Friday Five (December 22, 2023)

Upcoming Deadlines for Mandatory Module

Please be reminded that pharmacists are required to view this year’s mandatory webinar, Indigenous Health, by December 31, 2023, while pharmacy technicians must do so by May 31, 2024.  

The following document posted in the ‘Announcements’ section of  your registrant profile, provides essential details for accessing and completing the current and previous mandatory modules:  

 http://cphm.alinityapp.com/Client/PersonGroup/OpenDoc/1000004?ts=20231219080504 

December 8th Council Meeting Updates  

Amendments to the Patient Profile Practice Direction  

In 2014, the College of Pharmacists of Manitoba Council (Council) implemented a policy on practice directions, which includes the requirement for assessment and regular review at a minimum of every 5 years. 

In accordance with the Practice Direction Policy, Council has approved amendments to the Patient Profile Practice Direction (Practice Direction) at their December 8, 2023, meeting. The approval of the amended Practice Direction follows several reviews by the Standards of Practice Division of the Quality Assurance Committee (the committee), a public consultation in the fall of 2022 and collaboration with the Rainbow Resource Centre. CPhM thanks the committee, everyone who provided feedback during the consultation period, and the Rainbow Resource Centre for their feedback and engagement. 

The amendments include: 

• Changes to the mandatory information that must be recorded on a patient profile, and 
• The addition of an appendix developed in collaboration with the Rainbow Resource Centre to support pharmacy professionals in delivering inclusive care to gender diverse patients. * 

The amended Practice Direction is available on the CPhM website and the individual amendments to the Practice Direction are outlined in detail here. 

The amended Practice Direction is now in effect; all pharmacy professionals must familiarize themselves with the new requirements. 

*CPhM is exploring potential future professional development opportunities for pharmacy professionals to help promote pharmacy environments that are safe and inclusive for 2SLGBTQ+ and gender diverse patients.  

Required Preceptor/Supervisor Training  

As part of CPhM’s Strategic Plan for 2021-2024, Council set a goal of standardizing preceptor training.  As of March 1, 2024, all CPhM preceptors of post-graduate interns and supervisors of pharmacy technicians-in-training completing structured practical training programs must complete one of the following approved programs and complete the listed modules:  

OR

For those who are also preceptors of university pharmacy students and pre-graduate interns,  

University of Manitoba, Rady Faculty of Health Sciences, College of Pharmacy – Preceptor Development Program Modules   

• All modules as required by the College of Pharmacy at time of completion.  

Time spent completing the modules are eligible as accredited learning since these programs are provided by Canadian Universities and can be claimed as accredited continuing education units (CEU) in the online PD Log. Preceptors/supervisors who have previously completed one of the above approved programs will not be required to redo the program. A declaration stating completion of a program will be required when applying as a preceptor/supervisor.  Individuals are encouraged to complete the required training in advance. 

Addition of Specialty Qualification Program for EPPh Registration    

Council approved the American Academy of HIV Medicine: HIV Pharmacist (AAHIVP) certification as an additional Extended Practice Pharmacist (EPPh) specialty qualification program under section 96(g) of the Pharmaceutical Regulation.    

An EPPh applicant with this certification must be currently practicing and must have practiced for at least 1,000 hours within the specialty and in a collaborative healthcare setting in the two years before applying for EPPh registration.    

For more information on how to attain an EPPh designation and the current list of other approved specialty qualification programs, please see the Extended Practice Pharmacist webpage.   

Timing of the Jurisprudence Examination  

A motion was passed to allow for pharmacist and pharmacy technician applicants to complete the Jurisprudence (JP) Exam at any time after their application has been submitted to and approved by CPhM.  This gives applicants more flexibility and may potentially prevent delays in licensing or listing.
 
Applicants are still required to complete the JP Modules prior to attempting the exam, however, they may now attempt the exam at any point throughout their internship or structured practical training (SPT) program. The JP Exam must be successfully completed prior to licensure/listing.   

Licensing of Out-of-Province Graduates of a Canadian CCAPP-Accredited Pharmacist Degree Program  

Out-of-province pharmacist graduates of a Canadian CCAPP-accredited pharmacy program, who have not been licensed in another Canadian jurisdiction previously, are now able to register and license with CPhM without first licensing in their province/territory of graduation, provided they meet the licensing requirements. This ensures qualified applicants are licensed in Manitoba faster. These applicants must successfully complete a minimum 200-hour internship in Manitoba with an approved preceptor prior to licensure.   

For more information, please visit the Pharmacists from Inside Canada webpage.  

Discontinuation of Commitment to Professional Development Certificates 

Council made the decision to discontinue the life-long learning recognition program that occurred in conjunction with professional development (PD) obligations that pharmacists are required to fulfill annually. The certificates will be awarded one last time in January for the 2022-2023 PD year. 

This is in line with the decision Council made earlier this year to discontinue all awards and recognition programs to ensure impartiality and maintain public trust and confidence. 

CPhM Council commends those who have strived to acquire significantly more PD than the minimum 25 CEU per reporting cycle.  PD is an important aspect of maintaining competency throughout a professional career. 

Extension to NAPRA Sterile Compounding Exemption for Palliative Care Patients 

CPhM Council has again approved an extension of the exemption for the drawing-up of comfort care medications for Palliative Care patients in a setting that does not meet the NAPRA Model Standards for Sterile Compounding. Council reviewed the Sterile Compounding Exemption for Palliative Care survey results, along with other information, to inform their decision. Thank you to all the respondents who participated in the survey.  

