Primary health care is any medical service that is provided outside the four walls of a hospital, including aged care, community health, general practice, custodial, schools and many other primary health care settings. Australia's 96,000+ primary health care nurses play a critical role in disease prevention and control to keep people healthy. They provide proactive care and health promotion to keep Australians well.
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