Safety IQ Update: NIDR for Community Pharmacies Shares Recent Manitoba Safety Brief
Community pharmacies across Manitoba are reporting medication incidents and near-miss events to their incident reporting platforms. Your de-identified reports have been sent to the National Incident Data Repository (NIDR) for Community Pharmacies hosted by ISMP Canada. Medication safety experts at ISMP Canada analyze the aggregate data from across the country to share learning and recommendations with pharmacy professionals and other health care providers via Safety Bulletins and other communications.
In the spirit of knowledge dissemination and shared learning, the NIDR has communicated its second Manitoba Safety Brief for the period of October 2021 – March 2022. This report includes:
- Number of incidents received by the NIDR;
- Top five types of incidents reported;
- Level of harm from reported incidents; and
- Medication safety tips to prevent “incorrect drug” errors.
The majority of incident reports in this Safety Brief are categorized as “No Harm.” In some cases, the patient perhaps noticed the error before taking the medication. Although the patient may not experience harm, it would still be distressing as the patient contemplates the potential harm they could have experienced.
No matter the level of harm, a pharmacist must give the patient a sincere apology and acknowledge the incident and the possible distress it may have caused. Sincerity should be communicated with open and active listening that allows the patient to speak and ask questions before the pharmacy professional makes a judgement or tries to explain what happened. For more information on delivering a proper apology and disclosure, please visit the following link and click on the ‘Disclosing a Medication Incident’ drop down: https://cphm.ca/practice-education/safety-iq/
Each incident and near-miss report is an opportunity for pharmacy staff to reflect on what happened and make a commitment to improving safety within your pharmacy. Thank you for your commitment to sharing your medication incident and near-miss event experiences to benefit Manitoba patients and patients across Canada.
NAPRA Culture of Professionalism Update
Please be advised that the NAPRA Principles of Professionalism for the Profession of Pharmacy have been published on the NAPRA website. A comprehensive white paper on the topic of the culture of professionalism in pharmacy, written to support the development of the Principles of Professionalism, is also available for background reading.
Guidance for Pharmacy Professionals During Specialized Infant Formula Shortage
Due to a global shortage of infant formulas for infants with food allergies and certain medical conditions, Canada is experiencing an acute shortage of extensively hydrolyzed formula (EHF) for moderate food allergies, and amino acid formulas (AAF) for complex or severe food allergies. Several specialty formulas are now available and in stock in limited quantities in Manitoba and can be ordered from specific distributors. Canada has not seen a shortage of the regular infant formula.
When assisting patients with formula choices, please refer to the Use of Specialized Infant Formula during a Shortage Decision Tree.
A provincial working group has been convened to coordinate the response to the shortage of specialized infant formulas in Manitoba and will update healthcare providers through Shared Health and Manitoba Health communications channels.
Pharmacy professionals with questions can contact Population.PublicHealth@gov.mb.ca for more information.
The College and the provincial working group on infant formula shortage strongly recommend that pharmacists consider measures to manage supply of amino acid-based formulas and extensively hydrolyzed infant formulas via the following:
- Keeping specialty formula behind the counter to ensure supply for those infants who need it most.
- Limiting purchases of regular formula, given the potential pressure this specialized formula shortage could have on regular formula supply. It is also recommended that pharmacies consider placing purchase limits on all formula products (e.g., providing a two-week supply of formula). The CPhA has provided a resource document on typical formula consumption amounts for healthy term infants here.
- Reserving specialty formulas where possible and avoid, unless necessary, transferring children to more specialized products.
- Ordering hypoallergenic formulas only upon request by a parent or caregiver, as recommended by Health Canada, until supply has stabilized.
Resources for Pharmacy Professionals
- Use of Specialized Infant Formula During a Shortage – decision tree
- List of imported products, with printable labels – Health Canada
- Hypoallergenic infant formula shortage – Information for pharmacy professionals – Canadian Pharmacists Association
- Shortage of hypoallergenic infant formula additional information for pharmacists (availability and distribution of hypoallergenic infant formula during the shortage)
- Interim policy on importation – Health Canada
- Communicating with patients – Information for families factsheet – Health Canada
Manufacturer Communications for Health Professionals
- SMA® ALFAMINO® and SMA® ALTHÉRA® – July 13, 2022 (Letter to Pharmacists)
- SMA® ALTHÉRA® July 22, 2022
- SMA® Alfamino® July 22, 2022
- Nutramigen® Liquid Concentrate – June 13, 2022(Reckitt/Mead Johnson Nutrition, Canada)
- Gerber® Good Start® Extensive HA® – June 15, 2022(Nestlé Canada Inc)
- Similac® Alimentum® 32 oz. (946 mL) – June 17, 2022 (Abbott Nutrition)
Regulations to Improve Regulated Health Product Labels
Natural health product (NHP) use among Canadians has been increasing and is expected to increase further due to a number of factors such as Canada’s aging population, the COVID-19 pandemic, greater access to the Internet and other sources of information, and an increase in consumers’ role in their own self-care.
