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COVID-19 Guidance for Pharmacists and Pharmacy Technicians

The situation with COVID-19 is evolving rapidly. The guidance provided in this document is intended to provide pharmacists and pharmacy technicians with foundational information and advice, but be advised that anything that appears in this document is subject to change.

Page last updated on April 3, 2020, at 3:00 p.m. MT.

Pharmacy professionals should also review ACP's COVID-19 resources page on an ongoing and frequent basis for the latest updates.

Caring for patients

Health Canada s56(1) exemption for controlled substances

Read the s56(1) exemption issued by Health Canada on March 19, 2020, and see the FAQs for further information.

Read the joint message from ACP and the College of Physicians and Surgeons of Alberta (CPSA).

Read the guidance on the exemption prepared by ACP.

Temporary guidance for Opioid Agonist Therapy (OAT)

Ensure Continuity of Care

For patients who are stable on Opioid Agonist Therapy (OAT), interruptions to treatment can have severe consequences such as withdrawal symptoms and increased risk of relapse.

  • If pharmacists are not able to meet the needs of the patient due to reduced hours, pharmacy closure or other reasons, the pharmacy must transfer the care of the patient to another pharmacy.

Pharmacist Prescribing of OAT

  • Under Health Canada’s temporary Section 56 exemptions pharmacists are permitted to prescribe controlled substances in specific circumstances, including for continuity of OAT.  Refer to the ACP guidance for specific details to guide your prescribing. 
  • Collaboration with the original prescriber is always the preferred option and pharmacists should only prescribe an extension when it is in the best interests of the patient to do so and they have completed a thorough assessment.
  • Pharmacists may adapt a prescription for OAT only for the purpose of renewing an existing and current prescription to ensure continuity of care.
  • If a pharmacist does not have the original prescription or written order at their pharmacy, before prescribing an extension, the pharmacist must
    • contact the original pharmacy to transfer the prescription if there is quantity remaining on file, or
    • contact the original prescriber and collaborate to obtain a new prescription.
  • Pharmacists must not make any changes to the dosage of existing therapy except in collaboration with the prescriber.
  • Prescriptions for SROM should only be provided for a maximum of two days supply and only upon careful evaluation of the risks, to the patient or others, associated with the unique risks of this medication. The pharmacist must make every effort to contact and collaborate with the prescriber as soon as possible after prescribing.

Carried Doses

  • Pharmacists may accept prescriptions for methadone and buprenorphine-naloxone that include a number of carries greater than the standard 14 days.
  • Buprenorphine-naloxone patients may receive up to a 30-day supply of carried doses, in collaboration with the prescriber.
  • The threshold for when to provide carried doses may need to be lowered, and the maximum number of carried doses permitted may need to be altered based on the circumstances of the patient, the prescriber, and the pharmacy. Pharmacists should collaborate with prescribers to consider prescribing carried doses for patients whenever possible, unless the risk of opioid poisoning, to the patient or others around them such as children or roommates, outweighs the risks of presenting in person to the pharmacy.
  • Pharmacists should ensure that carried doses are provided only when they are satisfied that the carried doses can be transported and stored safely by the patient in a manner that minimizes risk to the public.
  • Pharmacists should advise patients that the return of used carry bottles is not recommended at this time. Pharmacists must provide direction to these patients to ensure the used carry bottles are rinsed and properly disposed of.

Witnessed dosing

  • For patients who are self-isolating, alternative measures to support witnessed dosing should be considered, including approved virtual communication methods or home delivery if the requirements of social distancing are maintained.
  • At the discretion of the prescriber, pharmacists may waive the need for a witnessed dose of buprenorphine-naloxone, slow-release oral morphine, or methadone. Despite this requirement being waived, pharmacists must make every effort to conduct a commensurate assessment, in person or remotely.

Dispensing to authorized individuals

  • For patients in self-isolation, a pharmacist may release OAT to another authorized individual. Pharmacists must take steps to confirm the individual is authorized by the patient, to confirm the identity of the individual before releasing the medication, and to confirm the receipt of the medication by the patient

Guidance for prescription delivery

Pharmacy professionals should exercise professional judgment to determine the most appropriate process to deliver prescriptions based on the circumstances at hand.

