COVID-19 Hospital (Inpatient) Immunization Orders
Alberta Health Services (AHS) and Covenant Health support COVID-19 immunization of eligible acute care patients who wish to be immunized while in hospital as part of Alberta's COVID-19 immunization program. All acute care in-patients should be considered for immunization during their hospital stay (first or booster doses).
Eligibility
A most responsible healthcare provider (attending prescriber) confirms that proposed patient(s) are medically stable and fit for immunization.
Patients or their alternate decision-makers are informed of COVID-19 immunization risks and benefits and indicate a (verbal) wish to receive inpatient immunization. Current immunization information can be provided to the patient and/or designated decision-maker to facilitate decision-making. Written consent is not required.
Logistics
Inpatient COVID-19 immunizations are administered by Acute Care Immunization teams or AHS Public Health teams, depending upon Zone and site.
Available immunization preparations may vary.
COVID-19 immunization may be co-administered with, or at any time before or after other immunizations (including live, inactivated, adjuvanted or unadjuvanted immunizations). There is not a requirement to space between immunizations. This includes influenza immunizations, which can be co-administered.
COVID-19 immunization scheduling information, including details about age restrictions and recommended intervals after prior doses or confirmed COVID-19 illness, is updated by Alberta Health online.
Workflow
Inpatient COVID-19 immunization orders are facilitated through an order set that helps associate the right immunization with the right patient.
Prescribers should validate eligibility for inpatient immunization, as above, and then search for the "COVID-19 immunization" order set.
Once a sufficient number of immunization orders accrue, arrangements are made for a group of patients to be immunized. If a patient's condition has changed, the immunization may be deferred with a reason documented in the medication administration record (MAR).
An appropriate entry in the patient's Connect Care immunization record is automatically created. Key information is automatically forwarded to provincial immunization information systems. An immunization record is also produced for the patient and/or alternate decision-maker.
Adverse Effect Surveillance
Patients are provided with information about possible side effects of immunization, also included in a discharge "After Visit Summary".
The attending prescriber is responsible for reporting any serious adverse effects, allergies or intolerances.
COVID-19 immunization SmartLink
Increasing numbers of patients receive initial or second COVID-19 immunizations during an inpatient or outpatient encounter where Connect Care is the record of care. Clinicians may want to rapidly document this information in consult, discharge, transfer or other notes. A dedicated SmartLink makes this easier:
".IMMCOVIDP" pulls in recent COVID-19 immunization information in a prose-friendly format