COVID-19 vaccination advice for general practice

2.1 Proximity to sufficient car parking either onsite or within a short distance from the practice

2.2 Proximity to public transport (where relevant, but not mandatory)

2.3 Accessible by other patient transport services (including ambulance)

3.1 Reliable water and electricity supply

3.2 Access to telephone, computer networks, internet and computer hardware as required

3.3 Ability to maintain room temperatures between 19 – 25 degrees

4.1Adequate number of appropriately trained staff to ensure clinical safety including:

-  4.1.1 Vaccinators to prepare and administer vaccines
-  4.12 Authorised immunisation provider (e.g. medical officer or fully trained immunisation registered nurse/nurse practitioner to assess patients and authorise other appropriately trained clinical staff (vaccinator) to administer the vaccine)
-  4.1.3 Concierge or team leader (to direct clinical flow)
-  4.1.4 Clerical staff
-  4.1.5 First aid staff, additional to vaccinating staff as per jurisdictional requirements
-  4.1.6 Staff to manage staff/patient/stock safety (if/when required)
-  4.1.7 Medical officer (may be the same as the authorised immunisation provider)

4.2 Acknowledge that everyone administering vaccines must have appropriate training and/or qualifications in line with jurisdictional requirements, and have received adequate specific training in COVID-19 vaccination, including regarding the use of multi-dose vials

4.3 Have documented procedure for managing and recording training of staff handling vaccine doses

NCIRS - Education and Training

NCIRS has a range of resources to support education and training of healthcare professionals in the field of immunisation. These include vaccine preventable diseases fact sheets and FAQs, recorded presentations, webinars, clinical decision-making resources and a multi-day workshop providing professionals with a comprehensive understanding of immunisation principles, the epidemiology of vaccine preventable diseases, and implementing and monitoring vaccination programs.

5.1 Have adequate number and capacity of refrigerators to store vaccines (in addition to usual vaccine stock), with refrigerators to be maintained and monitored at 2 – 8 degrees Celsius

RACGP - RACGP Standards for general practices (5th edition) fact sheet - Cold chain management

5.2 Have appropriate refrigerators and opaque containers to store vaccine syringes that have been prepared for administration under appropriate temperature conditions and protected from light from the time they are prepared till the time they are administered

5.3 Have specific procedures associated with receipt of vaccine doses including packaging acceptance, temperature checks

5.4 Sites must be able to adhere to the Strive for 5 guidelines and will need to have or be able to develop policies for cold chain management including:

-  5.4.1 Able to monitor the temperatures of the refrigerator(s) where vaccines are stored
-  5.4.2 Have an appropriate policy and protocol in place to respond to temperature breaches, including relocating vials to another refrigerator (or freezer, where relevant) and responding at times where clinic may not have any staff present

National Vaccine Storage Guidelines ‘Strive for 5’

The National Vaccine Storage Guidelines ‘Strive for 5’, provides information and advice for vaccine storage management for Australian immunisation service providers.

6.1 Access to patient management system and Australian Immunisation Register via Provider Digital Access (PRODA)

PRODA - How to register an organisation

PRODA is an online identity verification and authentication system. It lets you securely access government online services.

6.2 There will be a requirement for connectivity to support integration with a National booking system. More information will be circulated regarding integration to current practice management systems

6.3 Ability to meet mandatory requirements regarding reporting of all vaccine administration into AIR within an appropriate timeframe, ideally within 24 hours

Australian Government - Services Australia - Accessing AIR using PRODA for organisations USER Guide

This User Guide provides a step by step guide to the registration processfor‘other’vaccination providers, such as medical practices, councils, pharmaciesor commercial organisationsthat want to access the Australian Immunisation Register(AIR) secure website.

6.5 Have a process of obtaining and recording informed consent.
Further information regarding consent relating to COVID-19 vaccination will be provided by the Commonwealth.

6.6 Be able to develop policies and procedures for:

-  6.6.1 Identifying individual vaccine recipients, checking to confirm any record of previous receipt of any COVID-19 vaccine doses (including date and brand of product received), and recording immunisation encounters (electronic records are preferable)
-  6.6.2 Labelling syringes when they are drawn up from multi-dose vials, including date and time of preparation and of expiry
-  6.6.3 Recording and reporting of vaccines used and stock on hand and those discarded, including reasons for discarding, and vaccine wastage

6.7 Ability to monitor, manage and report adverse events following immunisation, including anaphylaxis
Australian Government Department of Health - Following vaccination - what to expect and what to do.
This tear off pad provides easy-to-read information on common reactions that may occur after vaccinations.

Australian Immunisation Handbook - Preparing an anaphylaxis response kit
This publication from Australian Immunisation Handbook outlines details for preparing an anaphylaxis response kit

Australian Immunisation Handbook - Managing anaphylaxis
This publication from Australian Immunisation Handbook outlines recommendations for managing anaphylaxis
Addition anaphylaxis info - https://immunisationhandbook.health.gov.au/vaccination-procedures/after-vaccination

7.1 Facilities to dispose of all waste, including sharps and unused vaccine appropriately in accordance with standard precautions (TGA, OGTR (if appropriate) and other regulatory requirements for vaccines)

Australian Government - Therapeutic Goods Administration - Health professionals

The information in this section is for health professionals, such as doctors, nurses, pharmacists, and complementary healthcare practitioners. It is not presented as medical advice to health professionals or consumers.

