December 3, 2024

Danielle Mahoney

COVID-19 administration of vaccination FAQs

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The Australian Government and NSW Health are updating information regularly. This information is a guide only. Please check the relevant government websites to ensure information is current. 

Can a registered nurse, enrolled nurse or midwife, who is not an Authorised Nurse or Midwife Immuniser, administer COVID-19 vaccines? 

 Yes, all registered nurses, enrolled nurses and midwives may possess and administer vaccinations, including COVID-19 vaccination, as part of their normal duties when they have an order from an authorised person. This includes nurses and midwives registered on the pandemic sub-register. 

 The order can be a standing order as noted in ‘Standard operating procedure for administration of COVID-19 vaccines in NSW vaccination clinics’ that can be accessed on the NSW Health information page ‘Covid-19 vaccination: information for NSW Health immunisation providers’.

All registered nurses and midwives administering any vaccine must be familiar with the procedures as outlined in the Australian Immunisation Handbook regarding preparation, route of administration, preparation of the person receiving the vaccine, vaccine injection techniques and injection sites. 

 AHPRA has provided additional FAQs here, noting that health.gov.au is the official site for the latest information about the novel coronavirus pandemic. 

 Can a student nurse or student midwife administer COVID-19 vaccines? 

 Yes, as of 28 June 2021, nursing and midwifery students can administer COVID-19 vaccines under certain conditions. This only applies to students working in a NSW Health vaccination clinic. The student nurse or student midwife must: 

  • successfully complete additional training on vaccination administration 
  • be enrolled in an NMBA approved course leading to registration as a registered nurse (division 1) or midwife and have undertaken at least one clinical placement of the relevant qualification 
  • an enrolled nurse student currently enrolled in a NMBA approved course leading to registration as an enrolled nurse (division 2) and have undertaken at least one clinical placement of the relevant qualification  
  • The student must work under line of sight supervision of a Medical/Nurse Practitioner, Authorised Nurse (or Midwife) Immuniser or Registered Nurse (year 2 and above). 

 A student can administer but not assess patients for their suitability to receive the vaccine or to obtain informed consent. 

 See the ‘Statewide Protocol for the Supply or Administration of COVID-19 Vaccine’  and ‘Standard operating procedure for administration of COVID-19 vaccines in NSW vaccination clinics’ for more information. 

 Can any other persons administer COVID-19 vaccines? 

 Yes, Assistants in Nursing and previously registered nurses and midwives can administer COVID-19 vaccines at NSW Health vaccination clinics (a hub) under certain conditions. 

 Assistants in Nursing 

 Assistants in Nursing can administer COVID-19 vaccines at a NSW Health Vaccination Clinic if: 

  • they hold a Certificate III Health Service Assistance (Assisting in Nursing Work in Acute Care); AND 
  • can demonstrate relevant clinical experience in NSW Health 
  • they complete additional training on vaccination administration as directed by NSW Health. 

 Previously registered nurses and midwives 

  • As of 1 September 2021, persons previously registered (in the past 10 years) as a nurse or midwife may also administer COVID-19 vaccines at NSW Health vaccination clinic. 
  • To participate in the vaccination rollout, the previously registered nurse or midwife must make a declaration about any adverse findings by the National Registration and Accreditation Scheme when registered, such as conditions placed on registration, suspension or cancellation of registration. 
  • The previously registered nurse or midwife must also undertake the additional training on vaccination administration as directed by NSW Health. 

See the ‘Statewide Protocol for the Supply or Administration of COVID-19 Vaccine‘ and ‘Standard operating procedure for administration of COVID-19 vaccines in NSW vaccination clinics’ for more information. 

Does a registered nurse, enrolled nurse, midwife, student or other vaccination worker need to undertake the COVID-19 Vaccination Training Program to administer the vaccine under the order from an authorised person? 

