Issue #72 – January 2021

NLPB COVID-19 Guidance for Pharmacy Professionals

Registrants are reminded that since March of last year, NLPB has maintained a guidance page specific to COVID-19 at https://nlpb.ca/covid-19-guidance-for-pharmacy-professionals/. This page is regularly reviewed and updated to provide pharmacy professionals with information and advice specific to the pandemic.

Recently, the page was updated to add information related to COVID-19 vaccines, the recommendations for their use, and their safety:

Registrants are asked to review the COVID-19 Guidance for Pharmacy Professionals page regularly to stay informed, as the situation continues to evolve.

 

Patient Counselling – Changes in Drug Therapy

Recently, the NLPB office was contacted by a physician who was concerned that his patient had not received some vital information from a pharmacist in relation to a recent medication dosage change. The patient had been previously prescribed 25mg of a medication in the morning and 50 mg in the evening. Since the medication was dispensed as 25mg capsules, she was taking one capsule in the AM and two capsules PM. After a period, the patient’s dose was increased to 50mg BID and subsequently dispensed as 50mg capsules. However, the patient was not counselled as to the change and continued to take according to the previous schedule, resulting in her receiving 50 mg in the morning, but 100 mg in the evening.

Pharmacists are reminded that patient counselling is a basic expectation of the standards of practice and that particular attention should be paid to changes in drug therapy such as dosage or regimen changes, as these are at higher risk for patient misinterpretation and medication errors.

 

Tips to Ensure Applications Are Processed in a Timely Manner

NLPB receives many applications over the course of a week. Unfortunately, a number of these applications are often illegible, incomplete, or missing supporting documentation or payment requiring office staff to contact the registrant, causing a delay in processing and approving the application. In order to ensure that your application is processed in a timely manner, please take a moment before submission to ensure that all fields are completed and legible, and that all supporting documentation is included. These small steps will help improve the process for both the applicant and NLPB.

 

SaferMedsNL / Quality of Care NL Interprofessional Session

SaferMedsNL, in partnership with Quality of Care NL, is hosting a free interprofessional session for prescribers and pharmacists in Newfoundland and Labrador to discuss the appropriate use of proton pump inhibitors and sedative-hypnotics for insomnia.

Details:
Thursday, January 28, 2021
7:00-8:30 PM (NST)

The session, presented virtually via Zoom, will focus on:

  • the evidence behind deprescribing these medications,
  • the tools and resources available to support health care providers,
  • recommending safer, more effective alternatives,
  • ongoing work in the province, supported by available data, to promote the appropriate use of these medications.

Speakers include:

  • Dr. Barbara Farrell – University of Ottawa
  • Dr. David Gardner – Dalhousie University
  • Dr. Justin Turner – SaferMedsNL
  • Dr. Kimberly Wintemute – Choosing Wisely Canada
  • Dr. Robert Wilson – Quality of Care NL

To register, visit https://us02web.zoom.us/webinar/register/WN_b7riYcyeTLej-bUyrePOUg.

 

Opioid Dependence Treatment Centre of Excellence- Project ECHO NL Sessions

Project ECHO NL: Opioid Use Disorder is a virtual community advancing care and treatment for opioid use disorder in Newfoundland and Labrador. This project offers free, virtual learning sessions using an interactive, web-based platform (Zoom) to link health care providers with a consistent, core interdisciplinary team of mentors with expertise in managing substance use care. The primary audience is prescribers (family physicians and nurse practitioners) and pharmacists.

Session 4: Opioid Agonist Treatment (OAT) and Pharmacy (Introductory)Flyer

 

Session 5: Trauma-Informed Care and Psychosocial Supports (Introductory)Flyer

 

For more information about Project ECHO NL: Opioid Use Disorder, including frequently asked questions, please visit their website at: https://mha.easternhealth.ca/adults/opioid-treatment-and-naloxone/echo/

 

 

Issue #73 – February 2021

Why is Maintaining Continuous Professional Liability Insurance So Important?

Over the years, NLPB has published numerous reminders – emails, Apothecary and PostScript articles, webinars – regarding the importance of professional liability insurance (PLI) and the expectation that all registrants maintain coverage but still each year, when audited, we find registrants who have not maintained adequate liability insurance coverage.

The Legal Basis

As a reminder, this requirement is absolute, as stated in sections 14-17 of the Pharmacy Act, 2012 and sections 8-9 of the Pharmacy Regulations, 2014. The legislation sets the requirement for registrants to have PLI coverage but gives the board the authority to set the criteria for this coverage – which can be found in the Interpretation Guide – Professional Liability Insurance Requirements for Registration. Additionally, registrants should note that section 85(c) of the NLPB Bylaws includes “practicing pharmacy while not covered by a policy of professional liability insurance acceptable to the board” in the definition of “Professional Misconduct”.

The Practical Concerns

Having sufficient PLI coverage is essential to protect both you and your patients. Even the most skilled and diligent practitioners make mistakes from time to time. Fortunately, most mistakes are caught before medications go out the door and do not result in harm. But, once in a while, the worst-case scenario happens, and a medication error occurs, or patient counselling goes wrong. When a patient is harmed by a mistake made or advice given by their practitioner, that patient may be entitled to damages (a financial award from the practitioner) to compensate for medical expenses incurred as a result of the mistake or lost wages if the patient loses work. In some circumstances, these damage awards can be significant, particularly if a patient requires medical care for an extended period of time, or is unable to return to work in their previous career. The patient may also be entitled to additional damages for pain and suffering, which are generally granted by a court to the patient suffering as a result of the mistake. If a patient dies after a medication error, their family may also be entitled to cost recovery for expenses and damages.

Having appropriate PLI coverage helps ensure that your patient gets the support and resources they need to prevent any further undue suffering after a mistake has occurred, pays the damages awarded to the patient, and also pays for a lawyer to handle any court matters. You will likely have only minimal involvement in the legal and financial processes, which greatly reduces the stress on both you and your employer. However, if you do not have active PLI coverage when such a mistake occurs, you may be held personally liable for any financial damages that result from the mistake. This means that you may be personally responsible for paying your patient’s related medical bills for the rest of their life, compensating for their lost wages, and paying for lawyers to handle the court matters. If you don’t have the finances in your bank account to pay these bills, you may lose your investments, vehicles, or even your home. In addition, the pharmacy you work for may also be held liable for damages that result from your mistake. In the worst case, your injured patient may suffer even further if you do not have appropriate insurance and you or your pharmacy cannot cover the cost of the damages they are entitled to.

What Can I Do To Make Sure This Doesn’t Happen To Me or My Patients?

In order to help ensure that these extreme situations do not happen to you,

  • Do not rely solely on reminders from your insurer or the board – we all know e-mails sometimes get lost, missed, or sent to junk mail. While reminders are a helpful trigger, ensuring your policy is up to date is your responsibility and relying on another organization to remind you might not be enough to protect you or your patients.
  • Set a recurring reminder in your calendar or on your phone for one month before your policy expires to make sure you remember to renew on time.
  • Pharmacists-in-charge should check in with staff (including relief staff) on a regular basis to ensure no one misses their policy renewal date. Adding it to your Staff Meeting standing agenda may be helpful.
  • If you do miss your renewal date, contact your insurer immediately upon discovering the lapse and make sure that they back-date your renewal to the day your policy expired.

If you have any questions about this requirement or the coverage criteria, please contact NLPB at inforx@nlpb.ca

 

Secure Storage of Methadone

In response to recent NLPB Quality Assurance activities and a break-and-enter resulting in theft, registrants are reminded that methadone stock bottles must be stored in a safe or cabinet that can be securely locked, as is required of all narcotics and controlled drugs. In the event that the bottles are too large to fit in the primary storage area, a secondary storage area meeting the Standards must be available and utilized. Methadone must not be left outside of secure storage areas when registrant staff are not on site.

If methadone is stored outside of a safe or cabinet during operating hours, when registrant staff are present, ISMP Canada recommends that this area be located outside of public view
(https://www.ismp-canada.org/download/safetyBulletins/2020/ISMPCSB2020-i9-Methadone.pdf). Similarly, methadone preparation and storage areas should be restricted to those under the supervision of pharmacy staff, with no opportunity for unauthorized patient access.

Diluted preparations must be stored in an appropriate secure location (e.g. lockable fridge) until they are released to the patient.

If you have questions about these requirements or want to ensure that your pharmacy’s storage areas are appropriate, contact NLPB at inforx@nlpb.ca.

