Section 9 Appendices Newfoundland and Labrador

Transcription

Newfoundland and Labrador
Immunization Manual
Section 9
Appendices
Appendix A: Vaccine Abbreviations ................................................................................ 2
Appendix B: Coverage Rate Report Forms for Newfoundland Labrador Immunization
Programs........................................................................................................................ 3
Appendix C: CRMS Documentation of Immunization ...................................................... 8
Appendix D: Latex Allergies and Immunization ............................................................... 9
Appendix E: Adverse Events Following Immunization Reporting Form ..........................11
Appendix F: User Guide: Report of Adverse Events Following Immunization (AEFI) .....12
Appendix G: Management of Anaphylaxis in the Non-Hospital Setting (Poster).............13
Appendix H: Vaccine Information for Immunization Program .........................................14
Appendix I: Self Directed Learning Module on Immunization ........................................15
Appendix J: Requisition for Biological Preparations .......................................................32
Appendix K: Biological Preparations Return Report (Wastage) .....................................33
Appendix L: Temperature Monitoring Form ...................................................................34
1
Immunization Manual – NL
September 2013
Appendix A: Vaccine Abbreviations
http://www.phac-aspc.gc.ca/publicat/cig-gci/app-anneng.php
Appendices
2
September 2013
Appendix B: Coverage Rate Report Forms for
Newfoundland Labrador Immunization Programs
Coverage Rates Report 1
Immunization Status at age 2 years
Report due March 31st of each year
Region _____________________
Birth Year ___________________
Number of two year olds with active files (Child Health Cards or CRMS and not
moved from region) in the region with that birth year ___________________
Date Reported _______________
DTaP/IPV/Hib
4 doses
Pneumococcal
4 doses
MMR
2 doses
1 dose
Varicella
1 dose
Men-C
1 dose
2 dose
# Children
who have
received
Percentage
Birth Year
2010
2011
2012
2013
2014
Immunization status at age 2
Due March 31,2013
Due March 31,2014**
Due March 31,2015
Due March 31,2016
Due March 31,2017
** Need New Coverage form to capture MMRV in 2014
Comments
Appendices
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September 2013
Immunization status at Kindergarten
Report due December 31st of each year
Region ___________________________
Kindergarten Enrolment ______________ (includes home schooled children)
School Year ________________________
Date Reported_______________________
DTaP/IPV/
Hib
4 doses
DTaP/
IPV or
TdapIPV
Pneumococcal
3 or 4
doses
MMR
2 doses
st
1
dose
Varicella
1 dose
Men-C
1 dose
nd
2
dose
# Children
who have
received
Percentage
Comments
Appendices
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September 2013
Immunization status for Men-C-ACYW135 Grade 4
Report due June 30th of each year
Region _______________________
School Year ___________________ (should include home schooled children)
Birth Year _____________________
Date Reported___________________
Men-C-ACYW135
# students
# children who have
eligible**
received
**Eligible includes children in grade 4 who have not already received a dose of Men-CACYW135
Comments
Appendices
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September 2013
Immunization status for Human Papillomavirus (HPV) vaccine Grade 6
Females only
Region _______________________
School Year ___________________ (should include home schooled children)
Date Reported____________________
HPV
Dose # 1
# students
eligible *
# children
who have
received
HPV
Dose # 2
# students
eligible*
# children
who have
received
HPV
Dose # 3
# students
eligible*
# children who
have received
Percentage
* Eligible includes children in grade 6 who have not already received a series of HPV
vaccine.
Comments
Appendices
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September 2013
Immunization status for Tdap Grade 9
Region_______________________
School Year ___________________
Grade 9 enrolment______________ (should include home schooled children)
Date Reported__________________
Tdap
# Students eligible
# Of students
vaccinated
Percentage%
Comments
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Appendices
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September 2013
Appendix C: Client Referral Management System
(CRMS) Documentation of Immunization
All regional health authorities must use CRMS to capture primary immunizations, school
immunizations, adult immunizations and vaccines that have been administered in
relation to communicable disease control. Please see the guidelines for documentation
in CRMS that have been developed by the regional health authorities where the client
resides for specifics.