 Yes, all registered nurses, enrolled nurses, midwives and students and other categories of Vaccination Worker must successfully complete the additional COVID-19 Vaccination Training Program developed by the Commonwealth Department of Health in partnership with ACN and other training as directed by NSW Health if working in a vaccination clinic. 

What is an Authorised Nurse or Midwife Immuniser? 

 An Authorised Nurse Immuniser or an Authorised Midwife Immuniser is a registered nurse or midwife who has been appropriately trained and accredited to deliver immunisation services and administer vaccines as an Authorised Nurse Immuniser or Authorised Midwife Immuniser.

A registered nurse or midwife who has not completed the specified training to become an authorised nurse or midwife immuniser may only administer vaccines under the direction and authorisation of a medical officer or nurse practitioner.    

See the NSW Health Authorised Nurse Immuniser and Authorised Midwife Immunisers Policy Directive PD2022_016

 Who provides nurses and midwives with the authority to immunise? 

The Chief Health Officer of NSW is the duly appointed delegate of the Secretary, NSW Health, provides the authorisation under the Poisons and Therapeutic Goods Regulation 2008 (NSW). 

 Updates to the list of authorised nurses and midwives (including COVID-19 vaccine) is found on the NSW Health website under Immunisation providers.  

How does a nurse or midwife become an Authorised Nurse Immuniser or Authorised Midwife Immuniser?  

A registered nurse or midwife must have:

  • successfully completed the NSW Department of Health Immunisation Accreditation Program for Registered Nurses prior to 2001, or 
  • The immunisation education program administered by the Australian College of Nursing or its predecessors prior to 1 December 2020, or
  • An immunisation course for registered nurses and midwives that conforms to the National Immunisation Education Framework for Health Professionals, following accreditation by Health Education Services Australia (HESA) and published on the list of approved courses on the HESA website, or 
  • An interstate immunisation education program that conforms to the National Immunisation Education Framework for Health Professionals, as approved by an education provider following the accreditation of their course by HESA and listing of their course on the HESA website. 

The immunisation education program for registered nurses and midwives is accredited by HESA if the course is based on the National Immunisation Education Framework for Health Professionals and is accredited by HESA as having met the Standards for Accreditation of Immunisation Education Programs.

A list of HESA accredited programs can be found here.

Authorised Nurse and Midwife Immunisers must ensure they follow the requirements outlined in the ‘Authorised Nurse Immuniser and Authorised Midwife Immunisers’ Policy Directive.’

Can an Authorised Nurse or Midwife Immuniser administer SARS-COV-2 (COVID-19) vaccine? 

 Yes, but only if the Authorised Nurse or Midwife Immuniser has successfully completed the following additional training: 

  • Core COVID-19 training modules from the COVID-19 Vaccination Training Program developed by the Commonwealth Department of Health in partnership with the Australian College of Nursing; and 
  • Additional COVID-19 training modules from the COVID-19 Vaccination Training Program, for each vaccine that the Authorised Nurse Immuniser or Authorised Midwife Immuniser is administering.  

 Does a medical practitioner need to be on site at a NSW Health vaccination Clinic (Hub) 

All hubs/clinics must have a medical practitioner designated to provide oversight and clinical advice to staff and patients. 

 The medical practitioner does not need to be on site. If the medical practitioner is not on site, an authorised nurse (or midwife) immuniser must be present if a medical practitioner is only available via phone or video consultation. 

NSW Health has published a ‘Statewide Protocol for the Supply or Administration of COVID-19 Vaccine’, which sets out the procedure for preparation of vaccines for administration and the clinical roles of all staff involved. 

‘Standard operating procedure for administration of COVID-19 vaccines in NSW vaccination clinics’ outlines the standard procedures for vaccination administration in vaccination hubs and clinics. 

COVID-19 vaccination resources

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Department of Health

Australian Technical Advisory Group on Immunisation (ATAGI)

NSW Health

National Centre for Immunisation Research and Surveillance

Further resources

Webinars

Safety at work remains a serious issue for nurses and midwives

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The results from a recent survey conducted by the Australian Council of Trade Unions (ACTU) have highlighted significant concerns from nurses and midwives around workplace safety and understaffing.  