 

Call for Expression of Interest – Working Group on Point of Care Testing and Laboratory Testing by Pharmacists

NLPB is seeking interested registrants to serve as members of a working group affiliated with the NLPB Pharmacy Practice Advisory Committee. The primary role of this working group is to consider the practices of point of care testing and laboratory testing and make recommendations regarding guidelines and/or standards of practice related to these practices.

If you have any questions about the working group’s role, please contact Melanie Healey, Associate Registrar-Professional Practice, at mhealey@nlpb.ca.

If you are interested in participating, please submit your name, contact information, a brief bio, and a few lines about why you’d like to be a member of the working group to inforx@nlpb.ca by March 12, 2021.

Thank you in advance for your interest in serving your profession.

 

Did You Know? – Health Canada & ISMP Advisories & Newsletters

Did you know that NLPB maintains a page on our website dedicated to sharing Health Canada and ISMP advisories and newsletters?

On this page, we regularly post:

  • Health Canada advisories for both the public and health professionals
  • monthly issues of Health Canada’s Health Product InfoWatch newsletter
  • upcoming ISMP Canada Education Events
  • monthly issues of ISMP Canada’s Safety Bulletin
  • monthly issues of ISMP Canada’s Safe Medication Use Newsletter

All of these sources contain valuable information designed to improve medication safety and help health professionals provide quality care to their patients.

One particular article of interest in a recent ISMP Canada Safety Bulletin was entitled “Medications Most Frequently Reported in Harm Incidents over the Past 5 Years (2015–2020)”. The information presented in this article highlights that while awareness of high-alert medications and the need for related safeguards has increased over time, there are a number of medications that continue to cause patient harm. Pharmacists should ensure that they are investigating and implementing effective strategies for reducing the risk for error and harm for high-alert agents.

For more from Health Canada and ISMP, visit the Health Canada & ISMP Advisories page of the NLPB website.

 

Opioid Dependence Treatment Centre of Excellence- Project ECHO NL: Opioid Use Disorder

Would you benefit from support in providing opioid agonist maintenance treatment (OAMT)?

To help increase educational opportunities for pharmacists currently delivering or interested in providing OAMT, the Provincial Opioid Dependence Treatment Centre of Excellence, located within Eastern Health, replicated the Project ECHO model. Originally developed to improve access to care for hepatitis C patients living in rural areas of New Mexico, there are now 960 ECHO programs worldwide and a body of evidence attesting to the model’s effectiveness for enhancing provider knowledge and ability in the treatment of opioid use disorder (e.g. Holmes et al., 2020; Kawasaki et al., 2019).

Project ECHO NL: Opioid Use Disorder offers free, virtual learning sessions to link health care providers with an interdisciplinary team of mentors with experience in managing substance use care. Each session is one hour in duration and includes a lecture aligning with the weekly curriculum topic and the discussion of a de-identified patient case presented by one of the participants. The schedule and registration details can be found on the Project ECHO NL website at: https://mha.easternhealth.ca/adults/opioid-treatment-and-naloxone/echo/

Benefits for pharmacists include:

  • Acquire new skills and competencies in OAMT
  • Join a community of learners and decrease feelings of professional isolation
  • Professional Development: Sessions are eligible for Mainpro+ credits, considered an acceptable accredited learning activity by the Newfoundland and Labrador Pharmacy Board
  • Schedule rotates between early morning and lunch timeslots
  • Minimal equipment and preparation required to participate via Zoom

Pharmacists are integral to increasing access to OAMT throughout Newfoundland and Labrador. As a primary target audience, if you have any feedback about this initiative and ways in which we can facilitate your participation, please contact Kate Lambert at kate.lambert@easternhealth.ca.

Upcoming Sessions

Session 6: Decoding Urine Drug Screens (UDS)
February 16, 2021
12:00 p.m. – 1:00 p.m. NST

Session 7: Sublocade: Indications and Use
March 2, 2021
8:30 a.m.– 9:30 a.m. NST

To register, please contact Chelsea Hynes at chelsea.hynes@easternhealth.ca.

 

 

Issue #74 – March 2021

March 2021 NLPB Board Meeting Update

On March 5, 2021, the NLPB board met via video conferencing technology. Among other business, at this meeting, the board approved:

    • a revision to the NLPB Code of Ethics related to inducements (section 6.7) as well as a new accompanying Interpretation Guide regarding the Prohibition on Inducements.
    • a revision to Appendix B to the Standards of Practice – Prescribing by Pharmacists to add COVID-19 to the list of Preventable Diseases approved by the board.
    • updates to the Standards of Practice – Administration of Drug Therapy by Inhalation or Injection.

Please visit the Standards, Guidelines, Policies, and Positions page of the website to view the full revised and new documents.

 

Clozapine: A Pharmacist’s Role in Providing Treatment

This information is being shared courtesy of Brittany Churchill, Pharm D, Waterford Hospital, Eastern Health

Clozapine is an antipsychotic used for treatment-resistant schizophrenia, and may be initiated and dispensed on an inpatient or outpatient basis. Due to a < 1% risk of potentially life-threatening agranulocytosis, dispensing clozapine requires monitoring of patient white blood cell counts. ANY pharmacist can participate in clozapine dispensing and monitoring once they are registered with an associated monitoring program and have access to patient bloodwork (HEALTHe NL). In fact, across the country clozapine is typically dispensed and monitored by community pharmacists. We are encouraging this transition in NL as it aligns with best practice with having patients receive all of their medication from a single pharmacy, where possible.

It’s important to note that there is no central registry for clozapine monitoring in Canada. Monitoring systems are associated with the brand purchased. (For example, Gen-Can for generic Gen-Clozapine). Once a patient is registered with a particular monitoring system, if a patient were to switch brands, they would need to be registered with the new monitoring system. This document will focus on the Gen-Can monitoring system as this is currently used by pharmacists in NL.

Initiation and Registration:

  • 1. Pharmacy and Prescriber complete and sign Gen-Can patient registration forms (pharmacist fills out section 3 only)
    • a. If you are a pharmacist not currently registered for Gen-Can, you can fill out section 3 on the patient registration form (found on gencan.ca) and fax to Gen-Can or call 1-888-955-1622.
    • b. They will notify you once you are registered with a username and password. You will then be partnered with a clinical nurse coordinator who will be available as a clinical support throughout treatment and monitoring.
  • 2. Once Gen-Can has received the patient registration forms both physician and pharmacist will receive notification registration. Treatment should only be started upon receipt of this notification.
  • 3. After registration, the responsibility of the pharmacist is to ensure patient is getting regular bloodwork. It is best practice for the pharmacist to review recent bloodwork and monitor for the presence of any signs or symptoms of infection. On gencan.ca, see “Hematological Guidelines” under the Forms & Resources tab for specific monitoring details.

Monitoring:

Outpatient pharmacists must ensure patients are getting bloodwork using the Gen-Can database / HEALTHe NL following this schedule mandated by Health Canada:

  • Weekly x 26 weeks
  • Biweekly x 26 weeks
  • Monthly indefinitely

Monitoring and treatment status would continue based on the hematological guidelines chart. On Gen-Can’s website, please see “Protocol for Outpatient Starts” and “Treatment Plan and Guide” under the Forms & Resources tab for more detailed information on treatment initiation and monitoring. Throughout treatment, Gen-Can provides ongoing clinical support.

If you have any questions or would like any resources regarding dispensing and monitoring clozapine as a community pharmacist, you can contact the Waterford Hospital Pharmacy at 777-3549 or Gen-Can at 1-888-955-1622.

 

Recent Changes to Health Canada’s Special Access Program

In the fall of 2020, Health Canada made several revisions to the Special Access Program. Among these changes are a streamlined application process and the ability for drugs to be shipped to other locations, including community pharmacies.

For more information on these changes, see the Canada Gazette, Part II, Volume 154, Number 21 and the Health Canada Guidance Document for Industry and Practitioners.

 

Invitation to Participate in Project ECHO NL: Opioid Use Disorder

What is Project ECHO (Extension for Community Healthcare Outcomes)?

  • Project ECHO NL: Opioid Use Disorder is a virtual community advancing care and treatment for opioid use disorder in Newfoundland and Labrador.
  • This project offers free, virtual learning sessions using Zoom to link health care providers with an interdisciplinary team of mentors with expertise in managing substance use care.
  • All sessions include a brief lecture on the session topic, followed by the presentation and discussion of a de-identified patient case.

