Administration of High Dose Flu and Pneumococcal Polysaccharide Vaccines
The College has received several inquiries regarding the high dose (HD) flu vaccine and the pneumococcal polysaccharide (Pneu-P-23) vaccine.
Without a prescription from an authorized practitioner, pharmacists in Manitoba can only administer the five publicly funded vaccines listed in Schedule 2 to the Pharmaceutical Regulation (HPV, flu, Pneu-P-23, Tdap, Td).
The eligibility criteria for the influenza vaccines and the Pneu-P-23 vaccine can be found here https://www.gov.mb.ca/health/flu/. Patients cannot be charged for a vaccine if they meet provincial criteria under the publicly funded program.
As per the Manitoba Health, Seniors and Active Living (MHSAL) letter to health care providers dated August 10, 2020, high-dose influenza vaccine will only be shipped to immunization providers who will provide on-site clinics to eligible facilities or those providing services to eligible homecare clients, individuals living in First Nation or remote/isolated communities, and those living north of the 53rd parallel.
Patients who do not meet the provincial criteria but still wish to receive the vaccine(s) must obtain a prescription from an authorized practitioner (i.e. physician or nurse practitioner) to have it administered by the pharmacist. The vaccines can be ordered directly from a wholesaler.
Note that if a vaccine is a NAPRA schedule II drug, and the patient does not meet provincial criteria but will be bringing the vaccine to a physician or nurse for administration, a prescription from an authorized practitioner is not required for the pharmacist to dispense it.
Pharmacists are encouraged to contact Public Health (MHSAL) through email at email@example.com or to check the MHSAL Seasonal Influenza website for updated information
https://www.gov.mb.ca/health/flu/pro.html with any questions regarding the influenza program or vaccine eligibility criteria.
Compounding Nasal Sprays
The College has received several inquiries regarding the compounding classification of a mixture of two nasal sprays. This would be a nasal inhalation solution and thus require the appropriate facilities and expertise for sterile compounding. The NAPRA Model Standards For Pharmacy Compounding Of Non-Hazardous Sterile Preparations, available here, includes the following information.
Compounded sterile preparations include the following types of medications:
- Nasal inhalation solutions
- Respiratory therapy solutions
- Solutions for live organ and tissue or graft baths
- Injections (e.g. intramuscular, intravenous, intrathecal, intradermal, subcutaneous)
- Irrigation solutions for wounds and body cavities (e.g. thoracic, spinal, abdominal, pelvic)
- Ophthalmic drops and ointments
- Otic drops for intratympanic administration
- Parenteral nutrition
- Dialysis solutions
- Allergen extracts
- Topical preparations (where sterility is essential to the therapy, e.g. for patients with burns)
According to the Model Standards, sterility is also required for the reconstitution and certain manipulations (according to manufacturers’ instructions) of sterile products approved by Health Canada and for the repackaging of approved sterile products, regardless of the route of administration.
Safety IQ Update
Safety IQ includes four elements that create the Safety IQ cycle: Report, Analyze, Share and Document.
Each element plays an important role in continuous quality improvement and the ultimate goal of preventing medication incidents in your pharmacy. Reporting of medication incidents and near-miss events is the foundational element of the Safety IQ cycle and sets the stage for quality analysis and shared learning.
Safety IQ requires pharmacies to report medication incidents and near-miss events to an online incident reporting program that satisfies College-set criteria. Pharmacy staff provide information such as:
- Date Incident Occurred
- Type of Incident (i.e. incorrect patient, drug, dose, etc.)
- Incident Discovered By (i.e. staff, patient, another healthcare provider, etc.)
- Medication System Stages Involved in this Incident (i.e. prescribing, order entry, drug preparation, etc.)
- Medication(s) Involved
- Degree of Harm to Patient due to Incident (i.e. no error, no harm, mild, etc.)
- Incident Description/How the Incident was Discovered
- Contributing Factors (missing patient or drug information, environmental, drug storage, etc.)
Detailed reporting with strong narrative (story-telling) elements will give pharmacy staff the opportunity to better understand what is happening in their pharmacy. Pharmacy staff can look for trends in when and at what stage medication incidents are happening and what medications are most commonly involved. With this information at their disposal, pharmacy teams can focus efforts to make effective changes in their procedures and systems.
Anonymous medication incident and near-miss event data are also sent to the National Incident Data Repository housed at ISMP Canada to be collated with incident information from across the province and the country. Incident analysis experts at ISMP Canada review the aggregate data for national trends and complete medication incident analysis to share recommendations with all pharmacy professionals.
Ultimately, high-quality, detailed reporting translates into high-quality, detailed analysis. While reporting on its own does not improve patient safety, it is the foundational first step in detecting, understanding, and improving patient safety.
Pharmacy Closure Processes
In order to provide guidance to Pharmacy Owners and Managers on the process for Permanent and Temporary Pharmacy Closures, please review the Permanent and Temporary Pharmacy Closures – Practice Direction.
If a pharmacy must close or cease to operate, either temporarily or permanently, the Registrar must be notified of the intended closure at least 30 days (or as soon as reasonably possible) prior to the closure date to ensure appropriate notification. This notification must also include information advising of where patient records will be securely stored and maintained in the case of a permanent closure, allowing for complete and uninterrupted patient access to care.
The Permanent and Temporary Pharmacy Closures Checklist includes a clear process to ensure compliance and provide a seamless transition of care for your patients. Should further guidance about pharmacy closure requirements be required, please contact Christopher Louizos, Assistant Registrar – Field Operations at firstname.lastname@example.org.
CPhM 2021 Licence Renewal Reminder
Please be reminded that all current licences issued by the College of Pharmacists of Manitoba expire on December 31, 2020.
Pharmacists and Pharmacy Managers are reminded to renew their corresponding practice licence using the online renewal process.
The deadline to complete the renewal process is Friday, November 13, 2020. Late penalties are automatically assessed after the deadline. Failure to renew a licence on or before the November 13 deadline will result in a late penalty, equal to 50% of the original licence fee, being added.
Pharmacists are reminded to upload all professional development activities to your online profile prior to November 13, 2020.
Pharmacy Managers are reminded that all supporting documents must be submitted in order for a pharmacy licence renewal to be processed:
- Owner’s Declaration Form, signed by the Signing Officer
- Annual Return of Information
- Proof of Commercial General Liability Insurance
As per its COVID-response plan, the CPhM office remains closed to visitors; registrants are encouraged to pay for licence renewal online. Cheques or money orders may be mailed to the CPhM office or dropped in the secure, black drop-box to the left of the main entrance of the office. Enclose a copy of your invoice if paying by cheque or money order.
Remember: a licence that is not renewed by December 31st is expired and invalid. A pharmacist or pharmacy that fails to renew a licence and continues to practice is in contravention of Manitoba law and will be referred to the Complaints Committee.
Thank you for your prompt attention and cooperation in the renewal process. Avoid unnecessary late penalties. Renew your licence promptly.
For current professional development opportunities, click here.