Friday Five (December 11, 2020)

This week's edition of the Friday Five is now available.

Highlights of the Dec. 7, 2020 Council Meeting

Electronic Licence Distribution 

Council approved the distribution of documentation, including licences, by electronic means.  

Distribution of paper versions of documents, such as licences, registration certificates, and receipts will be discontinued.  

Registrants will be able to access their 2021 pharmacist licence by logging in to their Registrant Profile. Pharmacy Licences for 2021 will be available on pharmacy manager profiles. Documents will be available to view and print on demand. Registrants will be responsible for printing documents for display, as required by regulation.

This process change provides a direct, secure means of distribution and allows registrants access to replacement documents.

Pharmacist and pharmacy licences will be available by Friday, December 18, 2020.

Approved Guidance Document on the Administration of Sublocade by a Pharmacist

Sublocade (buprenorphine extended-release injection) is a partial opioid agonist for the management of moderate to severe opioid use disorder, which is administered as a monthly subcutaneous injection in the abdominal region by a trained health care professional. CPhM worked with staff from the College of Physicians and Surgeons of Manitoba and College of Registered Nurses of Manitoba to create Guidance on the Administration of Sublocade by a Pharmacist to ensure the expectations of the pharmacists and prescribers are clear and to help ensure pharmacists are competent before undertaking this responsibility. All pharmacists who wish to administer Sublocade must first review the document and ensure they comply with the requirements.

Approved Changes to the Opioid Agonist Therapy (OAT) Guidelines

 Updates to the College of Pharmacists of Manitoba (CPhM) OAT Guidelines for Manitoba Pharmacists were approved and notable changes include:

  • Additional information from Manitoba Buprenorphine/Naloxone Recommended Practice Manual published by the College of Physicians and Surgeons of Manitoba (CPSM) and a requirement for pharmacists providing OAT to review this Manual;
  • Mention of the availability of generic methadone products;
  • Reference to the Health Canada safety review on switching methadone products;
  • Mention of slow-release oral morphine and its use in OAT in Manitoba; 
  • Changes to the section on methadone induction dosing to align with CPSM guidance; and
  • Changes to the standard of care to witness buprenorphine/naloxone consumption, if the buprenorphine prescriber has approved it.

All pharmacists providing OAT services must review this updated document.

Approved Smoking Cessation Programs and Deadline to Apply

The list of approved smoking cessation training programs was updated to recognize a new program and remove discontinued programs. In addition to the other requirements outlined on the application, to be eligible to apply for certification of authorization to prescribe a drug included in the category for smoking cessation, a pharmacist may complete one of the following smoking cessation training programs:

  • PACT (Level 1 and Level 2), or
  • PharmAchieve Smoking Cessation CE Program, or
  • TEACH (Core course).

A pharmacist must have successfully completed one of the approved smoking cessation programs within three years of applying.

As well, a pharmacist who is a certified tobacco educator and has met the other application requirements, is now eligible to apply for certification of authorization to prescribe a drug included in the category for smoking cessation.  

For more information, please see the Prescribing Drugs for Smoking Cessation Information Sheet.

Pharmacy Technician Listing Deadline Changes

As of January 1, 2020, all pharmacy technician applicants must be a graduate of a program accredited by the Canadian Council for Accreditation of Pharmacy Programs (CCAPP) program. 

Council approved a three-year listing deadline for new CCAPP graduates. Individuals who graduate from a CCAPP accredited pharmacy technician program after January 1, 2021, must become listed with the College within three years of graduation. 

Individuals who graduated from a CCAPP accredited pharmacy technician program prior to January 1, 2021 must complete the requirements and become listed with the College within five years of graduation. The shorter time limit also promotes graduate listings while the knowledge and skills they acquired in training is still current.

 

Structured Practical Training Updates

The Structured Practical Training (SPT) Program forms will soon be moving online. Technicians-in-training and supervisors can access and complete evaluation forms within their respective registrant portals. 

The SPT Manual has been updated to reflect these process changes. Other updates include the new pharmacy technician listing deadline and criminal record and abuse registry check requirements. The SPT Logbook has also been updated with additional hospital-related activities as well as a section with questions and scenarios for discussion between the technician-in-training and supervisor. 