Upcoming Sessions:

Session 8: Opioids and Benzodiazepines
Tuesday, March 16, 2021 (12:00 – 1:00 pm NDT)
Speaker: Stephanie Delaney, BSc (Pharm), RPh, PharmD (c) (Pharmacist, Opioid Treatment Centre/Recovery Centre and NuCare Pharmacy)
To register for Session 8, please contact Chelsea Hynes at chelsea.hynes@easternhealth.ca by Friday, March 12th.

Session 9: Transitioning between Pharmacotherapies (Advanced)
Tuesday, March 30, 2021 (8:30 – 9:30 am NDT)
Speaker: Dr. Jennifer Wyman, MD, FCFP, DABAM, MPH (Associate Medical Director, Substance Use Service, Women’s College Hospital, Toronto)
To register for Session 9, please contact Chelsea Hynes at chelsea.hynes@easternhealth.ca by Friday, March 26th.

Session 10: Special Populations: Youth and Young Adults (Advanced)
Tuesday, April 13, 2021 (12:00 – 1:00 pm NDT)
Speaker: Dr. Sharon Cirone, MD, FCFPC, CAC(AM) (Family Physician and Addictions Consultant, Child and Adolescent Mental Health Team, St. Joseph’s Health Centre, Toronto)
To register for Session 10, please contact Chelsea Hynes at chelsea.hynes@easternhealth.ca by Friday, April 9th.

Target Audience:

  • Primary: Pharmacists and prescribers (family physicians and nurse practitioners)
    • This 1 credit-per-hour Group Learning program has been certified by the College of Family Physicians of Canada and the Newfoundland and Labrador chapter for up to 10 Mainpro+ credits (1.0 Mainpro+ Certified Group Learning credit per session)
    • Mainpro+ certified programs are considered acceptable accredited learning activities by the Newfoundland and Labrador Pharmacy Board
  • Secondary: Other health care professionals providing care for individuals with opioid use disorder, including registered nurses, licensed practical nurses, social workers, and addictions counsellors.

Website:

More information about Project ECHO NL: Opioid Use Disorder, including frequently asked questions, can be found online here.

 

 

Issue #75 – April 2021

Administration of Injections

In light of recent changes to pharmacy technician scope of practice in some other provinces, NLPB would like to remind registrants that, in NL, in compliance with the Administration of Drug Therapy by Inhalation or Injection Regulations and the accompanying Standards of Practice, only pharmacists may be authorized to administer injections and this authority may not be delegated to a pharmacy technician.

In the interests of learning, pharmacy students and interns may participate in administering injections under direct supervision, in accordance with the NLPB Practice Policy – Pharmacy Students/Interns Administering Inhalations or Injections.

 

Health Canada Controlled Substances Bulletin

Please see the linked Controlled Substances Bulletin from Health Canada with updated guidance pertaining to post-consumer returns containing controlled substances in light of the ongoing COVID-19 pandemic.

 

2021 Wellspring Leadership Awards

The Board of the Canadian Foundation for Pharmacy (CFP) is pleased to announce our ongoing commitment to advancing the profession of pharmacy, with the Wellspring Pharmacy Leadership Awards.

CFP sees the value in continuing to invest in the future of pharmacy through the development of our leaders. In appreciation of the work of pharmacists during the pandemic, we have increased the funding this year to $20,000!

These annual awards recognize both demonstrated and potential leadership in individuals in the pharmacy profession. Recipients receive up to $10,000 for initiatives that further develop personal leadership through study, experiential learning, or mentorship.

These grants are made possible by the generous donations of individual pharmacists and our Corporate Sponsors.

Candidates can nominate themselves or be nominated by others.

The criteria and application form can be found at https://cfpnet.ca/grants-awards/details/award/36.

Please send submissions for the 2021 awards by May 7, 2021, to submissions@cfpnet.ca.

 

Invitation to Participate in Project ECHO NL: Opioid Use Disorder

The final session of the Project ECHO NL: Opioid Use Disorder pilot cycle is on Tuesday, April 13, 2021.

Session 10: Special Populations: Youth and Young Adults (Advanced)

  • Tuesday, April 13, 2021 (12:00 – 1:00 pm NDT)
  • Speaker: Dr. Sharon Cirone, MD, FCFPC, CAC(AM) (Family Physician and Addictions Consultant, Child and Adolescent Mental Health Team, St. Joseph’s Health Centre, Toronto)
  • To register for Session 10, please contact Chelsea Hynes at chelsea.hynes@easternhealth.ca by Friday, April 9th.

This 1 credit-per-hour Group Learning program has been certified by the College of Family Physicians of Canada and the Newfoundland and Labrador chapter for up to 10 Mainpro+ credits (1.0 Mainpro+ Certified Group Learning credit per session), also considered acceptable accredited learning activities by the Newfoundland and Labrador Pharmacy Board.

More information about Project ECHO NL: Opioid Use Disorder, including frequently asked questions, can be found online at https://mha.easternhealth.ca/adults/opioid-treatment-and-naloxone/echo/.

 

CAPT National Professional Development Virtual Conference 2021

May 29-30, 2021

The Canadian Association of Pharmacy Technicians National Professional Development Conference is taking place May 29th and 30th virtually for all pharmacy technicians and assistants across Canada; with a great lineup of speakers and topics this year! (Accreditation pending)

Virtual Conference Program

Register Today – www.capt.ca

$50 CAPT Members | $75 Non-Members

 

 

Issue #76 – May 2021

“Pharmacy Technician” – A Restricted Title

Registrants, pharmacists-in-charge, and pharmacy owners are reminded that, in accordance with the Pharmacy Act, 2012, the use of the “pharmacy technician” designation is restricted and protected. Only those registered with the NL Pharmacy Board as pharmacy technicians may be given this title or be referred to as pharmacy technicians. If you employ other unregulated support staff in your pharmacy, they may be called “pharmacy assistants” or be given another title.

 

Update to the Standards of Practice – Medical Assistance in Dying

The NLPB Medical Assistance in Dying Standards of Practice has been revised to reflect changes to the Federal Criminal Code that were assented to on March 17, 2021. Registrants are asked to review the document, which can be found on the NLPB website under Provincial Standards of Practice.

 

Tramadol – Amendments to the Controlled Drugs and Substances Legislation

Recent evidence has shown that tramadol, an opioid pain reliever, poses the same risks of potential dependency and problematic use as other opioids, such as morphine.  As such, the Government of Canada decided to pursue regulatory amendments that would provide additional safeguards around the use of tramadol to help prevent problematic substance use and other harms, while also protecting access to these medications for patients that need them.

These amendments to the Controlled Drugs and Substances Act and Narcotic Control Regulations were published on March 31, 2021 and will come into force on March 31, 2022, to provide stakeholders time to implement any changes required to comply with the new regulatory requirements. At that time, products containing tramadol will be subject to the same restrictions and documentation expectations as other CDSA Schedule I medications, such as opioids.

 

CAPT National Professional Development Virtual Conference 2021

May 29-30, 2021

The Canadian Association of Pharmacy Technicians National Professional Development Conference is taking place May 29th and 30th virtually for all pharmacy technicians and assistants across Canada; with a great lineup of speakers and topics this year! (Accreditation pending)

Virtual Conference Program

Register Today – www.capt.ca

$50 CAPT Members | $75 Non-Members

 

SaferMedsNL: Improving Medication Use Across Newfoundland and Labrador

SaferMedsNL is a deprescribing project developed by the Department of Health and Community Services, Memorial University, and the Canadian Deprescribing Network that launched in January 2019. The goal of this initiative is to decrease the use of potentially inappropriate medications and improve the quality of life of Newfoundlanders and Labradorians.

The initiative’s three-year plan has been adapted to allow sufficient time to bring public awareness to the benefits and harms of sedative-hypnotics. As such, the year two focus of sedative-hypnotics will now extend for the remainder of 2021.

Through SaferMedsNL, both healthcare providers and patients can access evidence-based tools and resources to facilitate approaches to deprescribing, improve both patient and healthcare provider competency for reducing inappropriate medications, and provide the opportunity for deprescribing via meaningful discussions between healthcare providers and patients.

Visit their website for a list of resources.

 

 

Issue #77 – June 2021

COVID-19 Vaccinations  – Recording Administration in the Electronic Health Record

Pharmacists are reminded that section 4.i) of the Standards for Administration of Drug Therapy by Injection or Inhalation specifically requires pharmacists to record administrations of vaccinations in the provincial electronic health record. This is done through the Pharmacy Network to help ensure the completeness of provincial vaccination records.  This documentation expectation is in addition to documentation recorded in accordance with section 4.h) and pharmacy dispensing records.

