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School Nurse Orientation

Dr. Michael Khoury. School Nurse Orientation. Nancy Hamilton, RN, CLC RN Consultant Field Staff Supervisor Immunization Program. Regulations Governing School/Daycare KRS 158.035 KRS 214.036 KRS 214.034 902 KAR 2:060 KRS 158.037. Required Immunizations. DTaP,Tdap, DT, Td IPV MMR Hib

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School Nurse Orientation

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  1. Dr. Michael Khoury School Nurse Orientation

  2. Nancy Hamilton, RN, CLCRN ConsultantField Staff SupervisorImmunization Program

  3. Regulations Governing School/Daycare • KRS 158.035 • KRS 214.036 • KRS 214.034 • 902 KAR 2:060 • KRS 158.037

  4. Required Immunizations • DTaP,Tdap, DT, Td • IPV • MMR • Hib • Hepatitis B • Varicella • Meningococcal • PCV-13

  5. Recommended Vaccines • Hepatitis A • HPV • Influenza • Rotavirus

  6. Changes in Regulations • Haemophilus influenzae type b (Hib) • Children at least 5 and less than 7 months of age are now required to have two doses of Hib vaccine instead of three. Some brands of Hib vaccine or combination Hib-containing vaccines permit doses at 2-4 months but do not require a dose at 6 months as described in the 2011 ACIP recommended schedule. This amendment gives providers more flexibility in choosing Hib-containing vaccine brands for their practice.

  7. Changes in Regulations • Hepatitis B Vaccine • The third dose is now required for children at least 19 and less than 48 months of age. This amendment allows providers the flexibility to administer the third dose of hepatitis B vaccine as late as 18 months of age while maintaining compliance with requirements for child day care entry. This is in compliance with 2011 ACIP recommendations for hepatitis B vaccine administration.

  8. Changes in Regulations • Measles-Mumps-Rubella (MMR) Vaccine • Age appropriate vaccination with a second dose of MMR vaccine now being required

  9. Changes in Regulations • Meningococcal Conjugate Vaccine (MCV) • One dose of meningococcal vaccine for sixth grade entry, 11 or 12 years or older is also a requirement. • While not a requirement of the regulation, adolescents aged 13 years and older and adolescents entering grades 7-12 who have not received a dose of Meningococcal Conjugate Vaccine should be administered a single dose. • The use of Meningococcal Conjugate Vaccine is preferred, but Meningococcal Polysaccharide Vaccine (MPSV) may be used if the conjugate vaccine is unavailable.

  10. Changes in Regulations • Pneumococcal Conjugate Vaccine (PCV) • Age appropriate immunization with PCV will be required for children up to five years of age. Children aged five years or older will not be required to receive PV as it is not licensed for healthy children in that age range.

  11. Changes in Regulations • Polio (IPV) Vaccine • The final dose of IPV vaccine should be administered at age four years or older regardless of the number of previous doses adn the minimum interval between this final dose and the previous dose should be at least six months.

  12. Changes in Regulations • Tetanus-diphtheria-accellular pertussis (T-dap) Vaccine • One dose of Tdap regardless of interval since last dose of tetanus-containing vaccine is required for students at sixth grade entry, 11 or 12 years or older, with option for Td for individuals who cannot receive pertussis containing vaccines. • While not a requirement of the regulation, adolescents aged 13 years and older and adolescents entering grades 7-12 who have not received a dose of Tdap vaccine, should be administered a single dose of Tdap vaccine.

  13. Changes to Regulations • Varicella Vaccine • A second dose of varicella will be required for kindergarten and sixth grade entry.

  14. Immunization Certificates • Immunization Certificate • Provisional Certificate • Medical Exemption • Religious Exemption

  15. Issuance of Certificates • Immunization certificates may be issued by: • A physician • An advanced practice registered nurse • A physician’s assistant • A pharmacist • A local health department • Other licensed facility administering immunizations

  16. Certificate Signatures • Immunization certificate may be signed by • A physician • An advanced practice registered nurse • A physician’s assistant • A pharmacist • Local health department administrator • A RN designee of a physician, local health department administrator, or other licensed healthcare facility

  17. School Survey • Survey is to be completed by October 31, 2011 • Links to paper survey, worksheets and instructions are on KIP’s website • Additional training available on website as well as for local health departments and school nurses • http://chfs.ky.gov/dph/epi/Immunization+Program.htm

  18. Storage and Handling • Vaccine Storage & Handling Toolkit www.2@cdc.gov.nip/isd/shtoolkit/splash.html • Monitor temperatures and report temperature variances to Kentucky Immunization Program, Judy Baker (502) 564-4478 x3518 & also your field staff representative • Rotate Vaccine • Safe Vaccine Handling & Storage Checklist

  19. Storage and Handling • Vaccine Delivery • Check monitor upon receipt of vaccine for temperature variance • Mark circuit breakers and plugs • Vaccine handling tips • Primary and back-up vaccine coordinators. Notify KVP of personnel changes • Train all staff who receive vaccine in proper S/H techniques

  20. Immunization Field Staff • Kim Gleitz. Bowling Green • Cindy Groves. Benton • Brian Holbrook. Prestonsburg • Tracy Kielman. Maysville • Sonya Moseley. Florence • Steve Norton. Somerset • Franda Sanders. Lexington • Jo Sickles. Harrodsburg • Chris Smith. Campton • Ida Taylor. Louisville • Donna Whistle. Owensboro • Doris Williams. Clay

  21. Kim Gleitz • Allen, Barren, Butler, Edmonton, Hart, Logan, Metcalfe, Monroe, Muhlenberg, Simpson, Todd, Warren. • Cindy Groves • Ballard, Caldwell, Calloway, Carlisle, Christian, Crittenden, Fulton, Graves, Hickman, Hopkins, Livingston, Lyon, Marshall, McCracken, Trigg

  22. Brian Holbrook Boyd, Floyd, Johnson, Lawrence, Martin, Pike • Steve Norton Adair, Casey, Clinton, Cumberland, Green, Lincoln, McCreary, Pulaski, Russell, Taylor, Wayne, Whitley • Doris Williams Bell, Clay, Harlan, Jackson, Knox, Laurel, Rockcastle

  23. Tracy Kielman Bath, Bracken, Carter, Elliott, Fleming, Greenup, Lewis, Mason, Menifee, Morgan, Robertson, Rowan • Sonya Moseley Boone, Campbell, Carroll, Gallatin, Grant, Kenton, Pendleton, Owen

  24. Chris Smith Breathitt, Knott, Lee, Leslie, Letcher, Magoffin, Owsley, Perry, Wolfe • Ida Taylor Bullitt, Jefferson, Oldham • Franda Sanders Bourbon, Clark, Estill, Fayette, Garrard, Jessamine, Madison, Montgomery, Powell

  25. Jo Sickles Anderson, Boyle, Franklin, Henry, Harrison, Marion, Mercer, Nelson, Nicholas, Scott, Shelby, Spencer, Trimble, Washington, Woodford • Donna Whistle Breckinridge, Daviess, Grayson, Hancock, Hardin, Henderson, Larue, Mclean, Meade, Ohio, Union, Webster

  26. KVP Staff • Alicia Tindall, RN Program Manager 3585 • Missy Eastman, RN Consultant 3334 • Nancy Hamilton, RN Field Staff Spv 3516 • Leslee Minch, RN Adult/Adol Coord 3513 • Julie Miracle, RN State Flu Coord 4038 • Laura Howard, VFC Coordinator 3855 • Judy Baker, KVP Asst. Coordinator 3518 • Rita Lathrem, VFC Representative 3914 • Clarissa Wilson, VFC Representative 3734 • LaKeta Ritchie, Office Manager 3519 • Carrie Tuggle, Immunization Coord 3690 • 502 564-4478 x

  27. State Address Department for Public Health Division of Epidemiology and Health Planning Immunization Program (502) 564-4478 Fax (502) 564-4760 or (502) 696-4923

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