Booklet to support competence in the administration of Intranasal Flu Vaccine

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1 Administration of the Intranasal Flu Vaccine by Healthcare Support Workers (Level 3 and 4 on the NHS Career Framework) to children in a school setting* Booklet to support competence in the administration of Intranasal Flu Vaccine August 2014 *School Setting may be interpreted as schoolchildren within a school setting or similar setting designated by the NHS board

2 Health Protection Scotland (HPS) is a division of NHS National Services Scotland. NHS Education for Scotland (NES) is a division of NHS Scotland. HPS website: NES website: Published by Health Protection Scotland and NHS Education for Scotland. First published August Health Protection Scotland and NHS Education for Scotland Reference this document as: Health Protection Scotland and NHS Education for Scotland. Administration of the Intranasal Flu Vaccine by Healthcare Support Workers (Level 3 and 4 on the NHS Career Framework) to children in a school setting. Booklet to support competence in the administration of Intranasal Flu Vaccine. Health Protection Scotland and NHS Education for Scotland HPS and NES have made every effort to trace holders of copyright in original material and to seek permission for its use in this document. Should copyrighted material have been inadvertently used without appropriate attribution or permission, the copyright holders are asked to contact HPS or NES so that suitable acknowledgement can be made at the first opportunity. HPS and NES consent to the photocopying or reproduction of the information in this document for use within NHSScotland and for non commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of HPS and NES. HPS and NES consent to the photocopying of this document for professional use. All other proposals for reproduction of large extracts should be addressed to either: Health Protection Scotland NHS National Services Scotland Meridian Court 5 Cadogan Street Glasgow G2 6QE Tel: +44 (0) NHS Education for Scotland 102 Westport West Port Edinburgh EH3 9DN Tel: +44 (0) Website: Designed and typeset by: Graphics Team, Health Protection Scotland

3 Table of Contents Introduction 1 Expectations of supervision 2 Expectations of HCSW 2 of competence in the administration of intranasal flu vaccine 3 Observation of the immunisation process and Supervised Practice 3 Supervised Practice 3 Overall knowledge, skills and behaviours 4 Supervised Practice: Checklist to be completed by the supervising Registered HCP 6 Parameters for a Senior Healthcare Support Worker (Level 3) 10 Parameters for an Assistant Practitioner (Level 4) 11 Certificate: Observation of Practice / of Competence per child vaccination 1

4 Introduction Prior to supervised practice, Healthcare Support Workers (HCSWs) at Level 3 and 4 on the NHS Career Framework must have received theoretical instruction at NHS board level to prepare them to administer intranasal flu vaccine to children in school settings under the supervision of a Registered Healthcare Practitioner (HCP). It is the employer s responsibility to ensure that HCSW are trained and competent in the administration of medicines/vaccines and immediate management of anaphylaxis. This booklet is offered as a tool to support the safe and effective practice of administration of intranasal flu vaccine and should be used and retained by the HCSW while undergoing training in intranasal flu vaccine administration. The Registered HCP should use the information in this leaflet as a reference point and the checklist criteria to make decisions around competence. It may also be useful to record annual updating and assessment of competence in this procedure. This booklet sets out the: Expectations of supervision by the Registered HCP. Expectations of the HCSW. Overall Knowledge, Skills and Behaviours mapped against the Healthcare Support Workers Code of Conduct. 1 Criteria for supervised practice and assessment of competence. Role parameters for those working at Senior Support Worker (Level 3 NHS Career Framework) and Assistant Practitioner (Level 4 NHS Career Framework). 2 1 Scottish Government (2009) Code of Conduct for Healthcare Support Workers. Edinburgh. Scottish Government. 2 Scottish Government(2010). A Guide to Healthcare Support Worker Education and Role Development. Available at: 1

5 Expectations of supervision by the Registered HCP Supervision of the HCSW must be carried out by a Registered HCP e.g. nurse / midwife or doctor. Each HCSW involved in the administration of intranasal flu vaccine should be supervised by an identified experienced immuniser e.g. a Public Health / School Nurse, to ensure that the HCSW has the required knowledge and skills to administer intranasal flu vaccine. The Registered HCP who delegates intranasal flu vaccine administration is responsible for the overall management and supervision of the HCSW role with regards to intranasal flu administration. They must adhere to guidance from their regulatory body on delegation e.g. Nursing and Midwifery Council 3 and must ensure that the HCSWs practice is safe and effective and appropriate immunisation information in accordance with local policy is available. For additional information about support and supervision in the workplace it may be helpful to access the following resource on the NHS Education for Scotland website. Expectations of HCSW The HCSW must only undertake the administration of intranasal flu vaccine after successful completion of a training programme as per local policy. They must be able to demonstrate safe and effective practice and deliver a high standard of care. The HCSW must ensure that they work within the limitations of their role, ensuring their practice is carried out in accordance with NHS Scotland HCSW Code of Conduct and adhere to local policies and legislation. They must refer to a Registered HCP any decisions or clinical events that are outside their sphere of responsibility. Healthcare Support Workers (HCSWs) are expected to adhere to local guidance and policy to ensure that they remain competent to perform this role. 3 Nursing and Midwifery Council (2010)The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives. London. Nursing and Midwifery Council of conduct, performance and ethics for nurses and midwives. 2

