccine Administration Record(Adult)  Vaccine Administration Record(Pediatric)  Vaccine Disclosure andInformedConsent  Vaccine Disclosure andInformedConsentClinicalProtocol  Vaccine InformationStatementClinicalProtocol  Vaccine ScreeningQuestionnaireClinical Protocol  Vaccine ScreeningQuestionnaire–Adult(English)  Vaccine ScreeningQuestionnaire–Children&Teens(English)
  • 10. Vaccine Administration and Documentation Confidential – Internal Use Only Page 10 of11 2. Helpful FormHints o Clinicianreview of the VSQisindicatedbythe cliniciansignature presentonthe "Form Reviewedby"line o Clinicianorderforvaccinationisindicatedbythe cliniciansignature onthe VAR o VaccinationandOrdervisuallyverified byadditional MSS/Nurse/ClinicianorClinicianin Allscripts
  • 11. Vaccine Administration and Documentation Confidential – Internal Use Only Page 11 of11