Administering immunizations safely requires competencies beyond that of routine medication administration. All nurses administering immunizations must possess the required knowledge, skills, and judgment to safely do so. Nurses comply with federal and provincial regulations, as well as with BC College of Nurses and Midwives’ (BCCNM) standards of practice and organization/employer policies, when administering immunizations. Your individual competencies may impact whether you can prescribe, dispense, compound, or administer immunizations in your practice.
All nurses are expected to use evidence-based information when educating clients or the public about immunizations. When engaging with clients and the public, nurses are accountable for identifying the effect of their own values, beliefs, and experiences about immunizations, recognizing potential conflicts, and taking action to meet the client’s needs.
It is within the nursing scope of practice for nurses of all designations to administer immunizations with a client-specific order. It is also within the nursing scope of practice for nurses of all designations to administer immunizations within their autonomous scope of practice (i.e. without a client-specific order from an authorized provider) if:
LPNs are authorized to compound or administer immunoprophylactic agents for the purpose of preventing disease (Schedule I & II drugs) within their autonomous scope of practice (without an order) as follows:
Limits and Conditions
BCCDC identified immunoprophylactic agents
Not authorized to give without an order
The BC Centre for Disease Control’s (BCCDC) education is the standard for assessment of immunization competencies. BCCDC
offers the education online. The education has several parts:
Nurses should assess their competencies regularly and refresh as needed.
See below for additional information about competence requirements by nursing designation:
Administering immunizations is a restricted activity within autonomous scope of practice (‘without an order’) under the
Nurses (Licensed Practical) Regulation. BCCNM requires LPNs who autonomously compound or administer immunizations to successfully complete the additional education established by the BC Centre for Disease Control, possess the competencies established by BCCDC and follow its decision support tools.
LPNs providing immunizations are accountable and responsible for assessing their immunization competencies regularly and undertaking additional education as needed to maintain their competence.
Review the following standards:
While you’re not required to have a flu shot to be registered with BCCNM, you are responsible for protecting your clients from the risk of infection. Nurses have a professional, ethical and legal duty to provide clients with safe care. Review the
BC Ministry of Health’s and your employer’s/organization’s policies about immunizations and influenza control.
Your designation’s Communicable Diseases: Preventing Nurse-to-Client Transmission practice standard provides more information about your responsibilities to provide safe care to clients.
The physician needs to give a client-specific order for each client that is to be immunized. There is no such thing as an order that is applied to a group or a population of clients.
Health care professionals who are authorized to give a client-specific order is laid out in your designation’s nursing regulation. Not all nursing designations have the same list of authorized prescribers. Review your nursing regulation to see who is authorized to give client-specific orders.
No. Administering an immunization is within the autonomous scope of practice for LPNs and they do not need to be supervised by another health professional when giving an immunization to a client. However, LPNs who administer immunizations work within a team approach to access support as needed. Working within a team approach means that when client care includes activities outside the LPN scope of practice or the individual LPN’s competencies, the LPN seeks out other members of the health care team to jointly review and determine how the client’s care needs will be met.
No. It is not within a pharmacist’s scope of practice to
give a client-specific order for an immunization. It is within a pharmacist’s scope of practice to
administer an immunization, but not to prescribe it. If a client-specific order is required, you need to get it from a health professional who is authorized to prescribe as laid out in your nursing regulation.
You cannot give this immunization within your autonomous scope of practice as you do not meet the BCCNM conditions/limits for this activity. You need to get a client-specific order from an authorized prescriber before administering it.
When you do not meet the requirements to act autonomously then you absolutely need a client-specific order to administer the immunization. You do not need to meet the BCCDC immunization competencies to act on a client-specific order, however, you would need to ensure you have the competence to give an injection and administer medication.
Review your scope of practice standard to see what the requirements needed to administer immunizations within your autonomous scope of practice.
Nurses must get a client-specific order to administer an immunization if they do not meet the standards, limits and conditions set out in their Scope of Practice standards.
Yes, if meet the conditions in your Scope of Practice standard, possess the competencies set by the B.C. Centre for Disease Control (BCCDC), follow BCCDC decision support tools, and adhere to your employer/organizational policies.
Within their autonomous scope of practice, LPNs can compound or administer immunoprophylactic for the purpose of preventing disease to clients four years of age or older with stable or predictable states of health in a team approach. LPNs must have the competencies set by BCCDC and follow BCCDC decision support tools.
For further information on the Standards of Practice or professional practice matters, contact us: