Immunisation - cold chain management for newborn services
The cold chain storage refers to the system of transporting and storing vaccines at +2 to +8°C to avoid cumulative irreversible loss of potency from thermal insult. Vaccines are freeze sensitive.
The cold chain storage refers to the system of transporting and storing vaccines at +2 to +8°C to avoid cumulative irreversible loss of potency from thermal insult. Vaccines are freeze sensitive. The cold chain starts at the vaccine manufacturers and finishes when the vaccine is administered to the patient.
Vaccines for Newborn Services
Vaccines are on imprest in NICU. The imprest is supplied weekly by Pharmacy.
Transporting of Vaccines from Pharmacy
A chilly bin with ice packs is used.
Vaccines are placed in the shredded paper in the chilly bin. Then a 10 mm thick sheet of polystyrene is placed on top of vaccines. Ice packs go on top of polystyrene. (Vaccines are kept separate from the ice packs to avoid freezing of freeze sensitive vaccines). The time taken to transport vaccines should be kept to a minimum. Vaccines are immediately unpacked upon arrival at NICU.
Storage of Vaccines in Newborn Services
Vaccines are stored in the dedicated vaccination fridge in NICU. They are kept in their individual boxes in an open container to allow air to circulate.
Fridge used for storing vaccines
A good seal, regular defrosting and minimising the number of times the fridge door is opened will also help temperature stability.
Non self-defrosting fridges are the best for the storage of vaccines.
NICU has a dedicated Rollex vaccine fridge
Power failure
During a power failure the refrigerator door should be left closed
If the power fails for more than 4 hours, vaccines should be transferred to an appropriately sized insulated vaccine container with the correct number and size of ice packs to ensure vaccines remain at +2°c to +8°c. A minimum/maximum thermometer will assist with monitoring.
If the power is not restored, the vaccines will need to be transferred to an alternative refrigerator that has a power supply , as outlined in the cold chain policy.
Monitoring
The NICU vaccine refrigerator is hard wired with an external monitoring system.
The temperature is checked and recorded daily by the Health Care Assistant.
If the alarm sounds at any time, push the red alarm button to silence the alarm.
Document in the Vaccine Refrigerator Recording Book the maximum/minimum temperature alarm.
Record actions taken on the back of the Vaccine Refrigerator Recording Book.
Vaccines exposed to Temperatures outside +2 to +8°C.
| Vaccine | Temperature below 0°C | Temperature between +8°C and +25°C |
| Hep B | Do Not Use | Contact immunisation coordinator at www.immune.org.nz |
| Prevenar 13 | Do Not Use | Contact immunisation coordinator at www.immune.org.nz |
| Infanrix-hexa® | Do Not Use | Contact immunisation coordinator at www.immune.org.nz |
| Rotarix, GSK | Do Not Use | Contact immunisation coordinator at www.immune.org.nz |
Immunisation Advisory Centre Co-ordinator facilitators are available to advise on fridge performance and if vaccine damage is suspected 0800 IMMUNE (0800 466 863).
Before discarding any vaccine, consult with Pharmacy.
Reviews of Fridges
To meet the requirements of the Immunisation Co-ordination Programme and Te Whatu Ora requirements. To maintain recommended fridge and freezer temperatures.
To ensure:
Vaccines are maintained in best possible condition.
Appropriate storage of medications/IVN
Appropriate storage of breast milk/formula.
Responsibility:
A senior nurse is the coordinator of Newborn Services Cold Chain Management and will liaise with the Immunisation Advisory Centre coordinator.
Newborn Services Cold Chain Management Team (Nurses/Hospital Aids/Clerks).
Frequency:
Daily monitoring and recording of fridge/freezer max/min temperature by Hospital Aids in Newborn Services.
Spot checks.
Daily temperature charts on view on Immunisation and Medication fridges.
Previous monthly charts filed in Cold Chain Management Information Folder (yellow) kept in NICU office.
Cold Chain Management Team completes monthly and two monthly audit checklist.
Procedure:
All fridge/freezers within the Newborn Service have:
Electronic max/min thermometer and temperature chart attached.
Fridge range between +2°C to +8°C.
Freezers containing frozen breast milk are maintained at -20°C.
Alarms:
Vaccination and medication refrigerators both have external monitoring systems.