A Collaborative Service to the Community: A COVID Vaccine Clinic Provided by a Mid-State University ()
1. Introduction
The need for the establishment of an additional COVID Vaccination Clinic became imminent in Middle Tennessee. Therefore, the Middle Tennessee State University (MTSU) School of Nursing (SON), MTSU Student Health Services, and local county health departments joined forces to establish a COVID Vaccine Clinic for the local community in February 2021. A multidisciplinary COVID Vaccine Clinic planning committee was organized to plan the coordination and operation of the clinic. Members of the vaccine clinic planning committee included the Director of the School of Nursing, Nursing faculty and staff, the Director of the Student Health Center of MTSU, the Medical Director of Student Health Services, the Director of the Health Services Pharmacy, MTSU Marketing, and members of the local health department. The purpose of this paper is to share the experiences and reflections of those individuals who participated in this event under circumstances that demanded additional time and dedication in meeting the unique, time-constrained healthcare needs of a community.
During the initial COVID Vaccine Clinic planning committee meetings, a variety of roles and responsibilities were identified to ensure the clinic would be organized and coordinated as efficiently as possible. Weekly meetings were scheduled to discuss a variety of topics such as supply distribution, procedures, and debriefing for each active clinic day to identify areas in need of improvement. (See Table 1 for the Roles identified to operationalize the COVID Vaccine Clinic).
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Table 1. Roles identified to operationalize the COVID vaccine clinic.
2. Nursing Faculty
The nursing faculty served in multiple roles during the COVID Vaccine Clinic. These roles included development of spreadsheets outlining schedules for faculty and student staffing, assignment of site leaders and registration workers, monitors for student vaccine preparers and vaccinators, and oversight provided for the observation area (Table 2).
3. COVID Vaccine Clinic
The vaccine clinic was held in the SON Lobby, a large open area. A trial run was scheduled prior to the official opening of the first vaccine clinic day. This provided an opportunity to test the effectiveness of patient flow and to identify any potential gaps in the planning phase of this process. Booths and large signs were placed in many areas to guide the public through the process. There were also student volunteers available to assist with wheelchairs and other needed equipment. Supplies such as masks, gloves, and hand sanitizers were available in all areas for everyone’s use. The Center for Disease Control (CDC) guidelines were carefully followed during the vaccine clinic, as well as weekly communication with the Tennessee Department of Health [1] [2]. Table 3 outlines descriptions of areas of the COVID Vaccine Clinic located in the SON Lobby.
4. Multiple Facets of Faculty Involvement
4.1. Marketing/Advertising
The MTSU Marketing Division assisted in the design of a T-Shirt that volunteers wore during the vaccine clinic hours of operation. The mantra of MTSU is “True Blue” so it was important to include this as part of the shirt. “True Blue… vaccination crew” was the logo. Three colors indicated each participant role: Black
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Table 3. Areas of the COVID clinic located in the SON lobby.
indicated the site lead, the go to person, for that day. Blue identified volunteers licensed such as registered nurses and pharmacists. Yellow indicated volunteers who were students of MTSU or volunteers in non-licensed roles. The purpose of the T-Shirts was to ensure quick identification indicating the role of each volunteer for people seeking vaccination. T-shirts also helped to promote bonding of all participants as members of the newly formed “True Blue Vaccination Crew!”
4.2. The Director of Pharmacy
The task of the pharmacist, also a member of MTSU faculty, was to oversee the set-up of vaccines used and to direct the managing of vials and doses of the Moderna and Janssen vaccines. This individual managed notebook created for each vaccine. These notebooks contained documentation accounting for dates and times when the vaccines were received, Lot numbers and expiration dates of each vial, and times vaccines were placed in the freezer or refrigerator for appropriate storage.
Each COVID clinic day, the management of the particular vaccine used was of utmost importance. For example, the Moderna vaccine had to be thawed when removed from the freezer to the refrigerator then thawed again at room temperature for fifteen minutes before it was used [3]. Once the doses were drawn into syringes, the vaccine was kept at room temperature and would be considered stable for twelve hours only. Any doses not used within the allotted time had to be disposed according to the vaccine guidelines.
Conversely, the Janssen vaccine was initially refrigerated and did not require any thawing but was only considered to be stable at room temperature for two hours [1]. Unlike the Moderna vaccine, the Janssen was drawn up and returned to the refrigerator for a maximum of six hours [4]. Due to the scarcity of the COVID vaccines, volunteers who handled these two vaccines felt they were working with liquid gold.
The pharmacist also worked with the person in charge of the appointments for the day of each clinic to ensure that no vaccine was wasted. Training and a brief review was provided by the pharmacist at the beginning of each clinic day and was attended by all faculty members and students assigned to the management and distribution of the vaccines.