This requirement is also specifically mentioned in the documentation sent from the Department of Health and Community Services pertaining to the COVID-19 vaccination program.

If pharmacists are uncertain about how to properly record the administration of vaccinations, or other injections, in the Pharmacy Network, they should contact the NL Centre for Health Information Service Desk for direction.

Standards of Practice – Upcoming Implementation Deadlines

Pharmacists-in-charge are reminded of the following upcoming implementation deadlines for Standards of Practice:

Pharmaceutical Care to Long-Term Care Facilities

The Standards for the Provision of Pharmaceutical Care to Long-Term Care Facilities will be in effect as of July 1, 2021.  Pharmacists-in-charge at pharmacies where these services are provided should ensure that the pharmacy’s policies, procedures, and practices are in accordance with this standard of practice.
NOTE: This standard of practice is not a replacement for the Standards for the Provision of Pharmaceutical Care to Personal Care Homes; this standard of practice remains in effect as well.

Compounding Standards

The deadline for the next phase of the Implementation Schedule for the Non-Sterile Compounding Standards is December 31, 2021.  Pharmacists-in-charge must ensure that all the requirements of Phase 2 are met by that date, including:

  • Meeting all the requirements of Phase 1
  • Having all Compounding and Cleaning Personnel trained
  • Having a Quality Assurance (QA) Program developed and at least partially implemented
  • Meeting all Level A compounding requirements

 

The deadline for the next phase of the Implementation Schedule for the Sterile Compounding Standards is also December 31, 2021.  Pharmacists-in-charge who offer or intend to offer sterile compounding services must ensure that all the requirements of Phase 2 are met by that date, including:

  • Meeting all the requirements of Phase 1
  • Having all Compounding and Cleaning Personnel trained
  • Having a Quality Assurance (QA) Program developed and at least partially implemented
  • Having Policies and Procedures fully developed

 

Consultation on National Principles of Professionalism for Pharmacy

Professionalism is a fundamental component in the delivery of quality healthcare. Recognizing the importance of a strong culture of professionalism, the National Association of Pharmacy Regulatory Authorities (NAPRA), along with pharmacy professionals and pharmacy stakeholders, has developed eight principles of professionalism.

These principles, applicable to all who work and contribute to the profession of pharmacy, represent the first steps towards enhancing the culture of professionalism in pharmacy practice. A comprehensive paper on the topic of the culture of professionalism in pharmacy has been written and is available for background reading.

NAPRA invites all pharmacy professionals, pharmacy stakeholders, and members of the public to provide feedback on the draft Principles of Professionalism. We invite you to share these documents as widely as possible.

The consultation process will be open between June 4, 2021 and August 3, 2021.

We invite you to provide feedback using the following link: FEEDBACK FORM

Questions about the consultation process can be directed to professionalism@napra.ca.

We sincerely appreciate your input on this important topic.

 

Ephedrine and Pseudoephedrine to Remain on the Provincial Drug Schedules Until 2024

In accordance with the NAPRA Policy on Natural Health Products (NHPs), and as previously communicated, all NHPs were to be removed from the Provincial Drug Schedules on January 2, 2022. The removal of the majority of NHPs from the Drug Schedules will proceed on that date with two exceptions: ephedrine and pseudoephedrine. In consideration of the impact of the COVID-19 pandemic and the substance use crisis in Canada, the removal of ephedrine and pseudoephedrine will be delayed to January 2, 2024, to allow time for the federal government to determine the most appropriate risk mitigation measures for these ingredients.

 

Issue #78 – July 2021

2021 Annual General Meeting & 2020 Annual Report

Due to COVID-19 safety precautions, the Newfoundland and Labrador Pharmacy Board’s Annual General Meeting will take place online via Zoom again this year. The meeting is open to all registrants, so if you would like to join, please mark your calendars for Friday, August 6, 2021, 9:30am-10:30am. The meeting link will be sent to all registrants at least one week prior to the AGM.

Agenda:

  1. Call to Order and Adoption of Agenda
  2. Introduction of Board Members
  3. Minute of Silence in Memoriam
  4. Highlights of 2020 Annual Report
  5. Questions on Annual Report
  6. Appointment of Auditor for 2022
  7. Board Member Election Results
  8. Recognition of Outgoing Board Members
  9. Inauguration of Incoming Chair
  10. Recognition of Outgoing Chair
  11. Adjournment
The 2020 Annual Report is now available for viewing online at: https://nlpb.ca/media/Annual-Report-2020.pdf

 

Requirements for Hiring Relief Pharmacists

Pharmacists in Charge looking to hire relief pharmacists are reminded that prospective pharmacist applicants, including those registered in other provinces, must fulfill all requirements of registration in NL, including providing proof of professional liability insurance, a current certificate of conduct, PANL membership, successful completion of NLPB’s Registration Examination, verification of hours from current employer, and a letter of standing from their provincial regulatory authority. Please view the appropriate registration interpretation guide on NLPB’s website for more information.

Please note that the registration process, following the opening of a file, requires a minimum of 4-6 weeks to complete. “Locum” registration is not available in Newfoundland and Labrador under the provincial legislation.

 

Extension of Health Canada Subsection 56 (1) Class Exemption for Patients, Pharmacists Prescribing and Providing Controlled Substances in Newfoundland and Labrador

In March 2020, Health Canada issued an exemption for certain provisions of the Controlled Drugs Act (CDSA) and its regulations, in light of the COVID-19 pandemic. The current exemption is set to expire on September 30, 2021.

Health Canada has recently authorized a five-year extension of this subsection 56 (1) class exemption from the CDSA, which will be effective October 1, 2021 to September 30, 2026, or until such time as it is replaced by another exemption or revoked.

This exemption provides practitioners with the authority to issue a verbal prescription for controlled substances.

This exemption provides pharmacists with the authority to transfer a prescription for a controlled substance, and to prescribe, sell, or provide a controlled substance to patients subject to the terms and conditions of the exemption.

Pharmacists acting under the authority of this exemption must:

  1. Only prescribe, sell, provide, or transfer the controlled substance to a patient while that patient is under their professional treatment;
  2. Only prescribe, sell, provide, or transfer a controlled substance to a patient in order to extend or renew an existing prescription;
  3. Only prescribe a controlled substance to a patient in accordance with any policies and/or guidelines established by the provincial or territorial government and by any relevant provincial or territorial licensing authorities;
  4. Comply with a record keeping obligations established by the provincial or territorial government and any relevant provincial or territorial licensing authority regarding all transactions involving controlled substances;
  5. If not already required pursuant to item 4, keep records of the following:
    • the name and address of any patient who is prescribed, sold, or provided a controlled substance under this exemption;
    • the name, quantity, and form of the controlled substance prescribed;
    • the name or initials of the pharmacist who prescribed, sold, or provided the controlled substance;
    • the date on which the controlled substance was prescribed, sold, or provided; and
    • the number assigned to the prescription.
  6. With respect to the transfer of a prescription, keep records of the following:
    • a copy of the prescription written by the practitioner or the record made in accordance with the practitioner’s verbal prescription;
    • the name and business address of the transferring pharmacist;
    • the name and business address of the pharmacist receiving the prescription transfer;
    • the number of authorized refills remaining and, if applicable, the specified interval between refills; and
    • the date of the last refill.
  7. All records should be kept in the pharmacy for a period of two years from the date that each record is made.

Maintaining Authorization to Administer Injections

Pharmacists are reminded that once a pharmacist is authorized to administer drug therapy by inhalation or injection, the pharmacist must:

  • administer inhalations and injections only in accordance with provincial guidelines, standards by NLPB, and within the limits of the pharmacists’ own competence;
  • maintain competence and skill level in administering inhalations and injections;
  • maintain appropriate CPR and First Aid certification; and
  • complete a professional declaration annually at renewal, indicating that they have taken action to comply with the requirements of this section. If this declaration cannot be made, remedial training, such as a refresher program, may be required.

In the past, NLPB has advised pharmacists seeking information about the annual professional declaration to register for and complete a formal refresher training program through an accredited provider. Unfortunately, as pharmacists have begun to administer injections more regularly, the need for these programs has waned, resulting in less availability of such programs. As such, we now advise pharmacists to:

  • ensure clinical competency by participating in self-study – review the online learning modules, the latest Immunization Guides, and product monographs for the medications/vaccinations that you intend to administer.
  • ensure technical competency by re-completing the live portion of the accredited program, shadowing another pharmacist or health professional, and/or asking that pharmacist or health professional to observe your technique and offer feedback.

If you let your authorization to administer injections lapse, reapply by completing and submitting the Application for Authorization.

