ࡱ> } zbjbjΨ Cʤfʤf6ff   8DL t< ^ L "r"$"sssssss$=wysu"""""s 4St((("R  s("s((hm Y{Y#>kFsit0tk}#}mm&}4mp""("""""ss6&b"""t""""}"""""""""fX : MODEL STANDING DRUG ORDER TitleMeasles-Mumps-Rubella-Varicella (MMRV) vaccine Priorix-Tetra or ProQuadLocation(Practice/Organisation name)Date ReviewedName and signature of person who performed the reviewNAME SIGNATURE Next Due Date for Review(should be every 12 months)AuthorThis template was provided by SA Health. The Adelaide PHN has completed this model SDO to support General Practice. Each General Practice has a responsibility to review it for correctness, relevance to the practice, and to update as required to meet their need and any legal obligations.Person Responsible within the General PracticeNamePositionPosition TitleReferences1. NHMRC The Australian Immunisation Handbook on-line version  HYPERLINK "https://immunisationhandbook.health.gov.au/" https://immunisationhandbook.health.gov.au/ 2. Health Practitioner Regulation National Law (SA) Act 2010 3. Controlled Substances Act 1984 (and its Regulations) 4. Consent to Medical Treatment and Palliative Care Act 1995 5. The Nursing and Midwifery Board of Australia approved codes and guidelines 6. The Australian Government Department of Health  HYPERLINK "https://www.health.gov.au/health-topics/immunisation" https://www.health.gov.au/health-topics/immunisation 7. SA HealthAPPLICATION OF MODEL STANDING DRUG ORDER1. Clinical practice areas where SDO can be usedAny immunisation service conducted by Medical Practice, Local Government, Community Health Centre, Hospital, Aboriginal Health Service, Royal Flying Doctor Service or any other service not employing authorised registered nurses. ENDORSEMENT It is recommended a vaccine SDO is in place within every organisation that provides an immunisation service where vaccines are administered by nurses, midwives and Aboriginal Health Practitioners who are  HYPERLINK "http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/clinical+topics/immunisation+for+health+professionals/approvals+for+immunisation+training+programs+and+organisations+delivering+immunisation+programs" not authorised in accordance with the South Australian Vaccine Administration Code. This vaccine SDO endorses appropriately qualified staff to administer the vaccine specified in this document to eligible individuals. All immunisation nurses must practice in accordance with the Nursing and Midwifery Board of Australia registration standards, codes and guidelines; must ensure equipment to manage anaphylaxis is available; must be able to recognise and appropriately manage anaphylaxis, distinguish between anaphylaxis and vasovagal episodes. The management of anaphylaxis may incorporate the commencement of basic life support (BLS). Updates to BLS training should be in accordance with the recommendations from the Australian Resuscitation Council. ENDORSEMENT COMMITTEE MEDICAL OFFICER, SENIOR NURSE AND MANAGEMENT Name Signature: Title: Date: Name Signature: Title: Date: Name Signature: Title: Date:  AUTHORISATION This Standing Drug Order authorises appropriately qualified staff that have read and understood the following information to administer the listed vaccines to eligible individuals  STAFF AUTHORISATION2. Staff credentialing requirements2.1 Registered Nurse 2.1.1 Accountable and responsible for own actions within nursing practice in accordance with the Nursing and Midwifery Board of Australia approved codes and guidelines 2.1.2 Practices in accordance with Division 8, Subdivision 1, section 94 (1) Health Practitioner Regulation National Law (SA) Act 2010 2.1.3 Current registration with Australian Health Practitioner Regulation Agency 2.1.4 Compliance with organisational standards, policies and procedures 2.1.5 Compliance with all relevant legislation and guidelines 2.1.6 Certificate in Cardiopulmonary Resuscitation (CPR)/BLS within the last 12 months Enrolled Nurse Can immunise if can demonstrate all of the following 2.2.1 Have received delegation from a Registered Nurse 2.2.2 Competence to practice and is responsible for own actions in accordance with the Nursing and Midwifery Board of Australia approved codes and guidelines 2.2.3 Compliance with organisational standards, policies and procedures 2.2.4 Compliance with all relevant legislation and guidelines 2.2.5 Practices in accordance with Division 8, Subdivision 1, section 94 (1) Health Practitioner Regulation National Law (SA) Act 2010 2.2.6 Assessment of the client by a Registered Nurse or Medical Practitioner prior to vaccination 2.2.7 Direct or indirect supervision