Can interns and students administer injections?

As you prepare for the upcoming flu season, we are sharing an updated version of information first shared in the October 7, 2014, edition of The Link regarding whether interns and students can administer injections. 

As you prepare for the upcoming flu season, we are sharing an updated version of information first shared in the October 7, 2014, edition of The Link: 

When interns and students are completing structured practical training (SPT) or extracurricular work experience and are being supervised by a pharmacist who has authorization to administer injections, the supervising pharmacist may allow the intern or student to perform an injection, but only if the following three conditions are met.

1. The intern or student must be under the direct supervision of a pharmacist who has authorization to administer drugs by injection.
2. The intern or student must have completed a recognized training program.
3. The intern or student must be enrolled in the ACP SPT program, or be completing a clinical placement as part of their university program, or working within a structured extracurricular student work experience program provided either by the Alberta College of Pharmacists or the U of A Faculty of Pharmacy and Pharmaceutical Sciences.

Note: Interns and students cannot receive authorization to administer injections. The supervising pharmacist is responsible and accountable for all components of the preparation and administration of the injection including meeting the requirements of Standards 16 and 17 of the Standards of Practice for Pharmacists and Pharmacy Technicians.

Standards and Details

Section 17 and 19 of the Pharmacists and Pharmacy Technicians Profession Regulation indicates that provisional pharmacists (interns) and pharmacy students who are under the supervision of a clinical pharmacist or a courtesy pharmacist may perform the same restricted activities as clinical pharmacists.

The rules for supervision outlined in Section 23 of the regulations and Standard 20 of the Standards of Practice for Pharmacists and Pharmacy Technicians require that:

• Supervision take place in accordance with the rules of the SPT program;
• The regulated member supervising remain responsible for all components of restricted activities that require the skills or training of a pharmacist; and
• The regulated member must not supervise any individual performing a restricted activity unless they are satisfied that the individual will perform the activity safely and effectively.

It is the opinion of the college that, to meet these requirements, the intern or student must have completed a formal training program and that their injections must be administered under direct supervision. 

What is “direct supervision”?

Direct supervision requires that the supervising pharmacist be present when the restricted activity is being performed and be able to observe and promptly intervene to stop or change the actions of the individual under supervision.

What formal training qualifies?

Individuals on the provisional and the student register cannot receive authorization to administer injections from ACP; therefore, there will be no authorization noted on their practice permit. The supervising pharmacist must ensure that training has been completed.

• Interns must complete a CCCEP Stage 2 accredited training program. Pharmacy students may complete training as part of a faculty of pharmacy curriculum. In both situations, the intern or student should be able to show you a certificate indicating successful completion of the training.

Application for the authorization to administer injections may be made upon transfer to the Clinical Pharmacist Register. Students must apply for the authorization within six months of graduation and interns must apply within one year of completing an accredited training program.

A note about SPT and extracurricular work experience

Extracurricular hours spent working in a pharmacy are not eligible as SPT; however, interns and students must notify ACP of any extracurricular work experience being undertaken as a provisional pharmacist or student pharmacist.

Students who work in pharmacies outside of clinical rotations and interns who have completed their SPT program, but continue to work in a pharmacy, must complete and forward the Extracurricular Student Work Experience Notification Form. This notification requires identification of a preceptor who will be responsible for the work of the intern or student.  

The opportunity to perform restricted activities under the supervision of a clinical pharmacist is an important part of developing competency. Administration of injections by interns or students should be considered in this context. Preceptors and supervising pharmacists are responsible for ensuring this occurs in an appropriate environment.  See the Lessons Learned section of the September/October 2015 issue of aφnews for more information.