ࡱ> 7 cbjbjUU &7|7|t? lllll8&8&8&8p&&[2'-"---1]45 $ D60166DGll--/GGG6l--G6GGGJb\thz-' . 8&:Bz+0[zA?xAzG|llll  FORMTEXT       (Site Name) Standard Operating Procedures For Vaccine Management Designated responsible staff person:  FORMTEXT       Alternate responsible staff person:  FORMTEXT       The importance of proper vaccine management cannot be overstressed. While it is the direct responsibility of the above named staff to safeguard and ensure the maintenance of vaccines used by this clinic, all staff personnel shall become familiar with the vaccine management concepts for this clinic and assist to ensure the quality of our clinic immunization practices. Read By: Date:Read By:Date: FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        Index for Standard Operating Procedures: 1. Summary of the Vaccine Handling Procedures Plan Page 3 Ordering VFC Vaccine (Manually) Page 4 Ordering VFC Vaccine On-Line Page 5 Receiving VFC Vaccine Page 6 Storing Vaccine and Maintaining the Cold Chain Page 7 Emergency Vaccine Handling Procedures Page 9 Handling Expired or Wasted VFC Vaccine Page 11 Handling Short-Dated VFC Vaccines Page 12  FORMTEXT       (Site Name) Summary of the Vaccine Handling Procedures Plan Routine Vaccine Handling Plan: A routine vaccine handling plan includes operations that take place on a continuous basis and help to prevent vaccine loss. Staff must: Maintain proper temperature for vaccine storage. Refrigerator: 35( to 46( Fahrenheit (2( to 8( Celsius). Maintain a daily log of temperature checks, twice a day, (beginning and end of each day), regardless of the type of thermometer used. Maintain temperature logs for 3 years. Open vaccine shipments as soon as they arrive and store properly following instructions on packing slip. Conduct monthly inventories and order vaccines sensibly as needed. Try not to order more than once a month. Store and rotate vaccines according to expiration dates. Use vaccines with the shortest expiration dates first. If vaccines are within 90 days of expiration and may not be used, they should be transferred to another VFC provider. Contact your Immunization Health Educator for assistance to properly coordinate such transfers. See page 11. Ensure refrigerator doors close properly and the unit is in good working order. Notify the designated vaccine manager immediately if problems occur. Never store vaccines in the door, crisper bins, near the outlet valve, or in closed containers. Advise maintenance and cleaning personnel not to unplug storage units. Post,  Do Not Unplug sticker/sign near outlet.   FORMTEXT       (Site Name) Standard Operating Procedures for: Ordering VFC Vaccine You have two options for ordering VFC vaccine: Manually or On-Line. I. Manually (submitting paper order via mail): Conduct a physical inventory of the current vaccine stock. Check expiration dates: If current stock is more than the clinic can use in 90 days see page 12 Handling Short Dated Vaccines. If the vaccine has reached its expiration date, see page 11, Handling Expired or Wasted Vaccine. Rotate vaccines with the shortest expiration dates to a position to be used first. Determine the amount of vaccine needed. Obtain a VFC vaccine order form from (location of forms stored  FORMTEXT      ). Complete the order form: (Instructions are on the back of the order form) . Our clinic PIN # is P- FORMTEXT       Make sure block numbers 1 through 6 are completed Order vaccines by dose. Send the completed vaccine order form to the address listed on the reverse side of the form. Expect delivery within 10 working days. Deliveries are shipped Monday through Wednesday via express carrier, and should be received Tuesday through Friday. Varicella and MMVR is shipped directly from Merck (the manufacturer) and can take up to 14 days for delivery. Notify your front office staff or supply personnel to expect a vaccine delivery and ask them to notify the appropriate staff when it is received. If you have any problems or need guidance, call your Immunization Health Educator at  FORMTEXT      . II. Ordering VFC Vaccine On-Line Go to  HYPERLINK "http://www.oregonvfc.org" www.oregonvfc.org B. Login : Provider ID  FORMTEXT      (VFC PIN #) Password  FORMTEXT      (available from  FORMTEXT      ) If you forgot or need assistance in obtaining your password call your State Health Educator at (971-673-0300). Select:  Order Your Vaccine Here from menu Click on the arrow on the green line Select vaccine to be ordered Select brand name, if desired If you want more vaccine than is indicated next to the blue box, enter the amount desired in the blue box and click on update Repeat steps 2 through 5 above for each vaccine to be ordered. When you have completed ordering all of you desired vaccine, click on verify your order (blinking in green box at the bottom of the screen) If your order is not correct, click on the make changes block. If your order is correct, check the blue box and enter your name in the blue pace provided. When your order is done, click on finalize your order. You should then see a confirmation that your order was sent. Print this for your records. Deliveries are shipped Monday through Wednesday via an express carrier and should be received Tuesday through Friday. Varicella and MMVR are shipped directly from Merck (the manufacturer) and can take up to 14 days for delivery. Notify front office staff or supply personnel to expect a vaccine delivery and to notify you when it is received. If you have any problems or need guidance, call your Immunization Health Educator:  FORMTEXT       at  FORMTEXT      .   