This presentation discusses strategies for public health nurses to reduce flu risks during flu season. It recommends setting up immunization stations with space between them for privacy and noise control. It suggests screening clients for influenza-like illness symptoms and taking precautions like seating them apart and having nurses wear masks. The document provides tips to help nurses avoid repetitive motions and maintain neutral postures to prevent injuries from immunizing many clients. It also reviews professional responsibilities and educational processes for nurses immunizing clients over five years old with single vaccines.

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6. Key Principles for Setting up Mass Imms Clinic Immunization stations should be well spaced to allow for privacy and noise control ILI imms stations should be close to entry and separate from other stations by at least 2 meters Post imms observation area for ILI clients should be next to ILI station if possible

7. Other Suggestions Separate entrance and exit if possible Traffic control person – second may be needed if entry and exist the same To avoid accidental immunization using a larger bore needle – use separate station to reconstitute pH1N1 – also provides a break from sitting

10. Sore throat

11. Arthralgia, myalgia or prostrationThe very young and elderly may not present with fever

12. Precautionary Measures for ILI Client wears mask Seat them at least 6 ft away from others Nurse immunizing them wears gown and mask Keep separate from healthy clients

13. The key injury risk factors for nurses are: repetition and awkward postures The usual areas affected are dominant shoulder (the arm you hold the needle in) the lower back.

14. General Tips Maintain neutral upright spine posture while seated

15. Attention Areas · Stand up for 10 secs once every 30 mins to reduce stress on the spine ( at least 5 times in a 2 ½ hour flu clinic - more is better) · Consider switching sides of the table after an hour OR at least every second day set yourself up on the opposite corner of the table

16. Pair a left and right handed nurse together at one table Ensure the client is sitting exactly where you need them to be. (They are only there for three minutes but you are there all day, so your comfort is the priority)

17. Strategies to Consider Avoid repetitive side bending while seated as this places stress on the disc and ligaments of the spine.

18. Consider putting the sharps bin on a chair behind or beside the patient.

19. Avoid reaching across your body’s midline to drop syringes into sharps bin.

21. Review Ensure you are comfortable Don’t forget a stretch break every 30 min. Make sure equipment is within easy reach Make sure you don’t have to twist or turn to reach supplies

22. Working with new single antigen immunizers

23. Professional Scope RNs now authorized per HPA: RN/NP Regulation to diagnose and manage conditions (including prevention), e.g. Anaphylaxis administer certain medications to treat conditions or prevent disease/disorders, e.g. immunization for influenza No order, transfer of function or delegation required Reserved Titles Defined scope of practice “Restricted Acts” With/without an order Requirements on practice “additional education” CRNBC Certified Practice 17 HPA - RN/NP Regulation 17

24. Professional Responsibilities CRNBC requires RNs to have “additional education” to administer influenza* without an order (as determined by their employer) and “strongly recommends” use of evidence-informed clinical decision support tools (“DSTs” or “CDSTs”) to guide practice, e.g. protocols, clinical practice guidelines, order sets, etc. 18 18

25. 19 Educational Process for CYFCH Single Vaccine Immunization Clinical Immunization of clients >5 years Observation of 5 immunizations Be observed doing 5 immunizations Skills Checklist Yearly Review Educational component Attend an Influenza education session or review Influenza materials 19

27. To observe a nurse perform 5 immunizations

28. To assist nurse to complete a skills checklist

29. To “buddy” with a new immunizer and help with questions and concerns