Nursing and Entry Immunization Form (EIF) Information Book a Nursing Appointment (EIF and Injections) What is an Entry Immunization Form (EIF) An Entry Immunization Form is a required health form you must complete before starting certain programs—especially programs with labs, clinicals, or placements such as healthcare, community services, or early childhood programs. What’s on the form: A checklist of required vaccines (such as tetanus, measles/mumps/rubella, polio, varicella (chicken pox), hepatitis B). TB testing (1-step or 2-step, depending on the program and the year of study) Immunity status. A section for a healthcare provider to review, complete, and sign. Why Durham College requires an EIF: Placement sites require proof that you are protected against certain diseases To keeps students, clients, and staff safe. Completing and having the form signed by a health care professional helps ensure you can attend your placement without delays. Helpful Tips Start early - some vaccines and TB tests take weeks to complete. Book your initial EIF appointment about 6 weeks prior to the Synergy due date. If you’re missing immunization records, the Durham College Health and Wellness Centre, your family doctor or a walk-in clinic can help with bloodwork and immunizations. Once finished, the EIF must be submitted by the student to Synergy, a 3rd party company, for review and approval. Here is a link with more information related to the Electronic Review Verification (ERV), Verified by Synergy Gateway (https://durhamcollege.ca/academic-faculties/faculty-of-health-sciences/field-placement-requirements/verified-by-synergy-gateway) About your EIF appointment EIF completion appointments should be made 4-6 weeks before your forms are to be submitted to Synergy. The first appointment will take up to 30 minutes; subsequent appointments will be 10 – 20 minutes. It will take 4 – 5 appointments and at least 2 – 3 weeks to complete your EIF forms. Please note, there is an $85 fee for completing the EIF. PREPARING FOR YOUR INITIAL EIF APPOINTMENT Locate the EIF online HERE Read pages 1 and 2, instructions BEFORE printing the form Complete Part A on line, with your personal and course information Click on the PRINT button (we do require a printed copy of the form) Bring your printed EIF, with Part A completed to your first appointment Obtain a copy of your Immunization Records, and bring a printed copy to your first appointment Accessing your immunization records Ontario residents: Bring your immunization records (Yellow Immunization card) if you do not have the records, you can obtain them from the Public Health Unit where you had your childhood vaccines. A list of all public health units can be found here: alphaweb.org/page/PHU If you are born in the Durham Region, you can access your records here: icon.ehealthontario.ca/#!/welcome or phone Durham Health Connection 1-800-841-2729 International Students: If you are an international student, please make every effort to obtain your immunization records from your home country. This information is very important, as it allows us to confirm your vaccination history and helps avoid the need to repeat or restart full vaccination series unnecessarily. INITIAL APPOINTMENT What to Bring and How to Prepare for Your Initial EIF Appointment Bring all your immunization records (even if they’re from another country), including COVID vaccine dates. Bring your PRINTED Entry Immunization Form (EIF), with Part A completed. Eat and drink before your appointment — this makes blood work easier Wear comfortable clothing that allows easy access to: Your upper arm Your forearm What to expect Your initial appointment will take up to 30 minutes. You will meet with one of the clinic nurses, who will walk you through everything. This appointment may include the following: Review of your immunization records. Tetanus, diphtheria, pertussis and polio vaccines (combined in one injection) if you’re due. TB (TST - tuberculosis) testing. Blood work. Don’t worry — the nurse will explain each step as you go. FOLLOW UP APPOINTMENTS Everything will be explained, and appointments will be scheduled step by step — you don’t need to figure it out on your own. All follow up appointments will be booked with you during your visit. If you are having a Tb test, your second appointment will be scheduled 48-72 hours after the initial appointment for the Tb reading. If a second Tb test, is needed it will be scheduled 7 – 21 days after the first test, followed by a reading appointment. At one of your final visits, you may meet with one of the clinic doctors to: Review your bloodwork. Discuss if any vaccines are needed. The nurse will give you any required vaccines following the Ontario. Immunization schedule and placement requirements. COMPLETING YOUR EIF Once complete, you are responsible for scanning and sending your forms to Synergy. If you are in a program that does not use Synergy, we recommend you take a photocopy of your form before handing it in to your placement officer. TB Testing (TST) A TB Skin Test is also known as TST (tuberculosis skin test) and is required as part of the Entry Immunization Form. TB testing checks to see if you have ever been exposed to the TB germ. It’s a routine requirement for many programs and helps keep everyone safe. 2-step TB test is required for students who have never had a Tb test before The first test “wakes up” your immune response, and the second test shows the true result. A 2-step is only done once in your life, if you have the documentation as proof. 1-step TB test is done annually, if there is documentation/proof of a 2-step WHAT TO BRING AND HOW TO PREPARE The 2 step Tb test will be documented in your EIF form. Be sure to bring the EIF form to every appointment. Wear clothing that allows for easy access to your forearm. WHAT HAPPENS DURING THE TEST? Step 1: During the first visit the 1st Tb test will be done – this is called a 1 step TB skin test. It is done by injecting a small amount of testing solution just under the skin of your forearm. A tiny, raised bump (“wheal” or “bleb”) will appear where the solution has been injected, which soon fades away. This feels like a tiny pinch and only takes a few seconds. The 2nd visit will be scheduled for 48-72 hours; the injection site will be “read” by a trained health care professional. The read is done by running a finger over the injection site and taking measurements if a bump is present. Step 2: 7-21 days later, you will need to have a second TB skin test, called Step 2 Returning in 48–72 hours