Over 1,850 NSW Nurses and Midwives’ Association (NSWNMA) members filled out the Work Shouldn’t Hurt work health and safety survey. In the past 12 months:

  • 97% have experienced stress at work
  • 90% skip rest breaks they are entitled to
  • 75% work unsafe hours
  • 60% perform work in an unsafe work environment
  • 88% have experienced traumatic events, distressing situations or distressed or aggressive clients/customers

When asked what affected their ability to perform their work safely:

  • 89% did not have enough staff
  • 78% did not have enough time
  • 67% cited a lack of realistic demands or targets
  • 66% cited a lack of sufficient support
  • 69% did not receive appropriate recognition and reward

NSWNMA General Secretary, Brett Holmes, concedes ongoing incidences of violence, excessive workloads and fatigue continue to impact nursing staff.

“Nurses and midwives are highly regarded community members, they deserve better and serious improvements must be introduced – no one should feel unsafe in the workplace,” said Mr Holmes.

Mr Holmes also points to ongoing widespread staff shortages being compounded by COVID-19 pandemic fatigue.

“Our members have done the hard yards in extremely tough circumstances and there’s still a way to go, but the best way forward is to deliver statewide nurse-to-patient ratios.”

The NSWNMA has repeatedly called on the NSW Government to prioritise the health and wellbeing of all nurses and midwives by introducing nurse-to-patient ratios on every shift, in every ward across the state.

“The NSW Government must listen to nurses and midwives on the frontline and not ignore the fact Queensland, Victoria and Canberra all have ratios. We need a better health system in NSW and to achieve that, you need more staff.”

Workers compensation for COVID-19 affected workers

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If you’re a health care worker and contract COVID-19, you may be entitled to workers compensation to support your recovery.

A presumption for COVID-19 affected workers means that nurses and midwives do not have to prove they have contracted it at work when making a claim (unless the contrary is subsequently established).

This includes casual workers if any shifts are worked in the weeks prior to falling ill.

The presumption covers workers in prescribed employment, including:

  • the health care sector, including nurses, midwives, ambulance officers and public health employees,
  • the retail industry (other than businesses providing only on-line retail),
  • disability and aged care facilities,
  • educational institutions, including pre-schools, schools and tertiary institutions (other than establishments providing only on-line teaching services),
  • police and emergency services (including fire brigades and rural fire services),
  • refuges, halfway houses and homeless shelters,
  • passenger transport services,
  • libraries,
  • courts and tribunals,
  • correctional centres and detention centres,
  • restaurants, clubs and hotels,
  • the construction industry,
  • places of public entertainment or instruction (including cinemas, museums, galleries, cultural institutions and casinos),
  • the cleaning industry
  • cafes
  • supermarkets
  • funeral homes
  • childcare facilities.

Liability for confirmed COVID-19 claims is assessed on a case-by-case basis and the insurer will need to establish facts and evidence for each claim. For more information, click here.

If you test positive to COVID-19, you should notify your employer immediately.

Your employer will then notify the insurer within 48 hours of receiving your notification.

Workers in prescribed employment are automatically presumed to have contracted COVID-19 at work, unless the contrary is established.

The insurer must start provisional weekly payments of compensation within 7 days of notification, unless they have a reasonable excuse.

Why is this important?

Besides being paid any leave entitlements, if liability is agreed through the assessment carried out by the insurer, you may have some out-of-pocket costs covered through workers’ compensation.

If you have not been notified of the insurer’s decision within 7 days, you can contact SIRA (State Insurance Regulatory Authority) for help on 13 10 50 or by email at contact@sira.nsw.gov.au 

SIRA has also developed a FAQ page that provides useful information about how COVID-19 is operating within the workers compensation scheme. Click here to access.