Council will review the exemption again prior to the new  expiry date of January 1, 2026. Any pharmacy or pharmacist that is considering the utilization of this exemption must be knowledgeable and fully compliant with the following requirements:   

When deciding if the service should be provided:    

• The patient must be registered with the palliative care program.    
• The medications should be non-hazardous, and the manipulation be low risk (as defined by NAPRA) and prepared from a commercially available sterile source only.    
• The preparation should be only a single manipulation (i.e., pre-filling a syringe).    
• All possibilities of training a caregiver or family member to draw up medication should be exhausted first before contemplating this option.    
• The physician determines that this is the only viable method of effective treatment of the patient and the prescription indicates “for emergency use.”    
• The benefit vs. risk favours rapid access to the medication.    

 Once the decision has been made to provide the service:    

• A process for obtaining informed consent must be implemented and followed. This must include a meaningful discussion with the patient/caregiver/decision-maker on associated risks and alternatives of the provided pharmacy service.   
• The product should be monitored for signs of potential contamination at draw-up, and further education should be provided to the patient’s agent to monitor before administration.    
• Preparation should take place in a designated compounding area following the standards for preparing immediate use preparations (see NAPRA Model Standards for Sterile Compounding).    
• The compounder must don minimum personal protective equipment (PPE), including but not limited to sterile gloves (or gloves that have been disinfected with sterile alcohol) and a medical grade mask.    
• The preparation must be performed by a pharmacist or regulated pharmacy technician.    
• The preparation is limited to a two day supply that must be labelled with a maximum beyond use date of 48 hours from the point of preparation.    
• The non-compliant pharmacy is limited to supplying a maximum of 6 days (three occurrences under this exemption).    
• Supply of medications beyond the limits must occur from a NAPRA compliant facility. The pharmacy must refer the patient to a compliant facility or obtain medications prepared from a compliant facility.   
• The product must be stored appropriately at the pharmacy, and education must be provided to the patient’s agent on storage at home.    

Prior to consideration of using the above exemption, it is imperative that pharmacists make every effort to seek the services of, or refer a patient to, a pharmacy that can provide sterile compounding that fully meets the NAPRA Model Standards for Sterile Compounding. This is considered ideal, best practice, and in the best interest of patient safety. The exemption is intended to provide timely access to necessary medications in order to offer the pharmacist and patient/caregiver time to source out fully compliant sources of the drug product.  

Reporting Pharmacy Ownership Changes 

During the course of the recent renewal of pharmacy licences for the 2024 practice year, it was discovered that numerous pharmacies  have been negligent in promptly reporting ownership changes to the College of Pharmacists of Manitoba, as mandated by law.  Section 47 of The Pharmaceutical Regulation states that an owner must notify the Registrar within seven (7) days, when any of the following occurs: 

Notice must be given: 

Within seven (7) days, if there is a change to: 

1. Pharmacy Manager 
2. Pharmacy Relocation or Renovation 
3. Partnerships:
   
   • Members of the partnership  
   • The General or Limited partnership 
   • Managing Partner
     
4. Officers/Directors of the Corporation  
5. Shareholders (50% or more of the Corporation’s voting shares) 

30 days advance notice is required if there is a change to: 

1. Pharmacy Owner/Signing Officer 
2. Pharmacy Licence Holder 

This information must be reported to CPhM at the time of the change, and not held beyond the notification period stated above nor held until the annual renewal.  

CPhM Council will deliberate further on this matter at its next meeting, scheduled for 23rd February 2024, and will consider implementing processes to encourage more timely compliance by pharmacy owners and managers regarding the obligation to report changes, as outlined above. 

Pharmacy managers and owners must work together to notify CPhM of any changes to their pharmacy’s operations in a timely manner.  Processes and requirements for any pharmacy changes are available via the Pharmacy Status and Information Updates page on the CPhM website. If you have any questions or concerns, please contact registration@cphm.ca.  

CPhM Office Schedule During Holiday Season     

The College of Pharmacists of Manitoba will observe the following holiday schedule:     

• Closed Monday, December 25, 2023, through Monday, January 1, 2024.  
• Regular office hours resume on Tuesday, January 2, 2024, from 8:30 a.m. to 4:30 p.m.      

Documents may be left in the black deposit box to the left of the main entrance. Email is the most efficient means by which to contact staff. Thank you for your kind attention and cooperation. 

Upcoming Events and Professional Development Opportunities

The following update comes from the College of Pharmacy (CoP), University of Manitoba:

Thank you to all pharmacists who participated in the Professional Development (PD) Survey distributed May 12 to June 9, 2023. The survey aimed to understand the programming that best met the PD needs of Manitoba’s pharmacists.

From 201 respondents across diverse practice settings:

1. 6.5% expressed interest in the PharmD Bridging Program, a decline from 27% in 2020.
2. Primary barriers included cost, uncertainty about program benefits, and time constraints.
3. In contrast, 20% showed keen interest, and 50% expressed general interest in a shorter Micro-credential program, Essentials in Advanced Patient Care for Pharmacists.

Considering these findings and based on PharmD Bridging Advisory Committee input and stakeholder discussions, the CoP Council recommended focusing on the development of a Micro-credential program and not continuing with the development of the PharmD Bridging Program.

The CoP website has been updated to include the specifics about the Professional Development survey results and information on the Micro-certificate program: https://umanitoba.ca/pharmacy/community-and-partners#professional-development-survey
If you have any questions, please contact PharmacyPD@umanitoba.ca.

Medical Examiner PD Webinar – Engaging Patients with Care: Tapering, Brief Interventions, and Substance Use Insights 

• Click here to view the live event recording. 
• 1.5 accredited CEU. 

Lessons from Complaints: A Series on Injection-Related Best Practices Part 1: Best Practices Review for Pharmacists & Part 2: Trends in Injection-Related Complaints 

• Click here to view the recordings. 
• 0.75 accredited CEU.

Managing Drug Shortages in Pediatric Patients 

• Click here to view the recording. 
• 0.75 accredited CEU.