Here are the responses that I got. Thanks to those who replied. I have been asked to post these questions to the L. 1. Are your Pneumonia and Influenza vaccines standing orders? 2. Is it part of a protocol? 3. If it is a standing order/part of a protocol, who carries it out- a designated nurse or the general nursing population? 4. Do you let your patient sign consent?
-----Responses---- 1. Yes 2. Yes 3. The nurse that admits the patient orders it. 4. No #2 Our staff asks the patient as part of the admission assessment if they have had the flu or pneumococcal vaccine. If not, they are asked if they would like one. If the nurse documents YES the patient wants a vaccination an order sheet is generated which prints off for the physician to review and sign. If the physician agrees to give the patient the injection, there is a consent and witness section to be filled out by nursing. #3 1. yes 2. yes 3. combination of general nurse and infection control nurse - only because the general nurse's workload does not permit him/her time to make multiple phone calls to track down the patient's immunization history, when the patient doesn't know that history 4. not sure what this question means - but if you are truly asking whether patients are allowed to sign consents, the answer is yes. I'm guessing you might have meant to ask if the hospital REQUIRES a patient consent. The answer to that is yes, also - writing. As part of this dialog, I would be interested to hear if anyone is getting a simple verbal consent. Would also be interested in some description of how far your hospital goes to obtain the immunization history. Will the nurse, or some other person, call multiple physician's offices for information? #4 Cristina: Our screening process is the one that was recommended by the CDC, it is a very busy screen! This is on the admission physical assessment and the RN's have to do this as it does generate an 'order' for these vaccinations to be given. Once the response is a "Y" to the last question to be placed on the MAR, an OA message is sent to pharmacy for the vaccination to be placed on the MAR and to be given when the patient is afebrile or ready to be discharged. The physicians approved this process since we have such a detailed screening. Once the OA message prints to pharmacy, another one prints to the patient location to be placed in the chart informing the physician that the person will receive a vaccination unless ordered to NOT GIVE. I have attached the pneumo screen, the influenza is the same with minor differences on the wording needed. The patient can refuse when asked or when it is ready to be given. If you have any questions, please feel free to contact me. Good luck! #5 Hello, We have set up both as a protocol. We have the screen questions in our Admission History Assessment. With this tool if the patient is eligible for the vaccination, with a YES query we send a OA message to the Pharmacy to add the vaccination to the MAR as well as sending up the consent with the medication. The patient has TWO opportunities to opt out. First in the Admit History they can refuse the screening which then skips all the screening questions or when the Nurse brings in the consent with the vaccination. They can opt out then also. Hope this helped. #6 Cristina- We have a protocol to give pneumonia or influenza vaccines if the patient has not had one and desires to have one while admitted. Our process works like this: * Queries to screen for vaccines are required fields on the admit history * If answered no message displays to complete screening process * Screening criteria for giving vaccine displays * When query vaccine indicated is answered yes an OA message sends an order for the vaccine to be signed as a verbal order, an information sheet for the patient and a consent form to the printer at the nurses station, a messages is also sent to the pharmacy to bring out the vaccine for the patient * When the vaccine is documented as given an OA message sends that vaccine given, date and time to our clinic to be part of the patients chart * It is the responsibility of the admitting nurse to make sure that this process is carried forward #7 We have algorithms to determine appropriateness for the vaccine. These print from the Admission Assessment when the patient hasn't had the vaccine and states they want to receive it this admission. They are placed with the paper MAR and scanned to Pharmacy and administered on discharge day IF appropriate per the algorithm or if the physician hasn't written an order to NOT give it. Cristina C. Kimball, BSN, RN Manager, Clinical Informatics Pacific Alliance Medical Center 531 W. College St. Los Angeles, Ca 90012 Ph: (213) 437-4214 Fax: (213) 617-9203 Email: [EMAIL PROTECTED] This electronic message is intended only for the individual or entity to which it is addressed and may contain information that is confidential and protected by law. If you are not the intended recipient of this e-mail, you are cautioned that use of its contents in any way is prohibited and may be unlawful. If you have received this communication in error, please destroy it and notify the sender immediately by e-mail. ________________________________________ From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Ruth Chapman Sent: Tuesday, April 24, 2007 4:11 AM To: [email protected]; Castillo, Cristina Subject: Re: [MEDITECH-L] Off MEDITECH-Pneumonia and Influenza Vaccine Please post to the L. We are having these same discussions on how to change or improve our process flow here also. Ruth Chapman BSN, RN-BC Nursing Analyst Central Michigan Community Hospital [EMAIL PROTECTED] >>> "Castillo, Cristina" <[EMAIL PROTECTED]> 4/20/2007 4:35 PM >>> I have been asked to post these questions to the L. 1. Are your Pneumonia and Influenza vaccines standing orders? 2. Is it part of a protocol? 3. If it is a standing order/part of a protocol, who carries it out- a designated nurse or the general nursing population? 4. Do you let your patient sign consent? Thanks in advance for the input. Cristina C. Kimball, BSN, RN Manager, Clinical Informatics Pacific Alliance Medical Center 531 W. College St. Los Angeles, Ca 90012 Ph: (213) 437-4214 Fax: (213) 617-9203 Email: [EMAIL PROTECTED] This electronic message is intended only for the individual or entity to which it is addressed and may contain information that is confidential and protected by law. If you are not the intended recipient of this e-mail, you are cautioned that use of its contents in any way is prohibited and may be unlawful. If you have received this communication in error, please destroy it and notify the sender immediately by e-mail. =*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*= To subscribe or unsubscribe to the meditech-l, visit MTUsers.NET. To check the status of the meditech-l, visit MTUsers.NET. 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