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?

[OutlawNurse86, BSN, RN]

At our hospital, we fill out this check sheet on admission, then doc the decides if he wants the patient to get it or not. Same thing for the pneumonia vac.

Usually it is given on discharge.

[pennyaline]

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

Not every pharmacist holds a doctorate, and having a doctorate in pharmacy does not automatically award prescribing privileges. Pharmacists are licensed to dispense, not to prescribe. If a pharmacist believes that one med could be more appropriate than another, or wants to recommend a new medication, or needs to make a substitution, the pharmacist needs to contact patient's prescriber for a valid order.

[career#2]

I worked flu immunization clinics this year and that was my first question. Standing order. It was physically present at each and every clinic that I participated in. Ditto what previous posters said about screening for contraindications/consent/liability, etc., too.

[Ace587RN, RN]

in my facility there is no order required

[pagandeva2000, LPN]

In my state, they also have various flu clinics (in fact, I worked for one for close to two years). We needed a standard order, but if there were no contraindications, the patient can receive it, as long as they were assessed by an RN.

[Purple_Scrubs, BSN, RN]

I would not give it without written protocols or standing order of some kind, which I must see with my own eyes. I worked too hard for my nursing license to risk losing it for prescribing/dispensing meds without a license.

[tewdles, RN]

I think it is important to note that when I worked in community health I was, actually, the "immunization coordinator". I established and supervised the vaccination practice for 6 community health centers in 5 counties. I organized, supervised, and participated in immunization clinics for the rural poor including migrant agricultural workers every summer for a number of years. Most clinics we had at least a NP or PA present. We operated from standing orders for efficiency. We completed the standard screening for routine and international vaccines.

[EarthChild1130]

I dunno about the order thing here, but I did see a pharmacist giving flu injections when I went to pick up some of my medication.

[mokiach]

In Texas you have to be licensed to give injections. RNs are automatically licensed with their valid nursing license; LVNs (vocational nurse) have to re-apply for the right to give shots every year, thus just being an LVN does not give them the automatic right to give shots even if their license is current. I suppose certain doctors are licensed, and others are not, depending on their specific license. Licensed psychologists PhDs technically can, PhDs in counseling cannot (unless you are in Florida). I think MDs can, and research doctors even in medicine cannot. I don't know about pharmacists here. Even if you are licensed to do so, you still have to stay within your scope of practice, so even being licensed does not necessarily grant you the right to do so. It's a scary thought, but I suppose there are people out there administering shots that are not legally allowed to, licensed and not (expired licenses). I think sometimes licenses only allow you to do it in certain states, where you are licensed, and not nationally or across state borders. NPs (nurse practitioners) can write Rx under a supervising doctors license, thus have blanket rights to make medication decisions without consulting their supervising doctor by association.

[pinkiepie_RN]

I'm on an inpatient psych unit, so this may not apply to you. We have to screen everyone for the flu vaccine. If they're over 50 or meet certain criteria (chronic illness, at risk population, live in a nursing home) and they want the vaccine, an order automatically generates without a doctor's order. If a patient wants it and they don't meet the criteria to auto-generate the order, our physician has given standing orders to administer it as long as the patient doesn't have allergies to latex or eggs. We have to write a verbal order for it, she'll sign it when she gets on the unit, and we have to write in the order that they aren't allergic to eggs and whether or not they're allergic to latex.

[MissJulie]

I got a flu shot yesterday at my clinical site for nursing school. The hospital was having a health fair with free shots to the employees, and since we were "working" there that day, we got them, too. All we had to do was be over 18 (of course), sign a form that asked some simple questions about allergies, etc., and then sign to give consent. Oh, and the shot was given to me by a fellow nursing student!

I don't know if this has any effect on the issue or not, but there was no doctor's order, and the shot was not given by a nurse (RN or otherwise), MD, or even a pharmacist.

[PiperRN]

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!

This string is a bit old but as an Occupational RN in the manufacturing sector, I have the same question. What must I do to 1) acquire inactivated 2011-12 vaccine, 2) go to get appropriate release forms and 3) record or report/document administration of the flu vaccine. I am registered in the State of Florida.

Thanks!