preparing for a busy flu clinic

[KateMason]

Hello,

I'm new here. I would like other peoples input. I work at a primary care clinic. We are busy giving the flu vaccine as I am sure many of you are too. The other day, while preparing for my day, I went ahead and took the fluzone pre-filled syringes and put screwed the needle on a bunch of them just to save a couple of steps when I go to administer them. Other places that I have worked have done this as well when holding immunization clinics and specifically with the flu clinic. Now, mind you, I work in adult health so we have 3 different formulations, one for 65+, one for medicare patients and the most popular, the fluzone for 19 and older which are the ones that I put the needle on. It sure makes my day a lot smoother as not only is every patient that we see getting the flu vaccine, but we also have nurse visits who are getting the flu vaccine as well. On top of my regular every day job of triaging, handling patient forms, medication reconciliation, teaching, coumadin management and a bunch of other daily duties. (too many to mention)

-Anyway, my boss came to me the other day and told me that per "Wendy", who is the clinical trainer for the company, we should not be screwing the needle onto the pre-filled syringe until we are ready to give it due to "risk of contamination". I didn't question it at the time, but I have been a nurse for 23 years and I've seen it common practice whenever I get the flu shot and also in school flu clinics that the syringes already have the needleson them and are drawn up and ready to give. To me it's common practice to have the flu vaccine ready to give. Not only that, but how can she say it's risk of contamination when your obviously not contaminating the syringe? This nurse who said this only has 7 years of experience and thinks that she's Gods gift to nursing and has a tendency to "make thing up" in my opionion.

-so I would like to know what everyone elses experience is. Do you have the flu shots ready to give with the needle already on them when you know that you are going to be giving a lot of flu shots?

-The only thing I read in the CDC guide was that it's not recommended to pre-fill syringes ahead of time due to possible error of giving the wrong vaccine and they aren't sure how the vaccine interacts with the plastic syringe long term. They recommend using pre-filled syringes like I do, but no where did it mention any contraindications to putting the needle on top of the syringe ahead of time.

-feed back please.

[mcdebb]

Hello

Be confident on what you are doing because you are dealing with health related problem here . Being a nurse requires knowledge and professionalism in handling patients.

[Farawyn]

You posted this twice, OP. Please don't do that.

[klone, MSN, RN]

Hello

Be confident on what you are doing because you are dealing with health related problem here . Being a nurse requires knowledge and professionalism in handling patients.

Huh? Was this supposed to be in response to the OP's question?

[Addigirl]

How is that different than the fs's we order coming with a needle on them??? I would say it's fine. I can see the incorrect med error as an issue but not contamination. Maybe if they set a while?

[BDOGGRN]

I've given thousands of flu shots, every year, for the past 15 years. Pre-filled syringes are a definite time-saver, and $-saver, since the cost of pre-filled vs multi-dose vials are nearly the same, except the pre-filled require only a needle, but multi-dose vials require syringe, needle, alcohol wipes, and staff time (and assumed accuracy) to prepare. In the absence of pre-filled syringes, it is acceptable to "pre-fill" syringes, for an event such as a "flu shot clinic," however they should be drawn/used on the day of, and should be filled by same person who will administer them, kept in proper temp/storage, and in a chain of custody in with which they can NOT be tampered.