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.
BCCNM does not train, educate or provide education materials for nurses related to giving COVID-19 vaccines; BCCNM sets the standards nurses must meet when giving immunizations. Nurses and organizations/employers work together to ensure nurses giving the COVID-19 vaccine have the required education. Please visit the
BCCDC website for required competencies and training information.
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:
Before prescribing (RN and RPN only), dispensing, compounding, or administering immunizations, nurses must meet and follow certain limits and conditions and apply relevant standards of practice.
RPNs are authorized to prescribe, compound, dispense 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:
BCCDC identified immunoprophylactic agents
Not authorized to give without an order
Nurses must meet the competencies set by the BC Centre for Disease Control’s (BCCDC) and this is often achieved through completing the BCCDC Immunization course. Check with your employer to confirm requirements. 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.
Administering immunizations is a restricted activity within autonomous scope of practice (‘without an order’) under the
Nurse (Registered Psychiatric) Regulation. BCCNM requires RPNs who autonomously prescribe, compound, dispense or administer immunizations to possess the competencies established by BCCDC. RPNs must also successfully complete the BCCDC immunization competency course and follow its decision support tools where indicated. RPNs administering influenza or pneumococcal immunizations are required to complete additional education, which may be education other than that specific to BCCDC.
RPNs 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.
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, RPNs can prescribe, compound, dispense or administer immunoprophylactic agents for the purpose of preventing disease to clients four years of age or older. RPNs must successfully complete additional education, have the competencies set out in BCCDC’s
Immunization Competencies for BC Health Professionals and follow BCCDC’s decision support tools in the
Communicable Disease Control manual.
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.
For further information on the Standards of Practice or professional practice matters, contact us: