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Infection Control guidelines for management
during Respiratory Pandemic
Respiratory Pandemic Sub Plan
Document ID CHQ-PROC-63330 Version no. 1.0 Approval date 19/08/2020
Executive sponsor Chief Finance Officer Effective date 19/08/2020
Author/custodian Infection Management and Prevention Service Review date 19/08/2023
Supersedes Nil
Applicable to All Children’s Health Queensland staff and persons, contractors and volunteers
Authorisation Executive Director Clinical Services QCH
Purpose
Children’s Health Queensland (CHQ) Infection control guidelines for Management during respiratory pandemic
procedure supports the strategic Pandemic Sub-Plan outlining infection prevention and containment measures
to be enacted during a sustained and significant public health event.
Scope
The aim of the CHQ infection management and prevention during respiratory pandemic is to provide an
effective infection prevention health response framework to contain and control the disease, as well as reduced
morbidity and mortality associated with a pandemic disease.
This procedure applies to all Children's Health Queensland staff, students, volunteers, consultants and
contractors.
Procedure
1. Definition
For the purposes of this procedure, a respiratory pandemic is defined as an epidemic of respiratory illness with wide geographical spread affecting large numbers of susceptible people, potentially world-wide. A respiratory pandemic can occur when a susceptible population experiences the emergence or introduction of a transmissible infectious organism. The most likely infectious organisms to cause a respiratory pandemic include novel strains of influenza or coronavirus.
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2. CHQ supports the prevention of a respiratory pandemic overseas or in
Australia by:
• Promoting seasonal influenza vaccination of all health care workers (HCW), volunteers and contractors.
• Promoting and advocating good personal hygiene measures to health care workers and the public e.g.
respiratory hygiene, cough etiquette, not attending public places and work when unwell. Refer to
Respiratory Hygiene Poster.
• Promoting the 5 moments of hand hygiene as the first and most important defence against transmission of
pathogens. Refer to 5 Moments of Hand Hygiene.
• Contributing to the state-wide influenza surveillance programs. This is achieved through the surveillance,
review and reporting of respiratory pathology specimens.
3. CHQ will prepare for a respiratory pandemic through ongoing:
• Development, maintenance, testing / exercising and review of this plan and;
• Provision of education for all HCW, contractors and volunteers related to:
- Personal Protective Equipment (PPE) use including P2 / N95 respirator masks when required.
- PPE donning and doffing. Refer to CHQ-PROC-63317 - Donning and Doffing of personal protective
equipment (PPE).
- Signs and symptoms of influenza like illness (ILI), notification of illness, exclusion from work when
sick and resuming work after illness.
- Pandemic awareness and readiness.
4. Control and Containment
Patients presenting / requiring admission to QCH who have confirmed, or suspected pandemic respiratory
illness are to be managed with appropriate transmission-based precautions in accordance with the following
procedures or new evidence for novel pathogens:
• CHQ-PROC-63210 - Admission Screening and Safe Patient Placement including Cohorting
• CHQ-PROC- 63110 - Standard and Transmission and Protective Based Precautions
• CHQ-PROC-63317 - Donning and Doffing of Personal Protective Equipment (PPE)
• CHQ-PROC-63002 - Infection Control Guidelines for the Management of Coronavirus (MERS, SARS or
Novel Coronavirus)
• CHQ-PROC-63005- Transport of a suspected and confirmed (MERS, SARS, SARS-CoV-2 or Novel
Coronavirus)
In the event of pandemic, organisms with high morbidity or mortality of disease such as avian influenza and
novel infectious organisms, Airborne Plus precautions may apply for inpatient settings. Specific requirements
may be advised by Queensland Health at the time of the pandemic. See applicable procedures for specific
organism transmission-based precautions requirements.
5. At Risk populations
As with historical ILI / respiratory pandemics, at risk populations may include those who are immunosuppressed
and / or have chronic lung disease. Additional at-risk groups may be identified by State or National
bodies/organisations when specific novel organisms are circulating in the population.
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6. Establishment/functioning of Fever Assessment Clinics
See Appendix 5 Fever Clinic Checklist for clinic equipment.
Fever assessment clinics (also known as fever clinics) are designed to relieve the diagnostic burden on
hospitals and reduce the risk of disease transmission to vulnerable populations. This is achieved by triaging,
assessing and providing treatment (if appropriate) to individuals with ILI who are not in need of emergency
care. This process enables the Emergency Department (ED) to continue to provide clinical services to non-
influenza like illness and critically ill patients.
The role of fever assessment clinics are to:
• Assess, treat and refer suspected, probable or confirmed cases of respiratory pandemic / pandemic
influenza and novel organisms.
• Reduce the impact on scarce health resources through use of a controlled triage system.
Initiate isolation and/or quarantine for suspected, probable or confirmed cases and household contacts.
CHQ will establish a fever clinic on the direction of the State Health Coordinator or as deemed necessary by
the CHQ Health Emergency Operation Centre (HEOC). The specific timing of opening and operating a Fever
Clinic, and the capacity to maintain regular services in the ED when the clinic is closed, will be determined by
the HEOC in consultation with the ED. Consideration must be given to State/National priorities including the
need for fever assessment clinics within the community.
All staff, volunteers and contractors working in the fever assessment clinic must:
• Be screened to ensure they do not have high risk factors such as chronic lung disease, pregnancy,
immunosuppression. Staff identified with high risk factors should not be employed in a fever clinic. For
COVID-19 refer to Vulnerable Staff Guideline.
• Have completed the online Personal Protective Equipment (PPE) donning and doffing education (these
competencies are recorded on CHQ TeachQ+)
• Be competent and confident in donning and doffing PPE.
• Be able to perform ongoing risk assessments to determine the required PPE.
• Be able to perform their own fit check.
• Remain bare below the elbow.
Suggested staffing for Fever Assessment Clinics include (Dependent on size and scale of pandemic):
• Nursing Controller - a senior nurse team leader.
• Registered Nurses – 1-3 per shift.
• Medical Controller – an appropriate medical officer to coordinate triage and assessment. (Dependent on
size of the clinic)
• Administration Officer –to provide administration support.
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Support Staff – the Fever Clinic may also be manned with additional ED staff or staff from areas stood down
from regular activities as a result of the pandemic response. (Dependent on size of the clinic)
Access to additional staff as required (Dependent on size of the clinic):
• Radiographer
• Operational officers
• Security officers may be required.
Operational support services, as provided to ED and outpatient services, will be required by the Fever
Assessment Clinic. Therefore, on commencement of a Fever Assessment Clinic the Executive Director of
Clinical Support and the Operations Manager - Division of Clinical Support should be notified to advise axillary
services of the requirements– i.e. Porterage, food services, cleaning, waste and linen services.
