NEW YORK NURSE: November 2009
Q.: I work in a clinic setting and have been asked to provide influenza vaccinations to anyone who asks for them. Is this legal?
A.: Influenza vaccinations, whether seasonal or H1N1, need to have a corresponding order and protocol from either a physician or a certified nurse practitioner, to ensure safe delivery of the vaccination. Education law was amended to include certain immunizations, anti-anaphylactic agents, PPD mantoux skin tests, and HIV testing, as non-patient-specific standing orders. “A non-patient-specific order authorizes named RNs or RNs who are not individually named, but employed or under contract with a legally authorized entity, to administer specified immunization agents or anaphylaxis treatment agents for a specified period of time to an entire group of persons such as school children, employees, patients of a nursing home, etc.”
Two examples of non-patient specific standing orders are:
The protocol should include but need not be limited to:
The vaccinations may be administered once the order has been obtained by an RN. Licensed practical nurses (LPNs) were not included in the law however; an LPN may assist in the administration of vaccinations or immunizations as per their scope.
As of December 2008, a new law and regulations were added to permit pharmacists who obtain additional certification to administer influenza and pneumococcal vaccinations to adults 18 years and older. Pharmacists may administer only these two vaccinations, they must be certified, and they must also have a non-patient-specific order and protocol received from a physician or certified nurse practitioner. For more information on non-patient-specific standing orders for RNs and pharmacists go to www.op.nysed.gov.
This is a sample of the questions NYSNA’s experts answer each day. The advice given is specific for the situation described and may not be applicable generally. If you have questions about your own work setting, it is recommended that you contact your NYSNA Nursing Representative or the Education, Practice, and Research Program, 11 Cornell Road, Latham, New York 12110-1499 or call 800-724-NYRN, ext. 282.