Front Door

• Meet at 0800 or 1300 in the observation room
• Base yourself outside the entrance (or just inside in bad weather)
• Beckon lost looking people towards you rather than letting them go in the pharmacy
• Ensure people are wearing face masks – we have some available if needed
• Check temperatures using a non-contact thermometer and issue hand gel – Anyone with a temperature of 37.8 or above should be advised to head home (or a continuous cough or loss of taste or smell)
• Encourage members of the same household to stay together through the whole process (including going in for their vaccine together)
• Encourage those from separate households to keep two meters apart

Check-in / Reception

• Meet at 0800 or 1300 in the observation room
• After the meeting head to reception
• Laptops will need to be set up (before or after the meeting)
• Login to Pinnacle sooner rather than later: https://outcomes4health.org
  
• Also sign into accuRx on another tab: https://chain.accurx.com
• Ask the patient their appointmen time and name, find them and tick "arrive patient" on accuRx
• Double click on their NHS and then right click and copy or press CTRL-C
• Switch to Pinncle and paste the NHS number into the serach box CTRL-V (or right click and paste)
• You will need to then ask the patient their date of birth and enter this in Pinnacle in their odd format e.g. 1-Apr-1985
• Provide the patient with a leaflet and a vaccination card – you will need to write their name and date of birth on the card
  
• If you cannot find the patient on Pinnacle put a star on their card and tell them to move on, vaccinator admin will then find them while in the vaccination room

Patient Flow

• Meet at 0800 or 1300 in the observation room
• One person should be stationed at the junction where the frail route goes straight on – send anyone you think looks particularly frail this way including all wheelchairs
• One person should be stationed at the T junction – this person should hold the queue here and is crucial for directing patients (or couples) to vaccination rooms as they become available, remember to watch out for vaccination room 5 which is quite a way away
• Encourage people to have their coats of and an upper arm accessible when they enter a vaccination room (if possible)
• The third member of the team should be stationed between the observation and the frailty queue helping those who need to leave the observation the wrong way

Vaccinators

• Meet at 0800 or 1300 in the observation room
• After the meeting head to a vaccinator room and login as you
  • Desktop has no password, just press enter
  • It is recommended that non-prescribers are in rooms 1 and 2
  • The person in room 5 needs to pull from the Blue queue when someone particularly frail is present
  • Signal to the patient flow team member standing at point B when you want them to send the next person down
• Gain consent from the patient
• Clean the vial top before each dose but allow to dry
• You need to withdraw some vaccine then inject the air bubble into the air inside the inverted vial and then withdraw some more vaccine to get 0.3ml (Pfizer), 0.5ml for Oxford/Astrazenec.
• Those on warfarin or a DOAC should hold (not rub) a piece of cotton wool over the area for 2 minutes
• With your support person provide them with an “after you have been vaccinated” leaflet (one per household) and their vaccination card
  
• Advise them to go out of the room and head left to the observation room where they will need to sit for 15 minutes, once they have done this they are free to leave
  

Vaccinator Admin/Support

• Meet at 0800 or 1300 in the observation room
• After the meeting head to a vaccination room
• Login as you when selecting the name of the vaccinator the first time you will need to serach for their name, subsequent times you click in the box you will be able to click on the user from a list which appears
• Take the patients vaccine card from them and use this to identify them on the system
• Do not worry about entering a patients email or phone number
• Ensure to enter the correct vaccinator and batch number
• Write the batch number on the patients vaccination card
• Document the time the vaccine was given and write this on the card and give the card back to the patient before they leave along with an “after you have been vaccinated” leaflet

Observeration Room

• Meet at 0800 or 1300 in the observation room
• Make yourself comfortable
• Welcome patients as they enter the room
• Those from the same household should be encouraged to sit together
• Point out the two radio controlled clocks and advise them they can leave once they have been here for 15 minutes after their injection time which will be writing on their vaccination card
• For the Oxford vaccine they should not drive for 15mins but can leave straight away, if they would like to wait in the observation room this is fine as long as there is space available
• Help people towards the exit
• Anyone in a wheelchair or who is particularly frail can go out the way they came in
• If anyone feels unwell seek support from the manager or clinical staff

Diluters

• Remove 10 vials of vaccine from the fridge before the briefing meeting – document the time this was done and the time the vaccine will expire
• You might want to consider doing some dilution before the 0800 and 1300 meetings
• Meet at 0800 or 1300 in the observation room
• After the meeting head back to the fridge room
• Deliver the first batches of diluted vaccine to the vaccination rooms
• After the clinic has started plan the next batch of vaccine dilution and delivery
• The 5 vaccination rooms will need additional diluted vaccine every hour if provided two vials at a time or every 30mins if provided one vial at a time
  

Clinical Lead

• Consider liaising with the diluter before the day as you may want to consider meeting early to dilute some vaccine before the 0800 meeting
• Meet at 0800 or 1300 in the observation room
• Any person who has not worked in the centre before may need a briefing
• Support staff to know what they should be doing and where they should be going after the meeting
• Monitor patient flow and speak with the team in the fridge room if there are any concerns regarding flow rate
• Deal with any issue which develops!
• Half way through the afternoon you need to start planning how to end the session limiting the potential for unused doses
• You might want to consider shutting down rooms and getting people to share vials (especially with the Oxford vaccine)
• You may need to phone some local people to come in to receive any left over doses

Manager

• Parking permits will need distibuting before the 0800 meeting
• Ensure internet access is working in all vaccination rooms and at reception
• Meet at 0800 or 1300 in the observation room
• Support staff to know what they should be doing and where they should be going after the meeting
• Monitor patient flow and speak with the team in the fridge room if there are any concerns regarding flow rate
• If the observation room is full then the vaccinators may need to be told to slow down