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  • 1.  administering immunizations: provider presence

    Posted 11-10-2023 08:30

    does anyone have locations where RNs are administering immunizations with no provider on site or do your policies state a physician or advance practice provider must be on site with an immunization is given? (ambulatory setting)

    any details to share?

    thank you

    carrie lemke



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    Carrie Lemke DNP RN NPD-S BC
    Aurora Health Care Medical Group
    Denmark WI
    (920)655-7795
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  • 2.  RE: administering immunizations: provider presence

    Posted 11-10-2023 10:43

    we require a provider to be on site.  Our immunizations must be ordered by a provider as we don't have any age based order sets.  The allergy injections we are little more flexible with but a provider must still be in the building in case of a reaction. 



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    Ryan Taylor MSN, RN, CPN, NE-BC
    Director of Medical Practice Management
    Memorial Hospital and Health Care Center
    Jasper, Indiana
    812-996-8489
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  • 3.  RE: administering immunizations: provider presence

    Posted 11-10-2023 11:13
    Thank you! This is helpful!
     
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  • 4.  RE: administering immunizations: provider presence

    Posted 11-11-2023 08:16
    We always have to have a physician on site if vaccines are being administered. 

    Karen Hunter, BSN, R.N., AMB - BC







  • 5.  RE: administering immunizations: provider presence

    Posted 11-11-2023 09:02
    Do you have areas that provide virtual health where no provider is actually present (outside the monitor) but an MA rooms the patient?
     
     
    Kind regards,
    (C) (920)655.7795
     
     
    Carrie Lemke, DNP, RN, NPD-BC
    Nursing Professional Development-Specialist, Clinical Nursing Practice
    Midwest Region-Medical Group
     
    If you have a question for one of our partnering departments, please feel free to reach out directly. 
     
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  • 6.  RE: administering immunizations: provider presence

    Posted 11-11-2023 12:27

    You'd want to check with your State's scope of practice for Medical Assistants.  Here in California, a LIP (MD, DO, NP or PA) must be physically present when an MA is doing anything clinical.  That includes rooming patients and administering medications and vaccines.  The Public Health vaccine clinics in our area use RNs to vaccinate, even sending them with outreach teams to vaccinate with Hep A when rates are increasing.



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    Lisa Duncan, DNP, MBA, RN, AMB-BC, CIC, NEA-BC
    VP, Regulatory and Compliance
    Family Health Centers of San Diego
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  • 7.  RE: administering immunizations: provider presence

    Posted 11-13-2023 10:33

    Hello Carrie,

    The use of Nurse driven immunization protocols depend on what is approved by your state Nurse Practice Act and what your facility policy has defined and established. One article published on the CDC website includes a cross walk of state laws for immunizations:  State Law and Standing Orders for Immunization Services (cdc.gov) This article is from 2016 but it does include a cross walk for RN, LPN and UAP's. It appears there are opportunities to have an updated crosswalk exercise conducted again! The variation in the laws could potentially present a challenge to successful implementation of public health goals to improve immunization rates. Expanded authorization of SOPs, protocols or policy  in all states could increase health practitioners' ability to deliver recommended vaccines.

    Do you have Nurse Driven Immunization protocols developed and policy guidance established? Having RN driven protocols developed like the example shared by Immunize.org may be helpful to develop for your virtual immunization instances: p3074.pdf (immunize.org)  Staff may be trained on how to handle any reaction through competency assessment. If the provider is available virtually they still can assess and intervene it just would need to be written into your local policy. 

    V/R,



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    Jami Falk MS RN-BSN CNML
    VHA OPC PCMO Chief Nurse
    VHA
    Bismarck ND
    (701)367-5431
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  • 8.  RE: administering immunizations: provider presence

    Posted 11-13-2023 20:15

    Our RN's in school based health centers give vaccines without a provider present. In our primary care clinics they could technically....but a provider must be present for us to see any patients covered under CMS. So essentially, a provider must be present.  



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    Rebekah Sherman
    Director of Nursing
    La Clinica de Valle
    Medford OR
    (541)221-3040
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