Appendices
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Appendix D: Latex Allergies and Immunization
To address concerns regarding latex allergies and immunization the following
documentation has been collected:
 Documentation from manufacturers
 Individuals identified as high risk
 Suggested guidelines for immunizing a person with latex allergies
 Screening questions to ask when using a product with latex content
Individuals identified as high risk for latex allergies:
 Those with spina bifida
 Those with myelodysplasia or complex congenital anomalies
 Those who have frequent contact with natural latex products and have
experienced allergy type reactions
 Those with a history of anaphylactic reactions of “unknown origin” during surgery
 Those who have food allergies to avocados, kiwi, bananas, chestnuts, tomato or
apples
Guidelines for immunizing a person with latex allergy:
 Ampules of vaccine do not contain latex
 Use an alternate product, latex free if one is available
 Inject vaccine immediately after drawing up
Screening questions to ask when using a latex containing product:
 Do you have any allergies?
 Do you have an allergy to avocados, kiwi, bananas, chestnuts, tomato or apples?
 Do you have spina bifida?
 Do you have a history of rash, hives, eye irritation, rhinitis (runny nose) or
asthmatic symptoms after handing latex gloves, balloons, condoms or other latex
items?
 Do you have any medical problems?
 Do your lips swell if you blow up a balloon?
 Have you had surgery, if yes how many?
 Do you frequently come in contact with rubber products in your workplace?
If the answer to any of these questions is yes:
 Inquire whether allergy testing has been done and did it include latex
 If status is unknown check with the parent or family doctor
 If the person is allergic to latex, use latex guidelines
If further information is unavailable refer to MOH
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Latex Content of commonly used Vaccine Closures
Vaccine/product
Trade Name
Manufacturer
DaPT-IPV-Hib
DaPT-IPV
MMR/diluent
Pediacel
Quadracel
Priorix (vial
only)
Sanofi
Sanofi
GSK
MMR/diluent
MMRV/diluent
Pneu-C-10
MMRII
Priorix-Tetra
Synflorix
Merck
GSK
GSK
Pneu-C-13
Varicella
Prevnar
Varilrix
Wyeth
GSK
No latex
No latex
Prefilled
syringe
contains latex,
vial does not
No latex
No latex
Varicella
Men-C
HB
HB
HPV
Flu
Flu
Pneu-P-23
Varilrix
Mengugate C
Recombivax
Energix
Gardasil
Fluviral
Vaxigrip
Pneumovax23
Merck
Merck
Merck
GSK
Merck
GSK
Sanofi
Merck
No latex
No latex
Latex
No latex
No latex
No latex
No latex
No latex
Sanofi
No latex
Twinrix
GSK
Latex
Havrix (vial
only)
Vaqta
Typhium Vi
Boostrix
GSK
No latex
Merck
Sanofi
GSK
Latex
No latex
Latex
Men-P-ACWY
Men-CACYW 135
Hib
Td
Menomune
Menactra
Sanofi
Sanofi
Latex
No Latex
ACT-HIB
Td Absorbed
Sanofi
Sanofi
No latex
No latex
IPV
Td-IPV
Imovax-Polio
Td PolioAbsorbed
Sanofi
Sanofi
No latex
No latex
Tubersol 5TU
PPD
HAHB
HA
HA
Typh-l
Tdap
Appendices
Closure
Content
No latex
No latex
No latex
Comments/alternate
Diluent in prefilled
syringe contains
latex
Diluent in prefilled
syringe contains
latex
Use Energix
Prefilled syringe
contains latex
Prefilled syringe
contains latex
Use Havrix
Use Adacel as it
does not contain
latex
Multi-dose vial
contains latex
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September 2013
Appendix E: Adverse Events Following Immunization
Reporting Form
http://www.phac-aspc.gc.ca/im/aefi-form-eng.php
Appendices
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September 2013
Appendix F: User Guide: Report of Adverse Events
Following Immunization (AEFI)
http://www.phac-aspc.gc.ca/im/aefi_guide/index-eng.php
Appendices
12
September 2013
Appendix G: Management of Anaphylaxis in the NonHospital Setting (Poster)
1. Administer epinephrine promptly*, subcutaneously or intramuscularly in the limb
opposite the site of injection. Use the arm if both legs have been used as injection
sites during the current visit.