  • A patient who screens positive or is in self-isolation should be advised to get someone from outside of their household to pick up their medications. Alternatively, the pharmacy should arrange for the delivery of medications if this service is available.  The medication should be delivered to the patient without direct contact. Operationally, there may be more than one way to accomplish this, which is left to the professional judgment of the pharmacist (e.g. place in mailbox, have delivery person call the recipient once the medication is left, wait or follow up by phone to confirm they have successfully received it, etc.)
  • When delivering controlled substances, the individual making the delivery must identify the patient or their agent and observe the receipt of the medications prior to leaving the delivery site.  For more information, please refer to the guidance on delivering controlled substances to patients’ homes.
  • Process any payments in advance, if applicable, by secure means when delivery is arranged with the patient, to limit interaction between patients and delivery personnel.
  • On the outside of the packaging, indicate transport conditions (related to temperature, fragility, and safety) and only the information required for delivery to the patient or other recipient (name, address, etc.).
  • Maintain social distancing requirements during the delivery.
  • Ensure any reusable totes used for delivery are sanitized inside and out before they come into the pharmacy and between each use. 

Mailing

  • Pharmacists cannot mail controlled substances (including narcotics, controlled drugs, and targeted substances) to patients located outside of Canada, as per the Controlled Drugs and Substances Act, Section 6(1). This requirement is still in force and is not affected by the recent Health Canada section 56(1) exemptions for controlled substances.
  • Mailing non-controlled prescription medications to your out-of-country patients is still permitted. However, medications arriving in other countries from Canada are subject to the laws of that country.
  • Not all prescription medications available to Canadian patients have been approved for use in other countries. Verify if the drug is approved, and if not, confirm the documentation requirements for any exceptions. Refusal of entry or seizure of the medication is at the discretion of the destination country.
  • Contact the delivery service to find out what documentation is required to ship prescription medications to a particular country. If the delivery service is unsure, the country’s embassy or consulate here in Canada may be contacted for information. 
  • Ensure all packages are traceable and auditable.
  • Advise patients that there may be delays.

Recordkeeping requirements

As per the Standards for the Operation of Licensed Pharmacies (SOLP) 8.1(e) and 8.2, the licensee must ensure that there is an effective system for creating, maintaining, securing storage of, and retrieving all required records.  This includes

  • keeping records of the mode of delivery for all medications delivered to patients, and
  • storing records securely in the dispensary or completing an off-site storage application if the records will be stored outside the dispensary.

Delivery of drugs to assisted living facilities

Read the guidance prepared by ACP.

Prescribing and dispensing of drugs to treat COVID-19

Read the joint message from ACP and the College of Physicians and Surgeons of Alberta (CPSA).

Increased urgency to affirm appropriateness of use

Assessing patients and critically evaluating their prescriptions are foundational responsibilities of pharmacists in supporting appropriate drug therapy. Standard 3 of the Standards of Practice for Pharmacists and Pharmacy Technicians states that pharmacists must consider appropriate information for each patient. Appropriate information is indicated in Standard 3.4 to include the need to consider the health condition to be treated and history of the condition.

This week, pharmacists have identified to ACP an increased demand for some drugs (e.g., Kaletra®, hydroxychloroquine) due to reports of them being prescribed as treatments for COVID-19. The prescribing and dispensing of drugs used to treat COVID-19 for the purpose of stockpiling for personal use is not appropriate.

Information we have received demonstrates the diligence of many pharmacists in assessing the appropriateness of drug therapy, and we commend them for this. We have heard stories of pharmacists receiving prescriptions for these drugs for groups of family members, for personal family members, and in other instances from specialties where these drugs are not normally used. Thank you to all of you who have been diligent in your assessments and have intervened by not dispensing these prescriptions.

ACP recognizes and appreciates the extraordinary efforts of pharmacists and pharmacy technicians during these unprecedented and challenging times. Your diligence will support appropriate use, improved health, and the continued availability of these drugs for those who need them most.

