Transcript (Synagis®) information

Health Canada
RSV Prevention
2016-2017
Objectives
•Short review of RSV and its transmission
•Program overview
•Discuss resources available to the clinics
•Review Palivizumab (Synagis®) informationhandling, storage, reconstitution, Liquid, dose, route
•Review clinic documentation
How Prevalent is RSV
RSV is very hardy outside the host
HANDWASHING
Prevention of RSV
•Avoid large crowds (large family gatherings, child care, air travel)
•Avoid sick contacts
•Avoid 2nd and 3rd hand smoke
•Ensure up to date vaccinations for close contacts for yearly flu and routine
immunizations (Adult Dtap)
Most hospitalizations occur in the first 1-2 months of life
PARENT TEACHING IS VERY IMPORTANT
“At Risk Population”
Criteria is determined each year following a provincial consensus meeting
that includes an evaluation of the previous season, and review of any new
information from research/position statements.
Criteria is usually set by the end of June for the next season.
The current CPS guidelines came out in July 2015
Identification
of Eligible
Patients
www.albertahealthservices.ca/rsvprogram.aspx
Identification
of Eligible
Patients
www.Albertahealthservices.ca/rsvprogram.asp
RSV
Prevention
Program
Web Page
www.albertahealthservices.ca/info/rsvprogram.aspx
Synagis®
•Humanized monoclonal immunoglobulin produced by recombinant DNA technology
(95% human and 5% murine amino acid sequences)
•Provides passive immunity specifically to RSV, does not stimulate the immune
system. Does not contain active RSV.
•Antibodies neutralize the virus to help reduce the risk of developing bronchiolitis or
pneumonia.
•Dosing every 28 days maximum of 4 doses or season end whichever comes first
Fit to inject
Recent or current illness?
• High fever NYD – hold dose, refer to physician
• Minor illness – not contraindicated (maintain therapeutic levels of Syangis if
kept to schedule)
Any allergies?
• Synagis or monoclonal antibodies – hold dose, refer to physician
Verbal agreement
Canadian Nurses Association Code of Ethics “…provide persons in their care
with the information they need to make informed decisions related to their
health and well-being.”
Agree or decline to participate in the RSV Prevention Program
Patients on anticoagulants
•
Always apply firm pressure to the administration site for 10 minutes post
injection
•
Avoid Ibuprophen for pain/fever management, use Acetaminophen
•
For children on Warfarin or ASA (Aspirin) - only recommendation is to apply
firm pressure for 10 min following the injection of Synagis
Recommendations supplied by:
Mary Bauman RN, BA, MN, NP
KIDCLOT Program
Precautions
• As with any intramuscular injection, Synagis® should be given with caution to
patients with thrombocytopenia or any coagulation disorder and those
receiving anticoagulant therapy.
• A moderate to severe acute infection or febrile illness may warrant delaying
the use of Synagis® , unless in the opinion of the physician, withholding
Synagis® entails a greater risk. A mild upper respiratory infection is not
usually reason to defer administration of Synagis® .
Reconstitution guide
Tentative Season
Start date
November 21 2016
Clinic Patient
Assignment
Clinic Dosing
Documentation
Synagis® Ordering
Drug
Confirmation
PICKING
LIST
Inventory & Synagis Stock
Management
•When Synagis is received, unpack and place immediately in the refrigerator.
Until reconstitution, Synagis should be stored between 2º and 8ºC.
•Check your packing slip ensure the drug received equals the drug sent. Mark
the Date/Time drug was received, and your initials fax/scan to email back to
the program
•Routinely check inventory, rotate shorter dated Synagis to the front, and
ensure shortest dated product is used first.
Inventory
Resources for Clinics
Program Web Page- information on enrollment /contact /drug reconstitution / recommended parent and care
giver resources
http://www.albertahealthservices.ca/rsvprogram.asp
Canadian Paediatric Society (CPS) handout available on:
http://www.caringforkids.cps.ca/handouts/respiratory_syncytial_virus
MyHealth.Alberta.ca – enter “RSV” in the search box:
https://myhealth.alberta.ca/health/medications/pages/conditions.aspx?hwId=hw174519
Pamphlet and other RSV Awareness materials available from Abbott through Dan Bruha:
[email protected]
Northern Alberta RSV Prevention Program Contact Information
780-735-4205 fax 780-735-6919
Resources for
parents
MyHealth.Alberta.ca
caring for kids.cps.ca/
enter “RSV” in the search box
enter “RSV Handout” in search box
RSV
Newsletter
CARESS:
CAnadian RSV Evaluation Study of Synagis
•Registry following children receiving Synagis collecting data on patient
outcomes.
•Consent and enrollment required. Research Nurse works in collaboration
with the program.
•Monthly interviews will determine how the child tolerated the injection of
Synagis® and if any respiratory illness occurred in the previous month.
“Alone we can do so little;
together we can do so much!”
Helen Keller