Table 1
Epinephrine Dose by Age
AGE
DOSE (1:1000 epinephrine)
2-6 months
0.07 mL
7 months to 11 months
Between 0.07 mL. and 0.10 mL
12 to 17 months
0.10 mL
18 months to 4 years
0.15 mL
5 years
0.20 mL
6-9 years
0.30 mL
10-13 years
0.40 mL
14 years and older
0.50 mL
2.
Call for assistance - transport to an emergency medical facility
3.
Place person in recumbent position with legs elevated.
4.
Initiate Cardio Pulmonary Resuscitation (CPR), if required
5.
Administer ONE dose diphenhydramine HCl (Benadryl ®) ** as an adjunct to
epinephrine immunization. This is given deep IM in a limb not used for initial
immunization/injection
Table 2 BENADRYL ® Dose by Age
6.
AGE
Injected 50mg /mL
Oral or injected
Less than 2 years
0.25 mL
12.5 mg
2 - 4 years
0.50 mL
25 mg
5 - 11 years
0.50-1.00 mL
12 years and over
1.00 mL
25-50 mg
50 mg
Repeat epinephrine at 5 minute intervals, if no improvement after initial dose.
May be repeated twice (total of 3 doses)
Emergency Telephone Number ___________________________
*Speedy intervention with epinephrine is of paramount importance; failure to use epinephrine promptly is more
dangerous than using it improperly
** Some RHA may include an oral dose of Benadryl ® for the treatment of the conscious patients. (See CIG for
rationale)
NOTE: In the event of an anaphylactic type reaction all events must be charted and the nursing manager and
Communicable Disease Nurse/Coordinator should be notified as soon as possible
Appendices
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September 2013
Appendix H: Vaccine Information for Immunization
Program
http://www.health.gov.nl.ca/health/publichealth/cdc/imm
unizations.html
Appendices
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September 2013
Appendix I: Self Directed Learning Module on
Immunization
Self Directed Learning Module on Immunization
Goal:
To provide an ongoing, standardized educational process that will guide health
practitioners’ immunization practise in accordance with policies and procedures outlined
in the Newfoundland and Labrador Immunization Manual and the Canadian
Immunization Guide.
Objectives:
On completion of the immunization educational process, the participant will be able to:
Define terms related to immunization and immunity.
1.
Demonstrate proper vaccine handling and storage.
2.
Provide adequate information to clients that will enable them to make an
informed decision.
3.
Demonstrate knowledge of the current Newfoundland and Labrador routine
immunization schedule.
4.
Demonstrate knowledge of vaccines used in terms of:
 recommended indication, route, site and dosage
 common side effects
 adverse effects
 contraindications
 risks/benefits
 patient education (i.e.: what to do if person being vaccinated experiences an
adverse event or common side effect)
 administration technique
Resources:
1.
Newfoundland and Labrador Department of Health and Community Services,
Immunization Manual. December 2011
2.
National Advisory Committee on Immunization.(2012) Canadian Immunization
(Evergreen Edition).Ottawa ON http://www.phac-aspc.gc.ca/publicat/ciggci/index-eng.php
3.
Control of Communicable Disease Manual.19th ed. 2008 Heymann. APHA.
4.
Manufacturers’ product monograph inserts.
5.
Your Child’s Best Shot. A Parent’s Guide to Vaccination, 3rd ed. 2006. Gold, R.
Canadian Paediatric Society
6.
Websites: http://www.immunize.cpha.ca
http://www.health.gov.nl.ca/health/publichealth/cdc/health_pro_info.html#immunization
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Self-Directed Learning Module on Immunization
Guidelines for the Practitioner
1.
To become knowledgeable in the field of immunization you will need to
successfully complete i) this written self-directed immunization learning module;
and ii) a supervised immunization experience; and iii) orientation session with the
Communicable Disease Control Nurse (CDCN)
2.
