Giving a flu shot to patients without a signed consent?

[Double-Helix, BSN, RN]

My PICU recently decided that we will be offering flu and pneumococcal vaccines to all of our eligible patients. This is a state requirement to reduce the number of children who are not vaccinated. The policy itself is fine.

However, what is concerning a lot of the nurses is that we can administer the vaccine with verbal consent from the parent/guardian. The guardian can also refuse verbally. Many of us feel that without the signed form verifiying consent and acknowledgement of risks, it sets the hospital up for potential problems or even lawsuits down the line.

Example: We administer an immunization with verbal consent. Child has a vaccine reaction. Parents claim they were not informed of the potential risk. No documentation to support that they were.

Example: We administer a vaccine to a young child with verbal consent. Child is later diagnosed with autism. Parents claim they never gave permission for their child to receive the vaccine.

What do you think? Are we too paranoid? Or should we refuse to give the vaccine unless there is a signed consent form that remains part of the chart?

[dudette10, MSN, RN]

Can you document under patient teaching in your chart? It may not be a consent per se, but there would at least be documentation that you had the conversation with the parents before administering the shots.

[melmarie23, MSN, RN]

yeah, I would not be comfortable in administering the vaccine without written consent. If this is a state-wide initiative and one in which your hospital is trying to be compliant with, is it really that hard for the facility to draft up a consent form for you to use?

Verbal consent leaves too much room for he said, she said. Thats not waters that I am comfortable in swimming in.

[SouthernPoint]

Ok. Think about this.

When a parent takes their child to the Pediatrician's for immunizations do they have to sign a consent?

My children are young adults now, but I know neither myself or husband ever signed any type of consent for shot's when they were receiving them.

[melmarie23, MSN, RN]

I definitely signed a consent for my son's flu vaccination at the pedi. I was just there yesterday.

[Horseshoe, BSN, RN]

Ok. Think about this.

When a parent takes their child to the Pediatrician's for immunizations do they have to sign a consent?

My children are young adults now, but I know neither myself or husband ever signed any type of consent for shot's when they were receiving them.

I always had to sign something when my kids received immunizations at the doctor's office.

[melmarie23, MSN, RN]

on my unit (L&D) we have a global consent form for the infant when they are first admitted. It has consent for Hep B, e-mycin, Vit K, circumcision etc. If the parents are not wanting any of those, they cross them out. If they want them all, then they just sign the form. Can your unit do something to that effect?

[nurse2033, MSN, RN]

I agree with all the posters who say that many people don't sign consents for vaccines. That has been my experience. However, I just worked on a presentation about the anti-immunization movement and there are many people who believe that vaccines damaged their kids. I even found a video on YouTube where the parents said their doctor "forced" vaccinations. A signed consent form would have taken care of that accusation. I don't think you are being paranoid in today's world. I think you should firmly make your concerns known and press for a policy. If you refuse to give a vaccination your employer could refuse to continue to employ you, so be careful.

[rnsrgr8t]

I agree with you, parents should absolutely sign consent. I worked in a pediatrician's practice and gave hundreds of immunizations. We had a work sheet that you would list them all with the date they were given and the parent signed by each one. Couldn't your PICU get the form your NICU uses when they give vacccines? You could copy it and give it to the parent to keep to give to the pediatrician so they know that their patient already received the vaccine. Younger kids need 2 doses of the flu shot when they first get it so you definitely need to have a way to let the PCP know when the first injection was given so they know when the second one is due. I think the AAP has a standard form on their website you could submit for approval. There is too much liability there and too much paranoia in the public to not cover yourself.

[NurseTrishaH]

I don't recall ever signing a consent form for either of my 2 kids (now 5 & 6 so it's pretty fresh in my memory). Nothing wrong though with giving the parents an info sheet on the immunization, then having them sign a consent form stating they understand the risks and benefits.

My only issue with your post is trying to link autism and the flu vaccine. Hasn't this been laid to rest yet??

[Txnursekristi]

I'm going to play devils advocate...

Lets say you do get written consent for the vaccine, give it, and have no problems.

Then, the same patient comes in 2 months later with an unrelated fever. You give prn tylenol, per orders, the child has an allergic reaction to the tylenol. The family decides that since you didn't get written consent to give their child tylenol, they are going to sue you. Where does it end?

[Double-Helix, BSN, RN]

I'm going to play devils advocate...

Lets say you do get written consent for the vaccine, give it, and have no problems.

Then, the same patient comes in 2 months later with an unrelated fever. You give prn tylenol, per orders, the child has an allergic reaction to the tylenol. The family decides that since you didn't get written consent to give their child tylenol, they are going to sue you. Where does it end?

I believe that the administration of tylenol would fall under the general consent for treatment signed upon admission, since the tylenol would be related to the medical symptoms we are treating. However, the flu vaccine is not related to the condition for which they are admitted and should require a seperate consent.