School of Nursing Faculty of Health Sciences

Transcription

1 School of Nursing Faculty of Health Sciences Policy On: Immunization Screening Process For students entering their first year of Nursing, this documentation is required for registration in the program. It is the responsibility of each student to maintain their health records. For all students, the absence of documentation will result in the student being deemed ineligible for clinical placements. Exception: Influenza immunization is not usually available until October and takes two weeks to become effective. Influenza immunization should be done as soon as the vaccine becomes available. Students are advised to attend their Family Physician, Student Wellness Services, or the Public Health Unit to have their immunization schedule reviewed. Contact your Family Physician if you need serology, as Public Health does not do any serology for immunizations. Immunizations or serology testing occurs at the student s cost. Documents that will be accepted as proof of immunization include the Provincial Immunization Record, documentation signed by a healthcare provider, and/or laboratory evidence of natural disease or immunity. Students may access Queen s Student Health Services at IMMUNIZATIONS TUBERCULOSIS-Tuberculin Skin Test (TST): Required A 2-step Tuberculin Skin Test is required once in a lifetime. Then, a 1-step TST is required annually. Documentation of the 2-step test must be provided with this form. For a valid 2-step, steps 1 and 2 should be done 1 to 3 weeks apart. If a 2-step TST was completed previously, and documentation can be provided, a 1-step TST can be completed annually. Note: A 10mm or more induration is positive (or 5mm or more for those infected with HIV, or in recent close contact with active TB, or with chest X-ray indicating healed TB). If either TST is positive, this must be reported to the School of Nursing. The student will require medical follow-up with chest X-ray and referral to the Tuberculosis Clinic at the Kingston General Hospital. INFLUENZA Vaccine (FLU): Recommended The Influenza vaccine is strongly recommended. If a student decides NOT to be vaccinated, in the event of a flu outbreak he/she will be removed from placement. Some agencies do not permit students to do their clinical placement if they do not have the flu vaccine. Influenza immunization is not usually available until October and takes 2 weeks to become effective. An annual influenza immunization should be done as soon as the vaccine becomes available. MEASLES, MUMPS, RUBELLA Vaccine (MMR): Required Students show proof of immunity in one of two ways: Form U1.1 Revised: March 24, 2016

2 1) Two vaccinations after the first birthday; OR 2) Blood work showing immunity. If not immune, students need to receive 2 doses of MMR vaccine. MENINGOCOCCAL Vaccine (Men-C-C or Men-C-A, C, Y, W-135): Recommended Either Men-C-C or Men-C-ACYW-135 vaccine (depending on local epidemiology and programmatic considerations) is recommended for adolescents (given routinely at 12 years of age) and young adults, even if previously vaccinated as an infant or toddler. For the Men-C-ACYW-135 vaccine, a booster dose is recommended every 5 years if individuals in these groups remain at ongoing risk. TETANUS/DIPTHERIA/PERTUSSIS Vaccine (Tdap): Required Students must provide proof of Tdap booster (Adacel/Boostrix) within the last 10 years. Students are responsible for ensuring that these boosters remain up-to-date after admittance to the School of Nursing. After receiving a Tdap at ages 14 to 16, everyone over the age of 18 still requires 1 dose of Tdap (or TD- IPV-see polio). A Td or Tdp booster (see polio) is required every 10 years after that. POLIO Vaccine: Required Students are required to provide documentation of a complete series of polio vaccine. Polio vaccine series consists of 5 doses for children up to 6 years old and 3 doses if primary series started after age 7 (adult dose). The four dose series is acceptable if the last dose is given between 4 and 6 years of age. If no evidence of complete vaccinations is provided, students who only need polio protection should receive two doses of IPV-containing vaccine given 4 to 8 weeks apart, followed by a third dose 6 to 12 months after the second dose. HEPATITIS B Vaccine and serology: Required For Hepatitis B vaccine, documentation of receipt of all doses by a physician or Public Health Unit as well as laboratory evidence of immunity (i.e. positive serology for antibody to Hepatitis B -Anti-HBs) is required. It is understood that Hepatitis B immunization may not be complete at registration; however, all tests and immunizations must be completed by the first clinical placement. Notes: 1) Students who are anti-hbs positive, no further action is required. 2) Students who are anti-hbs negative must be screened for Hepatitis B surface antigen (HBsAg). Students who are negative for anti- HBs despite one Hepatitis B vaccine series and who are HBsAg negative are required to have a second series of Hepatitis B vaccination and submit the results of a second anti-hbs one month after the completion of the second series of vaccination. If the student continues to have negative anti-hbs, this series should be completed. Another antibody level is required one month post series. 3) Students who continue to be non-immune after a second series of Hepatitis B vaccine are considered to be non-responders and will be referred for counselling. If the result of any HBsAg test is positive, the student will be referred for counselling by the Director of the School. They will also need HBeAg, Form U1.1 Revised: March 24, 2016