6.2 Fever Assessment Clinic Patient Flow
Patient flow through the fever assessment clinic should include:
• Triage, streaming and prioritising of patients, including those who require immediate transfer into ED
• Determining which patients are appropriate for the clinic based on a standard set of questions
• Collection of demographic, epidemiological and clinical data;
• Patients not requiring admission may be provided with, as indicated:
- pandemic information for patients; and / or
- advice regarding quarantine and follow up
- treatment such as anti-viral medications (As applicable)
- vaccine if available
6.3 Fever Assessment Clinic Location
A fever assessment clinic location to accommodate an assessment and/or isolation zone/s should be
established with guidance from the Emergency Leadership Team. At present for COVID-19 there is a fever
assessment clinic located in the CCHR building for children and their families, QCH staff members with
symptoms of COVID-19.
6.4 Patient presentation and assessment
The following principles or actions are required to manage the presentation and assessment of patients who
have confirmed or suspected pandemic respiratory illness.
• Clear signage along with an appropriate staff member to be in place to advise and direct
• All patients presenting with ILI / respiratory pandemic symptoms should be provided with a
surgical/procedural mask and directed to perform hand hygiene prior to further assessment
Note: surgical/procedural masks should not be placed out for public use, they should be distributed by
Nursing or Admin staff as required.
• If there is a shortage of PPE, educate patients and families of good hand hygiene and appropriate respiratory
and cough etiquette. Refer to Respiratory Hygiene Poster.
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• Emergency departments should have in place a plan for managing infectious patients on presentation
including:
- separate waiting area e.g. cohort suspected / confirmed ILI patients in the internal waiting room and
non-suspected confirmed ILI patients in the reception area waiting zone. NB: ED to incorporate a
strategy into their pandemic response plan.
- specific isolation rooms - initially orange zone can be utilised but when patient numbers extend
beyond this capacity, consider utilising the extension of the ILI zone waiting room in the ambulance
bay.
- dedicated staff (where possible) to be assigned to assess suspected cases.
- carefully consider placement of patients who require use of nebulisers and / or delivery of high flow
oxygenation as this increases the risk of dispersal / transmission of ILI e.g. utilise ED orange zone
negative pressure rooms or rooms where the door can be closed to prevent air flow out of the area
for the use of this patient group or alternative areas of the hospital where air circulation and return
air flow can be minimised.
- TL / NUM to review patient allocation each shift to ensure:
▪ high risk staff (e.g. pregnant, immunocompromised) are not allocated to suspected /
confirmed ILI patients
▪ staff have the skills to care for patients with ILI/novel infections and are confident and
comfortable to do so.
- In the event of a resuscitation in orange zone equipment can be taken immediately from the
emergency trolley on a tray and into the room by a runner. This prevents the trolley having to come
into the room and potential contamination of trolley contents.
- Adrenaline is kept on the trolley and all other drugs are in a pack in the green zone medication
room, and all other emergency drugs are in a specific pandemic drug pack stored in the green zone
medication room”. There is a full range of IV equipment and pathology tubes.
• Specific procedures for assessment, testing and notification of respiratory pandemic / pandemic influenza
are usually guided by QLD Health based on known / suspected organisms. In the paediatric population this
is likely to include nasopharyngeal aspirate (NPA) / nasal swab specimen collection. For testing
recommendations for Coronavirus see CHQ-PROC-63002 - Infection Control Guidelines for the
Management of Coronavirus (MERS, SARS or Novel Coronavirus).
• Specific procedures for management of cases, especially with regard to use of nebulisers/aerosol
generating procedures are usually guided by QLD Health based on known / suspected organism.
• Specific procedures for movement of patients within the facility may be advised by QLD Health. As a
minimum CHQ procedures should be followed regarding quarantining of patients in transport lifts etc.
The Australian College for Emergency Medicine (ACEM) has published guidelines for the Management of
Respiratory Disease Outbreaks including Severe Influenza, Pandemic Influenza and Emerging Respiratory
Illness to provide guidance to emergency department staff at all levels in managing severe seasonal and
pandemic influenza and other emerging respiratory illnesses.
Refer to the Pandemic Sub plan for divisional flow considerations and capacity, fluctuation will occur between
phases 1, 2 and 3 as surge and demand fluctuates. As the demand changes ensure capability and scalability
are considered to allow for increased capacity.
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7. General principles
7.1 Precautions
• Appropriate transmission-based precautions are recommended to be applied to all suspected or confirmed
cases of pandemic influenza.
- Use the Personal Protection Equipment Flowchart outlining the appropriate precautions for the level of risk.
- Contact Droplet precautions, or Contact droplet and eye protection, or Airborne Plus precautions are recommended for all suspected or confirmed cases of novel pandemic respiratory illness in accordance with the following procedures and as advised by any current Queensland Health guidelines at the time:
▪ CHQ-PROC-63210 - Admission Screening and Safe Patient Placement including Cohorting
▪ CHQ-PROC-63110 - Standard and Transmission and Protective Based Precautions ▪ CHQ-PROC-63317 - Donning and Doffing of Personal Protective Equipment (PPE) ▪ CHQ-PROC-63002 - Infection Control Guidelines for the Management of Coronavirus
(MERS, SARS or Novel Coronavirus) ▪ CHQ-PROC-63005- Transport of a suspected and confirmed (MERS, SARS, SARS-
CoV-2 or Novel Coronavirus)
7.2 Room Allocation
• In the event of a respiratory pandemic, there will be an increased demand for isolation rooms. Suspected
or confirmed cases should be placed in negative pressure room as a first preference. Suspected or
confirmed cases should be placed in a single room with the door closed, if negative pressure room is
unavailable. Refer to Appendix 2 - QCH Negative Pressure Rooms.
• If a single room is not available, refer to Cohorting section 8.3 of this procedure.
- TL/NUM to review patient allocation each shift to ensure high risk staff (e.g. pregnant, immunocompromised) are not allocated to suspected / confirmed ILI patients and to ensure staff have the skills to look after the patient and are confident and comfortable to do so. Refer to COVID-19 Vulnerable employees.
- The number of persons entering the cohorted area should be limited to the minimum number necessary for patient care and support e.g. restrict volunteers, education staff and entertainment staff. Refer to CHQ-PROC-64712 - Visitation and Access during COVID-19 Pandemic Period.
- Limit patient transport by having necessary equipment (e.g. portable X-ray) available in cohort areas.
- If transfer within the facility or transport to another facility is necessary, appropriate transmission-based precautions should be maintained.
