Who order's vaccines??

[askater11]

When we do an admission we have a list of questions we ask a patient...if they don't have any contradictions...there's about 6 possible contraditions and if the patient has no contradications we go ahead and give the vaccine.

We don't need a doctors order.

Well I had a severely ill patient who was fighting for her life for days. No fever but the body was shutting down. I asked the doctor about giving her a flu/pneumonia vaccine. The doctor jumped down my throat and said what...that's the last thing the patient needs.

So ever since than I'm asking the Dr's in critical care and 90 percent of the time the doctor says no. Our hospital is cracking down and want us to go ahead and give the vaccine. They say by state law we don't need a dr. order if it follows certain criteria and there's no contradiction.

How does your hospital do this???

[MatthewRN]

At my facility, if the patient meets certain conditions, it is an order that a nurse can place.

[pricklypear]

At my current hospital, the docs have an order they can choose regarding vaccines. It basically just says "nurse to evaluate pt's eligibility for vaccines and administer if no contraindications."

If there is no order for that, we don't evaluate or give.

One of the contraindications is any ACUTE ILLNESS - fever or not.

[SWEnfermera]

"One of the contraindications is any ACUTE ILLNESS - fever or not."

At our facility we have a standing physician order for the pneumoccoccal/influenza vaccines. The standing order contains defined SCREENING CRITERIA and authorizes the RN to order the vaccine from Pharmacy without an individual providers signature or prescription for the vaccine. Acute illness is a contraindication.

In order to be compliant with the Influenza and Pneumococcal Vaccination Performance Measures for the Centers for Medicare & Medicaid Services & (CMS) Core Measures, the patient should receive or be offered the vaccine before discharge from the hospital.