6 of competence in the administration of intranasal flu vaccine Observation of the immunisation process and Supervised Practice Prior to assessment of competence the HCSW should have an opportunity to observe the immunisation process and be able to discuss relevant issues with their identified supervisor. Resource material to assist reflective practice can be found at: support-and-supervision.aspx. Observations of administration of the intranasal vaccine must be structured by the Registered HCP to ensure that the aspects of practice identified in the checklist included in this booklet are covered.the number of observed immunisations prior to assessment of competence should be determined at local level. Supervised Practice The checklist in this document is offered to record observations of practice and aid decision making in relation to achievement of competence. A minimum number of supervised practices, prior to sign-off of competence in the administration of intranasal flu vaccine, should be determined by the supervising Registered HCP according to the progress made by the HCSW. The checklist may be retained by the HCSW to insert in their portfolio and a copy should be retained in the HCSW s personal file in accordance with local policy. Overall Knowledge, Skills and Behaviours - suggested mapping is offered against the Code of Conduct for Healthcare Support Workers Scottish Government (SG) (2009) and NHS KSF Core and Health and Wellbeing Dimension (HWB). 3

7 Overall knowledge, skills and behaviours Healthcare Support Workers (HCSWs) administering intranasal flu vaccine must be: Deemed competent by a Registered HCP to administer intranasal flu vaccine. (SG - Accountability 3.2.1, Protection , Awareness 3.2.2) (KSF - Core 2 People and Personal Development, Core 5 Quality, HWB1 Promotion of health and wellbeing and prevention of adverse affects on health and wellbeing, HWB4 Enablement to address health and wellbeing needs, HWB5 Provision of care to meet health and wellbeing needs, HWB7 Interventions and Treatments) Well informed e.g. have completed training on flu and administration of intranasal flu vaccine. (SG Accountability) (KSF - Core 4 Service Improvement, HWB10 Products to meet health and wellbeing needs) Able to answer concerns (but know when to refer to a nurse or doctor). (SG - Accountability ) Aware of child safety issues. (SG - Awareness, Integrity 3.2.3, Protection ) (KSF - Core 3 Health, safety and security, HWB3 Protection of health and wellbeing) Empathic be able to support and encourage the children. (SG - Advocacy 3.2.4) Respectful of parent / child confidentiality. (SG - Confidentiality 3.2.9, Consideration and Respect 3.2.7) Positive about vaccination. (SG - Awareness 3.2.2, Development ) Able to treat other people with honesty, respect and consideration. (SG - Integrity 3.2.3, Sensitivity 3.2.5, Objectivity 3.2.6, Consideration and Respect 3.2.7) (KSF - Core 6 Equality) 4

8 Able to give out relevant information and aware of informed consent issues. (SG - Consent 3.2.8) (KSF - Core 1 Communication, Core 5 Quality, HWB4 Enablement to address health and wellbeing needs) Able identify any communication barriers with the individual(s) and take appropriate action. (SG - Advocacy 3.2.4, Sensitivity 3.2.5, Objectivity 3.2.6) (KSF - Core 1 Communication) Able to select the most appropriate method of communication for the individual. (SG - Advocacy 3.2.4) (KSF - Core 1 Communication) Active listeners and respond appropriately to any questions and concerns raised during communications. (SG - Alertness ) (KSF - Core 1 Communication) Familiar with the resources produced by Health Scotland. (SG - Development ) Able to identify and source any leaflets for distribution including the post immunisation leaflet. (SG - Development ) (KSF - Core 5 Quality) Able to work effectively with other members of the Healthcare Team. (SG - Co-operation ) (KSF - Core 6 Equality) Alert to any adverse reactions to intranasal vaccination and take appropriate action. (SG - Alertness , Protection ) (KSF Core 3 - Health, safety and security, HWB6 and Treatment Planning) 5

9 Supervised Practice: Checklist to be completed by the supervising Registered HCP Observation of Practice / of Competence per child vaccination Performs hand hygiene. Checks child s identity including date of birth and/or age and/or addressverbal check. Checks child s consent form and ensures that child is well immediately prior to administration of intranasal vaccine. Explains procedure to child and obtains verbal consent. Ensures vaccine has been stored according to manufacturer s instructions. Checks correct vaccine dose and vaccine expiry date. Provides reassurance and positions child appropriately. 6

10 Supervised Practice: Checklist to be completed by the supervising Registered HCP Observation of Practice / of Competence per child vaccination Administers intranasal flu vaccine according to manufacturer s instructions. Disposes of used intranasal applicator in accordance with local waste management guidance. Disposes of all other waste in accordance with local waste management guidance. Documents vaccine batch number; expiry date; date administered; signature and prints name and designation onto consent form. Completes relevant parent information according to local policy and give to child. Performs hand hygiene. 7