- Quarantine the lift 17 or 18 for patient transport. Refer to routes of transport.
- Staff allocated to these patients should have completed their Donning and Doffing training and be recorded on Teach Q +.
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7.3 Patient movement, transfer and retrieval
Plan patient transfer to limit exposure to others:
• See Appendix 3 for Routes of Transfer
• Staff to wear PPE in line with recommendations for the pandemic organism. CHQ will develop guidelines
for specific pathogens/pandemics as they emerge. Please review those on the Gov e-Catalogue.
• Where tolerated, patient to wear a surgical/procedural mask if not intubated or on oxygen therapy and
maybe we should say
• Quarantine lift 18 or 19 for patient transfer between floors
• Clear corridors / passages for patient transport
• Where possible restrict patient movement and transfer e.g. arrange for services in the patient room such as
mobile X-ray.
• For COVID-19 and transport of a patient view CHQ-PROC-63005 – Transportation of suspected and
confirmed (MERS, SARS, SARS-CoV-2 or Novel Coronavirus
8 Infection Management and Prevention Considerations
8.1 Pathology specimens and specimen collection
• Advice may be provided by National / State bodies regarding specific pathology specimens indicated and
any specific requirements regarding collection and / or transport.
• CHQ will develop guideline for specific pathogens/pandemics please review those on the e-catalogue
• Unless advised otherwise, nasopharyngeal swabs are the specimens of choice.
• Nasopharyngeal aspirates should only be collected by experienced staff with the appropriate equipment
and training to minimise any risk of production of aerosols. This is especially important when a new strain
with pandemic potential has emerged.
• As surveillance information becomes available, testing requirements may be modified according to disease
characteristics and the capacity of the health system.
If rapid review of specimens is required, CHQ Infection Management and Prevention Commander and / or
Controller should be advised and can then liaise with laboratory staff or establish processes to ensure this is
facilitated.
Standard methods of transport of specimens will suffice unless Queensland Pathology / CDIM / PHU advise
an alternative method. In this case, consultation with these agencies regarding transport is required.
ALERT
All GeneXpert testing must have approval by the Infectious Disease Consultant On Call before
ordering.
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8.2 Personal Protective Equipment
• CHQ nurses in the target areas for accommodation of patients requiring isolation are responsible to maintain
proficiency in pandemic preparedness and PPE donning and doffing and to oversee the donning and doffing
of other healthcare workers attending to / visiting the patient
• Where the patient is accommodated in a room with an anteroom, PPE should be donned and doffed in
accordance with the appropriate precautions poster.
• If a patient is not in a negative pressure room, then PPE removed in the room as per the poster and the
mask outside of the room in the hallway. The HCW should treat the hallway as an anteroom to remove the
mask.
• Additional supplies of PPE can be obtained from the pandemic emergency PPE supply storage (Level B3
lift-well). Access is restricted to security, specified porters, patient flow managers, IMPS nurses and safety
CNCs.
• Queensland Health (QH) has an additional stockpile of personal protective equipment (PPE) to be used in
the event of state and national significance e.g. pandemic.
• The QLD pandemic stockpile includes: P2 / N 95 masks, surgical masks, long sleeved gowns and goggles.
• The authority to release the QH emergency PPE stockpile to other Queensland Health distribution centres
and Queensland Health Public Hospitals sits with the Chief Health Officer (CHO).
• In times of PPE shortages a PPE rationalisation instruction may be implemented to conserve supplies.
Actions in this will depend on the pathogen and modes of transmission. Refer to specific organism guidelines
Eg:
- Personal Protective Equipment (PPE) Rationalisation within CHQ - COVID-19
Refer to PPE advice on the staff portal for Donning and Doffing videos and posters
Contact and Droplet Eye Precautions PPE Sequence
Before Entering Room Before Leaving Patient Room
• Perform HH
• Put on apron/gown
• Put on surgical mask/face shield
• Dispose of gloves
• Dispose of Eye protection *
• Dispose of apron/gown
• Perform HH
• Dispose of mask and face shield/goggles
• Perform Hand Hygiene
After Entering room
• Perform HH
• Put on gloves
• *Gown can be removed before eye protection if desired either option of removal is safe.
Airborne Plus Poster for confirmed or critically ill patients or when performing AGP. Refer to Table 2 for list of AGPs.
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Airborne Plus Precautions PPE Sequence (Pandemic Respiratory Infections)
Before any CHQ staff member can don PPE to enter a How to fit check a P2 / N95 mask patient room
with Airborne Plus Precautions in place, the following steps must be taken:
• Face must be clean shaven, hair tied back.
• All objects removed from pockets and uniform (e.g. pens, phone, ID badge).
• Complete cover of all skin surfaces / hair is not required (unlike Ebola PPE as below).
• Have an observer to check correct application of N95/P2 mask prior to room entry. Completion of written
PPE checklist not necessary. Ensure you write your name on the staff log on the door.
In the Anteroom Room Before Leaving Patient Room After Leaving Patient Room
(In Anteroom)
• Perform HH
• Put on gown
• Put on N95/P2 mask and
perform fit check
• Put on eyewear/face shield
• Put on gloves, ensure the
gloves go over the cuffs of the
gown
• Dispose of gloves
• Perform HH
• Dispose of eyewear/ face
shield *
• Perform HH
• Dispose of gown
• Perform HH
• Perform Hand Hygiene (as you
have touched the door handle)
• Dispose of Mask
• Perform HH
*Gown can be removed before eye protection is desired either option of removal is safe.
ALERT
If an emerging or pandemic respiratory illness, an observer is desirable to check that N95/P2
mask has been applied correctly before the staff member enters the patient room.
Additional information
• Hand hygiene should be undertaken in accordance with the 5 moments for hand hygiene.
• Gloves should be changed if they become torn or heavily contaminated.
• Gowns should be changed if they become soiled.
• If re-useable PPE is used such as goggles, these must be cleaned and disinfected prior to re-use. Staff
must be trained in this process. Prescription glasses are not a substitute for goggles.
• Patient notes / charts should be kept outside the patient room.
• Pens / paper should be provided in the room and remain in the room.
• Patient equipment such as stethoscopes and sphygmomanometers should remain in the patient room.
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8.3 QCH nominated inpatient accommodation (Cohorting)
Cohorting
Confirmed cases
Cohorting of confirmed cases of a pandemic organism must only be undertaken following consultation with
local experts, such as infectious diseases physicians and IMPS. Where practicable, managing patients with
mild illness in their own home is the preferred approach rather than cohorting patients.
Cohorting patients who are infected with a pandemic organism confines their care to one area and prevents
contact with other patients.