Temporary authorization to waive requirements to see patients personally

As a result of the ongoing COVID-19 pandemic, ACP recognizes that seeing a patient personally may not be possible or advisable given requirements for social distancing and self-isolation. The Standards of Practice for Pharmacists and Pharmacy Technicians (SPPPT) have requirements that certain activities must occur in person with the patient present. In order to meet the needs of patients during this extraordinary situation, pharmacists have been given temporary authority to prescribe without meeting the requirements noted in SPPPT 2.6, 12.2(a), 13.2(a), and 14.2. Despite this authorization, pharmacists are advised that they must use their professional judgement as to whether it is appropriate and in the best interest of the patient to prescribe remotely. 

When prescribing remotely, pharmacists must meet their obligations to the SPPPT and provide a level of care commensurate with the care they would provide if they saw the patient personally. Above all else the pharmacist must

  • consider the well-being of the patient, and
  • take all reasonable steps to prevent harm to patients.

Pharmacists must establish and maintain a professional relationship with each individual for whom they prescribe medications remotely.

Establishing a professional relationship means the pharmacist must speak directly with the patient, their agent, or their caregiver to

  • identify the health priorities of the individual,
  • determine what the patient understands about their medication and their condition, and
  • gather information about their health history and current medication use.

Refer to ACP’s Chat Check and Chart – Vital to Patient Care tool to learn more.

Considerations when prescribing remotely

When prescribing without seeing the patient personally, pharmacists must:

  • Consider the limitations of the technology or method of communication used and evaluate the clinical activity being conducted to ensure the pharmacist can reasonably
    • access any information required to make a clinical assessment,
    • complete a thorough clinical assessment of the patient,
    • identify and take appropriate action for any drug therapy problems, and
    • ensure the privacy and confidentiality of the patient are maintained.
  • Reflect on whether you have the knowledge and information necessary to treat the patient’s condition. If not, determine whether you should contact other members of their health team or refer them to another prescriber.

If it is determined that it is appropriate to prescribe, the pharmacist must then perform a thorough patient assessment, including reviewing patient health information on Netcare, and proceed in accordance with the Standards of Practice for Pharmacists and Pharmacy Technicians and ACP’s Code of Ethics.

This authorization should not be used to normalize the practice of not seeing a patient personally, but instead should be used permissively in exceptional circumstances given the COVID-19 pandemic. Please note that nothing in this authorization relieves a pharmacist from their obligation to meet all other applicable standards of practice.

Temporary authorization to waive Standard 11.9 when adapting prescriptions

Due to the COVID-19 pandemic and the increased workloads pharmacists and other healthcare professionals are experiencing, ACP is temporarily waiving the requirement for pharmacists to notify other regulated health professionals whose care of the patient may be affected by their prescribing decision, when adapting prescriptions for the purpose of renewing a prescription to ensure continuity of care.

Notification about dose changes, therapeutic substitutions, prescribing in an emergency, and initial access prescribing or prescribing to manage ongoing care must still be provided as required by standard 11.9, as should any renewal that a pharmacist determines collaboration is required with the respective healthcare professional.

Repackaging non-prescription medications

Drug shortages for non-prescription medications, such as acetaminophen liquid, have increased. Repackaging of non-prescription medication is a temporary measure that can minimize the disruption of the drug supply and assist your patients. Once available, the commercially available product should be sourced again and any temporary measure to repackage the non-prescription medication should cease. Self-selection is NOT permitted for repackaged medications.

Ensure when repackaging medication for resale that the pharmacist or pharmacy technician considers the appropriate standards from the Standards for Pharmacists and Pharmacy Technicians to ensure patient safety and maintain records. Regulated members are expected to uphold Principle 1 of the Code of Ethics and hold the well-being of each patient to be their primary consideration. Regulated members should not allow their professional judgment to be impaired by personal or commercial benefits such as monetary or financial gain. When advising individuals about repackaged non-prescription medications, pharmacists must focus on an individuals’ best interests. Any advice or action that is based on providing financial advantage to the pharmacist, a pharmacy, or proprietor, without providing a material benefit to the health of the individual, may be considered unprofessional conduct.

As per Standard 7.3(b), items must be repackaged into child-resistant packaging unless

  1. the prescriber or patient directs otherwise,
  2. the pharmacist or the pharmacy technician is satisfied that child resistant packaging is not appropriate,
  3. child-resistant packaging is not suitable because of the form of the drug or blood product, or
  4. the pharmacist or the pharmacy technician is unable to obtain a child-resistant package for the drug or blood product because a supply of those packages is not reasonably available.  

