Healthy People, Healthy SaskatchewanThe Saskatchewan Health Authority works in the spirit of truth and reconciliation, acknowledging Saskatchewan as the traditional territory of First Nations and Métis People.

Seasonal Influenza Immunization Campaign

A System Wide Response

SHA Town Hall

September 24, 2020

Sponsors and Panelists

Sponsors:Sharon GarrattDr. Kevin Wasko

Panelists:Cara BenzTramerLinda McPheePatrick RobertsonAngela Muzykayka

Provincial Leads:Dr. Tania DienerPetrina McGrathSheila Anderson

Support/Moderator:Shayna OverendLenore PinderAdrienne DanyliwJessie Buhler

Dr. Kevin Wasko and Sharon Garratt

1. Increasing vaccination rates across the province will be imperative to prevent the health care system from becoming overwhelmed by both COVID-19 and Influenza Like Illness (ILI).

2. The COVID-19 pandemic will change the way we have historically delivered mass influenza immunization clinics and practices.

3. The 20/21 Influenza Immunization Campaign provides an opportunity to develop and practice strategies that can be used for the anticipated COVID-19 immunization program.

4. We need a system wide response to the 20/21 Influenza Immunization Campaign. Vaccine should be provided at every health care encounter by a variety of providers.

Think Influenza at Every Health Care Encounter

Provincial OverviewThink Influenza at Every Health Care Encounter

Sheila Anderson

Important Highlights

1. Saskatchewan launch – October 19, 2020.

2. Southern Hemisphere seeing a 40% increase in demand for vaccine.

3. Ministry of Health has purchased 36.5% more vaccine than last year to meet the anticipated increase in demand.

4. 50% of vaccines in Saskatchewan were administered by pharmacists, 38% by public health. and 11% by other in 19/20.

5. Expand areas across the province that offer influenza vaccine such as acute care, ER, outpatient clinics, PHC clinics, etc.

6. 4Flu.ca the source of truth

Think Influenza at Every Health Care Encounter

Provincial Working Groups

1. Pre-Booking

2. Clinical Standards and Work Flow

3. Staffing and Resources

4. Communications

5. Employee Health

6. System Wide Response – today's Town Hall focuses on updates from this work group including the Influenza Toolkit

Think Influenza at Every Health Care Encounter

Influenza Tool KitCOVID Screening Tool

Cara Benz Tramer

Influenza ToolkitCOVID Screening Tool

• Asked at every patient encounter, triggers next steps of a Practitioner Order Set, Medical Directive or 4flu.ca

• If a designated family member or support person = 4flu.ca and local pharmacist/physician

• If a HCW = Employee Health, 4flu.ca or local pharmacist/physician

Influenza Tool KitAuthorized Providers

Clinical Procedures

Practitioner Order Sets and Medical Directive

Linda McPhee

Influenza ToolkitAuthorized Providers

Provider Environmental & Professional Supports Required

Registered Nurse By prescriber order* or with RNSP clinical protocol that includes

a medical directive – refer to Clinical Procedure____

Registered Psychiatric Nurse By prescriber order* or under a medical directive as part of a

public health team (for persons age 5 years and older) or as part of an employee health team

Licensed Practical Nurse LPNAC by prescriber order* or under a medical directive as part

of a public health team or employee health team (for persons age 5 years and older). Anaphylaxis management requires escalation plan.

Paramedic As part of seasonal influenza campaign, anaphylaxis

management per paramedic protocols

Pharmacist As part of seasonal influenza campaign

Respiratory Therapist As part of public health team for seasonal influenza campaign

seasonal influenza campaign under the medical directive.