When key information on NHP labels is not presented in a clear, consistent, and legible format, it makes it difficult for consumers and health professionals to locate, read, and compare important safety information. Poor communication of key information on health product labels can lead to incorrect purchases and preventable harms. These preventable harms and delays in effective treatments due to incorrect purchases or use, negatively impact the health and safety of Canadians, add burden to the health care system, and impact the Canadian economy through lost productivity.
Health Canada is amending the Natural Health Products Regulations (NHPR) to introduce requirements to improve the labelling of NHPs so that information is clear, consistent, and legible for consumers and is in alignment with rules that have already been established for comparable non-prescription drugs.
To find out more about the publication of the Regulations Amending the Natural Health Products Regulations, please click here.
To find out more about the Improved Natural Health Product Labels Guidance, please click here.
Pharmacy Technician – Protected Title
Under the Manitoba Pharmaceutical Act, along with its accompanying Pharmaceutical Regulation, “pharmacy technician” is a protected title and the use of this title is restricted only to those individuals who meet and maintain the listing requirements and have their name on CPhM’s Pharmacy Technician List.
Pharmacy Managers and/or their delegates must ensure that their pharmacy job postings and positions use the appropriate language and reflect the correct title and corresponding qualifications and education for the position. Students of pharmacy assistant schools, pharmacy technician schools and other pharmacy staff must also ensure they are identifying themselves accurately and performing the tasks that are within their scope of practice, as outlined in the Pharmaceutical Regulation.
Manitoba Health Pediatric Vaccine Eligibility Update
Manitoba Health is expanding COVID-19 vaccine eligibility to include children ages six months to four years. This follows federal approval of the Moderna COVID-19 vaccine for children in this age group, as well as clinical guidance from the National Advisory Committee on Immunization (NACI).
Please see the July 20, 2022, Public Health Memo for further information and guidance on vaccine eligibility. Pharmacists are reminded to actively check the Manitoba Heath COVID-19 information page for updates: https://www.gov.mb.ca/covid19/vaccine/eligibility-criteria.html
Career Opportunity: Practice Consultant – Policy and Legislation, TERM POSITION
The College of Pharmacists of Manitoba is presently in search of a Practice Consultant – Policy and Legislation, to fill a term position. This individual will collaborate closely with colleagues across all division of the organization to analyze, develop, and maintain policies, standards, and other guidance items for pharmacy practice.
This is a full-time, term position, Monday to Friday, based on a 37.5 – hour workweek. Start and length of term to be negotiated, based on successful candidate’s availability.
For a complete description of the duties, qualifications, and required attributes for this position, and to apply, view the on-line posting: https://www.fitzii.com/apply/69847?s=fc
Applications will be reviewed from all sources as received until the position is filled.
The College values diversity and inclusion and encourages all qualified people to apply.
CPhM Office Hours Notice
Please be advised that the College office will be closed on Monday, August 1, 2022. Regular office hours resume on Tuesday, August 2, 2022, 8:30 a.m. – 4:30 p.m.
Upcoming Events & Professional Development Opportunities
Targeting Isolation Pharmacy Survey
Click here to participate in a University of Manitoba, research study entitled Reducing social isolation and loneliness among older adults.
Mental Health First Aid Standard (Virtual) Certification Courses
See website for dates and registration information. Please note this is a non-accredited learning activity.
ISMP Incident Analysis and Proactive Risk Assessment for Health Care Practitioners and Patient/Family Advisors
September 29-30, October 22-23, November 24-25, and December 8-9, 2022
ISMP MedRec and BPMH Training for Health Care Professionals
September 23 and November 18, 2022
Medication Safety Considerations for Compliance Packaging
Preventing and Analyzing Medication Errors