FORMTEXT       (Site Name) Standard Operating Procedures for: Receiving VFC Vaccine VFC vaccine will be delivered via an express mail carrier on a Tuesday, Wednesday, Thursday, or Friday. The following procedures should be followed: The vaccine should arrive in an insulated container marked Vaccines Please Rush. Open the vaccine shipments as soon as possible after delivery and store properly. Check the temperature indicators in the box and ensure they are within safe ranges. Notify your VFC Health Educator if they are not. Check the vaccine invoice against the product received to ensure that the type, quantity, and lot numbers of vaccine received match. Also check to make sure you have received a matching amount of diluent for MMR and Varicella orders. Check this inventory with your original order, and notify your Immunization Health Educator if there is a problem. Check the vaccine expiration dates. Put the vaccine into your designated vaccine refrigerator or freezer ensuring that the vaccine with the shortest expirations dates are placed in a position to be used first. II. Maintain the vaccine cold chain appropriately until used. See page 7,  Storing Vaccine and Maintaining the Vaccine Cold Chain   FORMTEXT       (Site Name) Standard Operating Procedures for: Storing Vaccine & Maintaining the Vaccine Cold Chain Keeping vaccines at the proper temperature at all times is called maintaining the cold chain. The cold chain starts at the manufacture, and continues until the vaccine is used. It is important that vaccines do not get too cold (with the exception of varicella and MMRV) or too warm. It is up to everyone to see that the cold chain is not broken. Refrigeration: The vaccine shall be stored in the refrigerator designated for vaccine storage. Ensure a working thermometer is used inside both the refrigerator and freezer. Refrigerator and freezer temperatures should be recorded twice per day (morning and evening) on an acceptable log. Maintain the logs for at least three years. The refrigerator compartment should be maintained at temperatures between 35( to 46( Fahrenheit (2( to 8( Celsius). Ideally, the temperature should be kept at mid range; 40( Fahrenheit or 5( Clesius. Do not let the refrigerator compartment reach freezing temperatures! The freezer component should be maintained at 5( Fahrenheit (-15( Celsius) or colder. Vaccines should be stored in the center of the refrigerator/freezer. Do not store them in the doors, air tight containers, crisper bins, or near valve outlets. Open-weaved, plastic baskets work best. Never store food, beverages or specimens in the vaccine refrigerator. Avoid disconnecting the vaccine refrigerator from its power source. Call the designated vaccine manager immediately if any problems with vaccine storage or refrigeration systems are detected.  FORMTEXT       (Site Name) Standard Operating Procedures for: Emergency Vaccine Handling Procedures In case of Power outage or equipment failure immediately notify: Primary person:  FORMTEXT       Phone:  FORMTEXT       Secondary person:  FORMTEXT       Phone:  FORMTEXT       These people should have 24 hour access to vaccine storage units. Initial steps after notification: (Note: Use an Emergency Response Worksheet to assist you. Your Immunization Health Educator can provide one). A. Document the time the problem was discovered. B. If possible, avoid opening the vaccine refrigerator or freezer. (The USDA states that a refrigerator will keep food safely cold for about 4 hours if it is unopened. A full freezer will hold the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed. Obtain dry or block ice to keep your refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic foot full freezer for 2 days. Plan ahead and know where dry ice and block ice can be purchased.) C. Ensure there are ice packs around the vaccine in the freezer. D. If available, place ice packs around the interior walls of the refrigerator and ensure they are not touching the vaccine containers. Be prepared to move the vaccine to a working clinic refrigerator or to another site if the power outage/ equipment failure is projected to be prolonged. See Note #1 (page 9) for possible sites. The responsible person above should let you know if transfer of the vaccine is indicated and if a repairman is to be called.(See Note #2 below for a list of repairmen). Moving Vaccine: Place the vaccine into zip lock storage bags (recommend double bagging them): bags are located in  FORMTEXT      . Obtain a Styrofoam vaccine shipping container or ice chest.