Flu clinics during COVID-19

Plan ahead

• Review and/or update your influenza/pandemic plan
• Ensure flu vaccination is on the team meeting agenda and everyone knows the plan (current and any changes that are made as situation changes)

Pre-flu clinic checklist considerations

General

• Maintenance of cold chain
• Patient and staff safety, e.g. monitoring patients, not working on roadways
• Sharps disposal

Roles and responsibilities

• Consider dividing into teams to minimise possible COVID-19 exposure for staff
• Consider using one team to provide flu clinics with backup team(s) in the event that a team member becomes unwell
• See current guidelines for symptoms and isolation requirements

Governance

• Refer to Australian Immunisation Handbook and National Vaccine Storage Guidelines – Strive for 5
• Consult with your professional indemnity insurance provider to ensure coverage for amended policies and processes

Appropriate staff and staff scope of practice

• Remember the Medication Rights. Is a drug order required? Check state regulations
• Nurse immuniser (do you have one?), what is your staff’s scope of practice?
• Clinic policy and procedure 

Anaphylaxis response

• Ensure adequate emergency equipment
• Other post-immunisation event such as vasovagal response

Advertising of the clinic

• Ensure reception and all staff have a script so there is a consistent message
• Place a message about flu clinics and COVID-19 in 2020 on your website

Documentation and patient identification

• Use a data extraction tool (such as Pencat or Polar) to arrange a separate clinic for over 65s and immunocompromised patients 
• Ensure adequate patient identification method
• How you will document and record vaccine administration?
• Ensure transfer of vaccination information to AIR

Clinic preparation and implementation: Where, when, how?

Where?

• Consider the best location for the clinics
• Determine whether you will provide the flu vaccine at one site or all sites
• Clinic might be run: inside, offsite or use the car park? Have a backup plan if the weather is bad—what’s the contingency plan? Develop a safety plan for patients and staff in this location.
• If the flu vaccine is being given in the car park, develop measures so the vehicle driver is not immunised that day—they can assist with monitoring those immunised—so everyone gets home safely. Remember—do no harm.

When?

• Consider flexible scheduling for clinics, maybe a Sunday clinic for over 65 years and/or immunocompromised patients

How?

Bookings

• Run your clinic by appointment only, to manage patient flow and promote social distancing
• When booking patients to the clinic/appointment, check they have not been overseas in the last 14 days and/or have any symptoms
• Send SMS reminders to patients that advises them to reschedule their appointment if they are unwell
• Ask patients to bring only one parent/guardian for childhood immunisation appointments
• Recommend patients wear short sleeved tops to reduce time and touching
• Determine how many people will be present from one family

Monitoring physical distancing and hand hygiene

• Determine how physical distancing will be ensured, e.g. tape on the carpet/floor, use every other car parking space
• How will you keep children from being active near other patients?
• Ensure vaccination clinics maintain physical distancing, e.g. place chairs 1.5 metres apart in the treatment room and within the waiting room. If this is not possible, consider asking patients to wait in their car until their appointment time, or when called by reception.
• Ask patients to use their own hand sanitiser if available, a good opportunity to have staff member check their technique
• Ensure the process for hand hygiene, cold chain management as well as sharps and anaphylaxis safety in the chosen location

Location management

• If you provide the flu clinic offsite (you may be able to use the local hall) does this venue have hand washing facilities and separate entry and exit? Consider how you will maintain, physical distancing and cold chain offsite or outdoors.
• Ensure all staff are clear about how patients will be monitored, who is responsible, how will the patient contact you if vaccines are administered outside, is this by mobile?
• Is there mobile reception at the site in case of emergency?
• Who will monitor social/physical distancing, what measures will you have in place?

Opportunistic vaccination

• Review your patient list and administer the vaccination during the GP consult
• If administered by the nurse prior to the planned GP consult, the patient will be present in the surgery for the duration of the post-vaccination 15 minute waiting time so plan patient flow while on site
• Enhance hygiene practices for staff and patients
• Washing hands frequently is the single most effective way to reduce the spread of germs that cause respiratory disease
• Alcohol-based hand gel is a suitable alternative if used and stored safely around children
• Display signage prominently regarding hand hygiene, respiratory etiquette, and physical distancing