It is ultimately up to the pharmacist to ensure that they are clinically and technically competent and, if not, refrain from offering the service until such time as they are able to address the deficiency.

 

Consultation on National Principles of Professionalism for Pharmacy

Professionalism is a fundamental component in the delivery of quality healthcare. Recognizing the importance of a strong culture of professionalism, the National Association of Pharmacy Regulatory Authorities (NAPRA), along with pharmacy professionals and pharmacy stakeholders, has developed eight principles of professionalism.

These principles, applicable to all who work and contribute to the profession of pharmacy, represent the first steps towards enhancing the culture of professionalism in pharmacy practice. A comprehensive paper on the topic of the culture of professionalism in pharmacy has been written and is available for background reading.

NAPRA invites all pharmacy professionals, pharmacy stakeholders, and members of the public to provide feedback on the draft Principles of Professionalism. We invite you to share these documents as widely as possible.

The consultation process will be open between June 4, 2021 and August 3, 2021.

We invite you to provide feedback using the following link: FEEDBACK FORM

Questions about the consultation process can be directed to professionalism@napra.ca.

We sincerely appreciate your input on this important topic.

 

 

Issue #79 – September 2021

When to Report Losses of Controlled Substances and Precursors

The following information is cited from the Health Canada Guidance Document: Reporting Loss or Theft of Controlled Substances and Precursors. Please click the link to review the Guidance Document in its entirety.

Losses or thefts of controlled substances or precursors can occur in many ways, and it may be difficult to discern if an incident should be reported to Health Canada’s Office of Controlled Substances. For guidance, please see the summary table of common incidents and whether to report them below:

Examples of incidents and whether to report them.
Incident Type Incident Sub-Type Definition Report?
Loss Loss Unexplained A loss that cannot be attributed to any particular cause or action on the basis of normally accepted business activities. Yes
Manufacturer’s Shortage The content of a sealed bottle is less than expected after counting. Yes, if greater than value listed in FDR C.01.061.
Manufacturer’s Shortage The content of a sealed bottle is less than expected after counting. No, if smaller than or equal to value listed in FDR C.01.061.
Wrong Dispensing Documented dispensing the wrong quantity or to the wrong patient. No
Breakage, and Spillage Change in the dosage form, or other known incident preventing dispensing (for example crushed tablet). No
Unusual Waste Waste or destruction of inventory beyond what is expected on the basis of normally accepted business practices. This could arise from unusual yield loss due to broken equipment, etc. Yes
Miscounts Error made in counting during inventory reconciliation or during dispensing. No, if documented and part of normal business practices.

Otherwise, report as Loss Unexplained.

Overages Quantity found to be in excess of inventory. No
Destruction Denaturation of a controlled substance to an extent that its consumption is rendered impossible or improbable. No
Other Any other type of loss not described above. Yes
Theft Filled Forged Prescription Dispensing of a prescription that was found to be fraudulent. Yes
Unfilled Forged Prescription Forged prescription that was not dispensed. No
Armed Robbery Theft accomplished through threats of violence toward personnel at a site. Yes
Pilferage (Internal Theft) Theft from a site by authorized personnel. Yes
Grab Theft Theft from a site during working hours without warning. The person conducting the theft ‘grabs’ the product and escapes. Yes
Break and Entry Theft from a site by forced entry. Yes
Impersonation An individual impersonating the individual for which the prescription has been dispensed. Yes
Other Any other type of theft not described above. Yes

Regardless of whether an incident is reportable to the Minister, all records associated with controlled substances and precursors must be kept on-site for a period of two years following the day on which the last record is recorded in the document.

Reports of any loss or theft of controlled substances or precursors must be submitted to Health Canada’s Office of Controlled Substances (OCS) using the Loss or Theft Report Form for Controlled Substances and Precursors (CS-FRM-011). Please see the Guidance Document: Reporting Loss or Theft of Controlled Substances and Precursors for applicable reporting timelines.

 

Extension of Health Canada Subsection 56 (1) Class Exemption for Patients, Pharmacists Prescribing and Providing Controlled Substances in Newfoundland and Labrador

The current exemption issued by Health Canada for certain provisions of the Controlled Drugs Act (CDSA) and its regulations is set to expire on September 30, 2021. Effective October 1, 2021, a  five-year extension of this subsection 56 (1) class exemption from the CDSA, will go into effect. To learn more about this exemption and what NL pharmacists can and cannot do under this exemption, please review the NLPB FAQ on the Health Canada Subsection 56(1) Class Exemption and the Health Canada FAQ on the Subsection 56(1) Class Exemption.

NLPB would like to remind pharmacists that the Health Canada Subsection 56 (1) Class Exemption currently in place does not permit interprovincial transfers of prescriptions for controlled substances.

Proper Documentation of Prescription Transfers

Pharmacists are advised, when any prescription is transferred, the original, written date of the prescription must be reflected in the dispensing record rather than the date that the transfer is completed.

Correct documentation ensures the integrity of the Patient Medication Profile, as per the NLPB Standards of Pharmacy Operation – Community Pharmacy Section 3.5 (a), as well as the patient’s electronic health record, which is used in a variety of settings for clinical decision-making.

The correct documentation process once the transfer has been processed through the Pharmacy Network by the sending pharmacy, is that the receiving pharmacy must create a local prescription from the Pharmacy Network record which then records its subsequent dispenses against that original Pharmacy Network prescription.

Following this process ensures the original written date is maintained and minimizes the likelihood of transcription errors. It also keeps the patient’s Pharmacy Network profile cleaner as no new prescription is created.

If you have questions about how to process a prescription transfer through the Pharmacy Network, please feel free to reach out to the Pharmacy Team at the Newfoundland and Labrador Centre for Health Information.

 

Approved Changes to the Provincial Drug Schedules

The following additions and revisions to the Provincial Drug Schedules have been approved effective August 24, 2021 to reflect the NDSAC recommendations that were finalized on July 28, 2021:

  • the Schedule I entry for herpes zoster vaccine has been revised as follows:
    • Herpes zoster (shingles) vaccine (live)
  • the following has been added to Schedule II:
    • Herpes zoster (shingles) vaccine (non-live recombinant)
  • the Schedule III entry for bisacodyl has been revised as follows:
    • Bisacodyl and its salts (except when sold in strengths of 5mg or less per oral dosage unit in package sizes containing no more than 105mg of bisacodyl, or 10mg or less per rectal dosage unit/suppository in package sizes containing no more than 50mg of bisacodyl)
  • the Unscheduled entry for bisacodyl has been revised as follows:
    • Bisacodyl and its salts (when sold in strengths of 5mg or less per oral dosage unit, in package sizes containing no more than 105mg, or 10mg or less per rectal dosage unit/suppository, in package sizes containing no more than 50mg of bisacodyl)

Please see the Provincial Drug Schedules page for more information.

 

Pharmacist-in-Charge: Leaving your Pharmacy

All licensed pharmacies in Newfoundland and Labrador must have a designated pharmacist-in-charge (PIC) to maintain the license and continue to operate. Therefore, it is a requirement that, as license-holders, all PICs who are leaving their pharmacy – whether through resignation, retirement, or termination – ensure a new PIC is in place prior to leaving.

Before applying for a change in PIC, the current PIC must identify whether the incoming PIC has received authorization from NLPB to be a PIC.

Is the incoming PIC authorized by NLPB?
Yes No
Complete and submit the Application to Change Pharmacist-in-Charge to NLPB 30 days before the scheduled change. The incoming PIC must complete and submit the Application for Authorization to be designated Pharmacist-in-Charge to NLPB upon completing all requirements.
Complete and submit the Application to Change Pharmacist-in-Charge to NLPB 30 days before the scheduled change.

 

Documenting CEUs for Service as a Preceptor

Registrants who served as a preceptor may claim 0.5 credits per week up to a maximum of 6 credits per year as per the Standards of Practice – Professional Development for Pharmacists and Pharmacy Technicians. These credits are classified as non-accredited learning and must be documented in the registrant’s Online Learning Profile.

The Documentation of Credits for Service as a Preceptor form can be retained as supporting documentation in case of an audit. A separate entry and form must be used if acting as a preceptor to more than one student, intern, or technician candidate in a given year.

 

New Opioid Use and Opioid Use Disorder Resources CASN, AFPC, and CASWE-ACFTS

The Canadian Association of Schools of Nursing (CASN), the Association of Faculties of Pharmacy of Canada (AFPC), and the Canadian Association for Social Work Education – Association Canadienne pour la formation en travail social (CASWE-ACFTS), are offering a new e-resource and free webinar series on the topic of opioid use and opioid use disorder.

