307 - 2502 St. Johns Street, Port Moody, BC, Canada V3H 2B4 www.crpnbc.ca Tel: 604-931-5200 Fax: 604-931-5277 Toll Free: 1-800-565-2505

College of Registered Psychiatric Nurses of British Columbia

2011 UPDATE: RPNs & IMMUNIZATION

With influenza season upon us, the CRPNBC is receiving daily contact from registrants and employers seeking scope of practice clarification for Registered Psychiatric Nurses’ (RPNs’) ability to administer flu immunizations.

The BC Ministry of Health Services (MOHS) recently provided clarification of the RPN role in immunization which can assist employers and other health service personnel to utilize RPNs more effectively in the planning and delivery of health services. In a letter dated October 19, 2011 (see below for full letter), the MOH states:

1. The RPN may give immunizations under a patient-specific order, including influenza vaccine and pneumococcal immunization.

2. Without an order: 2.1. Similar to Registered Nurses (RNs), RPNs need

to demonstrate competency to immunize by having completed the immunization course developed by the BC Centre for Disease Control (BCCDC) and offered online by CRPNBC to its registrants.

2.2. Similar to RNs, RPNs are able to participate in mass immunizations and peer immunization programs after having completed the BCCDC course

3. Anaphylaxis: Similar to RNs, RPNs are competent to make a nursing diagnosis of anaphylaxis and in an emergency situation, administer epinephrine.

This statement builds on the MOHS Spectrum of Nursing Roles & Responsibilities [Oct.26.2009] which states:

1. RPNs have the competencies to administer intramuscular and subcutaneous injections within their knowledge, skill and ability.

2. RPNs are responsible to assess and determine whether a specific client is eligible to receive an immunization(s) and are accountable for their decisions.

3. RPNs are responsible for consulting with and/or seeking clinical guidance from a physician, nurse practitioner or public health nurse when needed.

The RPN: Competency Profile for the Profession in Canada states in the Safety/Emergency Intervention Competency section that the RPN has the knowledge and ability to respond to emergencies.

Be advised that employers can choose to limit the role of their employees, including requiring RPNs to take an

immunization course before providing any immunizations, observing the RPN’s competence with the skill, and restricting RPNs from participating with immunization.

BACKGROUND

The Public Health Act (2008) provides the authority for the BC Immunization Program under the direction of the BC Centre for Disease Control (BCCDC). This legislation articulates how health authorities ensure the provision of immunization programs designed to reduce or eliminate vaccine-preventable diseases in British Columbia. Health Authorities collaborate with BCCDC in carrying out vaccine management, surveillance, and evaluation.

BCCDC IMMUNIZATION COMPETENCY PROGRAM

The purpose of the BCCDC Immunization Competency Program is to assist all health professionals who provide immunization to be knowledgeable vaccine providers, educators, and advocates for immunization. A vaccine provider should demonstrate the attitudes, knowledge, and clinical skills necessary to provide safe and effective immunization programs. The Immunization Program is updated regularly; please check the BCCDC Administrative Circulars for recent revisions.

IMMUNIZATION COURSE FOR RPN

The CRPNBC collaborated with the BCCDC to provide CRPNBC registrants access to an online immunization course. Successful completion allows RPNs to participate in mass immunizations & peer immunization programs. RPNs must follow the decision support tools established by the BCCDC in the BCCDC Communicable Disease Control Manual [Chapter 2]. These provide best practice guidelines to direct the provision of immunization services.

To begin the process of taking the online immunization course, please review A Guide to Access the Online Immunization Course for Registered Nurses & RPNs. After reviewing the guide you can log on at www.bccdcLearning.ca to register for the course:

1. The access code is bccdc135. 2. Upon completion of the course (100% to pass), you

print your electronic certificate of completion for your employer.

FOLLOW-UP

If you have any questions, contact the Practice Consultant at 604-931-5200 or via CRPNBC website.