Drug Topics®: First, introduce yourself.
Madeline Camejo: I am Madeline Camejo. Baptist Health South Florida has me as the chief pharmacist officer.
Drug Topics®: How common are the challenges or problems that can be faced by vaccine storage systems in the retail environment or health system?
Camejo:You need to make sure that you have the correct equipment for both storage and monitoring. You should also ensure that you have the right operating procedures in place to monitor your vaccines. Many people use substandard refrigerators, which don’t maintain consistent temperatures. They can cause serious damage to your vaccines if they fluctuate. If you are going to invest in vaccines, I recommend that you only buy medical-grade refrigerators. This is not a refrigerator you can use at home or in a dorm fridge. This is what I have seen happen. They buy refrigerators from their house and then add vaccines. It is important to have the best medical refrigerator on the market that has monitoring capabilities.
Drug Topics®: What is the current look of your vaccine storage system and what are its pros and cons?
Camejo: With our monitoring system, it was a lot of hard work. We assessed what we needed. We actually made a detailed checklist of all the things we had to do before we even went out and selected a company. So, for us, what was really important for us was being able to differentiate different types of monitoring like ‘what would I need in this room versus in another room’, ‘how is the temperature in this room or humidity versus others.’ Make sure you do that preassessment. When we did that, every room was customized to the type of fridge or freezer it needed. This was all done in advance. It does send and receive different types alerts. That’s very important.
We looked for a company that would give us lots of training, either in person or via a manual. You must continue to train new employees as you are constantly learning. We chose to train our employees. It was important to us to be able to set up alerts and customize roles. We also appreciate being able log in from home or on the jobsite. This capability is important even if you’re not physically present. The last thing that was important was sensor reading. It monitors the internet for downtime until it comes back online. Because you are constantly relying on that monitoring, it is important to be able to transmit the data. Technology has improved tremendously and you don’t need to use internet. Cellular data is now possible, which can be useful in areas without Wi-Fi.
We also valued the ability to record and document, so we wanted to make sure we got what we needed.
Drug Topics®: What elements would you include in your ideal vaccine storage system?
Camejo: I think that mobile apps should be more popular. You’re often remote because you can’t be there 24/7. Another thing is being able store data for longer than three years. It’s important for consistency, especially for audits and things that may need be done. A system that records temperature quickly and can send those alerts to you so you can document on-the-fly as you solve those issues. These are the most important features to include in a reliable vaccine monitoring system.
Drug Topics®: Why is it so important for the health system and retail pharmacies that they have reliable, high-quality vaccine storage systems?
Camejo: It is your responsibility to ensure that vaccine safety is maintained until the time the patient is administered. Vaccines are very fragile and they’re a biological substance and not storing them at the right temperature can make vaccines less potent and even destroy active ingredients. By giving an ineffective vaccine, you put your patient at serious risk. It is vital that the patient trusts that the vaccine you give is safe for their health and the benefit of the entire population.
Drug Topics®: What are some of the best practices for storing vaccines within a healthcare system or retail pharmacy?
Camejo: There are five things I believe I would consider best practices.
Understanding your practice’s needs is the first step. We did a preassessment of the types of locations that are going to require monitoring, how many sensors you’re going to need in each location. To ensure you have the right humidity, you should do a temperature map of the area where the refrigerator will be placed.
This preassessment is essential for them to be able have a clear, detailed installation plan. Your assessment will help you determine what sensors are needed, where they should be placed, and what equipment is required to perform the functions you want. Next, create your standard operating procedures for routine monitoring emergencies. Then identify the contacts who will be responsible to respond.
Third, I recommend establishing and implementing a detailed training plan for your staff. Each new employee should be trained on a regular basis. Make sure to go through all procedures for handling vaccines. We didn’t know how to store the COVID-19 vaccines, but we’ve gotten better before you had to have a subzero refrigerator. COVID-19 vaccines are stored differently than other vaccines. It is crucial to properly protect these vaccines.
Optimizing your alerts, and your alarm capabilities is the fourth thing I would recommend. If you want to ensure that notifications are sent to the right people or groups, set it up so they can be sent according to what problem has been detected. Send it to facilities personnel if your refrigerator reports a power outage. Is the power outage in the entire building or just one outlet? This alerts you to all possible alert messages so that the right person can resolve the problem quickly.
My last recommendation is to review your data logs regularly. It’s important to print out your data each month and review any out-of range recordings or other alerts in order to identify any trends. This is better than waiting for an inspector to come and ask for one year of data. That would leave everyone scrambling to find the data. It’s a great way to go. That’s how we do things. We just pull the logbook when an inspector arrives. This shows transparency in how we address programs and makes auditors feel more comfortable.
Drug Topics®: Is there anything you want to end our viewers’ day with?
Camejo: Protecting vaccines against temperature fluctuations is vital for public safety as well as financial security for your organization. Vaccines aren’t cheap and just 1 disaster can cause thousands of dollars in loss to your practice. It’s important to ensure that your practice has safe and sound storage. Also, be able give back that quality to ensure that you’re doing the right thing for the public.