The manufacturer’s suggested dose must be included in the labelling of a repackaged product. A copy of the manufacturer’s insert or the consumer information found in the product monograph must also be included with the repackaged product.

Relevant standards

Standards of Practice for Pharmacists and Pharmacy Technicians

Standard 21:

A pharmacist or a pharmacy technician who repackages drugs must take appropriate steps to protect patient safety.

Duty regarding audit trail

21.1     A pharmacist or a pharmacy technician who repackages a drug or blood product must ensure that, in respect of that drug or blood product, there is sufficient documentation to provide a clear audit trail of the repackaging process.

21.2     The documentation required under Standard 21.1 must identify:

  1. drug information from the original container including:
    1. DIN, NPN or HN;
    2. lot number;
    3. expiry date; and
  2. all individuals involved in the repackaging and verification process and the role of each individual.

Duty regarding labeling

21.3     A pharmacist or a pharmacy technician who dispenses or sells a repackaged drug or blood product must ensure that each repackaged drug or blood product has a label affixed to the package that meets the requirements of a prescription label required under Standard 7 or that explicitly identifies the following:

  1. a description of the drug, in English, by:
    1. generic name, strength and the identity of the manufacturer for a single-entity drug or blood product; or
    2. generic name, strength and the identity of the manufacturer for a combination drug or blood product, where possible, or the brand name and strength;
  2. the size of the package or quantity;
  3. a lot number that links to the audit trail described in Standard 21.1; and
  4. an expiry date for the drug or blood product.

Duty regarding directions

21.4     A pharmacist or a pharmacy technician who engages in repackaging drugs or blood products for sale to patients must ensure that the label includes a direction statement which has on it the words: “Take or use [insert the manufacturer’s suggested doses or use] or as directed by the prescriber”.

Duty regarding final check

21.5     A pharmacist or a pharmacy technician must perform a final check of all repackaged drugs, blood products or health care products to be satisfied that each step in the repackaging process has been completed accurately by verifying that:

  1. The drug or health care product, dosage form, strength, manufacturer and quantity package are correct.
  2. The information on the label is accurate according to the original container, including the drug, dosage form, strength and manufacturer. A pharmacist or a pharmacy technician who repackages drugs must take appropriate steps to protect patient safety.
  3. The label includes the information required in these standards.
  4. The package and packaging material are appropriate to protect the drug or health care product from light and moisture as necessary and to minimize the potential for interaction between a drug or health care product and the container.

21.6     Whenever possible, a final check of repackaged products must be performed by a pharmacist or pharmacy technician who did not create the label or select the drug from stock.

Special labeling requirements for individually packaged drugs

21.7     A pharmacist or a pharmacy technician must ensure that, when dispensed to a patient, individually packaged medications which include a drug (such as a lollipop) are: a) individually labeled with the name of the drug or compound, lot number and expiry date; and b) put in a larger container that bears a prescription label.

Temporary compounding of alcohol-based hand sanitizer by pharmacists and pharmacy technicians

Due to the COVID-19 pandemic and the recent shortages of commercially-manufactured alcohol-based hand sanitizer (ABHS), ACP has observed that some licensed pharmacies are compounding ABHS for the use of their pharmacy staff members and for distribution to the public. This temporary guidance is being provided to assist pharmacy staff members in carrying out necessary hand hygiene procedures and reducing the spread of the COVID-19 virus in the general public. Please remember that preparing and using a compounded preparation is inherently riskier in comparison to a manufactured product made under stringent conditions and quality controls.

This temporary guidance is consistent with Principle 8, Guidelines 1 and 2 of ACP’s Code of Ethics,which state that in serving as an essential health resource, pharmacists and pharmacy technicians must

  • maintain access to pharmacist services and care, and
  • be accessible and make resources available to care for patients and to mitigate further risk during public emergencies.

