Nurse immunisers - requirements and responsibilities

This summary should be read in conjunction with the Secretary approval under r. 8(1) and regulation 161 of the Drugs, Poisons and Controlled Substances Regulations 2017, and Nurse immunisers – approved client groups.

Nurse immunisers – requirements

A nurse immuniser who is registered in Division 1 of the Nursing and Midwifery Board of Australia register who provides evidence to the employer of currency of competence and ongoing professional development in immunisation, and who:

• on 30 June 2010 was registered in division 1 of the register of nurses endorsed under s. 27A of the Health Professions Registration Act 2005 by the Nurses Board of Victoria in the approved area of practice – Immunisation

or

• has satisfactorily completed the assessment of a nurse immuniser program recognised by the Chief Health Officer

or

• has satisfactorily completed the assessment of an ‘Immuniser program of study’ recognised by the Chief Health Officer, providing the education provider offers the program to nurses.

or

• has satisfactorily completed a nurse immuniser program not recognised by the Chief Health Officer and has written confirmation from the program provider that at the time the program was completed, it was of equivalent standard to a program currently recognised by the Chief Health Officer.

or

• has satisfactorily completed the assessment of an ‘immuniser program of study’ that meets the curriculum content requirements of the National Immunisation Education Framework for Health Professionals.

The list of recognised programs can be found at Programs of study for nurse immunisers.

Secretary Approval: Nurse Immuniser

Nurse immunisers are approved under regulation 161 of the Drugs, Poisons and Controlled Substances Regulations 2017, via a Secretary Approval made by the Secretary, Department of Health.

The Secretary Approval applies to a Registered Nurse who has completed a program of study. The nurse must meet the Secretary Approval criteria to practice.

The Secretary Approval for nurse immunisers (in force) was published in the Government Gazette S518 3 October 2022 pp. 1-3.

Japanese encephalitis vaccination

On 19 May, in response to the recent emergence of Japanese encephalitis (JE) in Victoria, the Secretary Approval: Nurse Immunisers has been amended to include administration of the JE vaccine in accordance with the conditions outlined in the Approval.

A condition of the Secretary Approval for administration of the JE vaccine by nurse immunisers is completion of the Japanese encephalitis - eLearning module for immunisation providers in Victoria, which has been recognised by the Deputy Chief Health Officer - Communicable Disease.

The module is free and available at the Victorian Immunisation Learning Hub.

Monkeypox vaccination

On 3 October 2022, in response to the recent emergence of monkeypox (MPX) in Victoria, the Secretary Approval: Nurse Immunisers was amended to include administration of the MPX vaccine in accordance with the conditions outlined in the Approval.

A condition of the Secretary Approval for administration of the MPX vaccine by nurse immunisers is completion of the Monkeypox vaccination- eLearning module for immunisation providers in Victoria, which has been recognised by the Deputy Chief Health Officer - Communicable Disease.

The module is free and available at the Victorian Immunisation Learning Hub.

Secretary Approval: Nurse Immuniser – SARS-CoV-2 (COVID-19) VACCINE

A time-limited approval, Secretary Approval: Nurse Immuniser – SARS-CoV-2 (COVID-19) VACCINE, authorises a Nurse Immuniser to possess and administer any SARS-CoV-2 (COVID-19) VACCINE approved by the Therapeutic Goods Administration (COVID-19 VACCINE) in accordance with the conditions outlined in the Approval until 19 October 2023 (inclusive), unless revoked earlier.

The Secretary Approval was published in the Government Gazette S 576 19 October 2022 pp. 1-3 (Nurse Immuniser – SARS-CoV-2 (COVID-19) VACCINE) or accessible via the Medicines and Poisons – Secretary Approvals webpage. This approval is in force from 20 October 2022.

• Further information is available in the Victorian COVID-19 vaccination guidelines. These guidelines provide a primary point of information and resources for Victorian COVID-19 vaccination providers based on information and minimum site requirements set out by the Commonwealth. Compliance with these guidelines is a condition of the Public Health Emergency Orders and Secretary's Approvals that authorise the necessary Victorian workforce (which includes nurse immunisers) to deliver the vaccine. The guidelines also state the required training and supervision ratios for the Victorian emergency authorised immunisation workforce, which includes nurse immunisers.

Nurse immunisers – employer and employee responsibilities

Employers and employees have the following responsibilities:

• Storage of each vaccine is at all times undertaken in accordance with the procedures specified in the National Vaccine Storage Guidelines: Strive for 5 current at the time of administration.
• The registered nurse must comply with the approved client groups for nurse immunisers.
• A reasonable check of the client’s immunisation history must be undertaken before vaccination, using the Child Health Record, the Australian Immunisation Register (AIR) or the client’s usual immunisation provider.
• An immunisation assessment for an individual is at all times undertaken in accordance with the procedures specified in the current edition of The Australian Immunisation Handbook.
• Contraindications must be observed as listed in The Australian Immunisation Handbook current at the time of administration. The specialist nature of some medical conditions, especially those involving immunosuppression, means that the individual’s treating doctor should make the final decision that vaccination is indicated for people with these conditions.
• Valid consent must be obtained for each vaccination in accordance with the protocol listed in The Australian Immunisation Handbook current at the time of administration.
• The process of establishing contraindications and valid consent must include the use of a ‘pre-immunisation checklist’ given to the parent or person to be vaccinated.
• Administered vaccines must be notified to the AIR.
• A record of the vaccine(s) given must be documented in both the vaccinated person’s clinical file and the personal health record, or individual record of vaccination provided to the client.
• An emergency kit containing adrenaline injection 1:1000, and a written protocol for the treatment of anaphylaxis, including adrenaline use, must be available for each vaccination occasion of service. Administration of adrenaline is, at all times, undertaken in accordance with the procedures specified in the current edition of The Australian Immunisation Handbook.
• The registered nurse must report significant or unexpected adverse events following immunisation (AEFIs) to SAEFVIC (Surveillance of Adverse Events Following Vaccination in the Community).
• The registered nurse must have access to a medical practitioner for advice.
• The registered nurse must review best-practice policy for immunisation each year. This may include, but is not limited to, attendance at updates or seminars on current practices, and proficiency in cardiopulmonary resuscitation.

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