In the article, we will consider how the vaccination room of an adult clinic should be organized.
For the proper organization of work and the implementation of vaccinations, a medical institution must necessarily have an appropriate license for this type of activity, which is issued by the territorial (regional, city, regional) body of the he alth system, and a vaccination office, he must answer to SanPin.
If it is impossible to have a separate room
If it is impossible to have a separate room (for example, in a clinic that serves the adult population), a fixed time should be determined for routine vaccinations, during which other medical manipulations and procedures should not be carried out in this room. It is strictly forbidden to carry out preventive vaccinations in dressing rooms.
At the registry of an adult clinicyou can get all the necessary information about how the vaccination is carried out, office hours and make an appointment with a specialist.
Equipment
Equipment of the vaccination room of an adult polyclinic should include:
- Refrigerator with special labeled shelves designed to store vaccines.
- Cabinet for anti-shock therapy and instruments (0.1% solution of adrenaline, norepinephrine or mezaton) and 5% solution of ephedrine.
- Ethyl alcohol, ammonia, a mixture of ether and alcohol.
- Glucocorticosteroid medicines - Dexamethasone, Prednisolone or Hydrocortisone, 2.5% solution of the drug "Suprastin", 1% solution of the drug "Tavegil", cardiac glycosides ("Korglikon", "Strophanthin"), 0.9% sodium chloride solution, 2.4% aminophylline solution.
- Disposable syringes, additional supply of needles for them, tonometer, thermometers, sterile forceps (tweezers), electric suction.
- Containers for disinfectant solutions and disposal of used instruments.
- Separate marked tables for types of vaccinations.
- Bixes with sterile material.
- Desk for records and storage of documentation of the vaccination room.
- Medical couch or changing table.
- Sink for washing hands.
- Instructions for the use of all medications used for preventive vaccinations (in separate folders).
- Germicidal lamp.
- Instructive and methodological documentation onimmunization.
- Vaccines and other medicines expenditure and record book.
- Vaccination log (for each type of vaccine).
- Journal for fixing the temperature regime of the refrigerator.
- Gericidal lamp operation log.
- Main cleaning log.
It is desirable to provide for the presence of two vaccination rooms in the adult polyclinic at the same time: one for tuberculin tests and anti-tuberculosis vaccinations, the other for all other vaccines. If it is not possible to have a room for a second office, it is necessary to establish special hours and days for vaccination against tuberculosis, equipping a separate table for the material (tuberculin vaccines, BCG) with labeled containers for the disposal of used needles and syringes.
Manual & Documentation
The deputy head physician for therapeutic work (according to the order of the head physician of the medical institution) or the head of the department in the absence of the first one manages the activities of the vaccination room of the adult polyclinic.
For the implementation of preventive vaccinations, only foreign and domestic vaccines approved for use in the territory of the state and registered in a certain order should be used.
Storage of immunobiological medicines for vaccinations for adults must be carried out in compliance with special sanitaryrules, namely in refrigerators, at temperatures up to 2-8 ° C in accordance with the annotations on the use of medicines. Vaccine diluents should also be kept refrigerated to avoid causing the vaccine to rise in temperature during preparation.
What else does organizing a vaccination room involve?
The duration of storage of vaccines in the vaccination room should not exceed 1 month. Based on this period, it is recommended to plan the number of incoming medicines, taking into account the volume of vaccination work carried out in this medical institution per month.
The work schedule of the vaccination room in each clinic has some differences - a sanitary day must be organized, a special schedule for receiving citizens, etc.
Responsibilities of a nurse before administering vaccinations
Before administering the vaccination, the vaccination room nurse must:
- check the conclusion of a doctor (therapist) about the state of he alth of the patient who came for vaccination;
- make sure there are no contraindications to vaccination;
- wash your hands;
- check the name of the medicine on the ampoule with the appointment of a specialist;
- carry out the required procedures for the preparation of the medication (shaking sorbed vaccines, opening the ampoule according to the rules of antiseptics, dissolving the lyophilized agent, etc.) according to the instructions for use.
Not eligible for vaccine:
- with inappropriate physicalqualities;
- in violation of the integrity of vials or ampoules;
- missing or unclear markings;
- expired;
- stored with temperature violations.
What needs to be ensured when vaccinated?
When vaccinating, ensure:
- necessary treatment of the injection site (for example, with intramuscular and subcutaneous injections - 70% alcohol solution);
- use only disposable needles and syringes;
- dosage of the drug, methods and places of its administration.
After vaccination you need:
- place the vial in the refrigerator when refilling the medication in compliance with the terms and conditions of its storage;
- make an entry about the vaccination in the medical document, as well as in the "Certificate of vaccination", which is in the hands of citizens, indicating the name of the drug, date of administration, series and dose;
- inform the patient about possible reactions to vaccination and medical care for them;
- to monitor patients after the administration of the medication for a period determined by the instructions for its use;
- vaccination room should be cleaned 2 times a day using separately labeled inventory using certain disinfectants (1% solution of perform, chloramine, alaminol, etc.). General cleaning of the vaccination room is carried out once a week.
Vaccinations for adults
In the vaccination calendar foradults included are vaccines given annually or every few years.
Compulsory vaccinations are:
- From the flu - held annually for people over 18 years of age. Vaccination is free for students or employees. It is carried out at work or in the place of the educational process. Retired and unemployed people can get their flu shot at their local clinic.
- From pneumococcal infection. This vaccination is carried out up to 60 years. The risk group includes students, smokers and pregnant women. The injection helps prevent diseases such as meningitis and pneumonia. Vaccination is optional and is paid.
