I am an RN and have been asked to administer flu shots at a pharmacy. What needs to be in place to support my practice in a pharmacy setting?

RNs require an order or another authorizing mechanism to administer a medication. In this situation a directive, as outlined in the RN Specialty Practices (RNSP) Guideline and as part of an RN Clinical Protocol, could be provided to enable RN administration of flu shots to a client population in a pharmacy.

RN Clinical Protocols are created by the employer – in this case the pharmacist, approved prior to implementation and contain all essential components where:

1. The RNSP is in the interest of the client in their environment. In this case, the pharmacy.
2. There is evidence to support the RNSP. There is ample evidence to support RNs as part of the health care team administering flu shots.
3. A client-specific or client population authorizing mechanism is in place. The clinical protocol required in this example needs to be signed by a physician or NP. Although pharmacists can administer the flu vaccine under their own authority, they are not considered authorized prescribers for RN practice and cannot sign the directive.
4. The required competencies and which RNs will engage in the RNSP are clearly defined. What education and skills are required to engage in the practice or to respond to an untoward outcome?

With an RN Clinical Protocol including a directive is in place and the RN has the competence to safely perform the required activities, RNs can administer flu shots in a pharmacy setting.

Liability Coverage

All RNs, holding a practicing license with the CRNS have liability coverage. RNs interested in supplemental liability coverage for this practice can reach out to the Canadian Nurses Protective Society at 1-800-267-3390 or https://cnps.ca/.

Questions can be directed to the Practice & Education Nursing Advisors at practiveadvice@crns.ca

Resources

RN Specialty Practices Guidelines 2020