Program Manual Policy & Practice Standards Manual

Transcription

1 Program Manual Policy & Practice Standards Manual Population and Public Health Disease Control Department Vaccine Refrigerator Monitoring Urban Offices Approved: Policy: Date: May 2012; R 11/12; 03/13; Page: 1 of 18 Policy: Vaccines are stored in refrigerators which maintain a temperature range between 2 C and 8 C. Purpose: To preserve efficacy and prevent wastage in the event of a biological refrigerator failure. Procedure: Regular Maintenance OAA/PHN Designate at each Health Centre 1. Checks refrigerator temperatures on a daily basis. 2. Records the minimum/maximum temperature on the Vaccine Refrigerator Storage Temperature Log (DC-288) at the beginning and end of the day. (See Appendix F for Data Logger Daily Reading Instructions) 3. Notifies the Health Centre supervisor or designate immediately if the temperature is outside of the 2 C - 8 C. Fridge Failure During Daytime Hours The Health Centre supervisor or designate 1. Inserts the data logger into the docking station and reads the printout. (Refer to Appendix G for Testo174 Data Logger Instructions for Reading ). If the was outside of 2 C - 8 C for less than 2 hours, it is not considered a cold chain break. Reset logger and put back in. If temp was out for longer than 2 hours, follows the cold chain break procedure as outlined in the Saskatchewan Immunization Manual. 2. If a goes out of range (2-8 ) an audible alarm will be heard. If the remains out of range for 15 minutes, the alarm company (Securtek ) calls the site directly.

2 Vaccine Refrigerator Monitoring Urban Office Page: 2 of Contact the ITC Program Manager to advise of the failure. If she is not available, call Polar Refrigeration at Advise that a has failed and that a timely response is essential. Fridge Failure Outside of Work Hours OOS Staff On Call 1. Receives call from Securtek. Note that some of the older s have temperature monitors that operate on electricity. A alarm for these s cannot be triggered if the power is out. For this reason, Securtek calls for power outages as well. 2. Ask which Health Centre(s) the alarm is for and whether or not the power is out. Ask how long it has been since the alarmed. If the alarmed more than 15 minutes before they called, advise the caller if you want a guard to meet you at the Health Centre. The alarm company will call guard service from the Commissionaires (phone # ). Wait for the guard outside the health centre when you arrive. 3. Access the Health Centre as per the table provided on page 4 of this policy. 4. Check the temperature on the LCD Display at the top of the. If the temperature is within normal range, check the temperatures on the data logger inside the. If the data logger also shows temperatures within the normal range, do not do anything. If the data logger temperatures are not consistent with the LCD display and they are reading temperatures outside of the acceptable range, then adjust the temperature up or down to get the back within normal range. If the regulator on the malfunctions, there will be a difference between the LCD display and the data loggers (a 1 or 2 degree difference is not significant unless the data logger is outside the range of 2-8 C). Always defer to the temperature on the data logger as this is considered to be the most accurate. 5. If the LCD display is above or below normal range (2-8 C) check the reading on the data logger. If both readings are out of range and the appears to be running, adjust the temperature down or up by 1-4 depending on how far above or below the appropriate temperature range the is running at. Use the data logger temperature reading as your reference. (See temperature setting instructions in Appendix E). Listen to see if the kicks in when the temperature is adjusted. If it doesn t kick in, adjust the temperature further and assess. If the does not kick in, make arrangements to move the. If the kicks in, wait 30 minutes to see if the returns to normal range. If the temperature returns to the normal range, call and advise Securtek to continue monitoring the and to call again if further temperature alarms come in. (See Appendix D for Account Information for Securtek.) 6. If the does not appear to be working, check to ensure that it is plugged in. Also check the breaker box (see Appendix B) to ascertain that the breaker has not flipped. If the is plugged in and the breaker has not flipped, make arrangements to move the. (See Section B).

3 Vaccine Refrigerator Monitoring Urban Office Page: 3 of If the power is out it is not necessary to go to the health centre if the power will be restored within 4-6 hours (see Power Outage table below). If you do go to a health centre at night, it is advisable to bring a flashlight from home as emergency flashlights are not always reliable (see Appendix B for emergency flashlight locations). 8. WWPHC or NE Office, call SaskPower at to get an estimate as to when the power will be restored. Note that WWPHC has emergency power back up for 1 hour on two of their s. The third is not on power backup so treat any outage as if no back up power exists. NE has a backup generator for the Vaccine Refrigerator room that runs indefinitely if the power is out. 9. IC, ONHC and SE, call the City of Saskatoon Electric Systems at during work hours or evenings and weekends to get an estimate as to when the power will be restored. 10. The Health Centre Supervisor or designate should always be informed of a power outage first thing the next day so that the data logger can be read to determine the length of time the was out of proper range.

