Knowledge Park at Penn State Erie, Building 4 | 5340 Fryling Road, Suite 205 Erie, PA 16510
Ph: (814) 899-2001 | Fax: (814) 899-2002

Nurse Orientation Program

Nurse Orientation

Overview of the Training by the Nurse Trainer

Day 1 – First Afternoon

  • Introduction of allergy to the office staff
  • Make sure all supplies and extracts are inventoried, logged (LOT #), and put away for convenient access
  • Discuss USP 797 Compounding Guidelines and the need to maintain a sterile environment for filling of trays, mixing dilutions, and making individual patient treatment vials
  • Setup prick puncture testing tray with allergens in the order they are in on the test form
  • Review proper patient selection, contraindications to testing, and patient preparation for testing
  • Discuss different types of allergy testing and treatment – overview of Prick, Intradermal, and In-Vitro testing
  • Demo/practice the prick and ID testing with saline on each other (type of testing being used in clinic)
  • If sufficient time, demonstrate proper mixing and begin making intradermal allergen test dilutions

Day 2 – Morning

  • Finish preparing all *intradermal allergen test dilutions in phenolated saline as well as the treatment dilutions in 50% glycerine thereby creating a test board and a separate treatment board  (*a math short cut can be used for making just the # 2, the # 5, and the # 6 dilutions only for testing)
  • Review proper expiration dating for all compounded vials based on current industry standards
  • Review and discuss testing process, need for controls, and accuracy in the process with proper documentation

Day 2 – Afternoon

  • Practice patient preparation (explanation of process, obtaining history, consent, etc.) and testing on volunteer test patients (real patients if at all possible pre-selected by the site physician)
  • Perform prick puncture testing on several patients and only do intradermal testing on those contemplating immunotherapy / trainer does initial testing with trainee observing – all per A.A.A.A.I and A.A.O.A. guidelines
  • Discuss outcomes and possible suggested treatment approaches (SCIT, SLIT, and OMIT)
  • Provide and explain patient education to patients tested with regard to avoiding allergens, medication use, and following instructions for immunotherapy

Day 3 – Morning

  • Review test results and cover dose calculation & formulation of treatment vials for all three immunotherapy approaches – review forms to use for each approach and complete appropriate forms
  • Additional practice patient prep & testing on volunteers and/or live patients with trainee performing all testing and trainer in observation and correction/encouragement mode

Lunch and Learn with the Physicians, Direct Allergy Nurse, and Office Staff – Complete Overview of Program

Day 3 – Afternoon

  • If time allows, additional testing done by new staff member
  • New staff member discusses results with patient, patient education, etc. just as they will be doing in clinic
  • Review test results, allergen selection based on history, and writing of formulas based on results
  • Review process, set up, and prepare patient specific treatment sets

Day 4- Morning

  • Discuss and review previous days testing and vial formulation
  • Review immunotherapy dosing and proper documentation
  • Review dosage decisions and adjustments
  • Discuss how to properly give subcutaneous injections and give several subcutaneous injections
  • Cover emergency protocols for adverse patient reactions in detail