When compounding and distributing ABHS, pharmacies must:

  • Follow all current ACP standards, including the Standards of Practice for Pharmacy Compounding of Non-sterile Preparations.
  • Refer to a compounding formula that is evidence-based. Three evidence based formulas are available from USP at Compounding Alcohol-Based Hand Sanitizer During COVID-19 Pandemic. Other evidenced based formulas are available from the W.H.O.
  • Choose a commercial product over a compounded ABHS, when available.
  • Record the name and contact information of members of the public that receive compounded ABHS from the pharmacy. This will assist in the event of a product recall.
  • Ensure any ABHS repackaged and provided over the counter (OTC) meets all the requirements outlined in the ACP guidance for repackaging non-prescription medications, including requirements and restrictions involving packaging, labelling, quality assurance, self-selection, and promotion.
  • Understand that compounding ABHS in pharmacies is a temporary alternative during the COVID-19 pandemic, and that the temporary alternative is only provided during the pandemic and while commercially-manufactured ABHS is not available.

Pharmacies may also wish to refer to the U.S. Food and Drug Administration guidance document on this topic as its guidance document about ABHS refers directly to COVID-19.

Finally, it is important that pharmacies do not exploit this temporary alternative for financial gain.  Regulated members are expected to uphold Principle 1 of the Code of Ethics and hold the well-being of each patient to be their primary consideration. Regulated members must not allow their professional judgment to be impaired by personal or commercial benefits such as monetary or financial gain in this time of crisis where demand for ABHS can be heightened.

COVID-19 assessment and referral

Pharmacists should advise patients with symptoms consistent with the AHS Emergency Coordination Centre COVID-19 Screening Criteria to self-isolate and access the AHS COVID-19 Self-Assessment tool to determine if they should contact Health Link at 811.  Patients with severe symptoms should be advised to call 911

Health Link at 811 may experience significant delays as the situation develops. Patients who suspect they may have been exposed should be advised to self-isolate until they are able to obtain service.

There are currently no additional processes for Alberta community pharmacists to refer or report COVID-19. However, the situation is fluid, and any updates or additional information will be communicated to pharmacists on the ACP webpage as soon as they become available.

Patient medication supply

ACP along with Alberta Health and the Alberta Pharmacists’ Association have established the expectation that effective immediately prescriptions are to be provided in quantities that do not exceed a thirty (30) day supply. This will assist in stabilizing Alberta’s drug supply, and ensure all patients have access to the medicine they need.

ACP recommends that pharmacists advise and assist their patients who require medication on a regular basis to ensure they are up to date and have a sufficient supply of not more than 30 days to manage their chronic conditions. If the patient does not have an adequate supply, pharmacists should take steps, including contacting the prescriber or adapting prescriptions as appropriate. For patients with limited access to pharmacy services in rural or remote locations, pharmacists should use their judgment as these patients may require a supply of medications greater than 30 days. Aim to provide only an adequate supply as stockpiling medications in large quantities is unnecessary and could trigger drug shortages.

If self-isolated patients require medications, ideally the patient should have someone who is not ill and has not been exposed, act as their agent to pick up the medications from the pharmacy. If this is not possible, medications may be delivered to the patient, but processes should be developed to prevent direct contact with the patient while maintaining security of the drugs and patient confidentiality.

When presented with patients whose pharmacies are closed and have no access to their patient records, pharmacists are advised to review Netcare and other evidence of ongoing therapy as a part of their assessment to renew the prescriptions. Refer to the ACP prescribing algorithms for adaptation and renewal to aid in decision making.

Protecting the vulnerable

Current evidence suggests that those most at risk of serious complications from COVID-19 include the elderly, those with compromised immune systems, and those with underlying conditions. Pharmacists and pharmacy technicians who work in settings with these individuals must take extra care and exercise extreme vigilance to ensure the safety and security of these populations. Provide direction to these patients on when and how to reach out for assistance. Whenever practical, to avoid infection, advise these populations to access pharmacy services by telephone, use of a patient agent, home delivery, or other means that minimize direct contact. Focus on providing elderly patients and those with more complex medical conditions or chronic illnesses additional support to ensure their well-being and to maintain an adequate level of pharmacy patient care.