The English e-resource can be found at OUOUD (casn.ca). In the e-resource, you will find the Education Guidelines, eight modules with content related to each learning outcome and indicator in the Guidelines, and Protocols related to naloxone and stigma. The French e-resource will be available later this month.

The webinars will provide a brief overview of the project, a short presentation from a member of the content development team, as well as several guest speakers. The topics below were selected to highlight some of the key themes in the e-resource and provide attendees a unique opportunity to learn from experts in these areas!

 

Webinar 1: Introduction to opioid use in Canada, the impact of COVID-19, and how stigma and implicit bias affect care.

Wednesday, September 15, 2021, 12:00 PM – 1:30 PM EST

Register now! Free Webinar! Opioid use and opioid use disorder: A look at current trends in Canada, the impact of COVID-19 and stigma, and implicit bias. – Canadian Association of Schools of Nursing / Association canadienne des écoles de sciences infirmières (CASN / ACESI).

 

Webinar 2: Opioid use and equity-oriented approaches; harm reduction, trauma, and violence informed practice and cultural safety.

Monday, September 20th from 11:30 AM – 1:00 PM EST.

Registration available soon at: www.casn.ca

 

Webinar 3: Chronic pain and opioid use

Friday, September 24th, 12:00 PM – 1:30 PM EST

Registration available soon at: www.casn.ca

 

**Please note that these webinars will be held in English and details about a French webinar will be available soon!

 

Issue #80 – October 2021

Annual Registration and Licence Renewal

NLPB’s annual renewal period will begin on October 25, 2021, at which time all registrants will be notified by email that the Member Portal is open for renewals. The deadline to renew both registrations and pharmacy licences is November 30, 2021. All continuing education units (CEUs) must be entered and all fees paid by that date. Annual renewals must be completed through the NLPB Member Portal. If you have forgotten your username or password, click “Forgot your password? Click Here to restore it” and enter your email to retrieve it.

BEFORE YOU CAN RENEW

Once the annual renewal period begins, registrants must do the following before the Renew Now link will appear on their member homepage:

  • Enter 15 CEUs in the Member Portal for the Dec. 1, 2020-Nov. 30, 2021 Professional Development (PD) Log Year.
  • Pay all outstanding invoices.

 

RECORDING CEUs

All registrants are required to complete 15 CEUs between December 1, 2020 and November 30, 2021 to be eligible to renew their annual registration. A minimum of 7.5 CEUs must be accredited and the remaining may be either accredited or self-assigned.

How to Enter CEUs

  1. Log in to the Member Portal using your username and password.
  2. Under the My Professional Development section, click Record a New Learning Activity.
  3. On the first Learning Portfolio Record page, select the current Professional Development Log (PD) Year, “Dec 1, 2020 – Nov 30, 2021”, from the drop-down box.
  4. Indicate if the PD is accredited by selecting the appropriate response to Is this activity accredited?
  5. Click Next.
  6. Input the requested information regarding the learning activity and click Next.
  7. Review the information you have entered, and if all information is correct, click Save.
  8. Repeat this process until all learning activities have been recorded.

 

Notes:

  • Registrants who served as a preceptor may claim 0.5 credits per week up to a maximum of 6 credits per year as per the Standards of Practice – Professional Development for Pharmacists and Pharmacy Technicians. These credits are classified as non-accredited learning and must be documented in the registrant’s Online Learning Profile. The Documentation of Credits for Service as a Preceptor form can be retained as supporting documentation in case of an audit. A separate entry and form must be used if acting as a preceptor to more than one student, intern, or technician candidate in a given year.
  • In accordance with the Professional Development Requirements for Pharmacists and Pharmacy Technicians, if you received notice of successful completion of the PEBC examination in 2021, you may claim one of the following:
    • 10 CEUs for successful completion of Part I only.
    • 5 CEUs for successful completion of Part II only.
    • 15 CEUS for successful completion of both Part I and Part II (please note that notification of successful completion of Part I and Part II must have both been received in 2021 to claim the full 15 CEUs).

 

REQUIRED DOCUMENTS

  • Pharmacists who are authorized to administer injections must upload proof of current CPR/First Aid certifications.
  • All registrants must ensure they have an electronic copy of their professional liability insurance certificate available to upload.

 

Proof of Insurance

Your professional liability insurance certificate must include the following information:

  • Insurance provider’s name
  • Policy number
  • Amount and type of coverage
  • Expiry Date

You can obtain a copy of your certificate from your insurance provider. Please note, a receipt of payment to your insurer is not sufficient.

 

RENEWING REGISTRATION ONLINE

Please note:

  • Once the renewal is started, it cannot be saved and resumed at a later time. The system will automatically log you out after two hours.
  • If your category of registration has changed (i.e. changing from relief pharmacist to staff pharmacist), please contact Registration and Licensing to have it updated in your profile.

 

  1. Click the Renew Now link on your member homepage to begin the online renewal process.
  2. Carefully review the information on your file, ensuring it is complete and accurate and making changes as necessary. All items marked with an asterisk (*) are required fields.
  3. Continue navigating through the renewal form, clicking Next at the bottom of the page to advance forward.
  4. Read and click to check that you agree to the declarations. Please note, by typing your name into the renewal, you are agreeing these declarations are true. Making false declarations or providing false or incomplete information on the renewal may be cause for revocation of registration and/or an allegation of conduct deserving of sanction.
  5. Click Save to complete the application.
  6. Choose Pay Now to pay by credit card (Visa or MasterCard) or Invoice Me to pay by cheque or money order, or if your employer will be submitting payment. A copy of your invoice must be included with payments made by cheque or money order.

 

Please note: Registration is not complete until all fees are paid.

 

Registration Renewal Fees

Please refer to the 2022 Schedule of Fees for a list of applicable fees.Additional fees may apply:

  • Any payment received after November 30 will be subject to an automatically applied 50% late fee.
  • A processing fee will be charged for a declined credit card or an NSF cheque.

 

A copy of your invoice will be emailed to you as proof of payment. You can also view or print invoices from your profile at any time by clicking Renewal/Other Invoices under the My Profile section of the Member Portal homepage and selecting the print icon for the appropriate invoice.

Your 2021 registration certificate will be emailed to your primary email address in December.

It is your responsibility to ensure your registration is complete, including payment of fees, prior to working in 2022. All pharmacists, pharmacy technicians, pharmacy students, and pharmacy interns are required to register with the Newfoundland and Labrador Pharmacy Board (NLPB). Practicing pharmacy without being registered with NLPB is in contravention of the Pharmacy Act, 2012 and may result in disciplinary action.

 

RENEWING PHARMACY LICENCE ONLINE

Please note:

  • Pharmacists-in-charge (PICs) must renew their own pharmacist registration before they are able to renew the pharmacy licence.
  • PICs have two usernames, one for their personal profile and one for the pharmacy profile. If you are having trouble logging in; try clicking “I’m not <NAME>” to enter a new username.

 

  1. Once logged in to the pharmacy profile, click Renew Your Pharmacy Licence to begin the online renewal process.
  2. Answer all questions in the renewal form carefully.
  3. Click Next to advance to the next screen.
  4. Review your pharmacy’s information, ensuring it is complete and accurate, making changes as necessary.
    • Fill in any missing information.
    • Ensure the names of dispensary staff, pharmacy hours, and ownership information are up-to-date (ensure you include non-registered staff members, including pharmacy assistants and clerks, but not temporary staff such as students or interns).
    • Continue navigating through the renewal form, clicking Next at the bottom of the page to advance forward.
  5. Read and click to check that you agree to the declarations. Please note, by typing your name into the renewal, you are agreeing these declarations are true. Making false declarations or providing false or incomplete information on the renewal may be cause for revocation of registration and/or an allegation of conduct deserving of sanction.
  6. Click Save to complete the application.
  7. Choose Pay Now to pay by credit card (Visa or MasterCard) or Invoice Me to pay by cheque or cash, or if your employer will be submitting payment. A copy of your invoice must be included with payments made by cheque or money order.

Please note: Pharmacy licence renewal is not complete until payment has been received by NLPB. 

The pharmacy licence will be emailed to the PIC before the end of December. It must be displayed in a conspicuous place in the pharmacy, in full public view.

The PIC is responsible for ensuring the licence has been renewed for 2022 and all regulated staff are registered to practice in 2022 before the end of the year.