You will direct your own learning experience with the goal of reaching or
maintaining competence in immunization. Feel free to use any resource: books,
journals, colleges, to assist you in completing the module. It is recommended
that you refer to the most current edition of the Newfoundland and Labrador
Immunization Manual and the Canadian Immunization Guide. All resources will
be provided to you by your manager.
3.
Complete the module prior to meeting with the Communicable Disease Control
Nurse for orientation on immunization. When you are finished, hand in or send
your completed module to the CDCN at least two days prior to your scheduled
orientation time.
4.
The NL Immunization Manual found at
http://www.health.gov.nl.ca/health/publichealth/cdc/health_pro_info.html#immuni
zation contains the provincial and regional policies and procedures for
immunization, therefore, it is important to carefully read and become familiar with
this resource.
5.
The module will be corrected by the CDCN (or nurse manager) and reviewed
with you at the orientation session.
6.
Remember, there is no grade or pass/fail designation awarded to this module.
Instead, all questions must be answered completely and must follow
Newfoundland and Labrador immunization policy.
Appendices
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September 2013
Self-Directed Learning Module on Immunization
Questions
Please answer ALL questions in the space provided. If additional space is needed,
please write on the back making sure the answer is well indicated. Please be brief but
complete with your answers.
1. What are the true contraindications for all vaccines?
2. What is meant by immunization precautions?
3. What are the characteristics of an “ideal vaccine”?
4. What are the five characteristics of a valid consent for immunization?
5. Before administering inactivated vaccines and/or live attenuated
vaccines, what would you discuss with the client in terms of benefits,
reactions and instructions if a reaction were to occur?
Vaccine
A. Benefits
B. Reactions
C. Instructions
Inactivated
Vaccines
Live
vaccines
Appendices
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September 2013
6. What documentation, charting and reporting requirements are needed when an
adverse event following immunization occurs?
7. What instructions would you give the parent/guardian for management of
common side effects post immunization?
8. Live vaccines are not recommended in which circumstances:
A. Pregnancy
B. Hypersensitivity to eggs
C. Immunocompromised
D. Previous anaphylactic reaction to the vaccine
E. A C & D.
9.
What is the difference in the diphtheria component between DTaP-IPV and Td
vaccines?
10. What is the best source for up to date information on vaccines regarding
dosage?
A. Immunization Manual
B. Internet site
C. Product monograph supplied with the vaccine
11. The term “cold chain” refers to:
A. the distribution for vaccines
B. how it is ensured that vaccines arrive at their final destination with their
immunogenic properties intact
C. storage for vaccines
D. maintaining the temperature of vaccines between 2C and 8C
E. All of the above
12. Check () the following True (T) or False (F):
When a cold chain break has occurred:
A. The nurse will notify the vaccine coordinator.
___T ___F
B. If it is known that the power outage will last less than two hours, the vaccines
can remain in the refrigerator; the door should not be opened.
___T ___F
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September 2013
C. If due to a witnessed power outage, the vaccine coordinator or designate will
take the vaccines out of the refrigerator and destroy them.
___T ___F
13.
How frequently should one monitor temperature in any vaccine
storage unit?
14. Of the following, circle those which are accurate when referring to a
refrigerator that is used to store vaccines:
A. The temperature within it must be maintained between 0 and 8 degrees
Celsius.
B. Food and beverages can be stored in the vaccine refrigerator.
C. The procedures to be followed in the event of refrigerator failure are posted on
it.
D. Bottles of water can be placed on any empty shelves and in the door spaces.
E. The refrigerator can be located in the coffee room so everyone can use it.
F. It must contain a maximum-minimum thermometer.
G. The refrigerator is checked regularly to determine if the temperature within it is
optimal.
H. It meets the approved Provincial Immunization Policy
15. Check () the following True (T) or False (F):
Refrigerators used to store vaccines shall:
A. be maintained at a temperature between 2 and 8C
___T
___F
B. be defrosted when 1 cm. of ice builds up in the freezer section
___T ___F
C. contain water bottles in order to maintain a more constant temperature in the
event of a power failure
___T ___F
16.
When vaccine has been exposed to temperatures outside the recommended
range, we should:
A. Use the vaccine if it has been exposed for less than two hours
B. Consult the appropriate manufacturer(s) and destroy the vaccine
C. Place the vaccine in a container labelled “do not use”, place at proper
temperature and notify the vaccine coordinator in your region or the provincial
Office and await further direction.