- Vaccination against lichen. Workers in the livestock and forestry sectors can become infected with shingles. At large agricultural complexes, employees, as a rule, are vaccinated free of charge. The rest of the population is injected at will until the age of 60.
- From measles. It is vaccinated in combination against mumps, measles and rubella. The vaccine is included in the compulsory vaccination calendar for any region. When is the measles vaccine given to adults? The injection is administered to adults 18-25 years old. Men can be vaccinated in the army. When adults are vaccinated against measles, not everyone knows. Also, the measles vaccine is given in the first trimester of pregnancy. People with low immunity need hepatitis and measles vaccinations first.
- Hepatitis B. This vaccination is performed until the age of 55, once at the age of 10. Such vaccination is carried out free of charge in the clinic. The risk group includes:he althcare workers, pregnant women, patients with diabetes.
- BCG. Patients under 35 years of age are included in the tuberculosis vaccination calendar (mandatory). Further, the vaccination is carried out until the age of 55 at will on a paid basis.
- From chickenpox. Vaccination against this disease is considered mandatory for people of childbearing age (for those who have not had it) or if there is a child in the family. It is carried out at the clinic at will.
- DTP. Adults are vaccinated against tetanus, diphtheria, whooping cough separately or in the DTP complex. The calendar includes vaccination against these diseases for patients of any age. Pregnant women are invited to perform it in the antenatal clinic. Adults are vaccinated against tetanus once every 10 years.
- From meningitis. This vaccine protects against meningococcal disease. It is included in the calendar necessarily in educational institutions and in military service. Done up to 24 years. Where to get vaccinated against tick-borne encephalitis, we will tell below.
- From hepatitis A. Performed up to 25 years. People who are promiscuous are at risk.
- From rabies. Vaccination is recommended once a year until the age of 60. According to the calendar, such an injection is mandatory for dog handlers, hunters, and zoo workers. Vaccination available upon request.
- From tick-borne encephalitis. Such vaccination is carried out, as a rule, in three stages, once a year. To protect yourself in the summer, it must be started at the end of winter. Where to get vaccinated against tick-borne encephalitis? The vaccine is paid andcarried out in polyclinics.
- From polio. The vaccine is given to adults who live in areas with an increased epidemiological threshold.
Vaccinations required
Not all vaccinations included in the calendar are mandatory. The epidemiological territorial threshold plays an important role. For example, in the southern part of the country, vaccination against polio is mandatory, in the middle lane - at will. The list of mandatory vaccinations includes vaccinations against hepatitis B, measles, rubella. All information can be obtained at the reception of the adult polyclinic.
Medicines for vaccination
Different types of biological medicines are used for immunization, the main of which are toxoids and vaccines.
Currently, the following types of vaccines are used to prevent infectious pathologies:
- Vaccines containing whole dead organisms, such as typhoid, pertussis, cholera or virus inactivated vaccines - Salk polio vaccine, influenza.
- Toxoids, which contain an inactivated toxin produced by a pathogenic microbe, such as tetanus toxoid, diphtheria toxoid.
- Vaccines, including live attenuated viruses and microorganisms: mumps, measles, polio influenza, plague, anthrax, tularemia.
- Vaccines containing live cross-reactingmicroorganisms associated with the causative agent of the disease (pox, brucellosis).
- Chemical vaccines, which consist of fractions of dead microorganisms (pneumococci, typhoid-paratyphoid, meningococci).
- New generation vaccines - recombinant, genetically engineered, subunit, artificially synthesized, polypeptide and others, created using the latest achievements in immunological sciences, biotechnology and molecular biology. Thanks to these methods, some vaccines have already been obtained to prevent influenza, hepatitis B and other diseases.
- Associated vaccines that contain several single vaccines (mumps-measles, DPT-vaccine and mumps-rube-measles vaccines, etc.).
Contraindications and postponement of vaccination
The vaccine must be effective and safe. To prevent the occurrence of complications and side effects, you need to know about contraindications to some vaccinations, which are divided into temporary and permanent. The latter are called life-threatening factors. For example:
- acute negative for previous vaccine (swelling, high fever, severe skin redness);
- immunodeficiency states (in this case, sera with live bacteria cannot be used, vaccination with dead pathogens of pathologies is allowed);
- complications that arose after the introduction of the same volume of serum (severe allergic reactions - convulsions, anaphylactic shock, encephalopathy, drop in blood pressure).
The list of temporary contraindications includes such conditions in which protection against infections in the body may not be formed. For example:
- SARS or influenza with fever (vaccination is carried out a couple of months after full recovery);
- chronic diseases (vaccination is possible only after the approval of the attending specialist);
- immunosuppressive treatment (no vaccination available at this time);
- time after blood transfusions, use of immunoglobulins (vaccinated after at least three months).
Reason for delay
There is also a list of reasons for delaying vaccinations for adults. These include:
- mild diseases that occur without fever;
- anemia;
- severe dysbacteriosis (digestive disorders may be grounds for postponing vaccination if antibiotic therapy is the cause);
- Down syndrome and other stable neurological diseases;
- allergies, asthma, atopic phenomena of a different nature (such pathologies are a serious indication for postponing vaccination, as infections are more severe with them);
- topical steroid treatment;
- congenital malformations, including those of the heart;
- chronic diseases of any organs;
- supportive therapy of chronic diseases with endocrine, homeopathic, antihistamines andantibiotics;
- increased thymus shadow due to hyperplasia.
We looked at how the vaccination room of an adult clinic works.
