Dimension 1: General organization
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The municipality has a vaccine coordinator |
The municipal vaccine coordinator conducts periodic supervision of the vaccination room, verifying the standard procedures, compliance with indicators and training for professionals |
The primary healthcare center has a nurse responsible for the vaccination room |
The vaccination room provides services throughout the unit opening hours, including lunch time, every day |
All vaccines from the current schedule of the National Immunization Program are administered during the entire period in which the vaccination room is open |
There are technical standards related to vaccination and they are made available to all professionals: vaccine administration protocols; cold chain; epidemiological surveillance of adverse events; reference center for special immunobiological agents; and personnel training in the vaccination room |
All professionals are aware of the technical standards |
The set of standard operating procedures for the vaccination room is implemented and updated by the team, according to the current standards of epidemiological and health surveillance |
All nurses and nursing technicians/assistants who work and are responsible for the vaccination process know the standard operating procedures for vaccination |
All nurses and nursing technicians/assistants who work and are responsible for the vaccination process are up to date on vaccination and immunization procedures for the population in the coverage area |
Specific training sessions are periodically carried out for all professionals who work in the vaccination room |
The nurse in charge periodically supervises all procedures performed by the nursing technicians/ assistants who work in the vaccination room |
Dimension 2: General aspects of the vaccination room
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The room is exclusively used for vaccination |
The room is easily accessible to the population |
The room is properly identified |
The physical area of the vaccination room meets the standards recommended by the General Coordination of the National Immunization Program/Agência Nacional de Vigilância Sanitária |
Light-colored, waterproof, and easy-to-clean walls |
Resistant and non-slip floor |
Waterproof and easy-to-clean floor |
The room has an easy-to-clean sink with a tap and a countertop |
The room has adequate protection against direct sunlight |
The room has adequate lighting |
The room has adequate ventilation |
The room is in ideal preservation conditions |
The room is in ideal cleaning conditions |
General cleaning (walls, ceiling, etc.) is done every 15 days |
The room temperature is maintained between 18º C and 20º C |
There are no decorative objects in the room (paintings, vases, etc.) |
The furniture has a good functional distribution |
Printed matters and information materials are organized |
Syringes and needles of daily use are properly packed (in clean and capped containers) |
Syringes and needles in the stock are packed in sealed packages and in place with no humidity |
The room has dispenser with liquid soap and alcohol |
The room has a medical examination table (stretcher) for vaccination, with a waterproof mattress or similar and protected with disposable material |
The room has a chair to accommodate the user during his/her vaccination |
Dimension 3: Technical procedures
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Age and interval between doses are checked, at each vaccine administration |
Adverse events from previous doses are investigated, at each vaccine administration |
Temporary or permanent contraindication to the indicated vaccine is evaluated, at each vaccine administration |
The technician in charge advises the user or guardian about the vaccine to be administered |
The technician in charge instructs the user or guardian about the record of scheduling |
The expiration date of the vaccine is observed, at each vaccine administration |
Vaccine preparation is performed according to technical standards |
The nurse responsible for the vaccination room periodically supervises the preparation of the vaccine performed by the various technicians of the team |
Date and time of bottle opening are properly recorded |
The expiration date after the bottle opening is observed |
The vaccine administration technique follows the defined standards |
The nurse responsible for the vaccination room periodically supervises the vaccine administration performed by the various technicians of the team |
Perforating and cutting materials are packed according to the biosafety standards, in a container used to pack perforating and cutting materials |
Vaccines with live microorganisms are treated before disposal, according to biosafety standards |
Active search for susceptible individuals among users in the coverage area is conducted |
Control cards (mirror cards) are used for vaccination in children |
Control cards (mirror cards) are used for vaccination in adolescents |
Control cards (mirror cards) are used for adult vaccination |
Control cards (mirror cards) are used for older adult vaccination |
Control cards (mirror cards) are used for vaccination in pregnant women |
The control cards are organized by return date |
Active search of defaulters is conducted |
The number of vaccines is sufficient to meet the demand of the population |
There is a vaccine stock management in the unit |
The number of syringes and needles is sufficient to meet the demand |
Expiration date of syringes and needles is observed |
Different types of waste are packed separately |
Final destination of the waste is in accordance with the norms of health surveillance |
Dimension 4: Cold chain
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Switches are available for the exclusive use of each equipment |
On the electrical distribution box there is a warning not to turn off the vaccination room circuit breaker |
The refrigerator is exclusively used for immunobiological agents |
The capacity of the refrigerator is equal to or greater than 280 liters |
The refrigerator is in good condition |
The refrigerator is an ideal state of cleanliness |