17.
How can you tell if someone has fainted versus someone who is having an
anaphylactic reaction?
Appendices
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18.
September 2013
Mona, a 16 year old female, has just received a Tdap booster. She states that
she is feeling faint, is pale and suddenly collapses.
Check () the following True (T) or False (F):
A. She is experiencing an anaphylactic reaction.
___T
___F
B. You should have her lie down and measure her BP, pulse and respirations.
___T ___F
C. The correct dosage of adrenalin to administer in the case of anaphylaxis
is 0.5 ml.
___T ___F
D. In the event of an anaphylactic reaction, you should never administer
CPR.
___T ___F
19.
For the vaccines noted below describe the following: administration
route; site; dosage and needle size that would be used for infants,
children and adults:
Answers:
Vaccine
Infants
Children
Infants
Adults
Route
Injection
Site
Dosage
NEEDLE
Size &
Length
MMRV
DTaP-IPV
Pneu-C-13
Influenza
20.
What are the key principles of risk communication?
21.
All of the following are principles of combination vaccines except?
A. Combination vaccines do not need to be tested.
B. Ideal combination vaccines are safe and effective as the single antigen.
C. They should fit the current schedule, be easily stored & easy to administer.
D. Helps to reduce the number of immunization
Appendices
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September 2013
22 . Give the recommended Newfoundland and Labrador schedule for a child
who began immunization at birth
.
Routine immunization schedule for children beginning immunization in early infancy
VACCINE
DTaP
IPV
Hib
Age
DTaP
IPV
Or
TdapIPV
HB
HPV
MMRV
MMR
Tdap
Inf
PneuC-13
Men C
ACYW 135
MenC
2 mos.
4 mos.
6 mos.
6-23 mos.
12 mos.
18 mos.
4 to 6 yrs.
Grade 4
Grade 6
14 to 16
yrs.
Answer:
DTaP-IPV-Hib
Diphtheria,acellular pertussis, tetanus, polio, Haemophilus influenzae type b
DTaP-IPV
Diphtheria, acellular pertussis, tetanus, polio vaccine
HB
Hepatitis B vaccine 2 doses at 0, 4-6 mo beginning in school year 2012
MMR
Measles, mumps, rubella vaccine
MMRV
Measles, mumps, rubella,varicella vaccine
Tdap
Tetanus, diphtheria, acellular pertussis vaccine
Tdap-IPV
Tetanus, diphtheria, acellular pertussis vaccine, polio vaccine
Inf
Influenza
Var
Varicella vaccine
Pneu-C-13
Pneumococcal conjugate 13 valent
Men-C
Meningococcal type C
Men-C-ACYW135 Meningococcal type A, C, Y&W135
HPV
Human Papilloma virus
Appendices
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September 2013
23. In the following 4 scenarios, give the immunization schedule and the
vaccines you would use to complete the child’s schedule to school entry.
A. A healthy four-year-old child who has never been immunized.
Immunization schedule for children < 7 years of age not immunized in early Infancy
Timing
DTaP-IPV
Hib
MMRV
MMR
Pneu-C-13
Men-C
TdapIPV
First visit
2 months later
2 months later
6-12 months
later
* 4-6 years
* 4-6 years can be omitted if fourth dose was given after the fourth birthday
B. A healthy 13-month-old child who has never been immunized.
Immunization schedule for children < 7 years of age not immunized in early infancy
Timing
DTaP-IPV
Hib
MMRV
MMR
Pneu-C-13
Men-C
TdapIPV
First visit
2 months later
2 months later
6-12 months
later
* 4-6 years
C. A seven-month-old infant who received two doses of DTaP-IPV-Hib and
Pneu-C- 13 at two and four months of age
Immunization schedule for children < 7 years of age not iimmunized in early infancy
