Do you need an order to give the flu vaccine?

[MikeyBSN]

I think the obvious answer to my question is "yes". However, I have seen and read about pharmacies, grocery stores and other places giving flu shots. I assume they are being given by an RN or LPN. However, I doubt all these people coming to pharmacies and grocery stores are bringing a prescription from their PMD. My employer offered them and I didn't need a prescription. So if you don't need an RX, and there is no doctor individual examining people and ordering a flu shot, then how are these places allowed to give people flu shots?

[proudnurseRN]

I don't think you need an order. We have a flu/pneumonia survey, and if the pt qualifies, has no contradictions, and wants the shot, then it automatically enters into our med list to give. We put a note on the chart that we gave it, and give the patient the info regarding the vaccine.

[whiskeygirl, LPN]

In Texas... you do not need to show up to the flu shot clinic with a script.

FYI, Pharmacists (in general) are the ones giving the shots at pharmacies.

[Key_]

Same. We fill out a form and then it shows up next day for 0900 meds. I have had a Dr say he didn't want the patient to get the shot before though, but never an order to give it.

[brighella]

As a corporate flu shot nurse, i can say that theres no order required. They need to meet requirements and not have any of the contraindications, answer the questions, and then sign a form which is both a consent and a release from liability. Its important for the nurse to screen well, and we carry smelling salts and doses of epi for if the unthinkable does occur. I gave over 150 shots today and into 4 digits this season so far, and while ive had a good number tell me 'my doctor said I should get it' I have yet to see any kind of directive from a doc.

I didn't know that pharmacists could give injections too, I guess i thought nurses & docs were the only ones who could drive a syringe like that, good to know!

[Daly City RN]

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I have been taking my family to the hospital's clinic almost every year and we just sign a consent. No need to get a doctor's order to get flu shots.

Unfortunately I can't get seasonal and H1N1 flu shots myself because I'm allergic to eggs. Rats!

I'd rather get the shots than have cough, fever, throbbing headaches and whole body aches that may last 7-10 days.

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[Sewbusy~RN]

I wouldn't give it without an order or a set protocol.

[mamamerlee, LPN]

Depends on the situation and state. Medicare pays for the shots regardless of where it is given, and the large flu-shot clinics have had an MD draw up protocols. However, in LTCs and such, there is sometimes a blanket order for the facility. Some facilities send out a form for the POA to sign to give permission. Knowing your 'audience' is the key here.

[Virgo_RN, BSN, RN]

No, you do not need a doctor's order for the flu shot. I believe that the way it works is that the state issues a protocol that must be reviewed and signed by a person with prescriptive authority, then the clinic/pharmacy can give the shots to persons over 18 years of age, following the protocol. Pharmacists may give injections in my state. They may also administer medications in emergency situations within a facility (i.e. a code), flush heparin and saline locks and administer IV meds under the supervision and direction of an MD. They may not initiate IVs, however.

[kids]

I didn't know that pharmacists could give injections too, I guess i thought nurses & docs were the only ones who could drive a syringe like that, good to know!

Technically pharmacist's are docs, they certainly have prescribing privileges.

[PolandM]

No order needed at my facility. If they want it and have no contraindications (egg, thimersol allergy, etc.) then we give it. If a patient is immunocompromised we may double check with their physician to make sure he/she is ok with it but it's not really a request for an order.

[tewdles, RN]

In my current setting of hospice we must have a docs order for the flu vaccine. This is per this companies policy. Another hospice, in same geographic area does not require MD order. So at least in some instances this practice is determined by the employer. In the hospital we had to have an order. In community health there were standing orders for vaccines including influenza. In public health there were standing orders for vaccines including influenza.

I feel more comfortable having a docs order. I am a registered nurse. To my knowledge that does not give me liberty to decide independently that a person requires an antigen and then administer it. While I am very well versed in vaccines and their administration and I advocate for a well vaccinated population I believe there are limitations upon what I may legally do, I think this is one of those things for which I am required to have some sort of formal oversight by a physician. But hey, I could be wrong.