Vaccination room of an adult clinic: requirements, documentation, work schedule. Vaccinations for adults

In the article, we will consider how the vaccination room of an adult clinic should be organized.

For the proper organization of work and the implementation of vaccinations, a medical institution must have an appropriate license for this type of activity, which is issued by the territorial (regional, city, regional) body of the healthcare system, and it must answer SanPin's vaccination room.

If it is impossible to have a separate room

If it is impossible to have a separate room (for example, in a clinic serving the adult population) for scheduled vaccinations, a fixed time should be determined during which other medical procedures and procedures should not be performed in this room. It is strictly forbidden to carry out preventive vaccinations in dressing rooms.

In the registry of an adult clinic you can get all the necessary information about how the vaccine is given, the office’s working hours and make an appointment with a specialist.

Equipment

The equipment of the vaccination room of an adult clinic should include:

• Refrigerator with special labeled shelves for storing vaccines.
• Cabinet for anti-shock therapy and instruments (0.1% solution of adrenaline, norepinephrine or mesatone) and 5% solution of ephedrine.
• Ethyl alcohol, ammonia, a mixture of ether and alcohol.
• Glucocorticosteroid medicines - “Dexamethasone”, “Prednisolone” or “Hydrocortisone”, 2.5% solution of the drug “Suprastin”, 1% solution of the drug “Tavegil”, cardiac glycosides (“Korglikon”, “Strofantin”), 0.9% solution sodium chloride, 2.4% solution of aminophylline.
• Disposable syringes, additional supply of needles for them, tonometer, thermometers, sterile forceps (tweezers), electric suction pump.
• Tanks designed for disinfectant solutions and disposal of used tools.
• Separate marked tables according to the variety of vaccinations.
• Bixes with sterile material.
• A table for recording and storing vaccination cabinet documentation.
• Medical couch or changing table.
• Sink for washing hands.
• Instructions for the use of all medications used to carry out preventive vaccinations (in separate folders).
• Bactericidal lamp.
• Guidance on immunization.
• Journal of expenditure and accounting of vaccines and other medicines.
• Vaccination logbook (for each type of vaccine).
• Magazine for fixing the temperature of the refrigerator.
• The journal of the functioning of the bactericidal lamp.
• Spring cleaning logbook.

It is advisable to provide for the presence of two vaccination rooms in an adult clinic at the same time: one for tuberculin tests and anti-tuberculosis vaccinations, the other for all other vaccines. If it is not possible to have a room for the second office, it is necessary to set special hours and days for vaccination against tuberculosis by equipping a separate table for material (tuberculin vaccine, BCG) with marked containers for the disposal of used needles and syringes.

Manual and documentation

The head of the vaccination room of an adult clinic is managed by the deputy chief physician for therapeutic work (according to the order of the head physician at a medical institution) or the department head in the absence of the first.

For the implementation of preventive vaccinations, only vaccines of foreign and domestic production registered for use in the state and registered in a certain order should be used.

The storage of immunobiological medications for vaccinations for adults should be subject to special sanitary rules, namely in refrigerators, at temperatures up to 2-8 ° C in accordance with the annotations for the use of medicines. Vaccine solvents should also be stored in the refrigerator, so that when preparing the vaccine for administration, it does not cause an increase in its temperature.

What else does the organization of a vaccination cabinet suggest?

The duration of storage of vaccines in the vaccination room should not be more than 1 month. Based on this period, it is recommended to plan the number of incoming medicines, taking into account the volume of ongoing vaccination work in this medical institution per month.

The schedule of the vaccination room in each clinic has some differences - a sanitary day should be organized, a special schedule for receiving citizens, etc.

Duties of the nurse before vaccination

Before the vaccine is administered, the nurse of the vaccination room must:

• check the conclusion of the doctor (therapist) about the health status of the patient who came for the vaccination;
• make sure there are no contraindications to vaccination;
• Wash the hands;
• check the name of the medication on the ampoule with the appointment of a specialist;
• carry out the required procedures for the preparation of the medication (shaking sorbed vaccines, opening the ampoule according to the rules of antiseptics, dissolving the lyophilized agent, etc.) according to the instructions for use.

Do not use vaccines:

• with inappropriate physical qualities;
• in case of violation of the integrity of vials or ampoules;
• missing or unclear labeling;
• expired;
• stored with temperature violations.

What should be provided for vaccination?

When vaccination should be provided:

• the necessary treatment of the injection site of the medication (for example, with intramuscular and subcutaneous injections - 70% alcohol solution);
• the use of only disposable needles and syringes;
• dosage of medication, methodology and place of its introduction.

After vaccination, you must:

• place the vial in the refrigerator when the medicine is re-packed in compliance with the terms and conditions of its storage;
• make a record of vaccination in a medical document, as well as in the "Certificate of Vaccination" held by citizens with the name of the drug, date of administration, series and dose;
• inform the patient about possible reactions to vaccination and medical care with them;
• to monitor patients after the administration of the medication for a period determined by the instructions for its use;
• the premises of the vaccination room should be cleaned 2 times a day using separately labeled equipment using certain disinfectants (1% solution of perform, chloramine, alaminol, etc.). Once a week, a general cleaning of the vaccination room is carried out.

Vaccinations for adults

The vaccination schedule for adults includes vaccines that are given annually or every few years.

