Refresher Training for Frontline Health Workers in Expanded ... - RHO

Exercise 3 (found in Section 9, Page 30 of the Module)
Buzz group discussion
Case study
Hiwot and the icepacks
Hiwot, a community nurse, conducts outreach immunization sessions on Tuesdays
and Thursdays.
On Tuesday she returns late from her outreach trip. She leaves her vaccine carrier
and other equipment at the health center and hurries home.
On Wednesday afternoon she cleans all her vaccine carriers and other equipment.
She checks the vaccine supply and puts the melted icepacks in the freezer.
On Thursday, Hiwot leaves for the outreach site early in the morning. It is already
hot. When she arrives at the site, people are waiting for her. She opens the vaccine
carrier and finds that the icepacks have melted. The thermometer in the carrier
reads +16 o C.
a) What should she do now?
Discussion
Hiwot must look at each vial of vaccine in the vaccine carrier to see if it has a
VVM label on it. If some of the vials do have VVM labels, she can hold the
immunization session using only those vials that the VVM indicates can still
be used. If none of the vials have a VVM label, she must cancel the
immunization session and dispose of all the vaccines in the vaccine carrier.
She should explain the situation to the people who are waiting and arrange
for a return visit as soon as possible. She could use the time to provide other
health services to the people or to talk with them about vaccine preventable
disease and how to prevent them.
b) What should she do in the future to prevent this problem?
Next time Hiwot should put the melted ice packs in the freezer as soon as she
returns from outreach. She should have done this on the Tuesday night. The
ice packs have not been in the freezer long enough to freeze completely by
the time she takes them out on the Thursday morning. It takes 24-48 hours to
freeze an ice pack, depending on the type of refrigerator and the outside
temperatures.
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