The NHS in England is using an increasing number of vaccines, all in unpreserved multidose presentations and each having unique handling conditions relating to their storage, reconstitution where necessary, and dose.
There is a need to store and use different vaccines within a single vaccination site. It is vital that all vaccines are stored, selected, handled and administered correctly, and that staff are trained in and practice safe preparation and administration of the vaccine to ensure that every patient receives the right dose of the right product at the right time.
To support this requirement, the following policy statements should be assessed and implemented locally.
The vaccinator is responsible for ensuring that the patient receives the correct vaccine at the correct dose and therefore robust systems should be in place to confirm if the patient is due to receive a first or second dose or a booster dose and which vaccine they should receive.
A series of principles should be followed:
Physically segregate different vaccines during storage
Ideally each vaccine will be kept on a shelf of its own or, if possible, is a fridge of its own. Packs should be positioned so that the label and identity of the vaccine is clearly visible on every pack when the fridge door is opened.
Administer one vaccine at a time
Only a single type of vaccine should be administered in any vaccination administration station during a single vaccine administration session.
Assess work- and patient-flows to minimise the risk of “wrong vaccine” errors
Typically, no more than two different vaccine should be in use on any one site on any working day. On a large site which may, for example, operate on three floors of the same building, it could be possible to offer three different vaccines, one on each floor.
Only staff who have been trained and assessed as being competent to undertake their role using a particular type of vaccine should be involved.
All staff safety briefing
Where there is a team involved in vaccine administration – all members of that team should be involved in a safety briefing prior to participating in each vaccination session to clarify the vaccine being used, remind staff of the dose to be administered and how that vaccine is handled, and to clarify roles and responsibilities.
Vaccine-specific consumables only
Only the vaccine, syringes, documentation and consumables needed for the specific vaccine to be administered should be available in the designated work station during a vaccination session.
Take a break between vaccines
When a different vaccine is to be administered, a break between vaccination sessions should be scheduled and a nominated staff member made responsible for ensuring that the work station is cleared completely of the first vaccine and all associated consumables and documentation prior to introducing the new vaccine and relevant consumables and documentation into the work station.
Report and learn from incidents
All errors and near misses are to be notified to the designated clinical lead and reported using local governance processes and to the SVOC and RVOC. This will ensure that learning can be shared more widely and the content of national SOPs adjusted if appropriate. A standard operating procedure is available.
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