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This document serves as a record for the administration of the pneumococcal vaccine, detailing patient consent, personal information, and information related to previous vaccinations and payment sources.

How to fill out pneumococcal vaccine administration record

How to fill out Pneumococcal Vaccine Administration Record

1. Begin by entering the patient's personal information at the top of the record, including their name, date of birth, and contact details.
2. Identify the specific pneumococcal vaccine administered and write the name of the vaccine in the designated section.
3. Record the date of vaccination clearly in the provided space.
4. Fill in the manufacturer's name and lot number of the vaccine from the vial label.
5. Note the site of administration (e.g., left arm, right arm) and the route of administration (e.g., intramuscular, subcutaneous).
6. Include any relevant information regarding pre-vaccination screening and patient education provided.
7. Document any adverse reactions the patient may experience post-vaccination, if applicable.
8. Ensure the healthcare provider signs and dates the record at the bottom.

Who needs Pneumococcal Vaccine Administration Record?

1. Individuals aged 65 and older.
2. People aged 2 to 64 with certain medical conditions (e.g., chronic respiratory issues, heart disease, diabetes).
3. Adults 19 to 64 who smoke or have asthma.
4. Residents of long-term care facilities.
5. Healthcare workers who may be exposed to the pneumococcus bacteria.

People Also Ask about

What should be documented when administering a vaccine?

By law, the following information must be documented on the patient's paper or electronic medical record (or on a permanent office log): The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered.

How is the pneumococcal vaccine administered?

Administer pneumococcal conjugate vaccines (PCV15, PCV20) intramuscularly. For infants and young children, use the vastus lateralis muscle in the anterolateral thigh. For older children and adults, use the deltoid muscle.

What needs to be documented when giving a vaccine?

What information does federal law require us to document when we immunize a patient? The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered. The name, office address, and title of the healthcare provider administering the vaccine.

What should be documented after administering an injection?

The Document Injected Medication form allows you to record the action of administering an injected medication and the details surrounding the medication itself, such as the NDC number, Lot number, expiration date, and manufacturer.

What details must be documented when a vaccination is given?

By law, the following information must be documented on the patient's paper or electronic medical record (or on a permanent office log): The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered.

What is pneumococcal vaccine called on shot record?

There are several pneumococcal conjugate vaccines (PCVs). The specific PCV and number of doses recommended are based on a person's age, vaccination history, and medical status. Your health care provider can help you determine which type of PCV, and how many doses, should be received.

How do you document the administration of the flu vaccine?

Medical record: Record the date the vaccine was administered, the manufacturer and lot number, the vaccination site and route, and the name and address and, if appropriate, the title of the person administering the vaccine.

What information must be documented regarding the administration of a vaccine Quizlet?

What information regarding vaccine administration must be documented? Date of administration; manufacturer and lot number of vaccine; name, address, and title of person administering vaccine; site; route; evidence that parent or guardian gave informed consent.

For pdfFiller’s FAQs

What is Pneumococcal Vaccine Administration Record?

The Pneumococcal Vaccine Administration Record is a document used to record the administration of pneumococcal vaccines to patients, ensuring proper tracking and documentation of the vaccination process.

Who is required to file Pneumococcal Vaccine Administration Record?

Healthcare providers who administer pneumococcal vaccines are required to file the Pneumococcal Vaccine Administration Record to maintain accurate records for patients and comply with public health regulations.

How to fill out Pneumococcal Vaccine Administration Record?

To fill out the Pneumococcal Vaccine Administration Record, healthcare providers should include patient information, vaccine details (such as type, lot number, and expiration date), administration date, the site of administration, and the provider's signature.

What is the purpose of Pneumococcal Vaccine Administration Record?

The purpose of the Pneumococcal Vaccine Administration Record is to ensure that pneumococcal vaccinations are properly documented for patient safety, tracking vaccination status, and to fulfill regulatory requirements.

What information must be reported on Pneumococcal Vaccine Administration Record?

The information that must be reported on the Pneumococcal Vaccine Administration Record includes patient’s name, date of birth, vaccine type, vaccination date, dose number, administering provider's name, and any adverse reactions if applicable.