1.3 July clinic newsletter

Clinic Immunisation Newsletter 1 July 2022 Tēnā koutou, Winter is well and truly here. We hope you enjoyed the Matariki long weekend and were able to take time out to relax and recharge. We know that clinics continue to be under pressure from winter workload and staffing shortages, we recognise the hard work you are all doing and thank you for this.

This month we have included a few key messages for successful immunisation:

Consent: Informed consent is a process whereby the individual or parent/guardian are appropriately informed in an environment and manner that are meaningful. Having been well informed, they are willing and able to agree to what is being suggested without coercion.

They must be able to understand: • that they have a choice • why they are being offered the treatment/procedure • what is involved in what they are being offered • the probable benefits, risks, side-effects, failure rates and alternatives, and the risks and benefits of not receiving the treatment or procedure.

To make an informed choice and give informed consent for vaccination, the individual or parent/guardian needs to understand the benefits and risks of vaccination, including those to the child and community.

Issues to discuss with individuals or parents/guardians about immunisation include: • the vaccine-preventable diseases • the vaccines used on the National Schedule (ie, the funded vaccines that are available) • how vaccines work, known risks and adverse events, and what the vaccine is made of, in case of known allergies • the collection of immunisation information on the NIR • the choice to vaccinate.

Informed consent is required for each immunisation episode or dose. Presentation for an immunisation event should not be interpreted as implying consent. Individuals and parents/guardians have the right to change their mind at any time. Where consent is obtained formally but not in writing, the provider should document what was discussed, and that consent was obtained and by whom.

We have attached a sample consent form to this newsletter. If you would like to trial it in your practice, it can be scanned into your PMS system.

Correct landmarking for intramuscular injections: Please take a moment to refresh your knowledge on finding the correct landmark to deliver a vastus laterlis and deltoid injections in infants (excerpt from the Immunisation Handbook 2020):

Deltoid 1.

2.

Find the acromion (the highest point on the shoulder) Find the deltoid tuberosity (the lower deltoid attachment point)

The injection site is at the axilla line, between these anatomical landmarks. The vaccine should be deposited at the bulkiest part of the muscle For all children up to approx. 7yrs old a short 16mm needle will be sufficient to achieve a deep IM injection into the deltoid. Around 6 – 8 yrs old please use your clinic judgement on which needle length to use depending on deltoid size and fat layer.

Notes for admin staff and practice managers: • Please email NIR when you have a patient transfer in or out, this means your ImmsNet list stays up to date with only your patients.

• Remember to do a NIR status query on all patients transferring in.

• NIR staff email your practice about overdue babies, please keep an eye out for these and reply in a timely manner.

• The reception staff play a critical role in the immunisation experience, being welcoming, friendly and using correct pronunciation help set up a successful immunisation visit and engagement with the practice.

“The practice receptionist has been identified as THE critical factor in the acceptance of GP based immunisation for Whanau.” (IMAC 2011 focus group, from ‘Recommendations to enhance General Practice to improve access of tamariki to immunisation’, 2013, Corbett).

Nga Mihi

Philippa and Kerri BOP Childhood Immunisation Coordinators