Public Health Nursing (PHN)
ADMINISTERING MEASLES/RUBELLA VACCINE AT A CHILD WELFARE CLINIC (CWC)
This is an activity carried out by the Public/Community health nurse at CWC by given live attenuated vaccine. The live attenuated vaccine is a component of measles/rubella which is given subcutaneously to the child at 9 and 18months respectively.
Purpose
- Protect children under five (5) or 0-59 months from measles/rubella
- Decrease the risk of death among young children from measles/rubella
- Achieve herd immunity amongst children under five (5)
- Educate mothers and caregivers to maintain a high level of proper personal and environmental hygiene
Indications
- Client requires measles/rubella vaccine at child welfare clinic (cwc) assessment or care.
Equipment
- Furniture which includes chairs, tables, bulletin board
- Tablecloth
- Two (2) registers, one for registration of children under one (1) year and the other for children above one year
- Attendance book
- Immunization tally sheets
- Maternal and child health record book
- Syringes and needles/solo shot
- Immunization tray containing gallipots, kidney dish, dissecting forceps, artery forceps, scissors
- Sterile cotton wool swabs in a closed drum
- Safety box for sharps
- A flask containing ice cubes
- Vaccine carrier containing vaccines/cold box
- Cheatle forceps
- Hand washing facilities- veronica bucket, plastic bowls, soap in a dish, hand towels
- Medication for treatment of minor ailments such as paracetamol syrup
- Electronic/manual visual aids for education
- Blue and red pens, pencils, eraser and rule
Preparation
- Review client records and history.
- Gather necessary equipment and supplies.
- Plan the visit timing and logistics.
Procedure steps
- Establish rapport and ask about general health or the health of the baby
- Find out from mother the type of immunization the child has had
- Look at the child’s health record book and check on which vaccine to give
- Explain the procedure to the mother/caregiver
- Explain any side effect to mother/caregiver and discuss with her what she can do about them
- Ask mother/caregiver for feedback
- Show mother/caregiver how to hold the child and wash hands with appropriate technique
- Check Vaccine Vial Monitor VVM and expiry date of vaccine and draw 0.5ml
- Clean the outer middle part of the left upper arm with damp cotton wool and discard it
- Hold the part tightly between the thumb and forefinger of left hand and gently push the needle deep into the muscle at an angle of 90˚/45˚
- Remove and discard solo shot after injecting vaccine, press the area with dry clean cotton wool ball and discard
- Tell mother/caregiver not to apply anything to the site but to give baby paracetamol syrup according to age in case of fever
- Commend the mother/caregiver for bringing her child for Immunization
- Wash hands with appropriate technique
- Record and report findings manually/electronically
Precautions
- Maintain infection prevention and control measures throughout.
- Respect client privacy and confidentiality.
- Ensure cultural sensitivity and dignity.
- Refer or escalate when complications arise.
Aftercare
- Evaluate client response to interventions.
- Schedule follow-up as needed.
- Ensure client understands care plan.
Nursing considerations
- Adapt care to client's unique circumstances.
- Involve family members as appropriate.
- Consider social determinants of health.
Patient education
- Provide condition-specific health education.
- Teach self-care strategies where applicable.
- Reinforce importance of follow-up.
Documentation
- Record all assessments and findings.
- Document interventions provided.
- Note client education given.
- Report any referrals made.
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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