4 Vaccine Refrigerator Monitoring Urban Office Page: 4 of 16 Power Outage Length of Outage Actions If power will be restored within 4 6 hours, leave the in the refrigerator. It is not necessary to go to the health centre but if you are at the health centre, place ice packs and refrigerated gel packs throughout the. Do not open the during the outage. Call Sask Power/City of Saskatoon in 4 hours to ensure that power has been restored. If the power is on you do not need to do anything. If the power is still out after 4 hours, contact SaskPower/City of 4-6 hours Saskatoon to find out how much longer the power will be out. If the power will be restored within 2 hours, do not do anything.. Check back in 2 hours. If the power has not been restored after 2 hours, go to the health centre and make arrangements to move the (see Section C.) Note: For the North East office, if the power has been out for 6 hours and it is still out, go to the health centre to ensure that the generator is working. If it is working, the s do not have to be moved. Take a flashlight with you as the generator only runs the s and not the lights in the room. Unknown Call SaskPower/City of Saskatoon in 4 hours to get an update. If the power is back on, do not do anything. If the power is not back on and the length of the outage is expected to last another 2 hours, do not do anything. Check back after 2 hours to see if the power has been restored. If the power still is not back on, make arrangements to move the. Note: For the North East office, if the power has been out for 6 hours and it is still out, go to the health centre to ensure that the generator is working. If it is working, the s do not have to be moved. Planned Power Outage If you receive notice of a planned power outage which will last more than one hour do the following: a) Place cooled 2 litre bottles of water and cooled gel packs throughout the. Always put gel packs in a solid bottom container to prevent gel leakage into the. b) Immediately prior to the outage, place frozen ice packs throughout the (ensuring that they are not in direct contact with s). c) DO NOT OPEN THE FRIDGE DURING THE OUTAGE. Remove the ice packs once the power has been restored. Note: If space permits, it is a good idea to always have some gel packs and bottles of water in the as this helps to stabilize the temperature during power outages/ failures.

5 Vaccine Refrigerator Monitoring Urban Office Page: 5 of 16 Health Centre Access WWPHC Always enter through the East entrance. If your prox card does not work, the key for the room will open this door. Alternatively, there are two lock boxes to the left when you are facing the door. The lower lock box has a key for accessing the building. The code for the lock box is (or any combination of these three numbers ie ,etc). Proceed straight ahead down the hallway to another door. Go through this door. The is in the room directly ahead at the end of this hallway. To access the WWPHC refrigerator room, the door code is If the power is out, the door code does not work. You must use the key which has been provided to you with the prox card. When you are at WWPHC, always keep your prox card and key with you at all times because doors will lock behind you. If you encounter any facility problems at WWPHC, i.e. accessing the building, call Jackie Verigin, WW building manager at or Innovation Place s Energy Centre at They manage this site and staff is available 24/7. SEHC Always enter through the back door closest to the east side of the building. There are 3 s located at the back of the Health Resource room. IC If the power is out, the Prox cards will still work. There are 2 s. One is in the Dental storage room. The other is in the STI lab. ONHC If the power is out, the key fob will still work. Always enter through the main entrance on the East side of the building using the key fob. The key fob sensor is to the right of the main door. Once you enter the building, the security pad is on the wall on the right. Go through the doors straight ahead and then turn left. Go through the CHEP eating area. The Public Health door is at the end of this room on the right. You need to swipe your key fob on the sensor to the right of the door. Proceed down the hallway (it goes right and then left) until you reach the open staff area. There is a door on your right. The is at the back right hand corner of this room. NEHC Always enter through the back door on the north side of the building. You will have to unlock the deadbolt and the door knob to gain access. Take the first hallway on your left. The room is the first door on the right. There are 11 s in the room.

6 Vaccine Refrigerator Monitoring Urban Office Page: 6 of 16 Moving the Vaccine Daytime and Outside Daytime Hours Health Centre Supervisor or Designate/OOS On Call 1. Once the decision has been made to move the, the data logger inside the should be read. Record the following information for entry on the Community Unusual Occurrence form (#101793) the next day Date: Time of day: Current temperature: 2. You will need a SUV, van or half ton to move the. Even one of the insulated boxes is too large to fit in the trunk of a car. If you do not have a large enough vehicle, call Saskatoon Radio Cabs at and request that they send a passenger van. (See Appendix D for Health Centre addresses). There are taxi vouchers for payment in the on call briefcase. If you use a voucher, notify the OAA to the DC Manager on the next work day so that she can replenish the supply. 3. Pack the s in Styrofoam containers or insulated cardboard boxes which are located at each Health Centre (Appendix A). Place ice packs in the bottom of the container. Put a data logger in the middle of the in the box. Put a layer of newspaper or bubble wrap on top of the ice packs. Place the in the container and then put another layer of newspaper over the. Top with gel packs. Note: SEHC & WWPHC both have a small amount of purchased s. These are in containers/baskets marked Purchased Vaccines in the s. These should be put in a paper bag and placed in the cooler in order to keep them separate from the other s. If you are moving s from NE, there is a large volume of purchased s. They are in ITC Fridges # 1, 2, 3, &4. Use separate coolers for the purchased s and label the coolers as Purchased s. 4. The volume of s at the Health Centres is large. The containers are large and weigh approximately 58 pounds when full. Always have two people to lift the containers in and out of the transport vehicle. It is recommended that you use a 2 wheel dolly to move the containers. A dolly causes less back strain and it is easier to navigate. If you use a 4 wheel cart, place the empty box on the cart before loading it. 5. If the s are being moved out of NE (due to a or generator failure), or if there is no room in NE s for health centre s, call RUH Pharmacy and make arrangements to have the temporarily stored there: a) If the power outage occurs during normal business hours call RUH pharmacy at b) If the outage occurs outside of normal business hours call RUH switchboard at and ask them to page the on-call pharmacist and security.

7 Vaccine Refrigerator Monitoring Urban Office Page: 7 of 16 Arrangements have been made for them to take our s. Ask the pharmacist to meet you at the walk-in. Ask security to meet you at the front entrance of the old hospital to unlock the door (this door is locked after hours). The Pharmacy is on the ground floor at the end of C wing in the old part of RUH. c) At RUH, the s are put in the walk in and they can be left in the Styrofoam container providing the ice packs are removed and the lid is left off. 6. Once the s have been moved, leave a voic for the ITC Manager at indicating that the s have been moved. Notify Securtek that the s have been moved and tell them not to call if there are more alarms for that site. (We will notify Securtek when the s are moved back.) 7. If s are being moved out of IC, SEHC, ONHC or WWPHC, move them to the NE office. a) At NE, unpack the containers and place the s in the two double wide biological s labeled #4 and #6. Do not store s in the inside the Styrofoam containers. If there is insufficient room in these s, put in any other s that have room. 8. Immediately on the next work day: a) Notify the ITC Program Manager about the alarm. If the was moved, notify the ITC Program Manager and the ITC Administrative Assistants ( ). Do not leave a message - you must speak to a live person to alert them that the has been moved so that they can immediately repack the and make arrangements for a courier or a staff member to return the to the health centre (providing the is working). If neither of these people are available, notify the Health Centre Supervisor or designate that the was moved from. They will be responsible for arranging to have the returned. b) Complete a Community Unusual Occurrence Report (#101793) and send to the DC Manager. c) If the was out of its cold chain in excess of 2 hours, the Health Centre supervisor or designate completes a Vaccine Cold Chain Interruption Incident Report and faxes it to the International Travel Centre Program Manager.

8 Vaccine Refrigerator Monitoring Urban Office Page: 8 of 16 Appendix A Location of Vaccine Packing Supplies Coolers Gel Packs Ice Packs Newspaper /Bubble wrap Dolly/ 4 wheel cart Paper Bags SE WWPHC ONHC CDC STI Lab NE Same room as Same room as s s Same room as s (in resource room on top of shelving units) Usually in staff room. May be in. In freezer of single and some in staff room freezer Inside coolers Both in same room as s Same room as s In staff room In freezer compartment of single In kitchen in same room as In kitchen in same room as Same room as s (in dental storage room, main floor, IC) In and some in kitchen near back door In freezer in Same room as s (in STI lab) In In freezer in Inside coolers Inside coolers Inside coolers Inside coolers 4 wheel cart in east end storage room Same room as s 4 wheel cart beside cooler Dolly and 4 wheel cart in photocopy room Dolly and 4 wheel cart in photocopy room You would need to get the coolers from all other Health centres In In upright freezer in room In bin under table in room -4 wheel cart by back staff entrance -Dolly in electrical room beside staff entrance N/A N/A N/A Same room as s

9 Vaccine Refrigerator Monitoring Urban Office Page: 9 of 16 Appendix B Emergency Flashlights are located as follows: South East Health Centre West Winds Primary Health Centre PHS-North East Idylwyld Centre Our Neighborhood Health Centre Enter through the back door closest to the east side of the building. At the hallway turn left. It is plugged into the wall. Flashlight is plugged into the wall in the foyer between the two sets of doors at the east entrance. There also are flashlights on the shelf in the room. First door on the left as you enter from the north entrance. It is plugged into the wall near the floor. Flashlight is plugged into the west wall of the front entrance door to PHS (beside main reception desk). On wall opposite entrance to supply room. Appendix C Breaker boxes are located as follows: PHS - South East West Winds Primary Health Centre Idylwyld Centre PHS - North East Our Neighborhood Health Centre The fuse box is in a storage room near the south exterior entrance to the resource room. Diagram given to staff that are on the power outage fan-out list. The fuse box is located in middle storage room in the southwest office in the atrium area. The door is locked but there is a master key in the OOS on call binder. The first door on the left as you enter from the north entrance. The breakers for the s are in Panel Box E. We do not have access to the breaker box.

10 Vaccine Refrigerator Monitoring Urban Office Page: 10 of 16 Appendix D MEMORANDUM POPULATION AND PUBLIC HEALTH Office of the Director # Idylwyld Drive North Saskatoon, Saskatchewan S7L OZ2 Phone: (306) Fax: (306) Security for Public Health locations (Saskatoon) February 2013 Could our accounts be entered in your database for the following Saskatoon locations to read as follows? Y Saskatoon Public Health-Northeast-# Ludlow Street ( ) Y Saskatoon Public Health-Southeast-3006 Taylor Street ( ) Y Saskatoon Public Health-Westwinds-3311 Fairlight Drive ( ) Y Saskatoon Public Health-310 Idylwyld-Rm 101/204 ( ) Y Saskatoon Public Health-310 Idylwyld-Rm 105 ( ) Y24-P00245 Saskatoon Public Health-310 Idylwyld-Rm 106 ( ) R Saskatoon Public Health-power outage/biological alarms only- Our Neighbourhood Health Centre- # th Street West( ) A. During regular office hours: (Monday to Friday-Except STAT Holidays ), in the event of a biological alarm, please call the phone number associated with the facility listed above. The exception to this is for Our Neighbourhood Health Centre. This health centre does not have and Administrative Assistant working on Fridays. If the alarm is on a Friday, call the Healthy Lifestyls Department Manager at B. After office hours: 1630 to 0800-Monday to Friday and 24 hours/day on Saturdays, Sundays and STAT Holidays, in the event of a security breach, power outage or biological alarm, please call the On-Call Manager at (306) If unable to get an answer (after several tries), then call: Suzanne Mahaffey (h) c) Tonia Ballantyne (h) c) C. Authorized users to make changes to above Public Health Accounts are: Jan Anweiler jan.anweiler@saskatoonhealthregion.ca Tonia Ballantyne tonia.ballantyne@saskatoohealthregion.ca

11 Vaccine Refrigerator Monitoring Urban Office Page: 11 of 16 Appendix E How to Adjust Biological Refrigerator Temperatures