The following principles apply when making decisions about patient placement:
• Unrelated COVID patients must be in a single room and must not be cohorted. Cohorting places families
and caregivers at significant risk.
• Siblings can be cohorted, however 1.5 meters must be maintained between each person. This is taking into
account the risk of other pathogens.
• Confirmed cases of the confirmed pandemic organism take priority over other conditions requiring contact
and droplet precautions. Consult with the IMPS for other diseases/presentations requiring isolation.
• Prioritise patients who have severe pneumonia symptoms for placement in single rooms with negative
pressure air handling.
• Care should be taken to ensure that confirmed pandemic organism cases co-infected with influenza are not
cohorted
ALERT
Unrelated COVID patients must be in a single room and must not be cohorted.
Siblings may be cohorted, however 1.5 meter spacing is required between patients.
Suspected cases
The decision to cohort suspected cases needs to be taken following consultation with local experts, such as
infectious diseases physicians and IMPS. Cohorting suspected cases is not recommended.
See applicable DisMAP for applicable plans for each area for patient placement. DisMAP can be located in
CHQ-PROC-63326 – Respiratory Pandemic Sub Plan.
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Table 1 - Mask Considerations
**Mask considerations when are applicable when there is a shortage or advised by IMPS***
Mask considerations in pandemics with PPE
restrictions and availability
Infection Cohort with Infants <12 months of age Children >12 months of
age
RSV RSV or HMPV No Mask Required
Unless AGP**
No Mask Required
Unless AGP**
Parainfluenza 1,2,3 Parainfluenza 1,2,3 No Mask Required
Unless AGP**
No Mask Required
Unless AGP**
HMPV RSV, HMPV, respiratory
adenovirus (and vice versa)
No Mask Required
Unless AGP**
Surgical Mask* Required
Mycoplasma
Pnuemoniae
RSV, HMPV, respiratory
adenovirus (and vice versa)
No Mask Required
Unless AGP**
No Mask Required
Unless AGP**
Influenza A, B Influenza A, B – do not cohort with
other resp viruses
Surgical Mask required * Surgical Mask required *
SARS-CoV-2
(COVID-19)
COVID-19-COVID-19 - do not
cohort with other resp viruses
Surgical Mask* required
N95/P2 Masks are required
for AGP or prolonged
contact
Surgical Mask* required
N95/P2 Masks are required
for AGP or prolonged
contact.
*If surgical mask is not available then ASTM level 1 procedure mask is acceptable in severe shortages for
droplet pathogens excluding SARS CoV-2. ASTM level 2 procedure mask is an acceptable alternative in
emergent situations for all droplet pathogens.
**AGP – Aerosol Generating Procedure (AGP): Refer to Table 2.
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Table 2: Aerosol generating procedures in paediatrics (with highest risk procedures listed first)
High Risk of Generating Aerosols Potential risk of generating aerosols Low risk for generating
aerosols
• Insertion or removal of endotracheal tube
• Intentional or inadvertent disconnection/reconnection of closed ventilator circuit
• High frequency oscillatory ventilation
• Open oropharyngeal or tracheal suctioning
• Bronchoscopy/BAL
• Nasendoscopy
• Tracheostomy change/open suction
• Intercostal catheter insertion
• Thoracic surgery that involves entering the lung
• Surgery with exposure of respiratory mucosa
• Invasive dental surgery
• High flow nasal oxygen
• Manual or non-invasive ventilation (CPAP, BiPAP)
• Collection of induced sputum
• Transoesophageal echocardiography
• Nebulised medication
• PEP and oscillating PEP devices
• BubblePEP
• Manual hyperinflation
• Positioning/gravity assisted drainage techniques and manual techniques (eg expiratory vibrations, percussion, manual assisted cough, intra/extra pulmonary high frequency oscillation devices)
• Positive pressure devices/PEP techniques
• Air enema reduction of intussusception
• Nitrous oxide
• Removal of nasal foreign body
• Insertion of a nasogastric tube
• Respiratory function tests
• Prolonged and high volume sound stimulation exercises
• Nasal application of barium
• High intensity exercise
• Coughing
• Sneezing
• Collection of a nasopharyngeal swab
8.4 Antiviral management (when applicable)
• Antiviral medications can be used for the treatment of symptomatic cases and prophylaxis of exposed
contacts. Treatment with antivirals aims to reduce signs and symptoms in individuals and hence lower
morbidity and mortality.
• Prophylactic use of antivirals aims to reduce the risk of infection and illness in contacts, potentially lowering
the spread and hence disease attack rate.
• The strategy for the use of antivirals will depend on stage of the pandemic, the epidemiology (transmissibility
and clinical severity) and virological (antiviral resistance) characteristics of the virus, pre-existing immunity,
vaccine availability and practicalities such as logistics of antiviral delivery and availabil ity (Australian
Department of Health 2014).
• In the event of a pandemic, the Communicable Diseases Network of Australia (CDNA) will provide
information outlining the strategy and use of antivirals (Australian Department of Health 2014).
• During a pandemic there may be rationed or restricted use of antivirals in Australia. The CNDA will advise
regarding use of prophylaxis.
• The CHQ medication advisory committee should be consulted to approve the use of a standing order for
antivirals if not already governed by instruction from Queensland Health.
8.5 Vaccine management (When applicable)
• Queensland Health Immunisation Program (QHIP) in coordination with Queensland Health Central
pharmacy will authorise the use of pandemic influenza / respiratory pandemic vaccine if and when available
during a pandemic response.
• Vaccine ordering, storage, cold chain management and distribution should be managed by CHQ pharmacy.
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8.5.1 Public Mass Vaccination Clinic (When applicable)
• If a mass vaccination clinic response is required, use of existing services within the community (e.g. GP)
will be the primary method to provide the pandemic vaccine to the public.
• In addition to these community-based services, on the request of the State Health Incident Controller, HHSs
shall be required to contribute to the mass vaccination of target groups within Queensland
• Queensland Health Chief Health Officer and / or local public health unit (MSHHS PHU) may request CHQ
to establish a mass vaccination centre for paediatric patients and their families. The establishment and
commitment of resources is at the discretion of the CHQ Health Incident Controller.
8.5.2 CHQ Staff Assessment and Vaccination Centre
• The Incident Controller should consider the establishment of a CHQ Staff Assessment and Vaccination
Centre for the distribution of antivirals and vaccinations.
• Staffing considerations should include: a medical officer, immunisation nurse, supporting general and
immunisation nurses and administration staff.
• The CHQ Staff Immunisation Database can be utilised by IMPS nursing staff to record immunisation of staff
receiving pandemic respiratory / influenza vaccination and / or antiviral therapy.