Timing
DTaP-IPV
Hib
MMRV
MMR
Pneu-C-13
Men-C
TdapIPV
First visit
2 months later
2 months later
6-12 months
later
* 4-6 years
D. A nine-month-old infant who received two doses of DTaP-IPV and PneuC-13 at two and four months of age.
Appendices
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September 2013
Immunization schedule for children < 7 years of age not immunized in early Infancy
Timing
DTaP-IPV
Hib
MMRV
MMR
Pneu-C-13
Men-C
TdapIPV
First visit
2 months later
3 months later
6-12 months
later
* 4-6 years
24. Steven is eight months old and is attending a Child Health Clinic. At six
months of age, he received one dose of DaPT-IPV-Hib and Pneu-C-13. Steven
is being breastfed, and his mother is two months pregnant. He looks well but
is taking Amoxil.
A) What are the contraindications to Steven receiving his immunization today?
a.
b.
c.
d.
On antibiotics
Household member pregnant
Being breastfed
None of the above
B) What vaccines should be given to Steven today?
a.
b.
c.
d.
e.
DTaP-IPV- Hib, Pneu-C-13
DT, Hib
MMRV
Var
Men-C
C) At what age should Steven return for his next immunization appointment?
a. 12 months
b.
c.
d.
9 months
10 months
15 months
D) What vaccines should Steven receive then?
a. DTaP-IPV- Hib
b. DT, Hib
c. MMR
d. Var
e. Men-C
E) What vaccines will Steven receive at 12 months of age?
a.
b.
c.
d.
DTaP-IPV-Hib, Pneu-C-13
MMRV, Men-C, Pneu-C-13
DaPT, OPV, Hep. B
MMR, Hib
F) What vaccines will Steven receive when he is 14-16 years of age?
Appendices
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a.
b.
c.
September 2013
Tdap
Td-P
Td
25. A preschool child has arrived at Child Health Clinic having previously
received a complete primary series of DTaP-IPV-Hib (in infancy). You are
informed that the child is allergic to dust, cats and several foods. What would
you do regarding the MMRV injection that is overdue?
26. Katelyn is 12 months old. She has previously received three doses of DTaPIPV-Hib and two doses of Pneu-C-13 at the recommended ages. After the third
dose of DTaP-IPV-Hib Katelyn had a fever of 105°F and a febrile seizure. Two
months ago, she was exposed to measles and was given immune globulin.
A) Does Katelyn have contraindications to any vaccines?
a. Yes
b. No
B) If your answer to A was yes, which vaccine(s) would be contraindicated at this
time?
a. DTaP-IPV-Hib
b. MMRV
c. IPV
d. Hep B
C) What vaccine(s) should Katelyn receive today?
a. DTaP-IPV-Hib, MMRV
b. Men-C and Pneu-C-13
c. Men-C only
D) When should Katelyn return for immunization, and what vaccine(s) should she
receive at that time?
a. In two months for DT-P, Hib
b. In two months for Hep B
c. In three to 11 months for MMRV
d. In two months for DTaP-IPV-Hib and MMRV
27.
A child received MMR two days ago and requires a Tuberculin Skin
Test (TST) with PPD. What do you do and why?
28.
Elizabeth is seven weeks old and was born one month premature.
Mom is breastfeeding her, and her father recently completed radiation
and chemotherapy for Hodgkin’s. Her sister has epilepsy.
Appendices
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September 2013
A. Should Elizabeth be immunized today?
a. Yes
b. No
B. Are there any contraindications?
a. Yes, due to prematurity
b. Yes, due to family history of epilepsy
c. Yes, due to family member receiving chemotherapy
d. None of the above
e. All of the above
C. What vaccines does Elizabeth need at two months of age?
a. DTaP-IPV-Hib, Pneu-C 13
b. DTaP-IPV-Hib
c. None until three months because she is one month premature
d. Not until she weighs 4500gms
D. After the first immunization is given, when should she come back and
what vaccines should she receive?
a. In two months for DTaP-IPV-Hib and Pneu-C-13
b. In two months for DTaP-IPV
c. In one month for Hib
d. None of the above
29. Austin, Elizabeth’s brother, is three years old and has no documentation of
his MMR or his fourth dose of DTaP-IPV-Hib.
