1. FLU Clinic Volunteer Orientation 2017-2018
Arkansas Department of Health

2. Goals and Objectives Provide protection against influenza
Decrease Illness
Decrease Absentees
Decrease Spread of Disease
Community Immunity
Herd Immunity
Cocoon Effect

3. Nursing/Volunteers Non ADH and ADH Non-Clinical Non-ADH nurses
Attend orientation
Non-ADH nurses
Provide current Arkansas Nursing
License
Picture ID
Sign Volunteer Indemnity form
Sign HIPPA form
If you are a volunteer nurse or are not currently working in the immunization program in the local heatlh unit.
we ask that you take a few moments to review this presentation.
Additionally, if you are not a current employee of the Division of Health, we will need a copy of your current nursing license and have you sign the indemnity or waiver form along with a HIPPA disclosure. 3 3

4. Indications for flu vaccine
Any person who wishes to reduce the likelihood of becoming ill or transmitting influenza
Inactivated influenza vaccine can be given to anyone 6 months of age or older, including breastfeeding and pregnant women

5. Recommendations
All persons aged ≥ 6 months, unless medically contraindicated.
Persons at higher risk for influenza-related complications

6. People at Increased Risk of Influenza Complications
People with asthma
People with diabetes
People with heart disease and those who have had a stroke
Adults 65 and older
Pregnant women
People who have HIV or AIDS
People who have Cancer
Children younger than 5, but especially children younger than 2 years old

7. People Who are Transmission Sources
Healthy household contacts and caregivers of:
Children ages 0-59 months
Persons > 50 years old
Persons at high risk for severe complications from influenza

8. Transmission Sources (cont.)
Health Care Providers:
People who provide home care to persons in groups at high risk
People working in health-care settings include physicians, nurses, and other workers in hospitals, long term care facilities, assisted living and outpatient-care settings
Medical emergency response workers
Students in these professions who will have contact with patients

9. Immunize the people who live with or care for them!
To prevent transmission to those who are at high risk for influenza-related complications:
Immunize the people who live with or care for them!

10. Influenza Vaccine
The Quadrivalent influenza vaccines contain the following influenza strains:
A/Michigan/45/2015 (H1N1)pdm09-like virus;
A/Hong Kong/4801/2014 (H3N2)-like virus;
B/Brisbane/60/2008-like virus (B/Victoria lineage)
B/Phuket/3073-like virus (B/Yamagata lineage)

11. All ADH vaccine will be in pre-filled syringes.
All ADH vaccine will be preservative free and latex free.

12. Vaccine Reactions
Approximately 2 weeks after vaccination, antibodies develop
Common reactions
Soreness/erythema/induration at site lasting 1-2 days (15-20%)
Fever/chills/malaise/myalgia lasting 1-2 days (<1%)
Rare: immediate hypersensitivity allergic reactions (hives/angioedema/allergic asthma/systemic anaphylaxis)

13. Age Group Dosage > 6 months FluLaval 0.5 mL IM*
*Children 8 years and younger may need two doses administered at least 4 weeks apart

14. Children aged 6 months through 8 years who are receiving influenza vaccine for the first time or those who have not received > 2 doses before July 1, 2017, require two doses of vaccine administered ≥ 4 weeks apart.

15. Influenza vaccine dosing algorithm for children aged 6 months through 8 Years, ACIP , United States, 2017–18 influenza season

16. Contraindications and Precautions:
Contraindications: Severe allergic reaction to any component of the vaccine or after previous dose of any influenza vaccine.
Precautions: Moderate to severe illness with or without fever; history of Guillain-Barre syndrome within 6 weeks of receipt of influenza vaccine *
*requires a consultation with patient’s physician

17. Side Effects/Adverse Reactions: FluLaval
Local: Pain, tenderness, and redness at the injection site
Systemic:
Drowsiness
Headache
Irritability
Myalgia
Fatigue, arthralgia, GI symptoms, and loss of appetite have also been noted in children

18. Flublok: Injectable > 18 years of age 0.50ml
Utilized for ADH employees with serious, anaphylactic reaction to eggs
10 doses available in each region and Central Office

19. Mass Flu Clinics

20. Clinic Site
A nursing coordinator will be at each clinic site for your assistance and can answer questions as needed
Locate emergency kit/first aid station at each clinic site 20 20

21. Clinic Flow Patient enters clinic/site Route to screening area
Give current VIS (Vaccine Information Statement)
Route to Data Intake area to complete Imm-Flu form
Patient must sign and date Imm-Flu form
Route patient to a nursing station with the Imm-Flu form for vaccination 21 21

22. Forms Vaccine Information Statements (VIS)
Arkansas Department of Health Influenza Season--Immunization Consent form (IMM-Flu form)

23. Nursing Station Shot code if requested
Greet patient/collect Imm-Flu form
Screen for contraindications/precautions- answer all questions
Administer the indicated vaccine
Complete the Imm Flu form and keep form
Shot code
Site/dosage/lot#
Nurse signature
Provide documentation of vaccination,
if requested
Route patient to exit 23 23

24. Injection Technique

25. Vaccine Administration
Sites:
Infants: vastus lateralis (anterolateral thigh)
Young children over the age of 12 months-anterolateral aspect of the thigh may be used if the deltoid is underdeveloped
Adults and older children: deltoid (upper arm)
Dosage:
6 months and older : 0.5ml IM

26. Injection Technique
Determine the appropriate vaccine and injection site
Prep site with alcohol wipe/cotton ball
Using a circular motion, wipe the site with alcohol from center out and allow to dry
Attach the safety glide needle to the prefilled syringe

27. Injection Technique (cont.)
Spread skin taut between thumb and forefinger OR grasp tissue and “bunch up” muscle (acceptable for pediatric and geriatric patients).
Insert needle fully into muscle at 90 degree angle and inject vaccine quickly.

28. Injection Technique (cont.)
Apply light pressure to injection site for several seconds with dry cotton ball or gauze
Dispose of syringe in sharps container

29. Injection Technique (cont.)
USE OF VANISHPOINT SAFETY NEEDLES
ADH will be using VanishPoint safety needles for injections
Activate safety mechanism immediately after injection by pushing the color coded tab toward the safety chamber, allowing the needle to automatically retract into the safety chamber
Activate the safety mechanism
away from self and others.

30. Vaccine Management
Influenza vaccine should be stored at 36°F-46°F (2°C-8°C)
Temperatures should be documented every hour
Report out of range temperatures immediately
Keep storage unit container(s) closed as much as possible
No more then 10 doses of vaccine should be removed from the storage unit and prepared during an off site clinic
Discard any vaccine-filled syringes if the needles have been attached after the clinic closes

31. Standard Precautions
Good handwashing is recommended but if soap and water is not available, you may use alcohol-based waterless cleanser between each patient (available at each nursing station)

32. Standard Precautions (cont.)
Gloves are not mandatory unless the provider has open lesion on hands. (Available at each nursing station) If latex free gloves are required, contact the nursing coordinator

33. If a needle stick injury occurs-report it IMMEDIATELY to the nursing
Needle Safety
If a needle stick injury occurs-report it IMMEDIATELY to the nursing
coordinator

34. Hotwash/Debriefing with Local Health Unit and Volunteers

36. THANK YOU! 36 36