 

DO I NEED TO RENEW? A QUICK GUIDE TO GOING ON LEAVE OR RETIRING

If you are not planning to practice pharmacy in 2022, you can choose to let your registration lapse and are not required to maintain professional liability insurance or PANL membership (if applicable). Please notify the board in writing indicating that you will not be registering for 2022, including the reason. If you are going on leave for part of 2022, please contact NLPB to reactivate your profile and renew your registration, 2-3 weeks prior to your return. The annual fee is prorated 50% for registration on or after July 1.

Pharmacy Students and Interns Administering Inhalations and Injections

Due to recent inquiries, NLPB would like to provide clarification regarding the administration of injections. As per NLPB policy, Pharmacy students and interns may administer drug therapy by inhalation or injection only if the following conditions are met:

  • The student or intern must be under the direct supervision of a pharmacist who has received authorization from the NLPB to administer drug therapy by inhalation or injection.
  • The student or intern must be registered with the NLPB (including maintaining appropriate professional liability insurance).
  • The student or intern must have successfully completed an education and training program on the administration of injections that has received CCCEP competency-based (stage 2) accreditation OR all education and training on the administration of injections are part of the pharmacy program core curriculum.
  • The student or intern must have current certification in CPR Level C or HCP and Emergency or Standard First Aid from a recognized provider (e.g. St. John Ambulance, the Canadian Red Cross).

Pharmacy students and interns cannot receive authorization to administer inhalants or injections and as such are not required to submit the Application for Authorization to Administer Drug Therapy by Inhalation or Injection. Students and interns are not required to submit proof to NLPB that all conditions above have been met. The supervising pharmacist is responsible and accountable for all components of the preparation and administration of the inhalants and injections, as well as ensuring the student or intern has met all NLPB requirements to administer inhalants and injections. When providing direct supervision, the pharmacist must be present when the activity is being performed and able to observe and promptly intervene to stop or change the actions of the individual being supervised.

Additional Resources:

Administration of Drug Therapy by Inhalation or Injection Regulations

NLPB Standards of Practice – Administration of Drug Therapy by Inhalation or Injection

NLPB Policy – Pharmacy Students/Interns Administering Inhalations or Injections

Securing Your Pharmacy

NLPB is reminding registrants to ensure all reasonable steps are taken to protect against the loss or theft of controlled substances under their control. Under the Standards of Pharmacy Operation-Community Pharmacy, both the pharmacy as a whole and the dispensary area must be equipped with a security system that provides suitable protection against theft, diversion, and tampering with drugs and other healthcare products. A combination of alarms, cameras, and motion detectors must be utilized to meet this requirement.

When having security systems installed, registrants should ensure that key areas of the pharmacy and dispensary are protected, such as installing motion detectors near the on-site narcotics storage.

Security systems should be maintained and checked regularly to ensure all components are working properly.

 

Project ECHO NL: Opioid Use Disorder – Upcoming Sessions

Project ECHO NL: Opioid Use Disorder, is a virtual community advancing care and treatment for opioid use disorder in Newfoundland and Labrador. The goal is to help primary care providers and their teams build capacity in the treatment and management of opioid use disorder.

This project offers free, virtual learning sessions using an interactive, web-based platform to link healthcare providers with an interdisciplinary team of mentors with expertise in managing substance use care.

ECHO sessions are designed around case-based learning and mentorship and support healthcare providers in gaining the knowledge and skills required to provide needed services in their regions.

The primary audience for Project ECHO NL: Opioid Use Disorder is prescribers (family physicians and nurse practitioners) and pharmacists. The secondary audience is other healthcare professionals providing care for individuals with opioid use disorder, including registered nurses, licensed practical nurses, social workers, and addictions counsellors.

Upcoming Sessions

Cycle 1 will include 11 sessions held every three weeks between October 2021 and May 2022.

Session 1: Optimizing Patient Retention in Opioid Dependence Treatment
October 12, 2021 – 8:30–9:30AM (NDT)
More details…

Registration is free but required. Registration is completed on a per-session basis.
To register for Session 1, please contact Chelsea Hynes at chelsea.hynes@easternhealth.ca

ECHO sessions are one hour, held every three weeks on a rotating schedule of Tuesdays from 8:30 a.m. to 9:30 a.m. and 12:00 p.m. to 1:00 p.m. NDT.

Session 2 November 2, 2021 12:00 p.m.– 1:00 p.m. NDT
Session 3 November 23, 2021 8:30 a.m.– 9:30 a.m. NDT
Session 4 December 14, 2021 12:00 p.m.– 1:00 p.m. NDT
Session 5 January 11, 2022 8:30 a.m.– 9:30 a.m. NDT
Session 6 February 1, 2022 12:00 p.m.– 1:00 p.m. NDT
Session 7 February 22, 2022 8:30 a.m.– 9:30 a.m. NDT
Session 8 March 15, 2022 12:00 p.m.– 1:00 p.m. NDT
Session 9 April 5, 2022 8:30 a.m.– 9:30 a.m. NDT
Session 10 April 26, 2022 12:00 p.m.– 1:00 p.m. NDT
Session 11 May 17, 2022 8:30 am – 9:30 am NDT

 

More information about Project ECHO NL: Opioid Use Disorder, including frequently asked questions, can be found online here.

 

2021 Annual Provincial Opioid Dependence Treatment Conference

The Provincial Opioid Dependence Treatment Centre of Excellence is excited to launch general registration for the Third Annual Provincial Opioid Dependence Treatment Conference on Oct. 28–29, 2021.

Registration is FREE. Register at https://signalhillcampus.com/ODTConference

Pre-Conference Session (Virtual Only) | Thursday, October 28, 6:30–8:30PM (NDT)

Target Audience: Health care providers with intermediate to advanced ODT practices

  • Stimulant Use Disorder in the Context of Opioid Use Disorder (Dr. Monty Ghosh, University of Alberta Hospital, Edmonton)
  • Concurrent Post-Traumatic Stress Disorder and Opioid Use Disorder (Dr. Tea Rosic, Clinician Investigator Program, McMaster University)

 

Main Conference (Hybrid) | Friday, October 29, 8:30AM–4:30PM (NDT)

Target Audience: Anyone with work and/or lived experience relating to opioid use. Clinical content will be emphasized where appropriate.

  • Caring for Youth and Families Affected by Opioid Use (Dr. Sarah Bagley, Boston University School of Medicine and Boston Medical Centre)
  • Concurrent Anxiety Disorder and Opioid Use Disorder (Dr. Kristopher Luscombe, Regional Chief (Psychiatry), Central Health)
  • Opioid Use Trends and Treatment Innovations: A Canadian Perspective (Dr. Paxton Bach, University of British Columbia and St. Paul’s Hospital)
  • Women and Opioids: Applying a Sex, Gender, and Equity Lens (Dr. Nancy Poole, Centre of Excellence for Women’s Health, Vancouver)
  • Voice of Lived Experience
  • Panel Discussion: ODT during COVID-19: Lessons Learned and Future Directions
  • Prescribing Hope: Opioid Agonist Therapy Initiative in the Emergency Department (Dr. Hasan Sheikh, University Health Network, Toronto)
  • Quick-fire Updates (Spoke Implementation, Sublocade: 1 Year Later, and Remote Patient Monitoring: Utility in Opioid Dependence Treatment)

 

Please note: In keeping with public health guidelines, there are limited in-person spots for the main conference on Oct. 29. However, there are unlimited virtual spots.

  • If we have reached capacity for in-person participation, and you would like to be added to a waitlist for an in-person spot, please email Chelsea.Hynes@easternhealth.ca.
  • As there are limited in-person spots, we kindly request your cooperation if your plans change. To cancel your registration at any time, please email conferencesevents@mun.ca
  • The main conference will be hosted at the Emera Innovation Exchange (100 Signal Hill Road), following all public health guidance in effect on Oct. 29.

 

Issue #81 – November 2021

COVID-19 Vaccine Regulations

As a follow-up to the email sent to registrants last week regarding the COVID-19 Vaccine Regulations filed October 22, 2021, under the Public Health Protection and Promotion Act, NLPB is providing additional clarification of the regulations as they pertain to pharmacies and registrants.  The regulations require that any individual who is employed by or provides services to a business that contains a pharmacy must be fully vaccinated by December 17, 2021. Businesses that contain a pharmacy include but are not limited to mass-market retailers, grocery stores, traditional pharmacies, and self-employed registrants. These regulations apply not only to registrants, as indicated in the previous email communication, but also to all staff of the business containing the pharmacy, such as pharmacy staff, front-store staff, inventory management staff, janitorial staff, and in fact, anyone who enters the premises to provide service to the business, such as cleaning or IT services.

NLPB is providing this information as a courtesy to registrants but is not involved in the development or administration of the legislation. As such, questions pertaining to the application of the regulations should be directed to the provincial government’s Business Response Team at: businessresponseteam@gov.nl.ca.

In addition, as of November 15, 2021, any person visiting the NLPB offices will be required to provide proof of vaccination or proof of an approved medical exemption upon entering the office.

NLPB Office – COVID-19 Vaccine Requirements

Effective Monday, November 15, 2021, any person visiting the NLPB offices will be required to provide proof of vaccination or proof of an approved medical exemption upon entering the office.

 

Ivermectin – Not Authorized to Prevent or Treat COVID-19

Health Canada has advised that Canadians should not use either the veterinary or human drug versions of ivermectin to prevent or treat COVID-19, as there is no evidence that it is safe or effective when used for those purposes.

The Newfoundland and Labrador Pharmacy Board is advising registrants not to dispense any prescriptions for ivermectin prescribed to prevent or treat COVID-19 and to report the prescribing practitioner to the appropriate regulatory body.

NLPB would like to commend those registrants who have demonstrated appropriate professional judgment in these instances to ensure patients receive evidence-based care.

Preventing Medication errors – COVID-19 and Influenza Vaccines

With two important vaccine campaigns happening simultaneously this fall, immunizers should take special care to anticipate and prevent medication errors. Registrants participating in both vaccine campaigns are reminded to confirm which vaccine the patient is to receive and to perform a final check on the vial before administering the medication.

 

Project ECHO NL: Opioid Use Disorder – Upcoming Sessions

Project ECHO NL: Opioid Use Disorder, is a virtual community advancing care and treatment for opioid use disorder in Newfoundland and Labrador. The goal is to help primary care providers and their teams build capacity in the treatment and management of opioid use disorder.

This project offers free, virtual learning sessions using an interactive, web-based platform to link healthcare providers with an interdisciplinary team of mentors with expertise in managing substance use care.

ECHO sessions are designed around case-based learning and mentorship and support healthcare providers in gaining the knowledge and skills required to provide needed services in their regions.

The primary audience for Project ECHO NL: Opioid Use Disorder is prescribers (family physicians and nurse practitioners) and pharmacists. The secondary audience is other healthcare professionals providing care for individuals with opioid use disorder, including registered nurses, licensed practical nurses, social workers, and addictions counsellors.

Upcoming Sessions

Cycle 1 will include 11 sessions held every three weeks between October 2021 and May 2022.

Session 3: TBA
November 23, 2021 – 8:30–9:30AM (NDT)

Registration is free but required. Registration is completed on a per-session basis.
To register, please contact Chelsea Hynes at chelsea.hynes@easternhealth.ca

ECHO sessions are one hour, held every three weeks on a rotating schedule of Tuesdays from 8:30 a.m. to 9:30 a.m. and 12:00 p.m. to 1:00 p.m. NDT.

Session 3 November 23, 2021 8:30 a.m.– 9:30 a.m. NDT
Session 4 December 14, 2021 12:00 p.m.– 1:00 p.m. NDT
Session 5 January 11, 2022 8:30 a.m.– 9:30 a.m. NDT
Session 6 February 1, 2022 12:00 p.m.– 1:00 p.m. NDT
Session 7 February 22, 2022 8:30 a.m.– 9:30 a.m. NDT
Session 8 March 15, 2022 12:00 p.m.– 1:00 p.m. NDT
Session 9 April 5, 2022 8:30 a.m.– 9:30 a.m. NDT
Session 10 April 26, 2022 12:00 p.m.– 1:00 p.m. NDT
Session 11 May 17, 2022 8:30 am – 9:30 am NDT

 

More information about Project ECHO NL: Opioid Use Disorder, including frequently asked questions, can be found online here.

 

Annual Registration and Licensing Renewal – FAQs

NLPB’s annual renewal period began last week, at which time all registrants were notified by email that the Member Portal is open for renewals. The deadline to renew both registrations and pharmacy licences is November 30, 2021. Below are common inquiries that we receive from registrants regarding the annual renewal period, which you may find helpful.

 

Q: How do I recover a forgotten password?

A: Click the “Forgot your password? Click here to restore it” link on the Registrant Login page: https://nlpb.in1touch.org/login.html. Type in the email address associated with your NLPB account on the Recover Password page and click the “Retrieve” button. You will receive an email with your secure login information.

 

Q: Why is the “Renew Now” button not appearing on my profile

A: In order for the “Renew Now” button to appear on your profile, your account must be active, you must have entered a minimum of 15 CEUs (7.5 of which must be accredited sources), and you must have paid any outstanding invoices. Please check that none of these issues are preventing you from renewing prior to contacting NLPB. If you have done so and the “Renew Now” button still does not appear on your profile, then please contact the Registration department at NLPB’s main office.

 

Q: Can I claim my PEBC Exam as my required 15 CEUs for the 2022 renewal?

A: In accordance with the Professional Development Requirements for Pharmacists and Pharmacy Technicians, if you received notice of successful completion of the PEBC examination in 2021, you may claim one of the following:

  • 10 CEUs for successful completion of Part I only.
  • 5 CEUs for successful completion of Part II only.
  • 15 CEUS for successful completion of both Part I and Part II ( please note that notification of successful completion of Part I and Part II must have both been received in 2021 to claim the full 15 CEUs).

 

Q: I am a Pharmacist-in-charge; how do I renew the pharmacy licence?

A: You must first renew your personal pharmacist registration before you are eligible to renew the pharmacy license, as a licence can only be issued to a registered pharmacist for the upcoming year. Once you have renewed your own registration, log in to your pharmacy profile account using the separate username and password that you received from NLPB by email.

 

Q: How do I pay my renewal fee?

A: The last screen in your online renewal is a payment page. You can enter a Visa or MasterCard number to pay by credit card or you can select “Invoice Me” if you will be paying later by cheque or money order. We do not accept e-transfer or debit payments. Registration is not complete until all fees are paid.

 

Newfoundland & Labrador Pharmacy Museum Board of Directors

The Newfoundland & Labrador Pharmacy Museum is currently seeking to fill Board member positions to establish the Board of Directors for the Newfoundland & Labrador Pharmacy Museum Inc. Volunteers interested in the preservation of the history of healthcare, building a sense of community, and enhancing tourism opportunities in the province are encouraged to apply.

The Board of Directors will work in a collaborative environment to provide the Museum Manager with oversite and direction for the daily operations of the Newfoundland & Labrador Pharmacy Museum. The museum is seeking a diverse group of professionals to fill the Board positions, comprised of arts/museum/tourism professionals, retired or active pharmacy professionals, and other professionals with experience in, but not limited to, fundraising, financial management, human resources, administration, event planning, technical expertise, and risk management. Board members will serve a 2- or 3-year term and be expected to meet once every 6-8 weeks for the first year of establishment.

For more details, please visit nlpharmacymuseum.com/board-of-directors. Interested persons can submit an expression of interest in the form of a cover letter or résumé to Deanna Walter, Museum Manager, at info@nlpharmacymuseum.com.

 

Regular reminders

  • Registrant Contact Information – Registrants are responsible for ensuring that the contact information on their registrant profile, including email address and practice site, is accurate at all times. The NLPB primarily uses email communication to send newsletters, renewal reminders, practice site assessment information, professional development audit information, calls for interest for committees, and other alerts. If the email address on file is incorrect, important information may be missed and/or disclosed to the wrong person. If your contact information changes, please log into the NLPB Online Registrant Portal to update your file with your new contact information as soon as you can.
  • Forgot Your Password? – You can retrieve your NLPB Online Registrant Portal password at any time. Under the Login box, click the message that says, “Forgot your password? Click here to restore it.” On the next screen, enter your NLPB username, if you know it, or your email address. Click “Retrieve.” In a few minutes, you will receive an email with your username and password. Once you are logged into your profile, you can change your password.
  • Receipts & Invoices – NLPB’s Online Registrant Portal maintains all receipts created by the system. If for any reason, you need a receipt or to view an invoice, you can do so from your registrant profile. Once logged in, click on “Renewal Other/Invoices” and then select either “view invoice” or “print invoice” next to the one you are interested in.

 

This e-newsletter contains information on a wide variety of topics intended to enhance the practice of pharmacy in the province of Newfoundland and Labrador. As it is published and circulated to all registrants on a monthly basis, it is the expectation of NLPB that all registrants are aware of the matters contained therein.



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