The refrigerator is away from heat sources, out of direct sunlight and at least 20 cm from the wall |
There is a maximum and minimum thermometer and/or an extension cable in the refrigerator |
Recyclable ice coils are kept in the evaporator in the recommended quantity |
The refrigerator has a water drip tray |
On the first shelf of the refrigerator, in perforated trays, only the vaccines that can be submitted to negative temperature are kept |
On the second shelf of the refrigerator, in perforated trays, only the vaccines that cannot be submitted to negative temperature are kept |
On the third shelf of the refrigerator, vaccine stocks, serum and diluents are stored |
Immunobiological agents are organized by type, batch and expiration date |
Distance between immunobiological agents and the walls of the refrigerator is kept in order to allow air circulation |
Dyeing water bottles are kept in the entire lower internal space of the refrigerator |
There is some material stored in the refrigerator inner door panel |
The correct reading and recording of the temperature at the beginning and end of the workday is routinely conducted |
Daily Temperature Control Chart is displayed in a visible place |
Defrosting and cleaning of the refrigerator is performed every 15 days or when the ice layer reaches 1.0 cm |
There is a preventive and/or corrective maintenance program for the vaccination room refrigerator |
The service has a cooler box (polyurethane and/or expanded polystyrene - Styrofoam) or other equipment for daily use, in sufficient number to meet routine activities |
The service has sufficient number of recyclable ice coils to meet routine activities |
The service has a sufficient number of maximum and minimum thermometers and extension cables to meet routine activities |
The service has sufficient number of polyvinyl chloride (PVC) tapes/crepe tapes to meet routine activities |
The recyclable ice coils are stored in the organization of the cooler box |
The temperature of the cooler boxes or daily use equipment is monitored |
When, for any reason, the immunobiological agents are submitted to temperatures that are not recommended, the hierarchically superior authority is immediately communicated |
When, for any reason, immunobiological agents are submitted to non-recommended temperatures, the evaluation form of the immunobiological agents under suspicion is filled out and sent to the hierarchically superior authority |
When, for any reason, immunobiological agents are submitted to non-recommended temperatures, the vaccines under suspicion are kept at a temperature between +2ºC and +8ºC until the decision of the hierarchically superior authority |
Dimension 5: Information system
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The National Immunization Program Information System is implemented in the unit |
All professionals know and routinely use the National Immunization Program Information System |
The unit provides the forms and instruments for recording vaccination-related care |
Child’s card |
Adult card |
Pregnant woman’s card |
Older adult card |
Daily Bulletin of Vaccine Doses Administered |
Monthly Bulletin of Vaccine Doses Administered |
Control Card (schedule) |
Daily Temperature Control Chart |
Adverse Event Investigation Form |
Form for the Evaluation of Vaccines Under Suspicion |
Monthly tendency of immunobiological agents |
The technicians in charge know how to fill out the forms and tools properly |
The nurse in charge periodically supervises the record of vaccination-related care |
There is a routine monitoring and evaluation of vaccine indicators |
The whole team takes part in the monitoring and evaluation moments |
The vaccination coverage indicator is monitored |
The dropout rate indicator is monitored |
Professionals know and periodically discuss the available information |
Dimension 6: Adverse events following vaccination
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Information about the occurrence of adverse events is shared with all professionals |
Professionals know the possible adverse events following vaccination for each type of vaccine |
Professionals identify adverse events that should be referred for medical evaluation |
Professionals report adverse events following vaccination |
Investigation of occurrence of adverse events is carried out |
Dimension 7: Special immunobiological agents
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All professionals know about the existing Reference Center for Special Immunobiological Agents |
Professionals know about the list of immunobiological agents available at the Reference Center for Special Immunobiological agents |
Professionals are aware of the indications of these immunobiological agents |
All professionals are aware of the flow to request these immunobiological agents and/or referrals for vaccination |
Dimension 8: Epidemiological surveillance
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Information about the occurrence of any vaccine-preventable disease cases in their area of coverage (measles, rubella, diphtheria, pertussis, tetanus, polio, rabies and others) is shared immediately with the whole team, generating the necessary alert |
The team evaluates the information about the incidence of vaccine-preventable diseases, comparing it with vaccination coverage |
The team takes part in transmission blocking vaccination, when indicated |
The team reports suspected cases of diseases under epidemiological surveillance that come to their knowledge |
Dimension 9: Health education
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The team develops partnerships with social entities and community groups for dissemination and mobilization of the target population for immunization actions |
The team uses educational programs in the primary healthcare center in order to suggest the theme of vaccination and immunization |
All users attending the vaccination room are guided and informed about the importance of vaccines and compliance with the vaccination schedule |
All staff members are informed about the available vaccines, the importance of being vaccinated, and referring users to the vaccination room |