4.3. Scheduling Factors
One aspect of faculty involvement was the scheduling of volunteers needed to successfully manage the clinic. This was accomplished by creating spreadsheets allowing for identification of days and available slots assigned to each role outlined earlier. These spreadsheets became the means electronically distributed allowing faculty and students to volunteer their time. Nursing students enrolled in the second through fifth semesters were able to vaccinate patients always under the supervision of a nursing faculty member. First semester nursing students were assigned to non-nursing roles. (Note: Nursing students at MTSU SON begin their curriculum as juniors completing their nursing requirements toward their BSN degrees in five semesters).
The Director of the SON encouraged all nursing faculty to actively participate in the operation and staffing of the clinic as their schedules allowed. This took an enormous amount of planning and effort. Communication was key in making this clinic the success it was, as each area of the clinic had its unique challenges.
4.4. Registration Area
The process for the flow of individuals seeking the vaccine worked well. As prospective patients parked in the SON parking lot, they were guided to a station outside the SON building where key information was obtained ensuring that all who entered the lobby were eligible to receive the vaccination. Individuals then proceeded to the registration area to complete required documentation. Registration forms were filled out, information regarding the vaccine was shared, and after completion of these requirements, individuals were then directed to the area where they would receive their vaccine.
4.5. Vaccine Preparation
Drawing up injections was challenging in the sense that every vial used was to be carefully timed as described earlier. It was discovered that a Vaccine Manager was needed to ensure the accuracy of initial vaccine counts, temperature checks, and oversee those providing the preparation of the vaccine. Nursing students participated in this process with supervision of the Vaccine Manager, a member of the SON faculty. The students became very knowledgeable with Lot numbers and skillful with vaccine preparations.
4.6. Vaccine Administration
When it came to administering the vaccine, faculty and students alike would work together to ensure that each individual seeking to receive their vaccination is treated with the upmost care. There was always supervision and oversight allowing students to become confident providers in this aspect of nursing care. All students allowed to volunteer in vaccine administration were already trained and tested with the use of competency skills performed each semester. This experience allowed students to become even more proficient with both their interaction of live patients and skills in the delivery of multiple injections in a single clinic day.
4.7. Observation Area
The observation area was situated at the end of the main lobby of the SON building. Many chairs were available and spacing of individuals who received the vaccine was positioned at least six feet apart from each other. These chairs were arranged in a way that faculty and students could observe all individuals who had received their vaccination for 15 minutes before leaving. The Centers for Disease Control and Prevention suggest that for those patients who are immune-comprised or in poorer health stay for at least 30 minutes while all other patients who are considered to be in good health are recommended to remain for observation post injection for at least 15 minutes [5]. If a vaccinated individual experienced any adverse reactions to their vaccine, they were requested to stay for an additional length of time to be further assessed and if needed, be transported to the nearest healthcare facility for further treatment.
5. Students Perspectives
The nursing students volunteered and participated in a variety of roles as well. They helped with the clinic set up each week, registration, administration of vaccines, and assisted in the observation area. The vaccine clinic provided an enhanced educational opportunity. The value of working with different levels of students, collaboration with other departments and interdisciplinary learning was such a positive for everyone. This model of collaboration and interdisciplinary learning has become an essential requirement for the preparation of future healthcare providers [6] [7]. During the COVID-19 pandemic, many clinical rotations for nursing students were disrupted, sparking a national and local problem identified for nursing education. Participation in the COVID Vaccine Clinic delivered valuable experiences for students affording them additional opportunities for patient interaction [8] [9].
Of interest, students greatly benefitted from the experience of working in the registration area enabling them to actively focus on verbal interactions with individuals from all areas of Middle Tennessee, all cultures, and all ages. It was noted that within an hour of working in this area, students’ confidence and ability to communicate were greatly enhanced. They shared with many faculty that they felt they were truly learning about the uniqueness of each visitor in matters of health and wellness.
The MTSU COVID Clinic was such a great experience for all students in the nursing program. They were able to perform many roles, including but not limited to, working in registration areas, preparing vaccines, administering vaccines, and assisting in the observation area. Later, after returning to their own clinical areas in later semesters, they discovered that many of their patients designated as critically ill were unvaccinated. Students acknowledged that they felt confident in knowing they helped provide hundreds of people obtain some aspect of immunity against the COVID-19 virus in hopes of preventing future hospital admissions. They were proud to have contributed to one of history’s most memorable pandemics by administering vaccines at the MTSU COVID Vaccine Clinic.
6. Conclusion
The COVID Vaccine Clinic was short-lived closing in April 2021 due to a lack of community need. Over 4000 vaccines were administered during scheduled clinic sessions. The collaborative effort between MTSU and the community to make possible a much-needed service provided enhanced opportunities for all volunteers. The COVID Vaccine Clinic provided an interdisciplinary learning opportunity during a pandemic that will never be forgotten by faculty or students. Many of the students went on to devote their summer break to further their experiences in medical facilities with increased patient care needs. While this reflection is only a tiny speck in the global context of the COVID pandemic, it contains lessons that can be appreciated for many years to come.
Appendix
Vaccine preparation room with faculty and students
Nursing faculty participating in the COVID-19 Vaccine Clinic
