Primary Care IT has produced a single flu administration protocol for the 2021/22 seasonal influenza season. Our “Flu clinic 2021/22 PCIT” protocol has been built as a one-stop resource to manage flu administration for all age groups. This year we have not included the additional elements of smoking status, shingles vaccination, pneumococcal vaccination, dementia screening, or AF screening. There are some steps you need to go through to set up your protocol:
Setting batch numbers
The base version of the protocol contains nodes to cover all types of influenza vaccination for this season (aQIV, QIVc, QIVr, QIVe, LAIV). Each multiple choice question (MCQ) has been built with all of the possibilities in mind but it will be possible to edit these later to prevent staff erroneously selecting the wrong vaccine type.
The area of the protocol you need to view to update batch numbers is on the right hand side of the protocol as shown in the overview:
For the four injections (aQIV, QIVc, QIVr, QIVe) you will see the following repeating layout and you will need to edit both Add Coded Data nodes (for right and left arms) to include the manufacturer, batch number, and expiry date for your flu vaccines. Each Add a Drug node has been pre-configured with the appropriate vaccine drug name. Add a drug will assist in completing your FP34D claims.
Double click on an Add Coded Data node to edit it. A window will appear similar to below, where you can change the details of the manufacturer and batch number. You can also add the expiry date of the vaccine by pressing Add qualifier. Do not change the injection site or date settings! Do not delete any right & left arm Add Coded Data nodes which you do not need to use as these may become useful later on.
Follow a similar process for the intranasal vaccination. We have provided nodes for a second batch number, but note the MCQ and concept will need to be linked up. There are Add Coded Data nodes for both first and second vaccination, the second vaccination being for children under the age of 9 who have never received an influenza vaccination before.
Next you may wish to edit the first set of MCQs, which are arranged in the same vertical line. To edit these boxes, again you must double click the node. Your first consideration will be how each vaccine will be labelled, since multiple QIV entries may look confusing! You can rename/edit each of these with something staff will recognise such as Flucelvax and Supemtek. You might consider adding the batch number to the line - this may become essential later on...
If you are definitely not using a certain type of vaccine it is possible to delete the entry, but this means you have to connect up all of the lines below the deleted entry. Instead we recommend editing the entry and changing the description to "---------", then once confirmed you can also delete the line from the MCQ to the next node.
There are two MCQ nodes for injections..... ....and another for the nasal spray.
We recommend you try to run a clinic using just one batch number for each vaccine. There will inevitably be a time when multiple batch numbers are in use.
With some careful editing you can either repurpose any unused nodes or create some extra nodes. For repurposing unused nodes, edit the description on the relevant MCQ line, update manufacturer/batch number/expiry for right & left arm coded data nodes, then update the Add a drug node to the corresponding drug name. For this last step, it is also possible to re-draw lines from the coded data nodes to link up with the correct existing Add a Drug node.
After the protocol has been updated and saved (and activated for Resource Publisher sites), anybody logged on to EMIS Web will need to open a new instance to see the changes.
The Flu clinic 2021/22 protocol will only work for those patients who fall into one of the eligibility cohorts based on age or codes on their record. When used with patients who are not eligible, users will see the popup below. After a clinical decision that the patient may be eligible, the code Needs influenza vaccination can be added to the record after which the protocol will work.
Rest of the protocol
Once the protocol has followed through to code the vaccination and the drug, it will complete any diary entries for a flu jab, and remind staff to check mobile numbers. Flu clinics are an ideal opportunity to confirm or update mobile numbers. There is no facility within the protocol to update contact details. If you have a separate procedure for checking or do not wish to have this reminder at the end of every patient, it is possible to delete these two nodes in the bottom right corner of the protocol. It is not necessary to join up all of the lines which disappear as a result of deleting these nodes.
Previously declined flu protocol
This protocol is best set to trigger on booking an appointment. In that way your admin team will be alerted that this patient hasn’t had their flu jab last year and has declined it in previous years. In this way they can give the patient the information about the importance of influenza immunisation, but then also record them declining it, if that is their choice. You can see in the protocol below that the Display Text node suggests that after your flu jab day you may wish to enter some specific information about further flu days or go straight to appointment booking, we will leave you to edit this to suit local requirements. We suggest early in the season that you leave the flow to bypass this Display Text box (or it will pop up for most patients), then later in the season a single line can be re-drawn from the Yes/No Prompt to show the information.