Protecting pharmacy team members

General advice to pharmacists and pharmacy technicians

  • There are several things pharmacies can do to best protect themselves, their staff, and patients from becoming sick with COVID-19.
  • Post signage on all entrances to the pharmacy area requiring individuals to self-identify and not enter if they
    • are experiencing symptoms including fever, cough, difficulty breathing, or extreme tiredness;
    • have a travel history outside of Canada in the last 14 days; or
    • have had contact with a person who is suspected or has been confirmed to have COVID-19.
  • Limit the number of individuals inside your pharmacy at one time.
  • Direct patients to remain an appropriate distance (approximately two metres) from others.
  • Similar messaging should be communicated on voicemail messages, websites, and social media. The Alberta Pharmacists’ Association (RxA) has developed awareness resources for pharmacy use.
  • If available, have alcohol-based hand sanitizer, tissues, and a lined waste container available to patients and staff in pharmacies.
  • Review Health Canada’s routine practices for infection prevention and control and review your pharmacy’s occupational health and safety procedures with all staff.

Community pharmacies have a shared responsibility for informing and educating the public on COVID-19, including promoting infection control and preventative measures.

Pharmacist and pharmacy technician occupational illness

Pharmacists and pharmacy technicians are subject to the public health orders enacted by the government of Alberta and listed on the Alberta Health website. If you have returned from outside Canada in the last 14 days or if you are experiencing symptoms, you must immediately review and comply with these orders before returning to work.

If you have symptoms:

  • A targeted approach to testing for COVID-19 is being implemented in Alberta to help prioritize groups at highest risk of local exposure and at-risk populations. This approach is consistent with testing happening across Canada. Use the online healthcare worker self-assessment tool to help determine whether you need to be tested and to get additional advice on COVID-19, such as the need to self-isolate.
  • Testing will be prioritized for healthcare workers with respiratory symptoms. This self-assessment tool is for all healthcare workers that think they may have COVID-19 or may have been exposed to COVID-19.
  • Review the information on the Alberta Health COVID-19 self-assessment for healthcare workers webpage and complete the self-assessment. Provide your contact information and healthcare number and you will be contacted to confirm your possible exposure, a referral for testing, and next steps.
  • Do not visit a hospital, physician’s office, lab, or healthcare facility without first consulting Health Link (811).
  • If your symptoms worsen, call 811. Heavy call volumes are being experienced by 811 and they will get to your call as quickly as they can.
  • Call 911 if you are seriously ill and need immediate medical attention. Inform them that you may have COVID-19.

Noncompliance with mandatory requirements to self-isolate

What to do when a patient or healthcare professional is not complying with the mandatory requirements to self-isolate.

As of March 25, 2020, the government of Alberta has put legally binding rules in place through a ministerial order to protect the health and safety of Albertans. These are not suggestions or guidelines – they are now the law and must be followed.

If a pharmacist or pharmacy technician suspects a patient, pharmacy professional, or other healthcare provider is not complying with the Alberta Health mandatory measures to stop the spread of COVID-19, they should approach the situation in steps:

  1. Speak to the individual to determine their awareness of their responsibilities and what steps they have taken. In many cases, especially with regulated health professionals, the individual may have already been assessed and cleared by Alberta Health Services.
  2. Educate the individual. Requirements and information vary from jurisdiction to jurisdiction and, even within Alberta, guidance has changed several times in the last few weeks and likely will continue to do so. Provide the individual contact information for the appropriate resource.
  3. If all else fails, report the individual to the appropriate authority. If an individual continues to refuse to comply with the mandatory requirements, the pharmacist or pharmacy technician should assess the situation and determine if they need to report the individual to the medical officer of health, as required under section1.1(1) of the Health Professions Act.

When to report

A pharmacist or pharmacy technician should not report an individual simply for having COVID-19. They must however make a report if they are aware that an individual with a diagnosis (or symptoms) is acting in a manner that is likely to cause transmission or if an individual is not complying with the Alberta Health mandatory measures to stop the spread of COVID-19.

How to report

Reporting patients or members of the public

If a pharmacist or pharmacy technician has reason to believe that the patient, despite being notified of the need to take such precautions, is acting in a manner that may be injurious to public health, or where there the patient’s actions may have already caused an increased risk of transmission, they are obligated to report the individual to the medical officer of health. Complaints should be made online.

Reporting a pharmacist, pharmacy technician, or other healthcare professional

If a regulated member has confirmed that another regulated member is continuing to provide professional services despite having been diagnosed with COVID-19, or after returning from international travel without first self-isolating as required by mandatory public health directives, they must

  • report the regulated member to the medical officer of heath online, and
  • report the individual to the complaints department of their respective regulatory college.