 

A Survey from the Public Health Agency of Canada

The Public Health Agency of Canada (PHAC) is surveying health care providers currently practicing in Canada to learn more about the training and resources that will be most useful to help providers discuss COVID-19 vaccines with patients/clients and receive the vaccine themselves, when they become available. While the questionnaire places some emphasis on health care providers who already engage in vaccination-related activities in their practice, PHAC is interested in other healthcare providers’ views as well.

The online survey is available to complete until December 13, 2020. 

The survey can be accessed here: COVID-19 vaccine resource and training needs survey for health care providers.

If you have any questions or comments, please contact the Immunization Promotion and Partnerships Unit at phac.vaccination.aspc@canada.ca

 

New Public Health Ministerial Order regarding COVID-19 Vaccinations

On December 9, 2020, a Ministerial Order pursuant to section 7 of The Regulated Health Professions Act was issued by the Honourable Cameron Friesen, Minister of Health, Seniors and Active Living, regarding COVID-19 vaccinations. The news release by the province can be found here.

To meet the immediate need to ramp up the province’s immunization campaign, the emergency order authorizes certain health care workers and health care students under specific conditions to perform the reserved act of administering the COVID-19 vaccine by injection. These conditions include, but are not limited to, applying for and being hired by a regional health authority, Shared Health, or a pandemic response provider, and successfully completing a Red River College micro-credentialling course on the COVID-19 vaccine. 

Pharmacists, including retired pharmacists, can apply for a position to administer COVID-19 vaccines and undergo the recruitment, training and micro-credentialing process as described above, like all other health care workers listed in section 2 of the Order. 

Please note that this Order applies only to COVID-19 vaccination. For the requirements on administering all other vaccines and drugs by injection, please review the College information sheet on administering drugs and vaccines.

For more information and to see all positions available in the province’s pandemic response, visit http://www.manitoba.ca/covid19/vaccine/jobs.html.

More information about the Red River College micro-credential course, including eligibility requirements, is available at https://www.rrc.ca/part-time/programs/health-education/covid-vaccine-administration/

 

Prescription Forgery

Forgeries are appearing in community pharmacies with increasing frequency. The difficulty in identifying a forged prescription has also increased due to more sophisticated technology and equipment used in forgery. 

Pharmacies should follow these steps if a forgery is suspected:

  • Verify the prescriber’s signature. Remember that a computer-generated prescription printed and handed to the patient must have an original ink signature by the prescriber to be valid.
  • Check the patient’s DPIN record, especially for new and inactive patients.
  • Confirm the prescription with the prescriber, using a phone/fax number from another verified source such as the regulatory body’s directory — not the prescription itself. 
  • Keep the prescription if possible. If the patient demands the prescription back, make a photocopy of the prescription and mark the original to alert the next pharmacy.

Note that all forgeries and forgery attempts must be reported to:

  • The pharmacy’s local police service (in Winnipeg, this would be the Winnipeg Police Service by phone at 204-986-6222);
  • Health Canada by fax at 613-957-0110 using the Health Canada Forgery Report Form for Narcotic, Controlled and Targeted Substances; and
  • College of Pharmacists of Manitoba by fax at 204-237-3468 (with a copy of the forged prescription and the Health Canada Forgery Report Form).

It is important to fill out the forgery report as soon as possible in order for the College to alert all pharmacy managers when necessary. When an alert is received, the pharmacy manager’s responsibility is to ensure all staff are made aware of the forgery. The best practice is to keep this alert on the prescriber’s file for future reference. For more information and a list of red flags that may indicate a forgery, please see the 2018 CPhM Winter Newsletter article on prescription forgeries(page 16-17).

 

Safety IQ Cycle: Document

In recent editions of the Friday Five, we reviewed the first three elements of the Safety IQ cycle: report, analyze and share. These elements outline the basics of continuous quality improvement (CQI) for pharmacy teams, including review of medication incidents, incident and near-miss analysis and shared learning to develop action plans that prevent recurrence. Today’s article brings CQI full circle with the final element: document.

For successful CQI, documentation is imperative to evaluate and monitor the effectiveness of action plans over time. The updated Medication Incidents and Near-Miss Events practice direction (effective June 1, 2021) outlines the documentation requirements of Safety IQ. Pharmacy managers must ensure medication incidents, CQI improvement plans and formal CQI meetings are documented and available for regulatory review.