by a Registered Nurse 2.2.8 Current registration with Australian Health Practitioner Regulation Agency 2.2.9 Certificate in CPR within the last 12 months Aboriginal Health Practitioner C Can immunise if they can demonstrate all of the following Have received delegation from a Registered Nurse Compliance with organisational standards, policies and procedures Compliance with all relevant legislation and guidelines Assessment of the client by a Registered Nurse prior to vaccination Direct or indirect supervision by a Registered Nurse Current registration with Australian Health Practitioner Regulation Agency Certificate in CPR within the last 12 months MMRV Vaccine ~ MODEL STANDING DRUG ORDER3. Background3.1 This model Standing Drug Order (SDO) will not meet the need of all cases and must always be used in conjunction with the Immunisation Handbook1 3.2 Clinical assessment and advice from a Medical Practitioner should be sought if the recommendations for a specific clinical situation cannot be determined using this SDO together with the Immunisation Handbook1 4. Purpose and scope4.1 To ensure the correct and controlled administration of the listed Priorix-Tetra or ProQuad vaccines by a person authorised according to the criteria in this SDO 5. Limitations5.1 Only to be given as a 2nd dose of MMR-containing vaccine in children d" 4 years of age due to increased risk of fever and febrile convulsion 5.2 Not recommended for individuals e"14 years of age 6. Precautions6.1 NOT to be mixed with other vaccines in the same syringe 6.2 NOT to be administered intravenously 6.3 Not to be administered to individuals e"14 years of age 6.4 If a person does not receive MMRV vaccine at the same time as other live attenuated parenteral vaccines, wait at least 4 weeks between vaccinations 6.5 Recent administration of immunoglobulin or blood products. Refer to Online Australian Immunisation Handbook for specific details 6.6 A tuberculin skin test (TST; Mantoux) may be unreliable for at least 46 weeks in people who have received MMR vaccine 6.7 Household contacts of people who are immunocompromised can safely receive measles-containing vaccines, because the vaccine viruses are not transmissible from vaccinated people to others 6.8 Only give as the 2nd dose of MMR containing vaccine in children aged <4 years of age. 6.9 If MMRV is inadvertently administered as dose 1 of MMR-containing vaccine at 12 months of age, the dose does not need to be repeated provided that it was given at e" 12 months of age. Parents need to be advised about the small increased risk of fever and febrile convulsion. MMRV should still be used at 18 months of age as the second dose of MMR containing vaccine 6.10 MMR-containing vaccines are not routinely recommended for infants <12 months of age. This is because maternal antibodies to measles persist in many infants until approximately 11 months of age. These may interfere with active immunisation before 12 months of age7. Contra-indications7.1 Anaphylaxis following a previous dose of MMRV-containing vaccine 7.2 Anaphylaxis after any component of the vaccine 6.3 Individuals who are immunocompromised. Refer to Online Australian Immunisation Handbook for specific details. 7.4 MMRV-containing vaccines are contraindicated in pregnant women 6.4.1 If vaccine is given to women of child-bearing age, it is recommended she is advised to avoid pregnancy for 28 days 8. Indications for use and dosagePriorix-Tetra is indicated for the active immunisation against measles, mumps, rubella and varicella and is registered for use in people aged e"9 months of age to <14 years of age. ProQuad is indicated for the active immunisation against measles, mumps, rubella and varicella and is registered for use in children aged 12 months 8.1 One dose of Priorix-Tetra or ProQuad vaccine is recommended for: 8.2 All children e"18 months who have previously received 1 dose of MMR containing vaccine at e" 12 months of age 8.3 Catch-up 8.3.1 For the recommended minimum interval between doses for children where doses have been delayed or missed, refer to the current edition of the Online Australian Immunisation Handbook. 8.4 A single 0.5 ml dose of the vaccine is used for immunisation9. Relevance to other SDOs9.1 Priorix-Tetra or ProQuad vaccine can be administered concurrently with other vaccines on the childhood schedules. Refer to the relevant SDOs. Refer to the Immunisation Handbook1 for more specific information. 