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- To ensure that vaccines received at a surgery or clinic were transported safely from the ordering source and the cold chain has been maintained.
- To ensure that vaccines are stored at 2-8°C, as recommended by the manufacturers’ guidelines.
- To ensure that all equipment used for storage of vaccines is regularly maintained.
- Vaccines must be stored in a vaccine refrigerator. Domestic refrigerators are not designed for this purpose and must not be used.
- The vaccine refrigerator should have an external thermometer so that the minimum and maximum temperature can be recorded daily and reset.
- The vaccine refrigerator should have an external lock so that it can be kept locked when not in use.
- No food or drink should be stored in the vaccine refrigerator.
- Ideally, the power should be supplied from a switchless electrical socket; otherwise, a switch protector should be used. Failing that, the plug should be taped over and a simple notice put up to prevent the refrigerator being turned off accidentally.
- A designated nurse with a named deputy should be responsible for ordering sufficient supplies of vaccines, maintaining stock levels and accepting delivery.
- Reconstituted vaccines must be used according to manufacturers’ recommendations and opened multi-vials must be discarded at the end of the immunisation session.
- If satellite clinics are organised, a vaccine-carrying bag may be needed so that vaccines can be transported safely and the cold chain maintained.
- Receptionists should be trained to contact the designated nurse as soon as vaccines are delivered. If no nurse is on duty the person accepting the vaccines must understand that they need to be refrigerated immediately.
- When vaccines are delivered, it is essential to check that transportation did not take longer than 48 hours. If in doubt, vaccines should not be accepted and the delivery company should be contacted immediately.
- On accepting vaccines, they should be counted and the expiry date and batch number noted and entered in the stocktaking book. They must then be refrigerated immediately.
- Vaccines stocks should be rotated in the refrigerator so that the oldest batch of numbered vaccines is available to be used first.
- Vaccines should be stored so that air can circulate freely around the packages and not packed tightly against the sides or back of the refrigerator.
- Vaccines should never be stored on the shelves of the fridge door.
- Vaccines should be removed from the refrigerator and reconstituted only when they are about to be administered.
INTERRUPTION OF POWER SUPPLY
- Avoid opening the door of the refrigerator unnecessarily.
- In the case of a power cut contact the electricity company to find out the possible duration.
- Contact the individual drug companies for guidelines but have the following information to hand:
- Length of time power has been (is likely to be) off;
- Last recorded minimum and maximum temperature readings;
- List of vaccines held in the refrigerator.
- In the event of a power disruption it may be necessary to contact the practice insurance company.
Department of Health (1996)Immunisation Against Infectious Disease (the green book). London: Department of Health. Available online at: www.doh.gov.uk/greenbook.
Kassianos, G.C. (2001)Immunisation, Childhood and Travel Health. Oxford: Blackwell Science.
Scade, C. (1999)A protocol for storing vaccines effectively. Practice Nurse; 17: 6, 387-388.
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