Influenza ToolkitClinical Procedure with a Patient-specific order

Clinical Procedure

Influenza ToolkitPractitioner Order Sets

Influenza ToolkitClinical Procedure without a Patient-specific order

Clinical Procedure

Influenza ToolkitClinical Procedure Without a Patient-Specific Order

Influenza Tool KitVaccine and Associated Supplies

Patrick Robertson

Influenza ToolkitVaccine and Associated Supplies

VACCINE

Acute care In-Patient sites – supply will be coordinated with local SHA pharmacy departments using previously established procedures

• Sites encouraged to connect with local pharmacy to determine distribution specifics and previously established procedures

• Vaccine delivery and storage :

• Delivery models variable by location – Delivered vs. Nursing pickup• Prompt administration is key to decrease concerns with storage and stability

(further detail on storage of vaccine can be found in Appendix 17 of the Saskatchewan Influenza Immunization Policy 2020-2021)

All other sites/locations– Contact Public Health for vaccine supply and considerations

• LTC – NOT provided by community pharmacies at this time

SUPPLIESSee Appendix 15 for further details on recommended immunization supplies

Influenza Tool KitDocumentation and Reporting Requirements

Education Materials 4flu.ca

Cara Benz Tramer

Influenza ToolkitDocumentation and Reporting Requirements

• Follow the Clinical Protocol and document per your unit, department or work areas process. That might be an EMR/paper chart, etc.

• All publicly funded vaccines administered should make it onto the patients Provincial Immunization Record called Panorama.

• All vaccines need to be accounted for statistically and reported to the Ministry of Health. Use your local process for vaccine reporting.

• Saskatchewan Public Health Act 1994 – it is mandatory to complete the Adverse Events Following Immunization (AEFI) form for any reportable AEFI and within certain time frames.

• For publicly funded vaccines, complete the AEFI form and submit it to local Public Health

• Back Entry required for all children under the age of 9 into Panorama (as may require a second dose)

Influenza ToolkitEducation Materials – 4flu.ca

Additional resources will be posted once available prior to October 19th

For example:

practitioner order sets/medical directive/clinical protocol/checklist

Influenza Tool KitEmployee Health Strategy

Angela Muzyka

Influenza ToolkitEmployee Health Strategy

Employees will be encouraged to receive their influenza immunization wherever it best suits their needs - employee health, pharmacist, PHC clinic etc.

Multiple strategies - Scheduled employee clinics, increased use of peer immunizers along with other local strategies will be utilized to provide influenza immunizations to staff throughout the SHA

Employee Health Teams will continue to work with operations to align strategies for on site peer immunizers and identify other opportunities to deliver influenza immunizations to staff

The SHA OHS Hotline will be the single point of contact for any employee with questions related to influenza immunizations

Historical 3 week blitz for employees will be extended

Next steps - strategy for SHA staff working off site to receive influenza immunizations

Influenza Tool KitInfluenza Readiness Checklist

Cara Benz Tramer

Influenza ToolkitInfluenza Readiness Checklist

q Team awareness of new COVID screening questions coming out October 14, 2020

q Which option is preferred for your area:

1. Practitioner Order Set

2. Clinical Procedure and Medical Directive

3. Encouragement of 4flu.ca for local influenza clinic availability

q Access to vaccine:

1. Support from pharmacy or local Public Health

2. Store your own (Review Vaccine Storage and Handling Checklist)

3. Other local options may be available

4. Review Cold Chain Break Management

Influenza ToolkitInfluenza Readiness Checklist

q Other supplies:

1. Anaphylaxis Kit - immediate management of adverse event (see suggested supply list)

2. Influenza Fact Sheet (Provide to Client/Patient for informed Consent)https://www.saskatchewan.ca/residents/health/accessing-health-care-services/immunization-services#immunization-forms-and-fact-sheets

3. Record of Influenza Immunization wallet cards to provide to Client/Patient (Request from your local Public Health office)

4. Copies of the practitioner order sets

5. Administration supplies (see Appendix 15: Public Health Immunization Supply List Recommendations)

What We Need From You

Sheila Anderson

What We Need From You

Commitment to Support Flu Immunization

1. Assign a lead in your portfolio to develop and support local plans.

2. Choose the process that will work best for your setting.

3. Use team huddles to discuss local implementation.

4. Report vaccine stats as coverage rates as required.

5. Encourage staff to get their influenza immunization.

Think Influenza at Every Health Care Encounter

Questions?