9.2 Adrenaline must always be readily available 10. Presentation10.1 Priorix-Tetra and ProQuad are presented as a lyophilised pellet in a monodose vial that requires reconstitution with a pre-filled diluent in a 0.5 mL syringe.11. Procedure11.1 Pre-immunisation 11.1.1 Obtain a detailed immunisation history. Refer to Australian Immunisation Register (AIR) secure site for records of vaccinations and the personal health record or other immunisation record card/book. 11.1.2 Refer to the relevant sections in the Immunisation Handbook1, for guidelines for pre-vaccination assessment including the Pre-vaccination Screening Checklist and the Comparison of Effects of Disease and the Side Effects of Vaccines 11.2 Preparation of Priorix-Tetra or ProQuad vaccine 11.2.1 Check the vaccine and expiry date 11.2.2 Reconstitute the vaccine by adding the 0.5mL pre-filled syringe of sterile diluent provided to the vial containing the pellet of lyophilised vaccine. Shake until the pellet is completely dissolved. 11.2 Method of Administration 11.2.1 Priorix-Tetra - Administer by SC or IM injection 11.2.2 ProQuad - Administer by SC or IM injection Refer to the Immunisation Handbook1, for recommendations regarding multiple injections at one visit and selection of needle gauge and length12. Site considerations12.1 Individuals aged 12 months to <14 years of age Administer into the deltoid muscle (preferred site). However, if multiple injections are required for children, the anterolateral thigh can be used.13. Documentation13.1 Record in the vaccine recipients personal health record or other immunisation record card/book and in your clinical record/data file 13.1.1 valid consent obtained 13.1.2 vaccine name, brand, dose number, batch number, route and site of administration 13.1.3 date and time of administration 13.1.4 name and designation of the person administering the vaccine 13.1.5 date the vaccine is next due (if applicable). 13.2 Report the vaccination of all individuals to the AIR 13.2.1 Ensure Aboriginal identification is documented14. Monitoring requirements14.1 Observation post-vaccination 14.1.1 Vaccine recipients should remain in the vicinity for a minimum of 15 minutes for observation for potential life-threatening adverse events. 14.2 Post-vaccination advice 14.2.1 Provide verbal and written information about common adverse events. Resources available include Immunisation Consent Resource, Common side effects following immunisation for vaccines used in the National Immunisation Program schedule (Handbook1), and the After-Vaccination Information leaflet (available from Immunisation Section SA Health) 15. Side Effects15.1 Common Pain, redness and swelling at injection site The following reactions may occur within 5 to 12 days after immunisation: Moderate fever High fever above 39C lasting 2-3 days (5-15%) Faint rash (not infectious) Head cold and/or runny nose Cold like symptoms Swollen glands, stiff neck or joint pain 15.2 Uncommon Injection site nodule lasting weeks, no treatment necessary 15.4 Very Rare Thrombocytopenia (reduced platelets in the blood), ataxia (impaired ability to coordinate movement) and encephalitis (brain inflammation) Severe allergic reaction (anaphylaxis).16. 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t0*644 la & F 7dh$Ifgd-W>>>>>>>>>??K?M?R?d?i?o?~???????????????LSj̰Ͱ "#$%678Dӻ#hG8uh-W5CJOJQJ^JaJhz h-W0JUhM>h-W0J hh-Wjh-WUhh-W5 h8j9h-Wh-W h-W5hZQh-W5CJaJAVSS/ 16.2.2 To report any serious or unexpected AEFI to the Immunisation Section: Complete and submit the online Vaccine Reaction Reporting Form, or Email a completed Vaccine Reaction Reporting Form to:  HYPERLINK "mailto:healthvaccinesafety@sa.gov.au" healthvaccinesafety@sa.gov.au, or Phone 1300 232 27217. Storage17.1 Store between + 2oC and + 8oC. Protect from light. DO NOT FREEZE NURSES/ABORIGINAL HEALTH PRACTITIONER PROVIDING THE IMMUNISATION SERVICE I have read and understand the recommendations of the Standing Drug Order. I accept that I will administer the vaccine under the described procedure in this Standing Drug Order. Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date: Signature: Printed name: Date:     Priorix Tetra Vaccine or ProQuad vaccine~ MODEL SDO Page  PAGE 6 of  NUMPAGES 6 Page  PAGE 1 of  NUMPAGES 6 d?S#$78Pzkdc$$Ifl00T($ ! t0*644 ladh$If^`gdz & Fdh$Ifgd-W8dh$If`8gd-W8DձRMM:!$dh]^a$gd gd zkd$$Ifl00T($ ! t0*644 la 7dh$If^`gd-W 7Pdh$If^`Pgd-WDHIMPZ[dekͱձ MRknqƲDz̲Ͳ 'GMfgkƳdz˳ÿÿÿÿh8h0ah jh Uh_$ hFCJ h CJ hn;bh h@h hF h-WH*h-Wh@h-W5FDz'Ggdz+,PgdREgd_Edhgd-WdhgdFdhgd  %+,2349:;<@AKLMNPQRSYZ`abcghrstuwxyzh_$h hRUmHnHujhK}Uh8h0ahRU0JmHnHu hK}0JjhK}0JUhyhy^J hyhyhK}hh,hy2PQRSwxyzdhgd-WA 0PP&P 1h:p1. 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