Flu Clinic Injury Prevention


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Injury prevention for Mass Imms clinics

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Flu Clinic Injury Prevention

  1. 1. Flu SeasonRisk Reducing Strategies for Public Health Nurses<br />VIHA<br />October 2009<br />This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation<br /><ul><li>In Slide Show, click on the right mouse button
  2. 2. Select “Meeting Minder”
  3. 3. Select the “Action Items” tab
  4. 4. Type in action items as they come up
  5. 5. Click OK to dismiss this box</li></ul>This will automatically create an Action Item slide at the end of your presentation with your points entered.<br />
  6. 6. Key Principles for Setting up Mass Imms Clinic<br />Immunization stations should be well spaced to allow for privacy and noise control<br />ILI imms stations should be close to entry and separate from other stations by at least 2 meters<br />Post imms observation area for ILI clients should be next to ILI station if possible<br />
  7. 7. Other Suggestions<br />Separate entrance and exit if possible<br />Traffic control person – second may be needed if entry and exist the same<br />To avoid accidental immunization using a larger bore needle – use separate station to reconstitute pH1N1 – also provides a break from sitting<br />
  8. 8.
  9. 9. ILI Clients <br />All clients presenting at clinic should be screened for influenza like illness<br /><ul><li> acute onset of respiratory illness with fever and cough with one of following:
  10. 10. Sore throat
  11. 11. Arthralgia, myalgia or prostration</li></ul>The very young and elderly may not present with fever<br />
  12. 12. Precautionary Measures for ILI<br />Client wears mask<br />Seat them at least 6 ft away from others<br />Nurse immunizing them wears gown and mask<br />Keep separate from healthy clients<br />
  13. 13. The key injury risk factors for nurses are:<br /> repetition and awkward postures<br />The usual areas affected are <br />dominant shoulder (the arm you hold the needle in) <br /> the lower back. <br />
  14. 14. General Tips<br /> Maintain neutral upright spine posture while seated<br />
  15. 15. Attention Areas<br />·     Stand up for 10 secs once every 30 mins to reduce stress on the spine ( at least 5 times in a 2 ½ hour flu clinic - more is better)<br />        <br />·     Consider switching sides of the table after an hour OR at least every second day set yourself up on the opposite corner of the table<br /> <br />
  16. 16. Pair a left and right handed nurse together at one table <br />Ensure the client is sitting exactly where you need them to be. (They are only there for three minutes but you are there all day, so your comfort is the priority)<br />
  17. 17. Strategies to Consider<br />Avoid repetitive side bending while seated as this places stress on the disc and ligaments of the spine.<br />
  18. 18. Consider putting the sharps bin on a chair behind or beside the patient.<br />
  19. 19.  <br />Avoid reaching across your body’s midline to drop syringes into sharps bin.<br />
  20. 20.
  21. 21. Review<br />Ensure you are comfortable<br />Don’t forget a stretch break every 30 min.<br />Make sure equipment is within easy reach<br />Make sure you don’t have to twist or turn to reach supplies<br />
  22. 22. Working with new single antigen immunizers<br />
  23. 23. Professional Scope<br />RNs now authorized per HPA: RN/NP Regulation to <br />diagnose and manage conditions (including prevention), e.g. Anaphylaxis<br />administer certain medications to treat conditions or prevent disease/disorders, e.g. immunization for influenza<br />No order, transfer of function or delegation required<br />Reserved Titles<br />Defined scope of practice<br />“Restricted Acts”<br />With/without an order<br />Requirements on practice <br />“additional education” <br />CRNBC Certified Practice <br />17<br />HPA - RN/NP Regulation <br />17<br />
  24. 24. Professional Responsibilities<br />CRNBC requires RNs to have “additional education” to administer influenza* without an order (as determined by their employer) <br />and “strongly recommends” use of evidence-informed clinical decision support tools (“DSTs” or “CDSTs”) to guide practice, e.g. protocols, clinical practice guidelines, order sets, etc. <br />18<br />18<br />
  25. 25. 19<br />Educational Process for CYFCH Single Vaccine Immunization<br />Clinical <br />Immunization of clients &gt;5 years<br />Observation of 5 immunizations<br />Be observed doing 5 immunizations<br />Skills Checklist<br />Yearly Review<br />Educational component <br />Attend an Influenza education session or review Influenza materials <br />19<br />
  26. 26. PHN’s Role<br />You may be asked to:<br /><ul><li> Let a nurse observe you at clinic
  27. 27. To observe a nurse perform 5 immunizations
  28. 28. To assist nurse to complete a skills checklist
  29. 29. To “buddy” with a new immunizer and help with questions and concerns</li>