• The incident controller should consider the need to be establish mobile immunisation clinics to deliver
vaccination to “at risk” clinical staff.
• A standing order may be provided by Queensland Health or CHQ Medicines Advisory Committee
(CHQMAC) to allow RNs to administer vaccinations and / or dispense antivirals.
• Guidance is provided at Appendix 5 CHQ staff mass immunisation clinic guide.
8.6 Handling of the deceased
• The risk of respiratory / pandemic influenza infection from deceased persons is low and is minimised using
infection control precautions.
• All staff handling persons who have died while infectious with pandemic / respiratory influenza should follow
the appropriate transmission-based precautions for the pathogen.
• Some high-risk procedures such as embalming and autopsy may require a higher level of PPE to be worn.
These do not occur at QCH.
• If demand for body storage extends beyond QCH capacity, there is a service level agreement with Mater
Public Hospital to provide deceased person storage prior to transfer to funeral home facilities.
• A death due to a pandemic will generally not require reporting to the coroner. Refer to Department of Justice
and Attorney-General for further information form the Coroners court of Queensland where necessary.
• For specific consideration regarding care of the deceased COVID-19 patient visit CHQ-PROC-63002
Infection Control Guidelines for the Management of Coronavirus (MERS, SARS, SARS-CoV-2 or Novel
Coronavirus)
Supporting documents
• Queensland Health Pandemic Influenza Plan
• Australian Health management plan for pandemic influenza (AHMPPI)
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• QH Drug therapy protocol – Pandemic influenza Program
• Australian Immunisation Handbook - Influenza
Resources
• CDNA National guidelines for public health units.
• The Australian College for Emergency Medicine has published guidelines for the management of Severe
Influenza, Pandemic Influenza and Emerging Respiratory Illnesses in Australasian Emergency
Departments
• Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19)
Procedures
• CHQ-PROC - 63110 Standard and Transmission and protective based precautions
• CHQ-PROC-63210 Admission Screening and Safe Patient Placement
• CHQ-PROC- 63505 Hand Hygiene and Bare Below the Elbow
• CHQ -PROC-62420 Code Brown External Emergency/ Disaster
• CHQ-PROC-63317 Donning and Doffing of Personal Protective Equipment (PPE)
• CHQ-PROC-63002 Infection Control Guidelines for the Management of Coronavirus (MERS, SARS,
SARS-CoV-2 or Novel Coronavirus)
• CHQ-GDL- 63327 -The Management of children with COVID-19
• CHQ-PROC-63326 – Respiratory Pandemic sub plan
• CHQ-PROC-64712- Visitation and access during COVID-19 pandemic-period
• CHQ-PROC-24703 -Special measures during the COVID-19 pandemic period.
• CHQ-WI-63324- Medirest cleaning and waste removal (PICU)- COVID-19
• CHQ-WI-63321 – Medirest Food Services Guide COVID-19
• CHQ-WI- 63322- Medirest Linen Guide – COVID-19
• CHQ-WI-63320 – Medirest Transport Guide - COVID-19
• CHQ-WI- 63319 – Medirest Cleaning and Waste Removal (Emergency and ward) -COVID-19
• CHQ-WI-63323 – Personal Protective Equipment (PPE) rationalisation within CHQ – COVID-19
• CHQ-WI- 64713 - Screening controls for visitation and access during COVID-19 pandemic period
• CHQ-PROC-63005 – Transportation of suspected and confirmed (MERS, SARS, SARS-CoV-2 or Novel
Coronavirus
Staff Resources
• Please visit the staff portal for details information about PPE and general IMPS information for staff.
• COVID-19 Personal Protection Equipment (PPE) Requirements for OPD and ED Assessment and Clinical
procedures.
• COVID-19 Personal Protection Equipment Flowchart
• COVID-19 Masks and uses
• COVID-19 Risk screening flowchart (Inpatient/Outpatient)
• All COVID-19 screening outside of emergency
• COVID-19 Personal Protection and Equipment chart guide
• CHQ-PROC-63002-1- Staff personal log for suspected or confirmed high risk cases of coronavirus
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Legislation
• Work Health and Safety Act Qld 2011
• Disaster Management Act Qld 2003
Consultation
Key stakeholders who reviewed this version:
• Director of Infection Management and Prevention Service
• IMPS Committee
• Clinical Nurse Consultant, Infection Management and Prevention Service
• Executive Director Medical Services
• Executive Director Clinical Services
• Director Strategy and Planning
• Executive Director Legal, Governance and Risk
• Disruption and Disaster Emergency Management Project Officer
• Nursing Director Clinical Support
• Nursing Director Critical Care
• QCH Emergency Management Working Group
• PICU Leadership
• Division of Medicine
• Medirest management
Audit/evaluation strategy
Level of risk High
Strategy The Infection Management and Prevention Service (IMPS) team will evaluate the management of the cases and make recommendations to the Disaster Management
Committee for future events.
Audit/review tool(s)
attached
Nil
Audit/Review date Annually
Review responsibility CNC. Infection Management and Prevention
Key elements /
Indicators / Outcomes
Management of all cases will be evaluated, and recommendations made to the emergency
management committee.
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Procedure revision and approval history
Version No. Modified by Amendments authorised by Approved by
1.0
19/08/2020
CNC, IMPS Divisional Director, Division of
Clinical Support
Executive Director Medical
Services
Keywords Pandemic, respiratory, influenza, flu, ILI, code brown, sub-plan, external emergency, 63326,
Coronavirus, COVID-19, 63330
Accreditation
references
NSQHS Standards (1-8): Standard 1 and 3
ISO 9001:2015 Quality Management System (4-10)
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Appendix 1 - P2/N95 respirator – how to perform a fit check
How to fit check a P2 / N95 mask
Fit checking is required to check your safety each time you don a high particulate mask (N95).
Two types of checks must be performed prior to patient room entry:
Negative Pressure Positive Pressure
The wearer inhales sharply. The mask should be drawn in to the face. If air can be drawn into the mask it will not
collapse. This indicates that the seal has failed. You need to reposition the mask and
perform the check again.
The wearer huffs or exhales sharply. Air should not be felt leaking around the edges of the mask. This indicates that
the seal is not adequate. Reposition the mask and perform the check again. The wearer should not feel any air leak between the mask and face. This is the
sign of a good face - mask fit, and a successful Fit Check.