for the second “reading”. You must return for every reading — missed readings means starting over. AFTER THE TEST A tiny, raised bump (“wheal” or “bleb”) will appear at the site, it will fade way within 15 minutes. There may be redness at the site and bruising is normal. The area may be itchy or irritated. Avoid touching the area. WHAT DO THE RESULTS MEAN? No bump under the skin: The test is negative (no evidence of previous TB exposure). Bump is present underneath the skin: The test might be positive, which usually means past exposure to the Tb antibody (germ). It does not mean you have active Tb, but you may have Latent Tb infection (LTBI) You are likely not contagious. Not all bumps mean a positive test. If the test is positive, you may need a chest X-ray to rule out active Tb in your lungs. After the x-ray you will need to see a doctor to review the results and determine the next steps. Once you have a positive test you should NEVER do another Tb test (TST) again as it will always be positive. IMPORTANT REMINDERS You must return for the Tb reading at the scheduled time, otherwise the test may need to be repeated. You can go about your normal activities after the test. 1 STEP TB (TST) – YEARLY (ANNUAL) FOR 2ND, 3RD AND 4TH YEAR STUDENTS Annual or repeat TB testing (for 2nd, 3rd and 4th year students) who have proof of a 2 step Tb test. Required for students who have had TB testing before that was negative. Usually done 1 year after your last Tb test, however some facilities may require the test to be done more frequently. **Note if this is your first time having a Tb test (TST) go to the 2 Step Tb for first year students WHAT TO BRING AND HOW TO PREPARE 2nd,3rd and 4th year students: bring the Yearly One Step TB Test Requirement Form Book 3 appointments: With a doctor to order the Tb test On the same day, with a nurse, to have the Tb test done 48 – 72 hours later, with a nurse, to read the Tb test Wear clothing that allows for easy access to your forearm. WHAT HAPPENS DURING THE 1 STEP TEST? On the first visit the doctor will order the 1 step TB skin test and then a nurse will do the Tb test by injecting a small amount of testing solution just under the skin of your forearm. A tiny, raised bump (“wheal” or “bleb”) will appear where the solution has been injected, which soon fades away. This feels like a tiny pinch and only takes a few seconds. The 2nd visit will be scheduled for 48-72 hours; the injection site will be “read” by a trained health care professional. The read is done by running a finger over the injection site and taking measurements if a bump is present. AFTER THE TEST A tiny, raised bump (“wheal” or “bleb”) will appear at the site, it will fade way within 15 minutes. There may be redness at the site and bruising is normal. The area may be itchy or irritated. Avoid touching the spot. WHAT DO THE RESULTS MEAN? No bump under the skin: The test is negative (no evidence of previous TB exposure). Bump is present underneath the skin: The test might be positive, which usually means past exposure to the Tb antibody (germ). It does not mean you have active Tb, but you may have Latent Tb infection (LTBI) You are likely not contagious. Not all bumps mean a positive test If the test is positive, you may need a chest X-ray to rule out active Tb in your lungs. After the x-ray you will need to see a doctor to review the results and determine the next steps Once you have a positive test you should NEVER do another Tb test (TST) again as it will always be positive. IMPORTANT REMINDERS You must return for the Tb reading at the scheduled time, otherwise the test may need to be repeated. You can go about your normal activities after the test. Vaccines VACCINES FOR STUDENT PLACEMENTS — WHAT YOU NEED TO KNOW Some Durham College programs require your vaccine status before you can start your clinical or field placement. Vaccines help to protect you, patients, and staff. You may need vaccines if your placement is in: Healthcare settings Childcare or schools Community or long-term care settings Commonly required vaccines Tetanus, Diphtheria, Pertussis (Tdap) – up to date adult dose OR Tetanus and Diphtheria – every 10 years Polio – proof after your 4th birthday Measles, Mumps, Rubella (MMR) – 2 doses or proof of immunity Varicella (chickenpox) – 2 doses or proof of immunity Hepatitis B (and blood work to confirm immunity) Influenza (commonly required during flu season, October - April) What to expect Your immunization record will be reviewed. You may need vaccines, boosters, or blood work. Some vaccines require more than one dose. Important Requirements vary by program and placement site. Missing vaccines can delay or prevent placement. Keep a copy of your immunization records for future use. WHAT TO EXPECT WHEN GETTING VACCINES Getting vaccines is quick and straightforward. Here’s what you can expect: Before your vaccine appointment Eat and drink water before coming to your vaccine appointment. Wear clothing that makes it easy to access your upper arms. During the vaccine The vaccine is given in your deltoid muscle or the back of your upper arm, depending on the type of vaccine. It feels like a quick pinch and is over fast. Some vaccines may be combined into one shot. It is ok to have 2 or 3 vaccines on the same day. After the vaccine You may be asked to wait 10–15 minutes to make sure you’re feeling okay. You can go about your day as usual. Move your arm after the shot — it can reduce soreness. Common side effects Sore arm Redness or swelling at the site Mild fatigue or headache These usually go away in a day or two. If you notice any other symptoms that don’t feel right, go back to the clinic or see a health care provider. Serious reactions are rare. Bloodwork Bloodwork is when a small sample of your blood is taken to check for a variety of medical issues. For the EIF we will be checking your immunity to certain infectious diseases. WHAT TO EXPECT WHAT TO EXPECT Why you might need it: To make sure you’re protected against certain diseases. This will tell us what vaccines you may need Before you blood work appointment: Drink water and eat before you come to the clinic. Wear sleeves you can roll up What happens: The lab tech cleans your arm and uses a small needle to take blood from a vein. It feels like a quick pinch – it is over in seconds. You can resume all regular activities after your blood work. A bruise is normal. Tips: Relax your arm to make it easier. Ask questions if you’re nervous—the lab tech is there to help!
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