ConcernedNurse

At a retirement home, in addition to influenza, our group is doing PNEMOVAX 23 for those who want it and meet the criteria. Quick question because internally none of us nurses have a consensus on how to administer it while remaining uniform with what the others do. The package insert says “for intramuscular or subcutaneous injection” and that is the hang up. We asked for policy or clarification and the physicians kind of nonchalantly seemed disinterested saying to follow the insert that they delegate to us to be the experts. I realize the answer may differ, but to survey what others do in their healthcare institutions, pharmacies, etc. Do you or your institutions prefer to give PPSV23 IM or SQ and why? Thanks

Being trained to give vaccines and the practical aspect of actually doing the work is very different because the literature does not train the provider how to handle people. From the book and training, giving a flu shot to a 14 year old and 34 year old is the same, but in practice it is often very different. When giving children and teens vaccines for school and young adults vaccines for college which order do you prefer to give them in? And what advice do you give the recipient or the parent? Case and point all my co-workers seem to say that the HPV vaccine for example is the most painful to receive, so they give it last, but Tetnus or Tdap tend to cause delayed muscle soreness. Where do the other ones fall on the spectrum? What I am asking is to quantify the pain level of each vaccine relative to other vaccines when received and afterwards. How do you handle different types of recipients? What do you say or do to make it easier? What aftercare do you give? I believe if we do a good job such as ensuring accurate placement to prevent prevent rare shoulder injury and go in the proper depth to prevent induration(knot), then if the the patient is relaxed and not anxious with a loose arm the patient should have a positive experience. How do you handle it and what works best?