Immunization competencies for healthcare providers

Any healthcare professional prescribing vaccines requires specific competencies in order to ensure that vaccines, like other medications, are provided in a safe, effective, and ethical manner. In order to promote safe and competent practice, the Public Health Agency of Canada (PHAC) developed a handbook in 2008 entitled Immunization Competencies for Health Professionals.  These foundational competencies include:

• Explaining how vaccines work using basic knowledge of the immune system.
• Understanding the rationale and benefits of immunization.
• Integrating into practice knowledge about the main steps in vaccine development and evaluation.
• Applying knowledge of the components and properties of immunizing agents as needed for safe and effective practice.
• Applying relevant principles of population health for improving immunization coverage rates.
• Communicating effectively about immunization.
• Implementing guidelines for safe storage and handling of vaccines.
• Preparing and administering immunization agents correctly.
• Anticipating, identifying, and managing adverse events following immunization.
• Understanding documentation requirements for immunizations.
• Recognizing and responding to the unique immunization needs of certain population groups.
• Demonstrating an understanding of the immunization system in Canada.
• Addressing immunization issues using an evidence-based approach.
• Acting in accordance with legal and ethical standards in all aspects of immunization practice (PHAC, 2008).

Health professionals need to be able to anticipate, identify, and manage adverse events that may occur following immunizations (PHAC, 2008). As you have learned in earlier chapters of this resource, adverse events following immunizations are rare. Although these events are rare, monitoring vaccine safety through mandatory adverse event reporting is an important aspect of the immunization program in Ontario. Adverse events following immunization can be reported with a form from the PHAC, which can be submitted to the local public health agency where the patient lives.

Optimizing the Role of Ontario RNs in Immunization Through RN Prescribing

Pending government approval of the proposed CNO regulation, RN prescribing will be authorized for certain medications that will allow RNs to manage non-complex patient care needs (CNO, 2019b). In the first phase of RN prescribing in Ontario, these medications will include some vaccines (CNO, 2019b).

While RNs in Ontario have typically participated in immunization as front-line providers in schools and community settings, this change will allow RNs to not only administer vaccines but prescribe them as well. Given the important role RNs play in primary health care and health promotion, a strategic focus on maximizing the involvement of RNs in immunization should help advance the public health goal of immunization for everyone across the life cycle (International Council of Nurses, 2013).