Below is a description of the ways in which an Aboriginal community controlled health service can maintain the potency of its vaccines. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.
A staff member at each clinic has designated responsibility for cold chain management and this is documented in their job description. Each health service clinic has a backup staff member who is able to manage the cold chain of vaccines if the designated staff member is ill or on leave.
The staff induction process includes cold chain management and staff training logs show records of cold chain in-service training. When interviewed, the designated staff members are able to demonstrate the procedures of cold chain management, from stock ordering to the accuracy of the digital thermometer in the refrigerator used to store vaccines.
The service has the latest edition of the Australian immunisation handbook and National vaccine storage guidelines: Strive for 5 available for staff reference.
Staff members are aware of the importance of promptly notifying the designated staff member when a vaccine delivery arrives.
Each clinic has purpose-built vaccine refrigerators, which are serviced on a regular basis and in response to unacceptable variations in temperature outside the recommended range.
The smaller clinic, which suffers from power interruptions, has a backup generator for maintaining electricity to the vaccine refrigerator.
The service’s policy and procedure manual details the processes for:
- ordering and receiving vaccines
- monitoring and recording the temperature of the vaccine refrigerator, at a minimum daily
- rotating stock so that vaccines with the shortest expiry date are used first
- monitoring and adjusting equipment such as the data logger, thermometer and thermostat
- equipment maintenance – for example, changing batteries in the thermometer, checking the accuracy of the thermometer
- action to take if the refrigerator temperature goes outside the recommended range, including what to do and how to prevent it happening again – for example, to report to the appropriate state or territory health department and document the incident
- how to pack a cooler for outreach clinics
- how to manage a power failure.
Designated staff members provide induction to new staff members and in-service to other staff members on the importance of the vaccine deliveries and what to do if they hear the vaccine refrigerator alarm going. They also check the vaccine refrigerator seals monthly for perishing or any damage.
A self-audit is conducted by designated staff members every six months, to determine:
- current staff members’ knowledge of the cold chain process and whether they know that the vaccine refrigerator is not to be unplugged and no food or drinks are to be stored in it
- if a record is available to show that the temperature has been checked each working day
- whether there is a valid documented reason if monitoring has been missed
- whether all deviations of temperature outside the acceptable range were reported to the appropriate state or territory health department
- if there is an appropriate gap between the vaccines and the walls of the refrigerator
- whether vaccines are stored in their original packaging in a set of plastic drawers or enclosed plastic containers to increase insulation
- if the refrigerator can continue to store the volume of vaccines safely as required by the service.
Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how it meets the criterion.