3 anti-hbe and Hepatitis B DNA levels. NOTE: Students infected with Hepatitis B will undergo an assessment of their potential to transmit Hepatitis B. This assessment could restrict or modify your participation in some aspects of the curriculum. Only electronic submission of this form will be accepted. Access the Nursing Undergraduate Portal using your netid at Or directly to Linda Suurdt (see below). Contact the Nursing Lab Manager with any questions. Suurdtl@queensu.ca Phone: ext Form U1.1 Revised: March 24, 2016

4 Immunization/Serologic Status for Students Entering the School of Nursing STUDENT NAME: DATE OF BIRTH: TUBERCULOSIS Skin Test A 2-step Tuberculin Skin Test is required once in a lifetime. Step 1: mm duration. Step 2: mm duration. If a 2-step TST was completed previously and documentation can be provided, a 1-step TST can be completed annually. For a valid 2-step, steps 1 and 2 should be done 1 to 3 weeks apart. Then 1-step TST annually: mm duration. VARICELLA Vaccine Dose #1: Vaccine Dose #2: Varicella Titre Result: A student must show proof of immunization (2 doses), and they must also provide serological status of immunity. *If you do not have record of you immunization (2 doses), serological status of immunity is sufficient. Reactive/Immune (+) Non-reactive (non-immune) (-) INFLUENZA MEASLES, MUMPS, RUBELLA VACCINE (MMR) Dose #1: Dose #2: Titre Result: Reactive/Immune (+) Non-reactive (non-immune) (-) Annotation: Recommended Influenza immunization is not usually available until October and takes 2 weeks to become effective. An annual influenza immunization should be done as soon as the vaccine becomes available. Students show proof of immunity in one of two ways: 1) Two vaccinations after the first birthday; OR 2) Blood work showing immunity

5 MENINGOCOCCAL Vaccine Date: (yyyy/mm/dd) Annotation: Recommended Type TETANUS/DIPTHERIA/PERTUSSIS (Tdap) Please document the most recent Tdap or Td vaccine: Date( yyyy/mm/dd) POLIO Dose #1: Dose #2: Dose #3: Dose #4: Students must provide proof of Tdap booster within the last 10 years. After receiving a Tdap at ages 14 to 16, everyone over the age of 18 still requires 1 dose of Tdap (or TD-IPV-see polio), and then a Td or Tdap booster (see polio) is required every 10 years. Students are required to provide documentation of a complete series of polio vaccine. Polio vaccine series may consist of a 3-5 dose series depending on the when the series was started and when the last dose was given. Dose #5: HEPATITIS B Initial Vaccination series (2 or 3 dose series): Dose #1: Dose #2: Dose #3: Surface Antibody Level (Anti-HBs) must be done to show immunity: Date: (yyyy/mm/dd) Document dates of Hepatitis vaccination. Then Surface Antibody Level (Anti-HBs) must been done to show immunity for all students. Students not showing immunity to Hepatitis B after vaccination are required to get a Hepatitis B surface antigen (HBsAg) test. Reactive/Immune (+) Non-reactive (non-immune) (-)

6 Physician/Nurse declaration: I confirm that the information provided on this form is correct: Name: Address: Telephone: Signature Date: (yyyy/mm/dd) Student Authorization: I give my consent that the information on this form may be shared as required with the Queen s University School of Nursing and clinical facility teaching and administrative staff. Student Name: Date of Birth: Signature Date: (yyyy/mm/dd)