A. Are there any contraindications?
a. No pertussis due to family history of epilepsy
b. No MMR due to family member receiving chemotherapy
c. No contraindications
B. What vaccines does Austin need?
a. DTaP-IPV-Hib
b. MMRV
c. a and b
d. DT-P, Hib
C. Does he need a booster i.e. DTaP-IPV?
a. Yes
b. No
D. When can he receive this fifth dose of DaPT-IPV?
a. One year later
b. Two years later
c. Three years later
d. Any of the above
30. The following questions relate to administering tuberculin skin testing (TST):
A. Which biological is used; what strength and dosage?
B. What site?
Appendices
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September 2013
C. Which route?
D. What type of syringe and needle?
31. How do you read and record the results of a TST? How do you interpret the
readings?
32. It is December and a family with 2 young children (7 months and 2 ½ years)
has moved back to Newfoundland and Labrador from Alberta. Paul, had
chickenpox at 5 ½mos of age, he is now 7months old and is feeling well. He
previously received DTaP-IPV-Hib, Pneu-C-13 and Men-C at two and four
months of age.
A. What vaccine(s) should Paul receive today?
a) DTaP-IPV-Hib, Pneu-C-13, Men C and Influenza
b) DTaP-IPV-Hib, Pneu-C-13 and Men C
c) DTaP-IPV-Hib, Pneu-C-13
d) DTaP-IPV-Hib and Influenza
A. When should Paul return to clinic and what vaccine(s) should he receive?
a) In 6 months for MMR, Var and Men C
b) In 5 months for MMR and Men C
c) In 5 months for MMRV, Men C and Pneu-C-13
d) In 5 months for MMR
e) In 6 months for MMR
C. What would Paul’s remaining vaccine schedule look like?
33. Paul’s sister Joy is 2 ½ years old; she was born in New Brunswick and moved
with her parents to Alberta when she was 5 months old. She previously
received:
DTaP-IPV-Hib at 2, 4, 6, and 18 months
Pneu-C-13 at 2, 4, 6 and 18 months
Men C at 6 months
HB at birth and 2 months
MMR & Var at 12 months and MMR at18 months
Influenza at 6 and 18 months
D. What vaccine(s) should Joy receive today?
a) None
b) HB and Men C
c) HB
d) Men C
Appendices
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September 2013
e) HB, Men C and Influenza
E. What would Joy’s remaining vaccine schedule look like?
34. John has just returned from Halifax where he had a bone marrow
transplant, what is the process for immunization?
35. What should be recommended to a 26-year-old woman who is not immune to
rubella?
36. Mrs. B is a 60 year old woman with diabetes, she has called the local health
unit to inquire about which vaccines she should receive this coming fall.
Which immunizations should she offered?
37. Who are the target population for pneumococcal polysaccharide immunization
in NL?
38. Who are the target population for inclusion in the high risk children’s
pneumococcal conjugate vaccine program; primary series (4 doses
versus 3) in NL?
39. The following questions pertain to hepatitis B vaccine.
A. Who is the target population for universal hepatitis B immunization?
B. What are the current schedules?
C. For prevention of hepatitis B in an infant born to a mother known prior to
delivery to be a surface antigen carrier (HBsAg+) see CIG for information
on HBIG administration.
40. Your co-worker has experienced a needle stick injury. What should be
done?
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September 2013
41. The following questions pertain to Human Papillomavirus (HPV)
vaccine.
A. Who is the target population for universal HPV immunization?
B. What is the current schedule?
C. From what disease does this vaccine protect?
42. What information should you record after completing immunization, and where would
you record it?
43. Hepatitis B infection can cause:
A. No symptoms
B. Death
C. Chronic carrier state
D. Cirrhosis and cancer of the liver
E. All of the above
44. The most severe complication of pertussis is:
A. Death
B. Brain damage
C. Apnea
D. Cough
E. Hib
45. Which disease can cause fetal abnormalities if a woman contracts it
during the first three months of pregnancy?
A. Measles
B. Mumps
C. Polio
D. Rubella
E. Hib
46. How is tetanus transmitted?
A. By direct, person-to-person contact
B. By contact with airborne droplets
C. Through a break in the skin
D. By an insect bite
E. By sexual contact
47. Which of the following diseases is considered to be the most
contagious?