Mandatory vaccinations are:

1. From influenza - carried out annually by people after 18 years. For students or employees , vaccination is free. It is carried out at work or at the place of the educational process. Senior citizens and non-working people can get the flu shot at a local health center.
2. From pneumococcal infection. This vaccination is carried out up to 60 years. The risk group includes students, smokers and pregnant women. Injection can prevent a disease such as meningitis and pneumonia. Vaccination is done at will and is paid.
3. Vaccination against lichen. Employees of livestock and forestry can become infected with shingles. On large agricultural complexes, employees are usually vaccinated for free. The rest of the population is injected as desired up to 60 years.
4. From measles. It is vaccinated in a complex against mumps, measles and rubella. The vaccine is included in the compulsory vaccination calendar for any region. When is a measles vaccine given to an adult? The injection is administered to adults 18-25 years old. Men can be vaccinated in the army. When a measles vaccine is given to adults, not everyone knows. A measles vaccine is also given in the first trimester of pregnancy. People with low immunity need hepatitis and measles vaccines first.
5. Hepatitis B. This vaccination is performed up to 55 years, at 10 years once. Such vaccination is carried out free of charge in the clinic. The risk group includes: employees of medical institutions, pregnant women, patients with diabetes mellitus.
6. BCG Patients under 35 years of age (mandatory) are included in the tuberculosis vaccination calendar. Further, the vaccine is performed up to 55 years of age at will in a paid manner.
7. From chickenpox. Vaccination against this disease is considered mandatory for people of childbearing age (for those who have not been sick) or if there is a child in the family. It is carried out in the clinic at will.
8. DTP. Vaccination for adults from tetanus, diphtheria, pertussis is performed separately or in the DTP complex. The calendar includes vaccination against these diseases for patients of any age. Pregnant women are encouraged to perform it at the antenatal clinic. Adult tetanus vaccine is given once in 10 years.
9. From meningitis. This vaccine protects against meningococcal infection. It is necessarily included in the calendar in educational institutions and in military service. It is made up to 24 years. Where to get a vaccine against tick-borne encephalitis, we will tell below.
10. From hepatitis A. It is performed up to 25 years. At risk are people who have an erratic sex life.
11. From rabies. Vaccination is recommended once a year up to 60 years. According to the calendar, such an injection is mandatory for dog handlers, hunters, zoo workers. Vaccination is carried out at will.
12. From tick-borne encephalitis. Such vaccination is usually carried out in three stages, once a year. To protect yourself in the summer, it must be started at the end of winter. Where to get tick-borne encephalitis vaccine? The vaccine is paid and is carried out in clinics.
13. From poliomyelitis. The vaccine is given to adults who live in areas with a high epidemiological threshold.

Optional vaccinations

Not all vaccinations that are included in the calendar are required. The epidemiological territorial threshold plays an important role. For example, in the southern part of the country vaccination against polio is carried out without fail, in the middle lane - at will. The list of mandatory vaccinations includes vaccinations for hepatitis B, measles, rubella. All information can be obtained at the reception of an adult clinic.

Vaccination medication

For the implementation of immunization, various types of biological medicines are used, the main of which are toxoids and vaccines.

Currently, the following types of vaccines are used to prevent infectious pathologies:

1. Vaccines containing whole dead microorganisms, for example typhoid, pertussis, cholera or viral inactivated vaccines - Salk's polio vaccine, influenza.
2. Anatoxins that contain an inactivated toxin produced by a microbial pathogen, such as tetanus, diphtheria toxoids.
3. Vaccines, including viruses and microorganisms living with reduced virulence: mumps, measles, polio, influenza, plague, anthrax, tularemia.
4. Vaccines, which contain live cross-reacting microorganisms associated with the causative agent of the disease (smallpox, brucellosis).
5. Chemical vaccines, which consist of fractions of dead microorganisms (pneumococci, typhoid-paratyphoid, meningococci).
6. Vaccines of a new generation - recombinant, genetically engineered, subunit, artificial synthesized, polypeptide and others, created using the latest achievements of immunological sciences, biotechnology and molecular biology. Thanks to these techniques, some vaccines for the prevention of influenza, hepatitis B and other diseases have already been received.
7. Associated vaccines, which contain several monovaccines (mumps-measles, DTP-vaccine and mumps-rubella-measles vaccines, etc.).

Contraindications and delayed vaccination

The vaccine must be effective and safe. To prevent the occurrence of complications and side effects, you need to know about contraindications to some vaccinations, which are divided into temporary and permanent. The latter are life-threatening factors. For instance:

• acute negative for a vaccine that was administered earlier (swelling, high fever, severe redness of the skin);
• immunodeficiency states (serums with live bacteria cannot be used, vaccination with dead pathogens is allowed);
• complications that arose after the introduction of the same volume of serum (severe allergic reactions - convulsions, anaphylactic shock, encephalopathy, drop in blood pressure).

The list of temporary contraindications includes those conditions in which the protection against infections in the body may not be formed. For instance:

• SARS or influenza with fever (vaccination is carried out a couple of months after full recovery);
• chronic diseases (vaccination is possible only after the approval of the treating specialist);
• immunosuppressive treatment (no vaccination at this time);
• time after the implementation of blood transfusions, the use of immunoglobulins (vaccination is done after at least three months).

Reasons to Postpone

There is also a list of reasons for delaying adult vaccinations. These include:

• mild diseases that occur without an increase in temperature;
• anemia;
• severe dysbiosis (digestive disorders may be the reason for postponing vaccination if antibiotic therapy is the cause);
• Down syndrome and other stable neurological diseases;
• allergies, asthma, atopic phenomena of a different nature (such pathologies are a serious indication for delaying vaccination, since infections are more difficult with them);
• local treatment with steroid medications;
• congenital malformations, including heart;
• chronic diseases of any organs;
• maintenance therapy of chronic diseases with endocrine, homeopathic, antihistamines and antibiotics;
• increased shadow of the thymus due to hyperplasia.

We examined how the vaccination room of an adult clinic works.