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Appendix 2 - Negative Pressure rooms within QCH
Room and Ward Room Number Room Description AHU Location
Positive / Negative
Bed 1 - Orange Zone 01.2.262 Isolation Bed 1 02.2.285 Negative
Bed 2 - Orange Zone 01.2.265 Isolation Bed 2 02.2.285 Negative
Bed 3 - Orange Zone 01.2.322 Isolation Bed 3 02.2.285 Negative
PICU Bed 5 04.1.062 PICU Bed 5 05.3.502 Negative
Ward 9A - Bed 20 09.1.001 Medical Ward Bed 20 09.2.302 Negative
Ward 9B - Bed 15 09.4.812 Babies Ward Bed 15 09.4.801 Negative
Ward 9A - Bed 5 09.3.594 Medical Ward Bed 5 09.3.523 Negative
Ward 9B - Bed 1 09.2.262 Babies Ward Bed 4 09.2.302 Negative
Ward 9A - Bed 11 09.3.514 Medical Ward Bed 11 13.1.005 Negative
Ward 9A - Bed 10 09.3.534 Medical Ward Bed 10 13.1.005 Negative
Ward 9A - Bed 15 09.1.042 Medical Ward Bed 15 13.1.005 Negative
Ward 10A - Bed 20 10.1.001 Surgical Ward Bed 20 10.2.325 Negative
Ward 10B - Bed 22 10.4.842
Cardiac/Oncology Ward
Bed 22 10.4.772 Negative
Ward 11B - Bed 20 11.4.856
Oncology & Bone Marrow
Ward Bed 20 11.4.772 Negative
Ward 11A - Bed 5 11.3.581 Neurosciences Ward Bed 5 11.3.525 Negative
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Appendix 3. - Routes of transfer of a patient with confirmed or suspected
Coronavirus or pandemic Influenza
Lifts for use
How to call Lift 19 instructions:
Call security with ETA to isolate Lift 19, meet at arrival point and assist with quarantine of route used to move
patient throughout QCH to destination
Location of lifts 18 and 19
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ED to Lift 18 or 19 and CHQRS/Helicopter Landing services route Lift 19 to ED isolation rooms.
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PICU discharges to 9A (Lift 18 or19 to 9A rooms) and DEM transfers to 9A (Lift 18 or 19 to 9A
rooms)
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PICU and Thearter/PACU
Route to be used for:
Staff lifts/Lift 19 to Theatre/PACU
Theatre/PACU to Staff lifts/Lift 19
Staff lifts/Lift 19 to PICU directly.
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PICU admissions (includes MET calls) from ED, QCH inpatient wards or CHQRS (Lift 19 to
Riverside PICU) and PICU discharges to inpatient wards (PICU to Lift 19)
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Appendix 4 - Theatre Plan - Management of patients with High Risk or confirmed
Pandemic respiratory organism
• Patients with highly suspected or confirmed coronavirus are to be treated in Operating Room (OR) 14 only. In the
event the patient is a Cardiac patient theatre 7 is used, Cath lab patient Theatre 10 or MRI patient. the intraoperative
MRI room is used. In the event of two coronavirus patients occurring simultaneously theatre 5 is to be used as an
alternative.
• All items not required for use must be removed from the theatre before the patient’s arrival.
• OR staff who are immunocompromised cannot participate in direct patient care of patients with suspected or confirmed
coronavirus. Refer to COVID-19 Vulnerable employees guideline.
• The OR Wardman, anaesthetist and two anaesthetic assistants will attend the ward, obtain handover of the patient
and transport them to OR 14. Parental escort will only be considered in exceptional circumstances on a case by
case situation.
• The OR team will ensure any parent accompanying the child is wearing appropriate Airborne plus precautions prior
to leaving the ward. Parents must also wear a surgical/procedureal mask. If the patient is old enough and not on
oxygen therapy they are to don a surgical/procedural mask.
• OR staff must don PPE which includes:
- Long sleeved yellow gown
- Duck bill mask (if this is ill fitting a filter mask can be used)
- Face shields or goggles
- Gloves
- Hair must be protected under a disposable hat
• The PPE trolley is to remain in theatre 14’s induction room with a yellow rubbish bin.
• The patient is to enter OR 14 via the scrub area and brought straight into the OR.
• The patient is to be anaesthetised in OR 14. Induction room 14 is not to be used.
• While a case is underway, one staff member must remain outside by the infection control trolley as a ‘runner’ in OR
14’s induction room. If equipment or consumables are required, the team inside the OR must ask the outside scout
nurse to collect it on their behalf. It is handed to the team inside the OR at the induction room doorway.
• While a case is underway, signage will be placed on all doors external to OR 14 indicating ‘no entry – enter via
induction room door only’.
• Single use anaesthetic equipment must be used where available. The anaesthetic circuit and associated filters must
be discarded at the end of the case and the rubbish bin sealed. Reusable anaesthetic equipment must be immediately
sent down to CSU for reprocessing with used instrumentation.
• Staff entering OR 14 must sign the Health Care Worker staff Log (lives on infection control trolley). Staff are to don
PPE as per the procedure and then to enter OR via the OR 14 induction room and leave via the scrub sink area. Staff
must be competent and PPE donning and doffing and have it recorded on Teach Q +.
• All patients are to be recovered in OR 14. Once ready for discharge, the ward is contacted to come collect the patient
for return to the ward.
• One ORS staff member (with fully donned PPE) must meet ward staff at the staff lifts and escort them to OR 14.
Handover will be given IN the OR.
• Staff in the room are to clean the anaesthetic trolley and any equipment, and trolleys within the room following the
patients departure
• The used instrument transportation trolley must be brought to door of the theatre and instruments placed directly
inside the trolley. The trolley must be closed, and a Covid-19 sign applied to front of the trolley prior to being sent to
CSU for decontamination and re-sterilisation as soon as possible. The CSU team leader must be notified.
• Staff must remove all PPE within the induction room(following the Airborne plus signage).
• Once all PPE has been discarded, the bin must be tied off.
• Hand hygiene must then be performed.
• Cleaners who enter OR 14 to clean the theatre after use must also sign the staff log form. An orange clean must be
performed.
• Cleaners to clean all items in the room.
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Appendix 5 - CHQ staff mass immunisation clinic guide
CHQ staff mass immunisation clinic
Purpose
CHQ will conduct immunisation clinics for staff, students, volunteers and CHQ contractors for the
administration of vaccines in the following circumstances:
1. Respiratory pandemic / pandemic influenza like illness (ILI) where a vaccine is available.
2. Outbreak response where a vaccine is available.
Scope
This work instruction applies to CHQ staff, contractors and volunteers.
Instruction
CHQ will conduct immunisation clinics as on-site mass vaccination clinics within QCH and mobile clinics to
service CHQ community sites. Mass vaccination of health care workers will occur in line with the Australian
Immunisation Handbook and the Queensland Health Guideline: Vaccination of Healthcare Workers.