Preventative measures for pharmacists and pharmacy technicians - Hand hygiene and cleaning

Please review ACP’s Guidelines for Hand Hygiene and Alberta Health Services’ (AHS) How to Hand Wash poster for proper hand hygiene technique.

Currently, the best defence against the spread of COVID-19 is the proper practice of hand hygiene and proper cleaning procedures. Ensure that you

  • wash your hands often with soap and water for at least 20 seconds, especially after using the washroom and before preparing food;
  • use alcohol-based hand sanitizer if soap and water are not available;
  • cough or sneeze into a tissue or the bend of your arm, not your hand;
  • dispose of any tissues you have used as soon as possible in a lined waste basket and wash your hands afterwards;
  • avoid touching your eyes, nose, or mouth with unwashed hands;
  • routinely clean high-touch surfaces and devices or areas that are mutually touched by customers and staff (e.g. debit machine keypad) with regular household cleaners or diluted bleach (one-part bleach to nine parts water);
  • focus on social distancing, maintaining a 2-metre distance from customers whenever possible; and
  • avoid any unnecessary high-risk procedures that require contact or can generate droplets, for example rapid strep throat testing (if these procedures are required, refer to the AHS Contact and Droplet Precautions guidance and utilize the required personal protective equipment before proceeding).

Pharmacies should implement regular cleaning and disinfecting procedures to mitigate the risk of COVID-19 infection. Important factors to consider when developing this cleaning policy include

  • the types of cleaning and disinfecting agents used,
  • surfaces and areas to focus on for cleaning and disinfecting activities,
  • frequencies for cleaning and disinfecting activities, and
  • documentation of cleaning and disinfecting activities.

Other workflow strategies such as placing hand hygiene stations at the pharmacy entrance, triaging patients before entering the pharmacy, and limiting the number of individuals inside the pharmacy at any time can assist in minimizing exposure risks. More detailed pharmacy cleaning and disinfecting resources are available from the Alberta Pharmacists’ Association (RxA) and the Canadian Pharmacists Association (CPhA).

Personal protective equipment (PPE) for direct patient care

Pharmacists and pharmacy team members are encouraged to review CPHA’s Best Practices for Pharmacies During the COVID-19 Pandemic. As ACP and the Alberta Pharmacists’ Association (RxA) work together to supply PPE for all community based pharmacies, this guidance will assist you in better understanding risk analysis, risk mitigation measures, and what to do when PPE is available, in order to best protect your pharmacy team and the individuals that you serve.

Pharmacies should obtain PPE from their wholesalers to keep on hand when it is required, but only in regular quantities to avoid shortages. The decision to use PPE should be made following an individualized risk assessment of a potential or confirmed COVID-19 case.

Adhering to stringent hand hygiene, cleaning, and social distancing processes at all times is also recommended. Information on infection control and droplet precautions, as well as social distancing, can be found on the Alberta Health Services and CPhA websites, respectively. It is important that garbing in PPE occurs in alignment with best practices, and information on proper technique for putting on (donning) and taking off (doffing) PPE can be found on the AHS website.

Pharmacy operations

Temporary closures

If a pharmacy is unable to continue to operate due to COVID-19, the pharmacy may close temporarily. If a temporary closure is required, please notify the ACP office in writing as soon as possible via email or regular mail, and adhere to the guidelines established by Council. As this situation constitutes an emergency, the requirement to obtain approval 30 days prior to closure is waived and the pharmacy may remain closed beyond 14 days if required.

If the pharmacy is temporarily closed, signage must be placed at the entrance to notify the public (click here to download a sign template). This sign should advise patients they can receive care at other pharmacies (include contact information for nearby alternative pharmacies). Additionally, voicemail messages, pharmacy websites, and social media should be updated with similar information.

For more information please review the ACP webpage on this topic.

Personal Protective Equipment (PPE) for compounding

Read the guidance on compounding prepared by ACP.

 

Currently, it is critical that pharmacists and pharmacy technicians keep themselves aware of the situation as it develops by checking abpharmacy.ca/covid-19 on a frequent and ongoing basis for updates and changes. If after reviewing the available resources you have additional questions, please call ACP at 780-990-0321 or toll free at 1-877-227-3838 and leave a voicemail. Messages will be returned during normal business hours.