12 Vaccine Refrigerator Monitoring Urban Office Page: 12 of 16 Appendix F Data Loggers-Daily Reading Instructions 1. When the logger is recording, you will see Rec on the top left of the digital display. 2. To read the minimum and maximum temperature, press the button marked Go. The word Max will appear on the top right of the display. The temperature on the display will then show the maximum temperature recorded. Mark this on the temperature recording sheet as the maximum temperature. Make sure that the work Max is in the display when you record the reading. If this word isn t on the screen you will record the wrong temperature (i.e. you might record the min/max settings as opposed to the actual temperature). 3. Press the Go button again. The word Min will appear on the top right of the display. The temperature on the display will then show the minimum temperature recorded. Mark this on the temperature recording sheet as the minimum temperature. Make sure that the work Min is on the display when you record the reading. If the word Min isn t on the screen, you will record the wrong temperature (i.e. you might record the min/max settings as opposed to the actual temperature). Return the data logger to the. 4. Continue to press the Go button after you have checked the minimum and maximum temperature, it will go through a few more cycles. One cycle shows the minimum temperature setting that has been programmed into the logger (2 ). One cycle shows the maximum programmed temperature setting (8 ). The final setting shows how much life is left in the battery. Keep pressing the Go button until Rec appears in the top left hand corner and there are no other indicators on the display (i.e. flashing signals or min/max notifications on the top right corner). 5. Do not keep the data logger out of the for more than a minute. If it is kept out of the too long, it will record the room temperature as the maximum temperature. The logger is set to take a temperature read every 30 minutes. 6. Once a minimum or maximum temperature has been logged, this same temperature will continue to show as the minimum or maximum until a lower or higher temperature is logged. For example, if the maximum temperature goes to 6 the maximum temperature will always show 6 as the maximum temperature unless the temperature rises above 6. If it goes above 6 then this becomes the new maximum temperature that the display will show. 7. If you get any readings below 2 or above 8, the logger must be plugged into the docking station to determine the length of time of the temperature aberration. If the printout shows that the logger was out of range for greater than 2 hours, you must notify Public Health immediately (call ). Once a logger goes out of range, it must be reset. The only way to reset the loggers is to attach them to the docking station. If you don t reset the logger, it will always read the highest or lowest temperature that occurred during the temperature aberration.

13 Vaccine Refrigerator Monitoring Urban Office Page: 13 of 16 Appendix G Testo 174 Data Logger Instructions for Reading (August 29, 2011) 1. Open the Testo Software program by clicking on your start button and then All Programs/Testo. Click on the bottom Orange Testo Comfort Software Basic Remove mounting bracket from logger. The tabs on the bottom slide to release the logger. 3. Put logger in docking station make sure it is inserted properly. 4. Click on Connect Instrument on the left side of the wheel which appears on the screen. 5. Click on Connect on the top right hand corner of the first box on the screen. If a little box appears that says Unable to Connect Instrument, it usually means that the logger has not been inserted into the docking station correctly. Click OK in this box and remove and reinsert the logger. Click on Connect again. If the same message appears, you may have to unplug the docking station from the computer and reinsert it. If this does not resolve the problem, you will have to call ITC Program Manager.

14 Vaccine Refrigerator Monitoring Urban Office Page: 14 of 16 Appendix G (Continued) 6. If the logger is inserted properly as in step 5, then click on Evaluating across the top of the screen. 7. Click on Import Measurement Data on the left side of the screen. 8. Click on Start Import on the bottom right side of the screen.

15 Vaccine Refrigerator Monitoring Urban Office Page: 15 of 16 Appendix G (Continued) 9. When the green bars are complete, the hourglass will disappear. Wait a bit and then the logger graph and line list will appear. Click on show alarms across the bottom of the screen. Review the data. Click on Show Alarms across the bottom of the screen and only the alarm temperatures will show. If no alarm temperature shows up on the printout, it means that the logger went out of range and then back into range between its 30 minute time interval for readings. In other words, it was a temperature increase of less than 30 minutes. This does not affect the integrity. The logger can be reset. If the temperature was out of range for less than 2 hours, then the is OK and you just need to reset the logger. If the temperature was out of range for 2 hours or more, then click on send on the bottom of the page and send this information to ITC Program Manager. She will review and advise you. 10. Once you have ed the log to ITC Program Manager or if the logger was out of range for less than 2 hours then you must reset the logger. 11. Click on Instrument across the top of the screen. 12. Click on Configure Instrument on the left side of the screen.

16 Vaccine Refrigerator Monitoring Urban Office Page: 16 of 16 Appendix G (Continued) 13. Scroll to the far right hand side of the screen and click on stop measurement on the bottom right hand corner. Wait for the hourglass to disappear. 14. Click on Transfer to Instrument on the bottom of the screen. 15. Click on OK in the box that pops up stating Saving data overwrites all measuring and configuration data in the logger 16. Once the above box disappears, the word wait will appear on the top of the logger screen (not the computer screen). This means that the logger has been resent and is now in wait mode. 17. Return the logger to the and wait for about 30 minutes for the logger to cool down to temperature before reactivating it. To reactivate, press and hold the Go button down for 3 seconds. Failure to let the logger cool to temperature before reactivating will result in the room temperature being logged as the high temperature. You will then have to reset the logger. 18. If you are reading more than one logger, you must complete the process for the first logger and then close the Testo program. Reopen the program and then read the second logger.