immunization quiz 1 Flashcards
What are the standards for immunization practice?
- assess immunization status of all patients at every clinical encounter
- recommend vaccinations that patients need
- administer needed vaccinations or refer patient to another provider
- document vaccine received by patient
- Ensure all staff are up to date for their own protection
What part(s) of the standards for adult immunization practice do pharmacists do better or worse compared to other health care providers?
recommend- pharmacists are able to build trust with their patients over many years, trusted to give risks vs. benefits
advocate- have access to knowledge about vaccines, medical records
good accessibility because there are so many pharmacies across the country in all areas
educator- able to dispel myths, use of internet resources, more time dedicated to immunization info and practice than other HCPs
limitations are on pediatric vaccines and things outside of CDC schedule (travel vaccines, etc.)
What is meant by the standards for immunization practice with regards to: assess, recommend, administer and document? Understand each of these standards and how you as a pharmacist would/could meet each of these standards?
- assess- stay informed with latest recommendations , implement protocols and policies to routinely review patient vaccine needs, have handouts for patients
- recommend- educate patients on their indications, address questions and concerns, SHARE acronym
- administer/refer- make vaccines you have readily available and find out who in the area has them if you don’t
- document- participate in immunization registries, notify patient providers of updated vaccine status, make sure patients follow through on recommendations
How can you assess potential patients in community practice?
- implement protocols and plans to check on immunization status at every encounter
- have standing orders and handouts ready
- tag indicated patients based on age and medication
- pay attention to vaccination prompts from software
- patient questionnaires
- mechanism for vaccine reminders
How to recommend using the SHARE process?
Share patient specific reasons a vaccine is indicated
Highlight positive vaccine experiences
Address the patient’s questions
Remind patient that the vaccine protects them and their loved ones
Explain potential costs of getting the disease you’re immunizing against
How and what to document?
- document to immunization registries and patient provider
- Medicare B and D require keeping records for 10 years
- informed consent required in some states
- screening for contraindications
What are the state of CT laws regarding pharmacist immunization? (slides 4 and 5 are very important to know the details)
- pharmacists can administer any vaccination on the CDC immunization schedule to any adult in accordance with a licensed HCP
- pharmacists must complete accredited training
- training must be accredited by the Accreditation Council for Pharmacy Education and including the list of things that must be included
- record keeping laws per state and per Medicare
What trainings do you need to become an immunization pharmacist and/or maintain your certification?
need to have completed training accredited by the Accreditation Council for Pharmacy Education and be CPR certified
Know situations where you would and would not be legally permitted to provide vaccines (based on law and situation)?
- student interns must be certified and administer under supervision of certified pharmacist
- pediatric is limited but has expanded since COVID
- vaccines must be covered under CDC immunization schedule, can’t give travel vaccines (ex. typhoid)
Explain how to create protocols or standing orders for vaccines.
- immunization protocol must include: name of HCP authorized to prescribe drugs, name of administering pharmacist, types of vaccines, procedures and plans for referring to provider, procedure for emergencies, record keeping and documentation procedures
- see standing order templates from The Society of Teachers of Family Medicine, The Immunization Action Coalition, Military Health System and teak to fit state law
What are recommended for immunization screening, vaccine information sheets, record keeping and registries pharmacists would use.
- immunization screening: may serve purpose of finding contraindications, indications, informed consent
- vaccine info sheets: legally must be provided to everyone for every vaccine
- record keeping: have a standard protocol in place and follow Medicare guidelines (keep for 10 years) for Medicare patients
- registries: CT WIZ, varies by state
Explain reimbursement for pharmacist vaccinations (including what vaccines are included for each type of Medicare).
Simple payment- patient pays out of pocket and seeks reimbursement, employer pays full cost, or pharmacy bills medical insurer
Divided payment- pharmacy bills insurer for vaccine and dispensing fee, patient pays copay and administration fee out of pocket, patient may seek reimbursement for administration
Collaboration- managed care contracts with pharmacy (Medicare C), MD office bills insurer for pharmacy and has service fee, pharmacy contracts out admin, partnerships with health departments
Medicare- need to be enrolled, have NPI number, and PTAN, give customers receipt for reimbursement
What is the general background for vaccinations and what impact have vaccines had on vaccine preventable diseases, including basics of herd immunity.
Vaccines help the immune system create antibodies against diseases so people are less likely to get sick if exposed to an illness. If enough people (average 90%) get a vaccine, it will eventually get rid of the disease entirely. This is herd immunity. But if people don’t get vaccinated, the disease can reemerge.
Describe the pharmacist’s role and impact in vaccinations as advocate, immunizer, recommender, and educator.
Advocate- educated to understand and communicate information about efficacy, adverse events, and the process of vaccine approval
Immunizer- trusted HCP that has strong relationships with patients and the ability to refer out if needed
Recommender- unique trusted relationship that can be used to reduce hesitancy
Educator- dispel myths for patients
