Publication - Advice and guidance

Coronavirus (COVID-19): Moderna vaccine - national protocol - edition 1.0

Published: 4 Jun 2021

This protocol is for the supply and administration of COVID-19 Vaccine Moderna to individuals in accordance with the national COVID-19 vaccination programme

32 page PDF

660.0 kB

32 page PDF

660.0 kB

Contents
Coronavirus (COVID-19): Moderna vaccine - national protocol - edition 1.0
Annex C: Clinical Supervision sheet

32 page PDF

660.0 kB

Annex C: Clinical Supervision sheet

COVID-19 Vaccine Moderna Protocol

Valid from: Expiry:

This sheet must record the name of the clinical supervisor taking responsibility and all of the people working under different activity stages of the protocol.

Activity stages of the vaccination pathway under this protocol:

Stage 1

a. Assessment of the individual presenting for vaccination

b. Provide information and obtain informed consent

c. Provide advice to the individual

Registered Healthcare Professionals Only

Stage 2

  • Vaccine Preparation

Registered Healthcare Professionals, non-registered professionals or non-registered Armed Forces staff

Stage 3

  • Vaccine Administration

Registered Healthcare Professionals, non-registered professionals or non-registered Armed Forces staff

Stage 4

  • Record Keeping

Registered Healthcare Professionals, non-registered professionals or non-registered Armed Forces staff

The clinical supervisor has ultimate responsibility for safe care being provided under the terms of the protocol. Persons working under the protocol may be supported by additional registered healthcare professionals, but the clinical supervisor retains responsibility.

Before signing this Protocol, check that the document has had the necessary authorisations. Without these, this Protocol is not lawfully valid.

Clinical Supervisor

Name:

Designation:

Signature:

Date:

Practitioner(s) and Activity Stages

Name:

Activity Stage(s):

Signature:

Date:

Note to Clinical Supervisor

Score through unused rows in the list of practitioners to prevent practitioner additions post managerial authorisation.

This authorisation sheet should be retained to serve as a record of clinical supervision arrangements for those working under this Protocol.


Contact

Email: VaccinationsDelivery@gov.scot