11 Supervised Practice: Checklist to be completed by the supervising Registered HCP Observation of Practice / of Competence per child vaccination In addition be able to: Explain the limitations of their role in the administration of intranasal flu vaccine and knows when to refer to a Registered Healthcare Practitioner (HCP). Describe their responsibilities in relation to the administration of intranasal flu vaccine and know the roles of other members of the immunisation team. Explain What is flu and why vaccination is important. Give appropriate age related advice and information to the child during and after procedure. Explain the importance of appropriate vaccine storage and cold chain management. 8

12 Supervised Practice: Checklist to be completed by the supervising Registered HCP Observation of Practice / of Competence per child vaccination Know who to contact for advice if unsure or if an adverse event occurs. Describe the signs and symptoms of an adverse event. Access appropriate adverse event equipment. Explain the importance of maintaining confidentiality throughout the vaccination process. Signature of Supervisior- and Registration Number 9

13 Parameters for a Senior Healthcare Support Worker (Level 3) 4 Senior Healthcare Support Workers (HCSWs) will have all the attributes, skills and knowledge described for HCSWs and: Will have a generalised knowledge and understanding of their job role and related tasks although it is expected that this will be further developed than a HCSW. Will have a broad skill base related to their practice. Will possess an awareness and relative understanding of what is normal concerning their patient / clients wellbeing and report issues outwith normal to registered practitioners. Will be able to problem solve and take action regarding patient / client care through an awareness of policy and legislation. Following an initial assessment of the patient / client by the registered practitioner, and under guidance and supervision while following set protocols and procedures, will carry out routine elements of assessment to enhance the patient/client journey. Will understand and be able to carry out reflective practice. Will work on their own initiative within their role remit that may involve more advanced clinical skills and tasks than a HCSW, dependent on the area and site of their work. Role remit will consist of delegated tasks and duties that they will plan and prioritise in consultation with registered practitioners. Can communicate both routine and complex / sensitive information to patients, clients, relatives and staff. Will have developed organisational and time management skills. As a co-producer, the senior HCSW will work with patients / clients with varying levels of dependence. At times they may be considered a lone worker and as such will carry out and undertake familiar tasks with minimum supervision. Will have an awareness of subtle cues concerning patient / client wellbeing and will respond to / take action concerning common symptoms within agreed protocols and guidelines pertinent to their work area. 4 Scottish Government (2010). A Guide to Healthcare Support Worker Education and Role Development. Available at: 10

14 Their general workload is likely to increase in complexity where familiar but less routine tasks will be delegated to them. Will be expected to participate in running groups and activities, giving help and support to registered colleagues. Will recognise risk in relation to care provision and will further develop risk assessment skills. Will support and act as a role model to HCSWs. Will show awareness of patient advocacy and an awareness of wider patient / client issues (e.g. home concerns, etc). They will recognise and understand their role boundaries and limitations. At all times, will act under the delegation and supervision of a registered practitioner. Parameters for an Assistant Practitioner (Level 4) 5 Assistant Practitioners will have all the attributes, skills and knowledge described for HCSWs and Senior HCSWs and: Will have an in-depth knowledge and understanding of their role remit and related tasks. Will recognise the need for evidence based practice and carry out delegated care accordingly. Will have a comprehensive skill base related to their practice. Interventions practised by the Assistant Practitioner will be achieved through additional, focused training and education. Will also develop knowledge on how and why their care provision and that of others in the multidisciplinary team, impacts on patients / clients journey. Working within agreed protocols and guidelines, an Assistant Practitioner will modify approaches and activities within care interventions and programmes under the direction and supervision of a registered practitioner. Will carry out routine elements of patient / client assessment following protocols and guidelines. Will problem solve related to needs and tasks and take action within the agreed parameters of the role. 5 Scottish Government (2010). A Guide to Healthcare Support Worker Education and Role Development. Available at: 11

15 Assistant Practitioners workload will increase in complexity where less familiar and less routine tasks will be delegated to them. Workload will be directed by the Registered Practitioner but Assistant Practitioners will participate in planning care. Will be responsible for planned, delegated care. Will support and act as mentor and role model to senior HCSWs and HCSWs. Can be a patient s advocate. Will have developed risk assessment skills in relation to patient / client care. As a relief / substitute, Assistant Practitioners will develop screening skills within agreed protocols and guidelines and will contribute to discharge planning and make referrals under direction and within agreed protocols. Will recognise and understand their role boundaries and limitations and at all times, will act under the delegation and supervision of a registered practitioner. 12

16 Certificate: Observation of Practice / of Competence per child vaccination Administration of the Intranasal Flu Vaccine by Healthcare Support Workers (Level 3 and 4 on the NHS Career Framework) to children in a school setting I agree that I have had sufficient training and consider myself competent to administer intranasal flu vaccine to school aged children. Name (full name): Designation: : I agree that the HCSW named above is competent to administer intranasal flu vaccine to school aged children. Name (full name): Professional Registration Number: Designation: :

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