2024 Q4 CQI Newsletter - Patient Safety PDF

NOVEMBER 2024 At The Helm of Patient Safety Newsletter Continuous Quality Improvement (CQI) Newsletter...

NOVEMBER 2024 At The Helm of Patient Safety Newsletter Continuous Quality Improvement (CQI) Newsletter VOL. 4 NO. 8 Highlights AVOIDING COMMON VACCINE ERRORS Common Vaccine Confirm vaccine with Related Errors Incorrect product administered consent form and verbally Needlestick Injury E.g., influenza vaccine given instead of with patient before Protocol COVID-19 vaccine injection Influenza and COVID-19 Vaccine Overview Confirm minimum Wrong vaccine given to interval with children under 12 Moderna SPIKEVAX is the only product available at stores for provincial guidance children 6 months to 11 years COVID-19 vaccine administered earlier than the minimum required interval Influenza and COVID-19 vaccines cannot be Vaccine administered past transferred between pharmacies in Ontario earliest Beyond-Use-Date (BUD) Document BUD on each vial immediately after Wrong dose administered to patient puncture and store in an empty prescription vial E.g., Pfizer COMIRNATY given as 0.5 mL dose with a completed Avery instead of 0.3 mL label template RECOMMENDED DOSES BY AGE FOR 2024 COVID-19 AND INFLUENZA VACCINES Influenza Vaccine Type Age* Dose COVID-19 Vaccine Type Age* Dose Flulaval Tetra 6 months to 4 years Fluzone Quadrivalent 6 months + Moderna SPIKEVAX 0.25 mL 0.5 mL COVID-19 mRNA 5 to 11 years Flucelvax Quad vaccine, Omicron KP.2 variant Afluria Tetra 5 years + 12 years + 0.5 mL Fluad Trivalent 0.5 mL Fluzone High-Dose 65 years + 0.7 mL Pfizer COMIRNATY Quadrivalent COVID-19 mRNA 12 years + 0.3mL vaccine, Omicron KP.2 FluMist Quadrivalent 2 years to 59 0.2 mL variant (Intranasal) years (0.1 mL per nostril) *Health Canada approval age may not reflect scope of practice in your jurisdiction. Confirm minimum age for injection with provincial resources Children 6 months to less than 9 years of age who have never received the seasonal influenza vaccine in a previous influenza season should be given 2 doses of influenza vaccine in the current season, with a minimum interval of 4 weeks between doses References: 1. Flip > Vaccine Resource Centre > National Injections Services Policy and Procedures Manual 2. Ontario Ministry of Health Health Programs and Delivery Division, Executive Officer Notice: Administration of the Publicaly Funded Influenza Vaccines in Ontario Pharmacies 3. Health Canada, Statement on seasonal influenza vaccine for 2024–2025 4. Moderna, Spikevax Dosing and Administration, 5. Pfizer, Product Monograph: COMIRNATY® COVID-19 mRNA vaccine PAGE 1 OF 3  NOVEMBER 2024 VOL. 4 NO. 8 Staff Needlestick Injuries: What to do Next Inform the patient of the incident and request they remain at the pharmacy. Cleanse the puncture site thoroughly. Ask the patient to attend an immediate physician assessment with you. If the patient can’t attend, request they sign the Source Patient Consent Form on Flip (in Manitoba, contact the Regional Health Authority Occupational Health Nurse if needed). Notify the Designated Pharmacy Manager (DPM) and arrange for coverage or store closure if necessary. Seek medical attention at the emergency department or with a physician within 2 hours. Follow up with the DPM to ensure they inform HR and report the injury within 24 hours via Pharmapod (Flip > Pharmacy Main > Pharmacy Incidents) Can I ask the patient FAQ: Can I check the about their health status Needlestick provincial Drug and history of infectious Information System? Injuries disease? Answer: It is never appropriate to Answer: Asking questions about the view provincial medical records or patient’s health status, sexual history, drug information systems to and risky behavior is best left to the attempt to identify risk of blood physician reviewing the incident, who borne infections. This is a breach can interview the patient confidentially of patient privacy. and provide next steps. What to do in the Case of an Adverse Event Following Immunization (AEFI): 1. After any immunization, the patient should be instructed to remain within close proximity to the injection provider for at least 15 minutes. If they feel unwell, they should return immediately for assessment. 2. If a patient experiences any serious or unexpected AEFI, the appropriate provincial AEFI form must be completed and submitted to the local Health Unit as soon as possible. In Alberta (AB), AEFI forms must be reported within three days. 3. A pharmacy incident report must be completed on Pharmapod. A de-identified copy of the AEFI Form should also be filed with the Pharmacy Incident Form. 4. Ensure that the completion of these steps and the reaction details are documented in the patient’s record according to standard documentation practices. References: PAGE 2 OF 3 1. Flip > Pharmacy Main > Pharmacy Standards > Pharmacy Standard Operating Procedures > Enterprise Pharmacy Standard Operating Procedures 2. Flip > Pharmacy Main > Vaccine Resource Centre > 2024 National Injection Services Policy and Procedure Manual NOVEMBER 2024 VOL. 4 NO. 8 Quick Reference for 2024 Influenza and COVID-19 Vaccines Influenza Vaccines Influenza Vaccine Storage and Age* Package Type Dose Volume Type Beyond Use Date Flulaval Store at 2-8 C Fluzone Between uses, return 6 months + PFS (prefilled syringe) to recommended and MDV (multidose 0.5 mL storage conditions Flucelvax vial) Discard MDV 28 days after first puncture Afluria 5 years + Fluad Trivalent 0.5 mL Fluzone High-Dose 65 years + PFS Store at 2-8 C 0.7 mL Quadrivalent FluMist Prefilled single use 0.2 mL 2 to 59 years Store at 2-8 C (Intranasal) glass sprayer (0.1 mL per nostril) COVID-19 Vaccines COVID-19 Vaccine Storage and Age* Vial Cap Appearance Dose Volume Type Beyond Use Date 6 months to 11 Store at 2-8 C 0.25 mL years Discard MDV after: Moderna SPIKEVAX 12 hours if stored at Dark Blue Omicron KP.2 variant 8 - 25 C 12 years + 0.5 mL 24 hours if stored at 2-8C Store at 2-25 C Pfizer COMIRNATY 12 years + Dark Gray 0.3 mL Discard MDV 12 hours Omicron KP.2 variant after first puncture Pfizer COMIRNATY 6 months to 11 NOT AVAILABLE AT SDM/LCL IN CANADA Omicron KP.2 variant years *Health Canada approval age may not reflect scope of practice in your jurisdiction. Confirm minimum age for injection with provincial resources References: Health Canada, Statement on seasonal influenza vaccine for 2024–2025; GSK. Flulaval Tetra Product Monograph; Sanofi. Fluzone Quadrivalent Product Monograph; Seqirus. Flucelvax Quad Product Monograph; AstraZeneca. Flumist Quadrivalent Product Monograph; Seqirus. Afluria Tetra Product Monograph; Fluad Product Monograph; Sanofi. Fluzone High Dose Quadrivalent Product Monograph; Pfizer Canada. COMIRNATY [COVID-19 mRNA Vaccine] Product Monograph. BioNTech Manufacturing; Moderna Biopharma Canada Corp. SPIKEVAX [COVID-19 mRNA Vaccine] Product Monograph. Moderna Biopharma. PAGE 3 OF 3