Roles, responsibilities and staffing
The preferred option is that the clinic lead will be a CHQ credentialed Immunisation Program Nurse (IPN).
Suggested staffing profiles are provided below under Staffing Requirements. As this is a mass vaccination
clinic staff for vaccination clinics should not be drawn from specialist services such as Emergency Department,
Intensive Care Units or Infection Control Units. It is suggested that staffing options are drawn from casual nurse
pools, agency and low acuity areas as services allow, minimising disruption to business as usual. Child and
Youth Community Health Service (CYCHS) has a cohort of IPNs who may be able to be utilised in pandemic
and outbreak situations.
Workflow design for a mass vaccination clinic
Clinical flow through a mass vaccination clinic should be organised to maximise throughput and minimise
waiting times. To facilitate efficient and safe administration of vaccine in a mass vaccination clinic, consider
the following:
• Clinic layout should promote a unidirectional flow of clients through the clinic (with side diversions for those
who are not processing quickly).
• Queue management systems should be in place. For example:
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- ticket controlled system to identify a person’s place in the queue.
- rigorous marshalling of individuals to prevent straying to improve efficiency and throughput.
- movable physical barriers could be used to delineate routes for clients to follow from station to
station.
Suggested stations in a mass vaccination clinic
Station Staffed by Functions / considerations
Entrance Security & greeter Large front entrance to reduce bottleneck effect.
Reception Administration officers (AOs)
Large reception area to reduce bottleneck effect.
Queue management process (e.g. ticket system) commenced.
Identify people who present with influenza like illness (ILI) and segregate them. Vaccination may or may not still be indicated. If
proceeding to vaccination – remain segregated for the duration of their clinic visit.
Clients given written information on the vaccine and side effects, a one-page medical questionnaire and / or pre-vaccination checklist
and consent form.
Clients advised to present completed consent forms to pre-vaccination assessment station.
- Note: clients should be given the opportunity to ask questions at the pre-vaccination assessment station prior
to completing the consent form.
Waiting area Volunteers and Queensland Health
staff.
Located next to reception area.
Clients to read information sheets & complete personal details / consent form.
Covered waiting area with adequate seating.
Toilets and hand washing facilities.
Drinking water available.
Management of clients who become unwell whilst waiting.
Public address system, preferably visual and audio, used to indicate next client to present to pre-vaccination area.
Pre-vaccination assessment
AOs, Registered Nurses (RNs), IPN
Answer any client questions prior to vaccination.
Clients’ eligibility for vaccination including contraindications and pre-vaccination checklist assessed. Eligible clients are directed to the pre-vaccination waiting area.
Clients not eligible or contraindicated for vaccination are counselled Clients who are acutely febrile (≥38.5°C) or show signs of systemic illness will need to be clinically assessed and referred. Adults may
need to be referred to an adult facility / GP.
Clinical queries addressed at this point.
AO role: Collation of completed forms and assessment.
Appropriate Storage of vaccines
Immunisation Program Nurse / RNs
Vaccines must be stored according to the current National Vaccine Storage Guidelines.
Appropriate equipment should be available to store and maintain the temperature of vaccines between +2˚C and +8 ˚C (i.e. a purpose-
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built vaccine refrigerator or purpose-built mobile vaccine refrigerators).
Vaccines management throughout the clinic must be closely monitored (i.e. the number of vaccines left out during a clinic should
be minimal and topped up when required).
At the end of the vaccination session (or up to a maximum interval of 4 hours after the vaccines have been drawn up), any remaining pre-
drawn syringes must be discarded unless otherwise instructed e.g. by PHU.
Multi-dose vials must not be used beyond 24 hours after first opening.
Vaccination administration
Vaccinators Vaccination stations should be clearly numbered.
Most work stations need to be able to accommodate family groups.
If possible, a degree of privacy should be afforded to the client e.g. a screen.
Clean area for drawing up vaccines.
Hand hygiene facilities.
Process for documenting vaccination records for client.
Pathway to post vaccination area where client must wait for 15 minutes unless otherwise instructed e.g. by PHU.
This area should not be used to manage people who present with
influenza like symptoms.
Post vaccination observation
Volunteer organisation / health staff
Large area that enables easy observation of clients post vaccination.
Adequate seating and access to drinking water for people post vaccination.
Process for transferring clients who become unwell from post vaccination area to first aid area.
First aid RN Located near post vaccination observation station.
Process for managing Adverse Events Following Immunisation (AEFI).
Mats or mattress with screen for privacy for unwell clients.
Emergency medications and equipment.
Telephone.
Medically compromised patients receive first aid and referred for further care as appropriate.
Complete AEFI form.
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Example of a mass vaccination clinic floor plan
Site Selection
Consider:
• Capacity to segregate areas and direct the flow in one direction with separate entrances and exits
• Capacity for emergency response access
At QCH suggested sites for a staff vaccination clinic include:
• Level 7 Auditorium
• CHQ School on level 8
• Marquees in the outdoor areas under cover on level 2
• Ambulance bay near the decontamination unit
• OPDs not in use by the patients and the public
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Mobile vaccination clinics in community-based locations are recommended to consider the requirements for
mass vaccination and the storage, security and transport requirements for all consumables and equipment
required.
Resources and consumables
Consumables
Medical stock and consumables can be ordered from the CHQ Central Resources Service – Consumables. Contact [email protected] or phone (07) 3068 4720.
Storage
IMPS have a storage area in the B3 area at QCH, access via contact with the IMPS team.
Equipment
IMPS nursing team have the following items in IMPS storage for use in vaccination clinics:
• Mobile vaccination trolley (large)
• Immunisation clinic consumables packs – for mobile clinics
• Anaphylaxis kits (minus adrenaline – source from pharmacy prior to commencing clinic)
• Emergency airway management equipment
• Baseline level of immunisation consumables
Supply of sharps containers and alcohol-based hand rub are accessible by contacting the CHQ Medirest
Helpdesk – phone 07 3068 4357 (HELP)
Immunisation clinic set up and checklist
Mass vaccination clinics work best with multiple stations in a large area with multiple nurses immunising at
once. The following is a guide for the set-up of a safe and efficient immunisation station. Adequate space is
required for the nurse to complete the pre-vaccination assessment and have access to all resources required.
A privacy screen is preferred.
A chair Is required for both the nurse and the patient.
