THE <NAME>PRACTICE
PROTOCOL
Title:
Protocol for the Administration of Inactivated Influenza Vaccine to Adults by
Health Care Assistants
Review Date:
March 2014
Version:
V1.2
Purpose of Protocol:
To enable suitably trained Health Care Assistants working for or on behalf of the <Name> Practice
who have undertaken relevant training (as outlined below), to administer inactivated influenza vaccine
to adults as a single dose, as a duty delegated by the General Practitioner or a Registered Nurse.
Staff Characteristics
Staff group
Additional
requirements
Continuing training
requirement
Health Care Assistants
 Completion of HCA training course on administration of influenza
vaccine to adults.
 Completion of period of supervised practice and completion of
assessment of competence.
 Training and competence in the correct procedure of administering
medication via intra-muscular injection.
 Knowledge of The <Name> Practice policy on management of
Anaphylaxis in the community.
 Access to and knowledge of the DH guidance ‘Immunisation against
infectious disease’.
 18-monthly update in Basic Life Support and treatment of anaphylaxis.
 Demonstration of competence in relation to this medication within the
PDP and appraisal process.
 Annual immunisation update.
Consent
Refer to The <Name> Practice policy on Consent.
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Protocol for the Administration of Inactivated Influenza Vaccine to Adults by Health Care Assistants
<names>
Date Reviewed: Oct 2012. Date Created: Oct 2009
THE <NAME>PRACTICE
PROTOCOL
Clinical Condition
Clinical condition to
be treated
Criteria for inclusion
Criteria for exclusion
including contraindications
Circumstances for
further advice / action
Recommended
treatment, route and
legal status
Dosage
All high-risk patients requiring influenza vaccination.
All patients aged 65 and over.
All patients resident in long stay residential accommodation (excluding
prisons, halls of residence).
Adults aged 16 – 65 in high risk groups:
 Chronic respiratory / heart / renal disease / liver disease.
 Diabetes.
 Immunosuppression (after consultation with GP).
 Health & social care staff / main carers.
Patients with one of the following:
 Aged under 16 years
 Current acute febrile illness
 Previous severe reaction to influenza vaccine or vaccine
component.
 Unable to give informed consent.
 Healthy adults aged 16 – 65.
 History of Guillain-Barre syndrome.
1. Consent not given; counsel with regards to risk of influenza and
protective effect of the vaccine.
2. Excluded patients: Refer to GP.
3. Suspected hypersensitivity reactions: Refer to GP.
4. Pregnancy & breastfeeding: Refer to GP
5. Acute febrile illness: Rearrange vaccination at appropriate date.
Influenza vaccine by intramuscular injection into the deltoid muscle (may
also be given by deep subcutaneous injection).
Prescription Only Medicine (POM).
Adults
0.5ml
Frequency of
administration &
maximum dosage
Follow-up & advice
In accordance with the DH Immunisation Schedule normally a single
annual injection ideally in September – November, repeated yearly.
Side effects & their
management
Local side effects; Redness, swelling, pain, bruising, hardness at injection
site.
Systemic side effects: Pyrexia, headache, tiredness, muscle & joint pain
etc.
Counsel patient that these reactions are rare and usually disappear within
1-2 days. If they do not, or more serious symptoms develop, then the
patient should contact the GP.
Extremely rare side effects; immediate reactions, e.g. Urticaria, angiooedema, bronchospasm and anaphylaxis – see protocol for treatment of
anaphylaxis for appropriate management.
No interactions known.
Patients receiving chemotherapy and / or corticosteroid treatment should
not be excluded from receiving influenza immunisation. Discuss with GP.
Special considerations
/ Concurrent
medication
Clinical Aspects
Re-vaccination in 12 months.
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Protocol for the Administration of Inactivated Influenza Vaccine to Adults by Health Care Assistants
<names>
Date Reviewed: Oct 2012. Date Created: Oct 2009
THE <NAME>PRACTICE
PROTOCOL
The following will be required:
1. Patient specific direction – written by the GP or Independent Nurse Prescriber.
2. Patient identification – required prior to the administration of medication (confirmed by the patient
declaring his or her name, date of birth and home address).
3. Consent – informed consent must be obtained from the patient. Health Care Assistants and
Assistant Practitioners are advised to familiarise themselves with the <Name> Practice Consent
Policy.
4. Record keeping – the following should be recorded in the patient’s notes or on the computer
system according to the GP practice system.
a Name of drug, dose, route and site of administration
b Date administered
c Batch number and expiry date
d Signature of person administering – written or electronic
e Checklist for influenza and pneumococcal immunisations
f Patients assessed as not appropriate for vaccination and any alternative action taken.
g If the patient has declined the vaccination and any alternative action taken
h Any reaction should be recorded in the clinical record
Adverse reactions
Health Care Assistants must ensure that Adrenaline 1:1000 or an Anaphylactic shock pack is
available.
If a general adverse reaction does occur:
 Record in patient’s notes
 Inform patient’s GP as soon as possible
 Local reactions should be seen by either the GP or practice nurse
 Complete Yellow Card if suspected severe reaction
If anaphylactic reaction occurs:
 Give treatment in accordance with the <Name> Practice policy on the Management of
Anaphylaxis in the community.
 Record in patient’s notes
 Inform patient’s GP as soon as possible
Relevant training
1. Health Care Assistants will undertake training covering the following aspects of the administration
of inactivated influenza vaccine:






Appropriate anatomy and physiology
Correct procedure for the administration of the vaccine via intra-muscular injection
Vaccine delivery, storage and stock control requirements, maintaining the cold chain as
per the <Name> Practice policy.
Cautions and side effects related to the administration of inactivated influenza vaccine
Documentation
Legal aspects of drug administration using Patient Specific Direction
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Protocol for the Administration of Inactivated Influenza Vaccine to Adults by Health Care Assistants
<names>
Date Reviewed: Oct 2012. Date Created: Oct 2009
THE <NAME>PRACTICE
PROTOCOL
2. Health Care Assistants should have a minimum of (2) years experience within a relevant Health
Care setting and either working towards or have successfully completed a relevant
course/qualification i.e. NVQ 3 / Foundation accredited course. They should have completed a
Basic Life Support course.
3. Health Care Assistants will undergo a period of supervised practice and assessment and will be
directly observed administering intramuscular injections of inactivated influenza vaccine by the GP
or nurse mentor.
Assessment of competence
The GP or registered nurse mentor will provide supervised practice and assessment of completion of
competencies. Health Care Assistants will be assessed by written assessment.
Competence will be assessed by direct observation and questioning of the Health Care Assistant’s
ability to:





Prepare the patient for the procedure
Safely administer the medication (including choice of site, needle size and injection
technique) and observation of the patient post procedure
Correct disposal of clinical waste
Correct documentation
Correct procedure followed for delivery, storage and stock control of the vaccine
Significant events
Any significant event which occurs during or as a result of administration of medication must be
reported in accordance with the <Name> Practice significant event reporting framework. The Patient
Services Manager/Nurse Co-ordinator or GP must be informed.
Audit: Health Care Assistants will be expected to participate in audit in relation to patient outcomes
and the development of this role.
Health Care Assistants must be familiar with the following documents:





Consent Policy (the <Name> Practice)
Vaccination Policy (the <Name> Practice)
Significant Event Reporting Policy (the <Name> Practice)
NMC Guidelines for the Administration of Medication 2004
NMC Guidelines for Records and Record Keeping 2004
References:
Immunisation against Infectious Disease (Green Book) DOH 2006
Liverpool PCT Education Package 2006
UK Guidance on Best Practice in Vaccine Administration. Shire Hall Communications 2002
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Protocol for the Administration of Inactivated Influenza Vaccine to Adults by Health Care Assistants
<names>
Date Reviewed: Oct 2012. Date Created: Oct 2009
THE <NAME>PRACTICE
PROTOCOL
Protocol Agreement:
Protocol agreed on behalf of the <Name> Practice Partners:
Signed by: ..............................................................................................................................................
<Name> - GP
Signed by: ..............................................................................................................................................
<Name> – Advanced Nurse Practitioner/Nurse Co-ordinator
Date: ......................................................................................................................................................
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Protocol for the Administration of Inactivated Influenza Vaccine to Adults by Health Care Assistants
<names>
Date Reviewed: Oct 2012. Date Created: Oct 2009