The NSW Nurses and Midwives’ Association can provide assistance for members whose employers are not progressing their claim. Contact us here.

Government signals privatisation of aged care assessments

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Aged Care Assessment Teams (ACAT) have been under the threat of privatisation for years to no avail. Despite the many failed attempts, the government is again pushing forward towards a tendering process as early as next month.

The many failed attempts to privatise

In December, 2019, the federal government, which funds ACAT, tried to push through a tender to privatise. This was met with strong opposition from unions, workers, aged care advocates, medical peak bodies and even the NSW Minister for Health, who said: “it seems pre-emptive and unreasonable to be effectively privatising health aged-care services while the royal commission into aged care is still under way… not a lot of logic there”.

The government’s decision to withdraw the tender was announced on 28 February via a Council of Australian Governments Health Council (CHC) communique released following a meeting of state and territory health ministers, stating:

‘The Commonwealth has agreed to work with the States and Territories to have a consistent, uniform, efficient and integrated aged care assessment process that meets the needs of senior Australians and their families.

‘The Commonwealth has confirmed that it is not proceeding with the current tender process.’

The current situation

In May, this year, the Morrison Government again signaled its intention to privatise aged care assessment teams (ACAT) in its response to the aged care royal commission recommendations.

The decision to put the recruitment of the workforce out to tender is a clear misinterpretation of the commissioners’ advice to ‘replace the Aged Care Assessment Program and the Regional Assessment Services with one assessment process’.

Last week, during Senate estimates, Aged Care Services Minister, Richard Colbeck, reiterated the government’s plans to put the tender to market.

Under the proposed arrangements, organisations will be contracted to provide these government funded services. State public health providers will have an opportunity to win these contracts, however this approach will likely result in a significant (if not total) privatisation.

“These services are far too valuable and integrated with the health and care needs of older Australians to leave it to a ‘procurement approach’,” NSW Nurses and Midwives’ Association General Secretary Brett Holmes said.

“Quality services need to be maintained, not reduced through the introduction of a profit motive”.

The NSW Nurses and Midwives’ Association is campaigning against any privatisation of ACAT. Assessment services are expertly delivered by a skilled NSW public health workforce of registered nurses, social workers and others. Privatisation would jeopardise the jobs of hundreds of skilled practitioners.

Work in a NSW public hospital? Here are the top 5 COVID-19 concerns from nurses and midwives

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  1. How do you qualify for Special Paid Leave? Does it apply to casuals?

NSW Health employees have access to 20 days of paid special leave (for COVID-19) prior to a accessing their own accrued leave. This will be granted to employees who are unable to work because they are:

  • Self-isolating due to travel or close contact COVID-19 exposure (exclusions apply)
  • Caring for family members sick with COVID-19
  • Caring for family members due to closure of school/daycare
  • Unable to attend work due to transport disruptions or workplace closure
  • A vulnerable health worker who, following completion of a risk assessment, is unable to be redeployed to a lower COVID-19 risk environment and is unable to work from home or self-isolate

After the 20 days total paid special leave has been used, employees may access accrued leave entitlements (in accordance with normal processes).

The 20 days special leave will be provided on a pro-rata basis for part time staff.

Where an employee is self-isolating on special leave and becomes sick for any reason; at that point the employee should transition onto sick leave. Where sick leave is exhausted, Health Agencies may grant additional sick leave on a case by case basis.

Casual employees are generally not entitled to paid special leave. If a casual is required to self-isolate due to close contact COVID-19 exposure in the workplace, each situation should be considered by the Health Agency on a case by case basis, including such things as the length of the casual engagement and whether the casual has regular and systematic shifts; however special paid leave may be appropriate for shifts which are already rostered during the self-isolation period.

  1. Will I be paid to be tested for COVID-19?

Wherever possible, NSW Health agencies will facilitate the opportunity for affected NSW Health staff ​​​​​to undertake the required COVID-19 testing during normal working hours.