RACGP - General practice toolkit - Waste management

RACGP 5th Standards outlines GP4.1 D All members of our practice team manage risks of potential cross-infection in our practice by methods that include: safe storage and disposal of clinical waste including sharps

8.1 Appropriate PPE, as per requirements in the Australian Immunisation Handbook and jurisdictional requirements

Australian Immunisation Handbook

The Australian Immunisation Handbook provides clinical guidelines for healthcare professionals and others about the safest and most effective use of vaccines in their practice. The guidance is based on the best scientific evidence available, from published and unpublished literature.

8.2 Adequate supplies of other medical equipment e.g. stethoscopes, examination tables, diagnostic testing equipment

8.3 Labels for syringes (if filling in advance)

Australian Commission on Safety and Quality in Health Care - National Standard for User-applied Labelling of Injectable Medicines, Fluids and Lines

The Labelling Standard sets out the requirements for label format, content and placement.

8.4 Antimicrobial /disinfectant wipes to clean stations between patients

8.5 Sanitation equipment for administration site

Australian Government Department of Health - Hygiene and cleaning for the health workforce during COVID-19

To protect yourself and your patients, from coronavirus (COVID-19) it is important to maintain good hygiene and a clean workplace. Follow the guidelines for personal hygiene, routine cleaning, disinfecting, terminal cleaning, and protective gear.

9.1 Able to claim MBS item numbers for billing

Services Australia - Health professionals

Services, payments and programs for health professionals, practice staff, health workers and pharmacy staff.

9.2 Have the appropriate accreditation required for the relevant clinic or practice, as advised by the Commonwealth (noting that accreditation will inform funding arrangements)

RACGP - Standards 5th edition

The RACGP has developed the Standards for general practices (5th edition) (the Standards) with the purpose of protecting patients from harm by improving the quality and safety of health services. The Standards support general practices in identifying and addressing any gaps in their systems and processes.

9.3 Willingness to comply with compulsory training

9.4 All immunisers to be authorised under the relevant state or territory’s Public Health Act or related legislation to provide vaccines

Australian Government - Australian Immunisation Register Act 2015

This Act establishes a register of information about vaccinations. The purposes of the register relate to supporting Australian vaccination programs, and vaccination matters more broadly.

10.1 Will have or develop policies and procedures for ensuring services are culturally safe for Aboriginal and Torres Strait Islander peoples

RACGP - Resources to support general practice teams

These resources provide practical actions and advice to support your practice to provide effective primary healthcare for Aboriginal and Torres Strait Islander people.

10.2 Will need to have arrangements for identification of and assistance for those with additional or specific needs, including:

-  Ensuring culturally appropriate policies and procedures for multicultural communities
-  Qualified interpreters available when needed such as through the Australian Government Translating and Interpreting Service (TIS)
-  Translations to languages other than English

Translating and Interpreting Service

The Translating and Interpreting Service (TIS National) is an interpreting service provided by the Department of Home Affairs for people who do not speak English and for agencies and businesses that need to communicate with their non-English speaking clients

10.3 Will need to have arrangements to provide accessibility to those with Disability (including intellectual disability and those with other mobility issues)

11.1 Standardised screening process to exclude patients who display symptoms of COVID-19, and refer for appropriate assessment for COVID-19 or other conditions (as per guidance provided in the ATAGI Guiding Principles for Maintaining Immunisation Services During the COVID-19 Pandemic).
ATAGI Guiding Principles for maintaining immunisation services during COVID-19 pandemic Guiding Principles for maintaining immunisation services during the COVID-19 pandemic.

11.2 Standardised screening process for contraindications, receipt of previous doses of COVID-19 vaccines and/or receipt of other vaccines (observing any interval requirements).

Australian Immunisation Handbook - Preparing for vaccination
Immunisation providers should screen people before vaccination, obtain valid consent, and ensure that the correct equipment and procedures are in place before vaccination.

11.3 Clear assignment of duties and responsibilities of all staff and clear plan of workflow, particularly regarding drawing up from a multi-dose vial and administering individual vaccine doses drawn from a particular vial for each clinic session.

Australian Immunisation Handbook
The Australian Immunisation Handbook provides clinical guidelines for healthcare professionals and others about the safest and most effective use of vaccines in their practice. The guidance is based on the best scientific evidence available, from published and unpublished literature.

11.4 Incident management in place, with staff knowledgeable about relevant procedures and able to report any clinical incident (e.g. injury in workplace) to the appropriate authorities.

11.5 Has process in place to manage injuries to workforce (e.g. needle stick injury).

11.6 Process in place to prevent and manage violence or aggression in the clinic.

RACGP - General practice - A safe place
A guide for the prevention and management of patient-initiated violence.

RACGP - General practice - A safe place tips and tools
This booklet outlines a range of practical strategies to assist general practices to appropriately minimise risks of violence.

Ability to securely store items listed below:

12.1 Sterile 2mL or 3mL syringes (latex free)

12.2 Sterile drawing up needle (19 or 21 gauge recommended to reduce risk of coring)

12.3 Sterile administration needle (22-25 gauge), 25mm for adults, 38mm for very large or obese person

12.4 Alcohol wipe (for vials)

12.5 Cotton wool ball

12.6 Hypoallergenic tape or latex free band aid

12.7 Dish for drawn up vaccine (kidney dish)

12.8 Sharps containers

12.9 Containers for disposal of biohazardous waste

12.10 Saline (as required)

12.11 Adrenaline 1:1000

12.12 1mL ‘single use only’ syringes, with 23 gauge needle

12.13 Paediatric and adult size Guedel airways