NEW YORK NURSE: October 2009
Q.: We are starting to give immunizations for flu. What are some of the nursing practice considerations that I will need to watch for with this injection?
A.: With all injections, infection control, Occupational Safety and Health Administration (OSHA) safety needle device regulations, medication safety, and alertness to signs and symptoms of possible side effects to the immunization must be considered.
Standard universal precautions should be taken prior to giving injections. This includes washing your hands or using hand sanitizers in between patients. Best practice dictates the use of gloves as well. These measures will minimize the risk of exposure from any oozing that may occur at the injection site.
OSHA mandated workplace measures give employees every necessary step to ensure safety in the work environment. This prohibits bending, recapping or removing contaminated needles. The Needle Stick Safety and Prevention Act was passed in 2000 requires facilities to involve frontline staff in the decision making process for obtaining and using safe medical devices, including needleless systems and retractable needles used for drawing up and administering medications. Engineering controls, such as puncture resistant sharps containers, prevent inadvertent needle stick injuries.
With all medications, safe practice requires ensuring that the correct medication, correct dose, correct route, correct time and correct person are checkd before administration. In the case of administering influenza vaccine, the facility and the registered nurse must follow the standard protocols already in place for seasonal flu vaccine. Be sure prefilled syringes are properly labeled with the name of the vaccine. The influenza vaccine is reminiscent of the majority of other vaccine solutions. It should be clear, free of visual matter and given the same way as other vaccines such as tetanus or MMR.
The influenza vaccine is not a live virus and will not cause the flu. People who have received the influenza vaccine may complain of a stiff, slightly swollen or reddened arm for a couple of days. Using or exercising the arm in which one receives the injection will minimize the discomfort. Applying ice or a cold compress to the injection site during the first 24 hours, followed by heat, will also minimize discomfort or swelling.
To continue receiving up to date information on influenza, check cdc.gov or the Nursing Practice section at nysna.org. You can also call NYSNA’s hotline extension at 518-782-9400 ext 346 or 1-800-724-6976 ext 346.
This is a sample of the questions NYSNA’s experts answer each day. The advice given is specific for the situation described and may not be applicable generally. If you have questions about your own work setting, it is recommended that you contact your NYSNA Nursing Representative or the Education, Practice, and Research Program, 11 Cornell Road, Latham, New York 12110-1499 or call 800-724-NYRN, ext. 282.