  • Where the COVID-19 test is available at the site where the staff member usually works, NSW Health agencies will facilitate the opportunity for employed staff to undertake the required testing during a rostered shift or normal working day wherever possible.
  • Where the COVID-19 test is only available at a site that is not the staff member’s usual work location, NSW Health agencies will facilitate wherever possible the release of staff for part of their rostered shift or working day to undertake the required COVID-19 testing at a site where it is available.
  • Where the NSW Health agency determines that neither option listed above is possible, employed staff who attend for the required testing outside of normal working hours will need to be paid for such attendance.
  1. What is the required PPE when caring for a confirmed COVID-19 case?

Updated guidance from the Clinical Excellence Commission in July 2021, directs workers to wear a P2/N95 when providing care to a patient who is suspected/confirmed COVID-19 positive, and also when providing care for patients with symptoms of acute respiratory illness in certain circumstances (when the transmission risk is higher).

Airborne Precautions (includes the use of P2/N95 respirator and eye protection) is required in the following circumstances:

  • Confirmed COVID-19 cases
  • Suspected cases (a person who meets clinical AND epidemiological criteria or a person identified as a close contact by the NSW Public Health Unit, regardless of symptoms)
  1. If I am required to isolate can I access accommodation?

Provisions for temporary paid accommodation for health workers providing frontline health services (including hospital and ambulance staff) were announced in April, 2020.

Due to the changing nature of the pandemic, Public Health Organisations (PHOs) will be required to use a risk-based approach when approving access to temporary accommodation. The immediate focus will be on:

Health workers providing frontline health services including permanent, temporary, casual (with booked shifts), hospital, ambulance and community staff. This includes Visiting Medical Officers (while working for NSW Health).

Temporary accommodation can be utilised in the following circumstances:

  1. Staff who have contracted COVID-19;
  2. Staff awaiting COVID-19 test results and/ or in self-isolation due to close contact with a positive COVID-19 case;
  3. Frontline staff living with vulnerable high-risk family members; and
  4. Frontline staff working extended hours, short shift changes, extensive overtime due to COVID-19 workload.

To note:

  • Use of the accommodation option is voluntary and is not mandated by the employer.
  • Different arrangements will be provided for COVID-19 and non COVID-19 affected staff.  For example, if someone has COVID-19 they will be required to isolate.
  • Hotels near hospitals have been identified and will be used for health worker accommodation wherever possible.
  • Meals will be included.
  • Booking will be undertaken by the PHO using government approved processes and not by the individual health worker.
  1. We have not been fit tested in our department. How do we get it done?

It is very concerning to hear that some management have not arranged fit testing for staff in theatres. Theatres staff fall within category 1B of NSW Health’s fit testing roll out, which has largely been completed.

Given the increased incidence of COVID-19 infection in the community, the need for fit testing of theatres staff is now urgent.

We encourage you to submit an incident report in IMS+ around the delay in fit testing and to raise it with your manager in writing as a matter of urgency.

It appears that the reason for the delays in the roll out of fit testing relate to insufficient numbers of portacount machines or staff trained properly to use them. If this is the case, your LHD should contract this work to external fit testing providers in order to get staff fit tested as soon as reasonably possible, (as has been done in other LHDs).

If management refuse to hire third party contractors and/or otherwise fail to expedite the roll out of fit testing, you should contact your organiser or the NSWNMA office for assistance to progress the matter, which may include a referral to the NSW Safety regulator, SafeWork NSW.

In the meantime, if asked to provide care to a known or suspected case of COVID-19, you should bear in mind that under s84 of the Work Health and Safety Act, you have the right to refuse unsafe work where you have a reasonable belief that carrying out that work will expose you to a serious and imminent risk to your health. If exercising this right, you need to report to your manager and remain available to undertake alternate duties.

The NSW Nurses and Midwives’ Association is here to assist you through COVID-19. If you have further questions, please get in contact with us through this form.

 

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