Medications Incidents and Near Miss Events are reported to the medication incident reporting platform and all communication with the patient and prescriber must be documented.

Pharmacy team action plans developed in response to incidents and near-miss events, safety self-assessments, and shared learning must be documented.

Formal CQI meetings must be documented including date, staff present and topics discussed.

CQI is an ongoing assessment of pharmacy processes to reduce risk and improve patient safety. Documentation is the anchor of CQI. When your team documents incidents and near-miss events and action plans for improvement you build a roadmap for success.

 

College Awards — Call for Nominations 2021

The College is now accepting nominations for the 2021 College Awards. If you or a pharmacist you know has made a noteworthy contribution to patient care and safety or the practice of pharmacy, please consider submitting a nomination or application for one of the awards listed in the College Awards brochure.

The College has created award submission guidelines for your consideration prior to forwarding your nomination to the Awards & Nominating Committee.

 

Young Leader Awards

The Young Leader Awards celebrate the efforts of up to ten leaders in pharmacy practice. The recipients will receive a plaque to commemorate their contributions to the pharmacy profession and a $500 cash prize.

The Young Leader Awards are open to recently licensed pharmacists (practicing one to five years post-graduation) and to pharmacy students (interns) in their final year of study who have made a professional contribution to patient care, the pharmacy profession or amongst their colleagues and peers at the University of Manitoba’s College of Pharmacy.

If you or someone you know meet these criteria, please submit a nomination or application package including the nominee or applicant’s Curriculum Vitae and a summary of their activities and contributions within pharmacy practice or within the College of Pharmacy, University of Manitoba.

The deadline for nominations or applications is Friday, January 15, 2021.  Please send submissions by email to info@cphm.ca with the subject line “Attention: Awards & Nominating Committee – CPhM Awards”.

 

Reminder to Check DPIN Records

The College has again been made aware of instances where a patient is wrongly claiming not to have a Manitoba Personal Health Information Number (PHIN) when obtaining prescriptions for controlled substances. The Pharmacist was able to verify with the Drug Programs Information Network (DPIN) that the patient did have a PHIN and was filling similar prescriptions elsewhere.

Pharmacists must conduct a DPIN history search for patients receiving any narcotic, controlled, or targeted substances if they are new to the pharmacy and periodically as appropriate. Pharmacists should contact DPIN to confirm if the name and date of birth are assigned a PHIN. 

Pharmacists are also encouraged to verify a patient’s DPIN profile, as required when filling a prescription for any medication to check for interactions or limited dispensing frequency. Checking a patient’s DPIN profile should always be part of the process when accepting a transfer from another pharmacy. For further information, please see the Manitoba Prescribing Practices Program (M3P) Information to Pharmacists regarding DPIN ENTRY. 

 

Announcements from the College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba

The following announcements are provided on behalf of the College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba.

  1. Indigenous Advisory Committee

The College of Pharmacy, Rady Faculty of Health Sciences at the University of Manitoba (the College) is establishing an Advisory Committee to provide input on Indigenous curriculum development. The College is seeking pharmacists with an Indigenous background or relevant experience who are interested in contributing to curriculum development in this important area. In addition to members from the profession, the advisory committee will include members from the College of Pharmacy and the Rady Faculty of Health Sciences. If you are interested in participating, please email Cheryl Lee at  Cheryl.Lee@umanitoba.ca

  1. Alumni of Distinction Award – Call for Nominations

The ‘Alumni of Distinction’ is an award that is bestowed on a College of Pharmacy graduate. We would like to invite nominations for its recognition at this time. Nominees must be a graduate of the College of Pharmacy (formerly the Faculty of Pharmacy) with a bachelor’s, Doctor of Pharmacy, master’s or PhD degree and must have served the profession or community in such a way as to have distinguished themselves and, directly or indirectly, brought distinction and honour to the College and the profession. To read more about the criteria and application process, please follow the link below. Application deadline is January 10, 2021.

http://umanitoba.ca/pharmacy/sites/pharmacy/files/2020-09/pharmacy-alumni-of-distinction-award-application.pdf