(these containers are located in:  FORMTEXT      . Place ice packs in the bottom of the container Place a layer to buffer the ice packs. Approximately one inch of buffer material or more is suggested. You can use crumpled-up newspaper, bubble wrap, cardboard, or flat pieces of styrofoam. Place the vaccine on top of the buffer material. Fill the open spaces with crumpled newspaper to secure the vaccine from shifting during shipment. Place container cover on and tape closed. Move the vaccine to the alternative site as soon as possible. See Note # 1 below for a list of alternative sites. At the alternate site, ensure the vaccine is removed from the shipping container and stored in a working refrigerator at temperatures of 35( to 46( (2(to 8( Celsius). If varicella vaccine or MMRV is taken from the malfunctioning freezer, ensure it is placed in a working freezer at temperatures at or below 5( Fahrenheit (-15( Celsius). Upon restoration of power or repair of the non-working refrigerator, repeat steps A through J above to return the vaccine to the working unit. IV. If the vaccines are possibly wasted due to exposure to excessive heat or cold, please refer to page 10, Handling Expired or Wasted Vaccine. Note: #1. List of alternative facilities to move vaccine to if necessary: Name:  FORMTEXT       Phone:  FORMTEXT       Name:  FORMTEXT       Phone:  FORMTEXT       #2. Names of equipment repair companies to call if indicated: Name:  FORMTEXT       Phone:  FORMTEXT       Name:  FORMTEXT       Phone:  FORMTEXT        FORMTEXT       (Site Name) Standard Operating Procedures for: Handling Expired or Wasted VFC Vaccine In the event that VFC vaccine is found to be expired, or exposed to conditions that negatively affect its viability, the following steps should be taken: Do not use the expired or potentially spoiled vaccine. Notify: Primary person:  FORMTEXT       Phone:  FORMTEXT       Secondary person:  FORMTEXT       Phone:  FORMTEXT       Place it into a bag and mark it  DO NOT USE . Place the bag in a working refrigerator. D. The primary or secondary responsible person should call the Immunization Health Educator with information about the situation, (i.e. type of vaccine, amount, manufacture, lot numbers, and the circumstances). The health educator will consult with the vaccine manufacture(s) to determine the vaccine viability, and will advise the clinic on what steps to take. E. Never discard questionable vaccine without first calling your Immunization Health Educator.   FORMTEXT       (Site Name) Standard Operating Procedures for: Handling Short-Dated VFC Vaccines I Occasionally, clinics have more vaccine than they can use before it expires. In these situations notify: Primary person:  FORMTEXT       Phone  FORMTEXT       Secondary person:  FORMTEXT       Phone  FORMTEXT       II. The clinic contact person should notify their Immunization Health Educator with the following information at least 90 days in advance: Vaccine type, amount you will not be able to use, manufacturer, and lot numbers. The Immunization Health Educator will assist in making arrangements for transferring the vaccine and will notify the contact person on how to proceed. Moving the Vaccine: Place the vaccine into zip lock storage bag: Bags are located in:  FORMTEXT       Obtain a Styrofoam vaccine shipping container or ice chest. These containers are located in:  FORMTEXT      . Place ice packs in the bottom of the container Place a buffer layer on to the ice packs. Approximately one inch of buffer material or more is suggested. You can use crumpled-up newspaper, bubble wrap, cardboard, or a flat piece of styrofoam. Place the vaccine on top of the buffer material. Fill the hollow spaces with crumpled-up newspaper to secure the vaccine during shipment. Place container cover on it and tape it closed. Transfer or ship the vaccine to the site designated by the Immunization Health Educator via the most expeditious means possible (i.e. Private vehicle if local, or by express carrier if sent to a distant place).  FORMTEXT       (Site Name) Special Notes: If the clinic notifies the Immunization Health Educator at least 90 days before expiration the site will not be held financially liable for the vaccine if wasted. If the site does not notify the Immunization Health Educator within 90 days or more before the vaccine expiration, the site will be held responsible for replacement costs of the vaccine if it cannot be used by another site. The transferring site is responsible for ensuring the vaccine is properly shipped or transferred and will be held responsible until it is appropriately accepted by the receiving facility. Your Immunization Health Educator is: Name:  FORMTEXT       Phone:  FORMTEXT       Fax:  FORMTEXT       The telephone number for the main Oregon Immunization Program in Portland is (971) 673-0300. Please use this number if you cannot reach your Health Educator directly.  PAGE  PAGE 1 Special Note: For vaccine storage, maintain the following temperatures: Refrigerator: 35( to 46( F (2( to 8( C) Freezer: 5( F (-15(C) or colder Ideally, refrigerator temperatures should be kept at mid-range. Special Note: For vaccine storage, maintain the following temperatures: Refrigerator: 35( to 46( F (2( to 8( C) Freezer: 5( F (-15(C) or colder Ideally, refrigerator temperatures should be kept at mid-range. Special Note: For vaccine storage, maintain the following temperatures: Refrigerator: 35( to 46( F (2( to 8( C) Freezer: 5( F (-15(C) or colder Ideally, refrigerator temperatures should be kept at mid-range. Special Note: For vaccine storage, maintain the following temperatures: Refrigerator: 35( to 46( F (2( to 8( C) Freezer: 5( F (-15(C) or colder Ideally, refrigerator temperatures should be kept at mid-range. Special Note: For vaccine storage, maintain the following temperatures: Refrigerator: 35( to 46( F (2( to 8( C) Freezer: 5( F (-15(C) or colder Ideally, refrigerator temperatures should be kept at mid-range.  Special Note: For vaccine storage, maintain the following temperatures: Refrigerator: 35( to 46( F (2( to 8( C) Freezer: 5( F (-15(C) or colder Ideally, refrigerator temperatures should be kept at mid-range.   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