A. Mumps
B. Measles
C. Rubella
D. Hepatitis B
E. Polio
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September 2013
48. Mumps is characterized by:
A. Orchitis in postpubertal males
B. Respiratory symptoms
C. Swelling of one or more salivary glands
D. Life-long immunity after lab-confirmed mumps disease
E. All of the above
49. Which of the following groups have the best sero-protection rates following
immunization with HB?
A. Children less than 2 years of age
B. Children between the ages of 5 and 15 years
C. People aged 20-29 years
D. Peoples greater than 60 years of age
50. Children in whom invasive Hib disease develops before 24 months of age
should still receive vaccine as recommended.
True or False?
51. Pertussis vaccine is recommended for whom?
A. Children greater than or equal to 2 months of age
B. Adolescents
C. Adults
D. Persons who have had natural Pertussis infection
E. All of the above
52. Diphtheria is seen most often:
A. during the summer months in Canada
B. in infants of immune mothers
C. in non-immunized children under 15 years of age
D. in countries where mass immunization is carried out regularly
E. All of the above
53. Which of the following diseases can cause meningitis?
A. Haemophilus influenzae type b
B. Mumps
C. Polio
D. All of the above
E. None of the above
54. Rubella:
A. is usually a mild disease
B. can be confused with measles
C. can occur without a rash
D. can be complicated by arthritis
E. All of the above
55. People born before 1970 are considered to be immune to which of the
following diseases:
A. Pertussis
B. Mumps
C. Measles
D. Polio
E. None of the above
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September 2013
56. The incubation period for hepatitis B can be:
A. 45-180 days
B. 60-90 days
C. 6-9 months
D. 2 weeks
E. All of the above
57. If a child has had varicella (chickenpox) prior to their first birthday the varicella
immunization is not required.
A. True
B. False
58. Which of the following are vaccine preventable diseases?
A. Chickenpox
B. West Nile virus infection
C. Influenza
D. Invasive Pneumococcal disease
59. Once a vaccine has been drawn up into the syringe when should it be given?
A. Within 90 minutes
B. Within 24 hours
C. As soon as possible
60. The following is true about the Human Papillomavirus (HPV) vaccine:
A. HPV vaccine is not licensed for use among males
B. Vaccine ideally should be administered before potential exposure to HPV through
sexual exposure
C. HPV vaccine does not take the place of regular pap screening
D. All of the above
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September 2013
Checklist for Supervised Immunization Experience
ACTIVITY
DATE
COMPLETED
COMMENTS
Completed the Self Directed Learning
Module
Shared Vaccine Information with Client
Assessment Prior to Immunization
Discussed Risks and Benefits
Obtained Informed Consent
Washed Hands
Vaccine Preparation - Sections 3 and 4
 Checked adrenalin/ benadryl dose
and availability
 Vaccine selection
 Checked expiry date
 Dosage
 Reconstitution as required
 Choice of syringe, needle and site
 Sterile/aseptic technique
 Vaccine storage handling
techniques
Demonstrated Appropriate Vaccine
Administration - Section 4
 Inspect vaccine
 Positioning, holding
 IM
 SC
 ID
 Disposal of needle and syringe
 Comfort measures
 Assessment post immunization
Demonstrated Appropriate Documentation
Section 1.4
 Client=s Record of Immunization
 Provide post-immunization info
 Provide record of immunization
Completion Date: _______________________
Appendices
Signature: ____________________
31
September 2013
Appendix J: Requisition for Biological Preparations
http://www.health.gov.nl.ca/health/publichealth/cdc/Requisiti
ons%20for%20Biological%20Preparations.pdf
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September 2013
Appendix K: Report Form for Biological Products
Wastage
http://www.health.gov.nl.ca/health/publichealth/cdc/Biol
ogical%20Preparations%20Return%20Report.pdf
Appendices
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September 2013
Appendix L: Temperature Monitoring Form
http://www.health.gov.nl.ca/health/publichealth/cdc/Temperat
ure%20Monitoring%20Log.pdf
Appendices
34

Section 9 Appendices Newfoundland and Labrador

Transcription

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