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Equipment
Clinic Checklist Yes or No
Opening checklist
Station set up as per instructions
Vaccine fridge cold chain maintained and recorded
Check expiry dates of vaccines and consumables
Orientate self and others to emergency equipment including location of emergency phone
Take note of the address of the clinic, location and telephone system
Allocate team roles for clinic session
Nurse resource folder accessible on each vaccination station
Resuscitation equipment
Adrenaline 1:1000 three (3) x ampules within expiry date
Three (3) x 1 ml syringes
Three (3) each drawing up needles and 25G 25mm needles
Recognition and treatment of anaphylaxis chart - in resource folder
Adult and child resuscitation masks and Air-viva
Oxygen cylinder and tubing if available
Emergency phone, charged and working
Adrenaline administration clinical documentation sheet, clipboard and pens
Stock trolley
Thermometer
Sphygmomanometer and stethoscope
Consider stock requirements relative to size of clinic
- Extra consumables including needles, cotton wool, micropore tape, tissues, sharps
containers etc
- PPE
- Extra ABHR
Vaccination Station set up and checklist
1 Nurse resource folder
3 Alcohol based hand rub
4 Safety Engineered Sharps (BD Eclipse)
5 Sharps container
6 Post vaccination information sheet (if applicable)
7 Pens
8 Tissues
9 Cotton ball or gauze ball
10 Micro pore tape
11 Rubbish bag
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Checklist
General Items Equipment Yes/No – Comments
Personal Protective Equipment (PPE) Masks (Staff and patients) n95 and Surgical
Gowns
Eye protection
Gloves (All sizes)
Observation Equipment Thermometers
Pulse Oximeters (Observations Machines)
Sphygmomanometers
Safety Equipment Oxygen Tubing
Oxygen Masks
Suction equipment all sizes
Suction equipment if none present on the wall.
Waiting room Chairs
Waste Bin
Tissues
Cleaning Rubbish Bags
Linen trolleys
Spare Linen Bags
Pathology Floq swabs
IeMR printers
Replacement stickers for printing
Patient Movement Wheelchairs
Technology Deck Phones
Security devices for staff
Computers
List of phone contacts
Vaccine
Prescribing and orders
IPNs working at CHQ are required to work under the CHQ Health Management Protocol when administering
vaccines under the funded National Immunisation Program Schedule. IPNs are required to have access to
the following resources in immunisation clinics:
1. Australian Immunisation Handbook
2. Drug therapy protocol
3. Health (Drugs and poisons) regulation 1996
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Stock
Vaccine stock is accessible by order for QH central pharmacy and needs to be organised in advance with the
Immunisation Pharmacist and or the Materials manager lead at CHQ Pharmacy
Storage options for staff vaccination clinics need to be discuss with the CHQ Immunisation Pharmacist and will
be dependent on space requirements. Lady Cilento has a number of dedicated vaccine fridges including two
portable ‘Twinbird’ vaccine fridges in the hospital.
Vaccine fridges are located at CHQ community sites in Acacia Ridge and Zillmere locations. CHQ has a mobile
vaccination vehicle equipped as a mobile vaccination clinic; this clinic operates out of the Logan community
site.
Cold Chain management
All vaccines must be monitored and maintained at appropriate cold chain temperatures as per the National
Vaccine Storage Guidelines – Strive for 5 (Australian Government Department of Health and Ageing 2013b).
Multi dose vials
Multidose vials are not routinely used in Australia however where mass vaccination of the population is
required multidose vials have some advantages over single-dose vaccines (Australian Government
Department of Health and Ageing 2013a). Multidose vials provide for the availability of a vaccine substantially
earlier than single dose or pre-filled syringes as the time it takes for the manufacturer to fill and finish the
vaccine is significantly reduced in comparison to single doses (Australian Government Department of Health
and Ageing 2011). This allows for more vaccine to be available for use in a shorter period of time.
Please refer to:
• The guideline for the administration of pandemic influenza vaccine from multi-dose vials
• Pandemic Influenza Vaccine from Multi Dose Vials Theory - iLearn module for instructions on appropriate
use including instructions for drawing up multiple doses for multi-use vials.
Staff Training
Staff working in vaccination clinics need to complete the following teaching and training as relevant. The Staff
Immunisation Nurse as the program coordinator will determine the training requirements for clinical staff
providing vaccinations:
1. BD Eclipse product – training video from BD
2. Multi dose vial use – iLearn link http://qheps.health.qld.gov.au/ilearn/
3. ANTT online education package - Teach Q
4. Hand hygiene online education package – Teach Q
5. PPE donning and doffing video – Teach Q
6. Mask Fit check – education via https://www.health.qld.gov.au/clinical-practice/guidelines-
procedures/diseases-infection/infection-prevention/transmission-precautions/p2n95-mask including
PowerPoint presentation
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The following tables provide guidance for staffing requirements for vaccination clinics. Complete the
appropriate table(s) below and delete the table(s) that does not apply.
Staffing requirements
Large vaccination clinic
This table is based upon the assumption that a large vaccination clinic could average 4,000 people per day
over an 8hour period.
Staff type Guide
estimated total
required
Guide
estimated number required
breakdown per role
Actual number rostered
District total *Where nurses will be accessed from
**Where admin officers will be accessed from
Other Whole of Government support
required
Site manager 1 1
Clinical team leader
1 1
Logistical team leader
1 1
Admin team leader
1 1
Clinical Staff
assessment area
vaccination area
post-vaccination area
first aid area
26 9
12
2-3
2
Administration staff
registration area
assessment area
10 8
2
Volunteers
registration area
waiting area
post-vaccination area
floaters
8 2
2
2
2
Security staff 3 3
Cleaner 1 1
Small vaccination clinic
This table is based upon the assumption that a small vaccination clinic could average 1,000 people per day
over an 8hour period.
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Staff type Guide
estimated total
required
Guide
estimated number required breakdown per role
Actual number rostered
District total
*Where nurses will be
accessed from
Where admin officers will
be accessed from
Other Whole of Government
support
required
Site/facility manager
1 1
Clinical team leader
1
Clinical Staff
assessment area
vaccination area
post-vaccination area and first aid area
11
4
5
2
Administration staff
3
Volunteers 2
Security staff 2 1-2
Cleaner 1 1
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Outreach clinic
This table is based upon the assumption that an outreach vaccination clinic could average 200 - 250 people
per day over an 8hour period.
Name of mass vaccination clinic facility:
Staff type Guide
estimated total
required
Guide
estimated number required
breakdown per role
Actual number rostered
District total
*Where nurses will be accessed from
Where admin officers will be accessed from
Other Whole of Government support required
Clinical team leader and
assessor
1 1
Clinical staff
vaccination area and assessor
floater – back up, post vaccination
area and first aid area
2
1
1
Administration staff
1 1